Mont. state community paramedicine pilot starts strong amid pandemic

State health officials said the program, which began in April, has shown benefits in aiding COVID-19 screening and improving patients' cardiovascular health


Nolan Lister
Independent Record, Helena, Mont.

HELENA, Mont. — The Montana Department of Health and Human Services is piloting what it is calling Community Integrated Health programs around the state in an effort to alleviate an overburdened health care system.

DPHHS ponied up about $300,000 of federal and private funding to run the programs for the next two years, including a local version administered by St. Peter's Health

Commonly referred to as community paramedicine, the concept has been implemented around the country in one form or another since the 1970s. It is a different care delivery model that allows emergency medical services workers to provide in-home care for patients who do not need to make a visit to the hospital, simple things such as drawing blood or monitoring patients with chronic illnesses.

"We see so many patients who called for an ambulance, but didn't need one," said St. Peter's Health Emergency Medical Technician Jennie Webster, who is one of the three EMTs participating in the local version of the program. "You start to think there's got to be a better way."

The Montana version of community paramedicine was born out of Senate Bill 38, sponsored by Sen. Margaret MacDonald, D- Billings, which passed during the 2019 legislative session. The Bureau of Medical Examiners, DPHHS and others are working to expand training opportunities, medical oversight, data collection and funding to help ensure the services are sustainable, according to DPHHS spokesman Jon Ebelt.

"DPHHS is working with emergency medical services providers across the state to implement Community Integrated Health, also known as community paramedicine," a statement from DPHHS reads. "This program allows emergency care providers to work in new, innovative ways that connect community members with the healthcare and social services they need, without routing through an unnecessary EMS transport and emergency department visit. These non-emergency transports challenge Montana's EMS services, which are struggling with limited staffing and resources, especially with volunteer services in rural communities. Challenges that have only been compounded by the COVID-19 pandemic."

The programs, located in Great Falls, Broadus, Hamilton, Red Lodge, Glasgow, Jefferson Valley and Helena, have been operating since April. Community paramedics have provided care to more than 2,600 in that time. About 1,600 of those calls were for COVID-19 related screening and testing.

While the program was not created because of the global health pandemic, it certainly benefited health care providers during the pandemic.

St. Peter's Health has been operating at or above capacity for weeks. Webster said her and her fellow community paramedics' efforts have helped during surges.

The patients have benefited too. According to DPHHS, approximately 120 patients participated in the CIH for assistance with managing their cardiovascular health; of these, patients with Stage 1 or greater Hypertension at the time of enrollment had an average 18 point decrease in systolic blood pressure. And 95% of patients, whose blood pressure was previously uncontrolled, successfully improved or maintained their blood pressure while enrolled.

"I've learned so much more about the chronic illnesses that I normally don't deal with as an EMT," said community paramedic Andrea Goyins. "It's made me more well-rounded in my job, and I use these skills to give overall better care to patients."

The St. Peter's Community Paramedicine Program is a referral based program, and is available to people who are referred to the program for eligible services from a medical provider.

The vast majority of the community paramedicine program is part of the community benefit programming at St. Peter's Health, meaning many of the services included in the program are provided at no, or little cost to the patient, St. Peter's Health spokeswoman Kathryn Gallagher said in an email.

"This is part of the organization's growing focus on preventative care and population health, which ultimately will help decrease healthcare costs in the long-run and lead to improved health outcomes."

"The local health care system is dedicated to identifying funding sources to sustain the successful, growing program so it is available to eligible community members for years to come," Gallagher said.

Webster called her involvement with the program a unique new venture in her career, especially the closer interactions with patients over more time than a 10-minute ambulance ride.

"There are so many more soul fulfilling moments in the job," she said.

Webster described a recent call to administer a flu shot to an elderly woman. She said it was not until the end of the visit when paperwork had to be completed that she realized the woman was blind.

"It just hit me like a ton of bricks, how something so simple could mean so much to someone," Webster said.

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(c)2021 the Independent Record (Helena, Mont.)

McClatchy-Tribune News Service

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