1. Community Paramedics: Here, There, (and soon) Everywhere
National Rural EMS Conference
May 5, 2015
Gary Wingrove, President
The Paramedic Foundation

2. © 2014 The Paramedic Foundation. All rights reserved.
National
International
EMT
Primary Care Paramedic
Advanced EMT
Intermediate Care Paramedic
Paramedic
Advanced Care Paramedic
(None)
Critical Care Paramedic
Community Paramedic
Ambulance Service
Paramedic Service
© 2014 The Paramedic Foundation. All rights reserved.

3. © 2014 The Paramedic Foundation. All rights reserved.

4. © 2014 The Paramedic Foundation. All rights reserved.
IRCP 2014
© 2014 The Paramedic Foundation. All rights reserved.

5. Special Recognition for Nevada
Photo via Twitter
© 2014 The Paramedic Foundation. All rights reserved.

6. © 2014 The Paramedic Foundation. All rights reserved.
208 Delegates
7 Countries
Australia
Canada
England
Ireland
Norway
United Arab Emirates
United States
© 2014 The Paramedic Foundation. All rights reserved.

7. © 2014 The Paramedic Foundation. All rights reserved.
IRCP 2015
Hosted by the Council of Ambulance Authorities of Australasia (Australia, New Zealand, New Guinea)
October 13 & 14, 2015
Melbourne, Victoria, Australia
© 2014 The Paramedic Foundation. All rights reserved.

8. 10 Years of International Collaboration
Our Governments Are Investing
© 2014 The Paramedic Foundation. All rights reserved.

9. Our Governments Are Investing
2012
United States - $13,500,000 Innovation Awards for CP Programs
2013
Australia – $4,000,000 CP Workforce Grants
2014
United States – $29,200,000 Innovation Awards for CP Programs
Ontario – $6,000,000 Expansion of CP Programs
Minnesota – $800,000 to one program for Shared Savings From Medicaid ACO
© 2014 The Paramedic Foundation. All rights reserved.

10. © 2014 The Paramedic Foundation. All rights reserved.
What’s In A Name?
Community Paramedicine
Most people “get it” with little explanation
Largely rural
Clinically integrated primary care teams
Community Paramedic is a specific practitioner
College course – v4 late 2015, international exam coming 3Q2015
Mobile Integrated Healthcare
Requires explanation
Largely urban
Is a misnomer – the care isn’t mobile
Administrative pathways, not clinical integration
Variety of practitioners
© 2014 The Paramedic Foundation. All rights reserved.

11. Paramedic Service Implications
MIH – give a lot of staff a little training, be prepared for all calls
CP – give a few staff a lot of education, integrate into primary care
© 2014 The Paramedic Foundation. All rights reserved.

12. © 2014 The Paramedic Foundation. All rights reserved.
The Models – CP
Primary Healthcare
Substitution
Community Coordination
Blacker, N., Pearson, L., & Walker, T. (2009). Redesigning paramedic models of care to meet rural and remote community needs. The 10th National Rural Health Conference, Cairns, Australia, May 17-20, (Accessed via on November 30, 2011).
© 2014 The Paramedic Foundation. All rights reserved.

13. © 2014 The Paramedic Foundation. All rights reserved.
CP Example
Minneapolis – ACO
Primary Care team Community Paramedic immersion
In home assessments, medication verification
Lab tests, scheduled treatments
Consultation with Primary Care Provider
Implements altered care plan
Schedules ancillary services
Integrated IT system
© 2014 The Paramedic Foundation. All rights reserved.

14. © 2014 The Paramedic Foundation. All rights reserved.
The Models - MIH
Administrative integration
Referral pathways
9-1-1 nurse phone triage, referral
Transport to “alternative destinations”
Assessment with reporting findings to PCP
May include CP (NP, PA, CHW) component
© 2014 The Paramedic Foundation. All rights reserved.

15. © 2014 The Paramedic Foundation. All rights reserved.
MIH Example
Reno – Blended Program (CMMI funded)
Create new care and referral pathways (MIH)
Administrative integration
Post-discharge in-home follow-up care (CP)
Primary care integrated, Reduce readmissions
Nurse Health Line (MIH)
Administrative referral
Community Health Paramedics transition of care (CP)
Care plan education and follow up
Ambulance Transport Alternatives (MIH)
Administrative transportation destination pathway
© 2014 The Paramedic Foundation. All rights reserved.

16. © 2014 The Paramedic Foundation. All rights reserved.
How CP Grew Up
1990s – New Mexico, North Carolina
2005 – IRCP
Curriculum
2007 v1 (Minnesota – CHW Roots)
2009 v2 (Colorado)
2012 v3 (35 colleges)
2014 – estimate 1,000 CPs nationwide, 400 at HTC alone
2015 v4, Int’l Exam
2015 – CPT Curriculum Pending
© 2014 The Paramedic Foundation. All rights reserved.

17. © 2014 The Paramedic Foundation. All rights reserved.
The Curricula
Original CP Course
12 – 14 college credits
Primary care integration
V4 – 2015
Exam
© 2014 The Paramedic Foundation. All rights reserved.

18. © 2014 The Paramedic Foundation. All rights reserved.
Out With the Old and ….
© 2014 The Paramedic Foundation. All rights reserved.

19. © 2014 The Paramedic Foundation. All rights reserved.
… In With the New
© 2014 The Paramedic Foundation. All rights reserved.

20. Community Paramedic Technician
4 college credits
9-1-1 centered
Treat/no transport
Treat/refer
Treat/alternative destination
Assess & Report
© 2014 The Paramedic Foundation. All rights reserved.

21. Community Paramedic Clinician
14-16 college credits
Version
Exam 2015
Primary care integration model
© 2014 The Paramedic Foundation. All rights reserved.

22. © 2014 The Paramedic Foundation. All rights reserved.
And In Reserve…
© 2014 The Paramedic Foundation. All rights reserved.

23. Community Paramedic Practitioner
Only delivered as part of a bachelor’s degree program
Available date????
© 2014 The Paramedic Foundation. All rights reserved.

24. © 2014 The Paramedic Foundation. All rights reserved.
Where We’re Headed
International Registry of community paramedicine and MIH Programs
International Registry of CPTs and CPCs
CPT and CPC CE online and time zone conferences
© 2014 The Paramedic Foundation. All rights reserved.

25. Questions? Gary Wingrove The Paramedic Foundation 2800 N. 7th Street
St. Cloud, MN 56303
Questions?
© 2014 The Paramedic Foundation. All rights reserved.