Editor’s note: This story has been corrected to clarify that Marathon County is not making any financial contributions to this program at this time. The Marathon County Health Department continues to provide support and advocate for the creation of this program in the Wausau community. Wausau Pilot was notified of an error in meeting packet materials.
By Shereen Siewert | Wausau Pilot & Review
The Wausau City Council on Tuesday will vote on whether to implement a Community Paramedic program in the Fire Department, opening the door to a relatively new and evolving model of community-based health care.
The proposal saw significant support in past meetings. Specifically, on March 11, Marathon County Health Officer Laura Scudiere offered a presentation on statistics of falls and EMS calls in Marathon County and the shortage of health care and mental health providers in the area, a crucial aspect of the program’s goals. From Aspirus, Tara Draeger spoke in support of the role discussed the increase in patients Aspirus is encountering, an issue that could be mitigated through this new proposed resource.
First-year costs including equipment, training, a vehicle lease and wages are estimated at about $192,000, with ongoing costs per year calculated at about $130,000, according to city documents. Funding would come from the city of Wausau along with the Aspirus Hospital and Foundation, Marshfield Clinic Health System and community grants. A three-year trial is proposed with quarterly and annual progress reports.
The program calls for paramedics who function outside of their customary emergency response and transport roles in ways that can facilitate better and more appropriate use of emergency resources. Community paramedicine is an emerging field in health care where EMS providers, including EMTs and paramedics, operate in expanded roles to increase access to primary care and facilitate appropriate use of emergency care resources, according to the Centers for Disease Control and prevention.
According to the National Institutes of Health, Community paramedicine provides a bridge between primary care and emergency care, representing a solution to address the need of those patients with low acuity but lack of access to primary care, elderly patients without mobility, or residents in rural andremote areas. City leaders in Wausau have discussed this proposal for months as a way to address a medical provider shortage and Marathon County need.
For example, the number of falls-related EMA calls in Marathon County for residents older than 60 have trended upward. Last year alone, Marathon County EMS fielded more than 2,800 calls due to falls – many of which could be addressed in the home, between a Community Care Paramedic and the patient.
CCPs can also help patients manage medications and conduct home visits that can identify safety risks. An analysis funded by the HHS Office of the Assistant Secretary for Preparedness and Response shows that about 15 percent of Medicare patients transported to the emergency department by ambulance could be safely cared for in other settings if they are available, resulting in significant savings to the Medicare program.
First home visit assessment tools would include a look at food security trips and fall hazards, fire and life safety assessment and an evaluation of all medications a patient is taking. Area hospitals could refer patients being discharged who do not qualify for home health services but could benefit from a home visit. Some examples of referral diagnoses are COPD, CHF, pneumonia, diabetes, stroke and homelessness, among others.
If approved, the Wausau Fire Department would seek a paramedic with three years of experience, preferably in Wausau, with a preferred background in Community Care medicine. The CCP would be equipped with a cardiac monitor and proper evaluation tools and use a dedicated department-labeled vehicle.
The objective, according to city documents, is to improve the overall health of the Wausau community, reduce ambulance reliance and emergency room usage by non-acute and repeat patients, reduce readmissions and build relationships with other healthcare resources within the community.
The matter will be reviewed Monday by the Human Resources Committee, on Tuesday by the Finance Committee and finalized by the Wausau City Council Tuesday evening.
