Welcome! Kevin McGinnis, MPS, EMT-P Community Paramedicine Coordinator

Transcription

1 Welcome! Kevin McGinnis, MPS, EMT-P Community Paramedicine Coordinator

2 EMS in the FLEX Program: Community Paramedicine and Other Considerations

3 EMS Opportunities in FLEX TRAUMA Support trauma and EMS systems (state, regional or community) development Support trauma and EMS system (state, regional, or community) assessments(s); Employment of HRSA s Benchmarks, Indicators, and Scoring (BIS) approach Facilitation of BIS processes for EMS at the local and regional level. Facilitated Trauma System Development Support trauma center designation of CAHs Conduct State strategic planning and systems development to address weaknesses identified by the BIS assessment; other weaknesses Support CAH Trauma Team Development Rural Trauma Team Development (RTTD) courses

4 EMS Opportunities in FLEX CLINICAL/OPERATIONAL TRAINING AND LEADERSHIP Comprehensive Advanced Life Support (CALS) courses Support the improvement of EMS Medical Direction Training courses for Medical Directors Training in comprehensive EMS agency budget processes Rural EMS Manager leadership and management training.

5 EMS Opportunities in FLEX SERVICE/SYSTEM STAFFING AND OPERATIONS Support the implementation of mechanisms to support EMS agencies in efforts of recruitment/retention, reimbursement and restructuring including: Recruitment & retention initiatives Implement evidence-based recruitment and retention programs Reimbursement Participation of EMS agencies in group buying and billing programs Restructuring Development of Systems and Pilot programs to better utilize pre-hospital care personnel in meeting the health care needs of rural communities in cooperation with State EMS offices.

6 Real World EMS Context Where We Are Where We Want to Be How To Get There Recommendations

7 Development of Systems and Pilot programs to better utilize pre-hospital care personnel in meeting the health care needs of rural communities in cooperation with State EMS offices.

8 Paramedic Paradox The further one moves from an emergency medical facility The more one needs a higher level of local EMS capability And the less likely that that EMS capability will be available

9 Rural Paramedicine Paradox Financially Less Supportable Fixed Cost of Paid Crew Availability of Volunteer Paramedics Operationally Less Supportable Skill Retention

10 Blueprints for the System of EMS EMS Systems Act of 1973

11 Blueprints for the System of EMS EMS Agenda for the Future (1996) The Vision Emergency medical services (EMS) of the future: Community-based health management Fully integrated with the overall health care system Able to identify and modify illness and injury risks.. Able to provide acute illness and injury care and follow-up, and Able to contribute to treatment of chronic conditions and community health monitoring

12 Blueprints for the System of EMS

13 Community Paramedicine Adapting EMS resources to address community health care and public health need not currently being met and embracing the paramedicine paradox as one of those needs.

14 Rural/Frontier EMS Agenda for the Future Community Paramedicine An organized system of services, based on local need, which are provided by EMTs and Paramedics integrated into the local or regional health care system, working with and in support of mid-level practitioner, nursing and other community health team colleagues and overseen by emergency and primary care physicians.

15 Rural/Frontier EMS Agenda for the Future Community Paramedicine This not only provides resources to address gaps in primary care/public health services, but enables the presence of EMS personnel for emergency response in low call-volume areas by providing routine use of their clinical skills and additional financial support from these non-ems activities.

16 Evolving Concept.. Community Paramedic A state licensed Paramedic who is certified as graduating from a recognized college program in community paramedicine and operates within the scope of practice for their licensure level as approved by the state under appropriate medical direction for the nature of their practice.

17 IS A generic concept Community Paramedicine A means to fill a temporary or on-going need Expansion of EMS roles and services to assist community health team colleagues (compliments primary role & enhances skills) IS NOT An expansion of EMS scope of practice Just for the Paramedic license level. The same in every (or any) community Competing for community health roles, but leverages the 24/7 presence and mobility of EMS resources in the community

18 CP Models in Practice Community Paramedic Model Licensed Paramedic Hour College-Based Program Primary Care Medical Oversight Extended Role/Services Model Licensed Providers Within Their Scope Limited/Selected Services

19 Statutory Approaches No Statutory Changes Delegated Practice No Statutory Change/Current Definitions Work Maine Statutory Changes Needed for Practice and/or Reimbursement Minnesota North Dakota

20 Collaboration: Maine CP Project Maine EMS (DPS) Maine Office of Rural Health (DHHS) Components (Over 3 Years) Develop Task Force Develop Detailed Plan and Implementation Models Health Gaps/ALS Gaps Assessment Medical Direction/Quality Improvement Processes Education Model and Mechanism Prospective Research Methodology

21 Maine CP Project Components (continued) Develop Pilot Program and Requirements Current Paramedic Capacity Relationship With Primary Care Practice Site Willingness of Site To Provide Medical Oversight/QI Access Data on Patient Population Solicit Pilot Sponsors Assist Pilots to Establish Services Evaluate Effectiveness of Pilots/Work With Payers

22 Maine CP Task Force Initial Planning Core: Jay Bradshaw (State EMS Director) Dr. Matt Sholl (State EMS Medical Director/MMC) Dr. Steven Diaz (MGMC) Dr. Timothy Pieh (Regional Medical Director/MGMC) Dr. Amy Madden (Family Medicine Physician/HRN) David Winslow (Maine Hospital Association) Myra Broadway (Board of Nursing) Kevin McGinnis

23 First Statewide CP Meeting Invitees/Attendees EMS Hospital Systems/Primary Care (ACO/PCMH Sites) Association/Licensing Organizations: Physicians PAs/NPs Nursing Home Health/Extended Care/Hospice Public Health Third Party Payers

24 Maine CP Program Kevin McGinnis, MPS, EMT-P