Duane Hicks
District paramedics now will help identify, assess, and refer patients to agencies to help them live independently longer.
It is one of several initiatives the Rainy River District Emergency Medical Services will be undertaking as part of a new community paramedicine program here.
The Rainy River District Social Services Administration Board announced Thursday that the local EMS has received $165,000 from the Ontario Ministry of Health and Long-Term Care to develop such a program.
The ministry previously had announced that $6 million would be granted to work toward an expansion and development of community paramedicine initiatives across the province.
After a detailed application process, the local EMS was one of 30 new community paramedicine programs from across Ontario chosen to participate.
“We are thankful for the support and encouragement from the province, as well as the continued support of our community partners who aided in the application process,” DSSAB CAO Dan McCormick, who also is chief of the local EMS, said during a press conference Thursday.
Prior to submitting the application, McCormick gathered many of the various service agencies across the district and identified deficiencies in the current health-care setting that could be addressed by the implementation of community paramedicine programs.
“Our community partners participated in identifying existing gaps in health care, and we will continue to work co-operatively with them to fill those gaps and not to duplicate services,” McCormick noted.
“Utilizing existing staff, the community paramedicine program will improve access for patients to the right care in the right place, as well as improve service coordination for those in need,” he stressed.
The funding provided to the local EMS has been used to hire a designated co-ordinator and support staff, as well as fund paramedic and public education, public communications, and equipment relevant to the program.
The funding has been allocated on a one-time basis for a 12-month period to establish the development and implementation of community paramedicine activities.
Long-time EMS paramedic Dave Black has been hired as the community paramedicine co-ordinator for the next 12 months.
Lauralee Both will provide clerical support on a part-time basis.
“Dave comes to this position with 15 years’ experience as a paramedic with RRDEMS, an affiliation with our Regional Base Hospital Program, and he also works with the Confederation College student paramedic program,” noted McCormick.
“Dave assisted with the initial application process, and is going to have a very busy year bringing the community paramedicine program to fruition across the Rainy River District,” McCormick added.
Community referral
One of the initial objectives of the program is to implement a strategy known as “Community Referral by Emergency Medical Services,” or CREMS.
“Ontario’s ‘baby-boomers’ are aging, it’s a well-known fact,” said Black.
“They’re also living longer, healthier, and they’re living in their homes longer,” he noted.
“According to the Ontario population projections, the
percentage of seniors [people over age 65] in Ontario currently is 14.6 percent and that is expected to double over the next two decades,” Black added.
He said the percentage of seniors here in Rainy River District currently is 24.3 percent but is expected to grow to 38 percent in just 10 years.
The ministry identified this and, in a 2012 action plan, committed to a senior strategy for Ontario with an intense focus on providing support for seniors to stay healthy and to stay at home longer, said Black.
This, in turn, reduces strain on hospitals and long-term care homes.
Community paramedicine programs are part of that action plan.
Black said that by working with the North West Community Care Access Centre, CREMS utilizes the unique position paramedics often find themselves in to identify, assess, and refer patients to an agency that would be best-suited to assist district residents to live longer independently.
“With the provincial government promoting home and community care as an alternative to health care in institutions, such as hospitals and long-term care facilities, there are going to be more people aging at home,” Black explained.
“And CREMS allows individuals an opportunity to get the specific care they need to stay in their homes longer and at a higher quality of life.
“Paramedics are often the first health-care providers that people interact with in their homes, thus they may not be aware of all the different services available to them,” noted Black.
“Currently, confidentiality legislation prohibits a paramedic from making a referral,” he said.
“CREMS addresses those issues and allows for a legal and smooth referral process.”
Other community paramedicine objectives to be initiated include:
•home safety visits by paramedics to reduce high user 9-1-1 calls and emergency room visits;
•home visits by paramedics to ensure medication reconciliation/compliance;
•fall prevention assessments on 9-1-1 responses or scheduled home visits where paramedics provide assessment, interventions, and education in the home;
•discharge follow-ups for patients released from different health programs or ER visits; and
•community paramedicine wellness clinics throughout the district.
Community paramedicine is a broad and developing field of practice for paramedics, which allows them to apply their training and techniques beyond emergency response and transportation to an emergency department, said Black.
He added it may be adapted to fit the specific needs of a particular region.
It is anticipated that as the community paramedicine program is developed and implemented, further service gaps may be identified and the program expanded to address those.
Black also clarified that any community paramedicine initiatives will be developed around the principle that there cannot be a delay in paramedics responding to an emergency call.
It grants the paramedics the ability to leave immediately to maintain emergency coverage.
Allan Katz, president and CEO of Riverside Health Care Facilities, Inc. and a former paramedic himself, was among the community partners who lauded the new program last Thursday.
“You see the clients, the patients, in their homes, in the community, and you add that additional value and set of eyes to improve the overall health care in the community and to promote wellness,” he told Black.
McCormick confirmed none of the initiatives are meant to replace any existing services, but rather to fill in service gaps identified by community partners.
The current roster of community partners with the local community paramedicine program includes the North West Community Care Access Centre, Central Ambulance Communication Centre, Canadian Mental Health Association (Fort Frances branch), Rainy River District Victims Services, Family Health Team (Fort Frances), Family Health Team (Atikokan), physicians from Fort Frances, Emo, Rainy River, and Atikokan, Atikokan General Hospital, and Riverside.
They are joined by the Northwest Local Health Integration Network, Rainy River Integrated District Network, North West Regional Base Hospital Program, Northwestern Health Unit, Fort Frances Chiefs Secretariat, Northern Independent Living Services, Rainy River District Social Services Administration Board (Social Housing), Fort Frances Tribal Area Health Authority, OPP, and the Fort Frances Community Clinic.
