Local Planning for Community Paramedic: A Case Study of EMS and Public Health Integration

In Colorado and nationally, access to healthcare, particularly primary care services, is a growing concern. Primary care providers are in short supply, and the uninsured population is on the rise. Uninsured patients are less likely to seek out preventive care services, and are more likely to go to the Emergency Room for non-urgent care, increasing the cost of healthcare. In rural areas, like Eagle County, Colorado, the problem is exacerbated due to a higher uninsured rate and shortage of healthcare providers as compared to urban settings. To address these issues in urban and rural areas, it is necessary to evaluate current resources within communities and explore innovative access to care solutions. The Community Paramedic model, based on international best practices, is a potential solution that provides access to essential healthcare services. Paramedics have the training, expertise and scope of practice to provide care services such as assessments, blood draws, wound care, medication administration, and have the proven ability to take health care into the home. International Community Paramedic models have provided Emergency Medical Service (EMS) personnel with additional training to enhance the skills within their traditional scope of work. Thus allowing them to provide expanded community services such as post-op follow up, hospital discharge follow up, fall prevention within the home, medication reconciliation, and wound care. These services often overwhelm the healthcare system and increase costs. The Community Paramedic “Program” has demonstrated increased health outcomes and cost savings. The Program in Western Eagle County, Colorado was initiated to maintain and improve health of both the individual and the community especially for the 26% of uninsured residents and 68% of Latino households that don't have medical insurance. The collaboration between Public Health, primary care and EMS has been instrumental to the early success of the Program. The Program's international model utilizes healthcare systems already in place, but in a new role. The community collaboration efforts have been instrumental to the unique foundation established that will drive the success of the program, especially the relationship between Public Health and EMS. This relationship has captured worldwide attention that is driving healthcare changes at the grass root level within local, state, national, and international agencies. The presentation will explain the integration and roles of private and public partnerships, discuss the mobilization of community partnerships and prioritizing Program objectives, and describe how the Program was created using Public Health best practices.