Fla. city to expand community paramedicine program

A pilot program where medics make house calls was made permanent, and the department will deploy a mobile unit for low priority calls

By Lisa J. Huriash
Sun Sentinel

CORAL SPRINGS, Fla. — Paramedic Susan Toolan might be rummaging through somebody's cabinets to point out the food that's too high in sodium. Or finding a transportation service to get a cancer patient to doctor's appointments. Maybe an elderly person needs her advice to keep from falling.

The Coral Springs Fire Department, which handles fire and paramedic service for both Coral Springs and Parkland, rolled out a "community paramedicine" pilot in the spring. It now appears here to stay, as the first phase of an old-fashioned house call service from medical workers.

Next: a "The Mobile Integrated Healthcare Unit" to respond to homes in its coverage area for non-emergency issues such as wound care, sports physicals, or checkups for a toddler's ear infection.

"It's been a great success so far," said Fire Chief Frank Babinec, whose community paramedicine brainchild is one of only a couple throughout South Florida; Sunrise has had a similar program for several years where paramedics target repeat 911 callers to provide other resources.

The city isn't making money, said Sunrise Fire Deputy Chief John McNamara. "But we believe it's a better methodology to provide a better service to the community. In the grand scheme of things it's better to prevent the 911 calls so it's available for true emergencies."

He said he'd rather the agency be known as "community problem solvers."

In Coral Springs, since May, Toolan, who has been assigned the role of community paramedic, has seen 18 cases and "really makes a difference in their quality of life for these people," Babinec said.

In one case, a woman moved into an apartment where the doorways were too narrow to allow her wheelchair to fit. She was confined to the living room. Toolan connected her to a service organization that gave her a new, smaller wheelchair. "Now she has full mobility," Babinec said.

Toolan said she gets referrals mostly from crews who respond to 911 calls. "I listen to what their needs are first," she said. "And [ask], are you willing to accept help?" She has tried to steer people away from using 911 to get them linked to other medical and transportation services.

A man in his 80s with no family had called 911 to go to the hospital for weakness. When Toolan followed up, she found out he had no way to get to his doctor since he was unable to drive. Diagnosed with a disease, he was confused about how to "navigate the medical system on his own and he kept getting sicker and sicker and couldn't get his medications," she said. "I could do leg work, I got him a cellphone that worked, I went grocery shopping for him, he didn't have any food, I took out his trash."

Then, she connected him with a Medicare service that delivers prescriptions and pays for doctors to make house calls as well as aides to help him bathe. Feeling better, the man told Toolan he was "110 percent better," no longer depressed and driving again.

"I love finding resources for people," Toolan said. "There is no reason for anybody in this county to go without medication or food or electricity. I have the resources to find whatever they need."

"You dial 911 we are always going to be there in time of need," Babinec said. But community paramedicine is to get people less reliant on 911 since "there are other resources out there, they just don't know about it."

Babinec said while this first phase helps people to keep them out of the hospitals, his next project phase sends actual medical care to your door.

His agency is in the final stages of contract talks with Cleveland Clinic to send a nurse practitioner along with paramedics to deliver medical care. A rescue truck will be converted to a mobile exam room and paramedics and the nurse can make house calls.

"Their quality of life can depend on it," Babinec said.


©2015 the Sun Sentinel (Fort Lauderdale, Fla.)

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