1. Welcome to Community Paramedic: Protecting Seniors in Riverside
There is a NEW player in town that can help people stay SAFE at HOME……and they aren’t in a hurry
Welcome to Community Paramedic: Protecting Seniors in Riverside
Introduction
Today’s presentation is welcome community paramedic: protecting seniors in Riverside. This unique pilot program is being offered through Reach Out’s collaboration with the City of Riverside Fire Department.
I will cover a brief background on the project and how community paramedic can be an integral player in protecting seniors from neglect, abuse, or fraud.

2. What is Community Paramedic
Paramedics are out in the community, are highly trusted and respected, and are ideally suited to:
act as gateways or access points to social services
provide early assessment of chronic or worsening morbidities in order to prevent unnecessary hospital readmissions
What is Community Paramedic
This is an innovative approach to addressing community health gaps for underserved populations and to reduce the over utilization of EMS transports and costly ED use for primary healthcare by establishing Mobile Integrated Healthcare program or “COMMUNITY PARAMEDIC”
What is Community Paramedic?
The definition and role of the community paramedic is evolving in throughout the nation. I would like to start with what community paramedic is NOT.
Physicians Law enforcement
Home health agency providers Permanent solution
Community paramedics are fully trained and certified advanced paramedics. In our situation, they work with a registered nurse, as well as their medical director to provide referrals, assistance, and support to residents. In some areas, they are aligned with area hospital emergency departments and social workers.
The significance of paramedics is they are in the neighborhood 24 hours a day, 7 days a week. In most communities, there is no other agency with skills in physical and mental assessment or the ability to quickly determine appropriate courses of action with comparable working hours.
What Community paramedics offer the health care system is the 24 hour service and the ability to provide a safety net for gaps. Some of those gaps include:
Week end discharges needing medication, clarification, or reassurance
Alternative resources for care, including getting an appointment with primary care
Evaluation of social determinants of health that are negatively affecting the individual’s or family’s health or perception of health and making referrals

3. Evolution
Community paramedicine ( mobile integrated healthcare) has previously demonstrated its utility in rural and metropolitan healthcare systems. The U.S. Department
of Health and Human Services defines community paramedicine as “an organized system of services, based on local need, provided by emergency medicine technicians and paramedics that are integrated into the local or regional health care system and overseen by emergency and primary care physicians.
This law for Ohio became part of Gov. John Kasich’s state budget in June 30, 2015 and went into effect Oct However other states had Community Paramedicine underway as early as 2000.
The law allows paramedics and EMTs to function in non-emergency roles in addition to providing traditional 911 emergency services.
Community paramedicine has it’s roots in rural health care. In the 1990s, the concept was proposed to give paramedics increased authority to make decisions in the field regarding a patient’s health care needs , under the supervision of a licensed physician.
Previously, EMTs were limited in their scope of practice to immediate medical stabilization and transport to an appropriate hospital.
The lack of resources in the rural community and restrictive scopes of practice, contributed to many unnecessary transports to emergency rooms for primary care, medication refills, and treatment of minor conditions.
The experiences in rural health care with paramedics contributed to a new model of care that has proven successful in several states, most notably California, Texas, Arizona, and Washington.
In Ohio, the centralization of health care systems, limited access to primary care, and changes in insurance, led Gov Kasich to sign legislation that increases EMTs ability to perform in non-emergency roles.
Expansion of Existing Resources

4. Community Paramedic Program
Pharmacy
Community
Paramedic
Durable Equipment Providers
Community Paramedic Program

5. City of Riverside Started in October 2017 Extension of HHC Services
Community Paramedic
Started in October 2017
Average 312 EMS calls a month
Average 85 (27%) of all calls a month are related to a senior
1:4 calls regarding seniors are for a fall
Extension of HHC Services
In-home assessment – “Bird’s Eye” view of environmental conditions
Opportunity to work together …………
Police Dept to identify at risk individuals
Home health care agency to monitor chronic disease
Out-Patient Offices evaluation/assessment
Referral Agencies
Hospital Discharge Coordinator
Fills Gaps Encountered
Lack of awareness of available resources
Applied once “for help” and never tried again
Fear they will make me leave my home
Safety
Continuity of Care
Population : 24,981
Reach Out was approached by the City of Riverside to help their residents. A needs assessment revealed:
population 25,000 median income $45,606 (below OH ave)
no primary care or pharmacies
Since starting in Oct 2017, just over 1:4 EMS calls involves a senior—many with an acute condition requiring emergency care. In addition, 1:4 seniors calls is related to a fall—often not requiring a transport to the hospital.
Community paramedics have a largely singular opportunity to see what is happening in a client’s household—a bird’s eye view if you will.
Traditionally, they have been limited to being able to refer to the police or adult protective services.
Community paramedicine allows them the opportunity to assess and make referrals and recommendations BEFORE the situation gets to the criteria warranting Adult Protective Services intervention.
While in the home and during follow-up after a 911 call is resolved, paramedics have the privilege of talking with patients, caregivers, and family/friends. Often, they see and hear things the doctor would never know about without the paramedic.
In Riverside, runs are reviewed, referrals are made by individual paramedics, and residents are now calling in for guidance and information.
Gaps we routinely identify include: lack of awareness of available resources, tried once to get help and haven’t tried again, or fear of forced displacement.

6. Program Outcomes
Reinstated Healthcare Insurance
Inspected Durable Goods for Safety/Compliance
Hospital bed
Wheelchair
Walker
Repaired/modified homes
Hot water heater
Stairlift/Ramp
Reconciled Medication List
Drug Store Selection/cost or coverage
Dose packaging for safety in administration
Monitoring Information
Transportation access
Home health Care Resources/Feedback
Primary Care Compliance Feedback
Promotional Health Education

7. Lessons Learned Each community is unique
EMS perceptions of neighborhoods and homes are “invaluable” to designing a plan of care
Social determinants influence our health
We need to ALL think outside the box
We Need to Connect to Each Other
We Are Paving the Way for Telehealth

8. Presented by: Tami Whalen, MAOM, RN Special Needs Coordinator - Reach Out of Montgomery County Riverside Fire Department Community Paramedic Program Paula Balcom, EMT-P City of Riverside Fire Department Community Paramedic Reach Out 25 E. Foraker St. Dayton OH (937)

9. Questions?