Our program this week was our own member Fire Chief Bruce Stedman telling us about a Community paramedic Primary Care program that is being sought for the northwest Washington Counties as a Medicaid Transformation demonstration project under the federal Accountable Communities of Health grant project.  It is anticipated that the state of Washington will receive $1.12 billion in federal funds rewarding this type of care.

 

                                                              Bruce Stedman--City of Arlington Fire Chief

 

At the core of the initiative is dealing with the small portion of Medicaid eligible persons who use a disproportionate amount of emergency medical services (EMS).  Under the current system when called the only option that EMS has is to transport the individual to the closest hospital.  Often times it is for something that that the local hospital is not equipped to handle such as a person with mental issues.

 

Each region, through its Accountable Community of Health (ACH), is able to pursue projects aimed at transforming the Medicaid delivery system. Transformation projects focus on health systems capacity building, care delivery redesign, prevention and health promotion, and increased use of value-based payment (VBP) models that reward providers for quality of care rather than the volume of services and procedures provided. The effort to do this for the North Sound ACH is being led by Bruce and others in the Arlington Fire Department.

 

 

The outcome that Bruce is seeking is to find alternative avenues for those individuals who are overburdening the system.  Examples:  instead of taking an individual with mental issues to the hospital take the person to a mental health facility; provide transportation besides ambulances to take the person to a primary care physician; allow the paramedics to do routine procedures without taking them to the hospital; better integrated health record systems so all health care providers including first responders have a better understanding of the individuals needs.  

 

Because of the growth in calls for Medicare and Medicaid eligible patients, without a change in the system many more paramedics and equipment, including aid cars and ambulances will be required.  Bruce and others are working to have Everett Community College or one of the other technical or institutions of higher learning start paramedic training courses in the north sound region.  Bruce expressed the hope that the new approach will save Arlington the cost of new equipment including a new ambulance.

 

Here is what is being sought through the federal grant:

 

 

Here are the possible roles of the proposed community paramedic: