The URL can be used to link to this page

Home My WebLink AboutSS2 - Paramedicine Pilot Project - PowerPointCommunity Paramedicine — Paving the Road for the Future Cathy Ord, EMS Division Chief Prepared for the City Council Study Session September 22, 2015 RMW' " Newport Beach Fire Department - "Safety, Service, Profession/ism Community Paramediane A community based model of healthcare that utilizes paramedics with expanded training to fill gaps in healthcare needs identified in the community. AKA; "Mobile Integrated Healthcare" �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Why do we need it? Growth in Total Health Expenditure Per Capita, U.S. and Selected Countries, 1970-2008 $8,M0 =7,000 $0 1970 1975 1980 1985 1990 1995 2000 2005 —UN(Rd States �Switrerland —Canada OECD Average Sweden —United Kingdom saaroc Dr'9aNnam fa Ec«Kax coapama nand oe dopniert (xnlo), •o¢o N fth Date•, [ MmA � (didbue). dot myujdxaomso- an (Oc[.---, an 19 Febi.N 2➢11). ft'Data frM A Mala and Japan ana 20x7 data. Rom hr 6akon, Canada, Nerfnrlaft fa wand %ntaaland, are OECD BadpaOE. Numben are PPF aduatoi. break in;aic:LAN(19951;SNE(1993, 2001); 9N1(1995); UK (1997). hm. s an PPP adjusbA Esamea for Canada and SmhaYMn rope. �' �>s (� N✓ FIRS, Newport Beach Fire Department -"Safety, Service, Profession/ism" _, Affordable Care Act ♦ Triple Aim: improved quality of care, improved patient satisfaction, and reduced costs ♦ Accountable Care Organizations (ACOs) - will be gatekeepers ♦ Build in incentives and penalties — Hospitals penalized for any readmissions of specified medical conditions within 30 days ♦ 10% of all hospitals in California are predicted to close �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Changing EMS &Healthcare Environments in California ♦ Widening gap between the demand for healthcare services and the supply of physicians/other healthcare workers — Population growth & aging — Rise in chronic diseases — Increased health insurance coverage resulting from the Affordable Care Act (additional 3.4 million by 2016) ♦ Healthcare workforce is shrinking due to — Aging (1/3 of MDs are 60+ yrs.) — No increase in medical school graduates — Cost control measures — Growing dissatisfaction with MDs and private practice �k Newport Beach Fire Department - "Safety, Service, Profession/ism" ""At the very broadest level, the health care system is ill-equipped to take care of the volume of patients and provide the care needed. We have to deliver health care and bring about health in new ways." — State Agency Official x R^W ) " Newport Beach Fire Department -"Safety, Service, Profession/ism Community Paramedicine in California ♦ State EMS Authority and California HealthCare Foundation contracted with UC Davis to provide a report of the feasibility of CP programs in California ♦ Report published in July 2013 Community Paramedicine: A Promising Model for Integrating Emergency and Primary Care — Recommended CP Programs in California — CP not recognized by state law — Pilot studies first, before changing legislation �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Pilot Studies in California: Areas of Focus — 13 Sites 1. 911 patients with minor conditions — transport to alternate destinations other than emergency departments (EDs) (4) 2. Frequent 911 callers - connect with primary care and/or social services (2) 3. Discharged patients at risk for readmission — make follow-up visits at home (5) 4. Patients with chronic conditions - make periodic wellness checks and provide education (2) �k Newport Beach Fire Department - "Safety, Service, Profession/ism" OC Alternate Destination Pilot Project ♦ OC Fire Chiefs Association sponsoring the OC pilot project — Involves NBFD, HBFD, and FVFD — Start Date: September 14, 2015 (2 year pilot) ♦ Objective — Study if Paramedics with advanced training can safety triage & transport 911 patients with minor conditions to urgent care centers instead of EDs �k Newport Beach Fire Department - "Safety, Service, Profession/ism" OC Alternate Destination Pilot Project -Requirements ♦ Advanced level training for AD Paramedics ♦ Medical protocols approved by the state & county medical directors ♦ Patient must consent to participate ♦ Patient must agree to be transported to the urgent care center (UCC) ♦ AD Paramedic must accompany patient during transport ♦ Partner UCCs must be approved Close monitoring & medical oversight 1, FRF Newport Beach Fire Department - "Safety, Service, Profession/ism" Triage &Transport Criteria for UCCs Inclusion Criteria ♦ Simple closed extremity injury ♦ Simple laceration with controlled bleeding ♦ Soft tissue injury or infection, small ♦ Isolated fever & cough Exclusion Criteria ♦ Abnormal vital signs ♦ Age less than 18 yrs ♦ Pregnant ♦ In custody ♦ Involved in alleged assault or criminal activity ♦ Unable to provide consent ♦ Suspected drug/alcohol intoxication... Newport Beach Fire Department - "Safety, Service, Profession/ism" Project Partners ♦ OC Fire Chiefs Association - N BFD - HBFD - FVFD ♦ Care Ambulance ♦ Hospital Systems — St Joseph Hoag Health — MemorialCare — Kaiser Permanente ♦ Urgent Care Centers: (5) Participating ♦ OC EMS Agency ♦ State EMS Authority ♦ Office of Statewide Health Planning & Development ♦ UCI, Research Center ♦ Emergency Nurses Association �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Challenges ♦ Currently no funding structure in place for reimbursing 9-1-1 transport costs to UCCs or for UCC services ♦ Loss of revenue during the pilot for transport agencies and UCCs ♦ Securing grant funding for operating costs ♦ Patients may not want to go to UCCs ♦ Research approval process very difficult �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Pilot Operating Costs �x FIRS' Newpo FY 2015 Training $ 50,685 Research/Principal Investigator $ 16,200 TOTAL $ 66,885 FY 2016 Transport Provider Fees $50,250 UCC Service Fees $ 35,000 Research/Principal Investigator $ 18,700 TOTAL $103,950 FY 2016 Transport Provider Fees $50,250 UCC Service Fees $ 35,000 Research/Principal Investigator $ 16,200 TOTAL $101,450 GRAND TOTAL $272,285 Beach Fire Department - "Safety, Service, Profession/ism" Grant Funds Pilot Partners ♦ California Health Care Foundation ♦ Hoag Community Benefit Program ♦ Hoag Community Benefit Program ♦ MemorialCare Foundation GRAND TOTAL Amount Status $ 16,600 Recd $ 50,685 Recd $125,000 Pending $ 80,000 Pending $272,285 �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Our Alternate Destination Paramedics H BFD - Josh Hyink - Ryan Cooke - Keita Sato - Dane Morrissey - Chris Brown - Berkeley Northrop - Kane Johnson - Yahya Alwakza FVFD Joel Brandt Gordon Cromwell Sea n O'Donnell Dan Lancaster Rony Dawly Jon Ruth Cory Sorenson NBFD - Joseph Harrison - Jason Leftige - Steve Martin - Joseph Laser - Brian Mahnken - Jude Olivas - Kelly Conte - Ray Kang - Joseph Janis Newport Beach Fire Department -"Safely, Service, Profession/ism" What happens after the pilot study is done? Project Completion When either of the following are met: ♦ 24 months from start of pilot ♦ Enrollment of 400 total patients, including greater than 150 patients transported After the Pilot ♦ Wrap up ♦ Final Report ♦ State Recommendations ♦ Legislative Changes �k Newport Beach Fire Department - "Safety, Service, Profession/ism" Inaugural Community Paramedicine Course State of California: Graduated 77 CPs San Diego Training Site R _ I li�wvIw� Newport Beach Fire Department - "Safety, Service, Profession/ism"