The Aspen Ambulance service is expanding its efforts beyond immediate medical care and a ride to the hospital. Next year paramedics will be trained to help people at home through a program called community paramedicine. Emergency officials say the home health service fills a need for patients who are most under-served. Marci Krivonen reports.
Aspen Ambulance director Gabe Muething steps into a large garage at the District’s headquarters.
"So this is the ambulance bay. It’s where we keep our ambulances. We have the ability to keep three ambulances here at our quarters," he says.
Paramedics here will respond to more than 100 emergency calls this month. This time of year, many are ski injuries. Muething says there’s another common call.
"I would say the big cases are those folks who have a medical condition and they put off going to the doctor. And the condition worsens and worsens until it gets to the point where it’s an emergency. That’s when we get called."
In those cases, he wishes he could have reached the patient a few days earlier "...just to stop and talk to them and say, ‘Hey, here’s what can happen if you don’t treat this soon or effectively.’”
Muething says such situations can be avoided with community paramedicine. The program puts paramedics in the homes of patients prior to any emergency.
"By visiting a patient’s home, we gather so much information about their lifestyle: how they live, when they leave the home, if they have access to food.”
Paramedics may instruct someone at home on how to treat a wound. Or, make sure prescriptions are filled and dressings changed. They may even draw blood. Sometimes it’s just a matter of ensuring the heat and lights are turned on.
Such a program already exists in Eagle County. Chris Montera oversees it.
“Really, it was - how do we serve patients and really keep them in their home and keep them healthy. That was the start of the program and we were the first rural program in the United States.”
That was 2010. In the first three years, his staff saw 150 patients multiple times throughout the program. It’s most used by the underserved, like those on Medicaid. It’s tough for this group to find care outside of the program, he says.
"What we’ve found is just because patients have a health insurance card doesn’t mean they have access to care, and it doesn’t mean all of our providers in the (Vail) Valley will accept that Medicaid card. For instance, we only have one provider in our county that accepts Medicaid. From that perspective, there really is a lack of resources.”
Eagle County developed a community paramedicine start-up handbook and now, it’s involved in legislation that would grow similar programs around the state.
"You see more and more communities exhausting hospitals," says Leroy Garcia, a state senator from Pueblo.
"Many times a hospital is not the place that a patient should be transported to. These are things that could be resolved through a health care provider coming to your home.”
Garcia is a democrat and a paramedic, himself. He plans to introduce a community paramedicine bill during the upcoming session.
“It models the uniqueness of what is going on in Eagle County, as well as takes into consideration other counties that have successful programs in what’s called ‘community paramedic’ or what some call ‘mobile integrated health.’”
The bill may define a community paramedic and propose a state license for such a service.
Back in the ambulance bay in Aspen, paramedic Gabe Muething explains ambulances won’t actually be used in home visits.
"The reason being is when you see an ambulance out in front of your neighbor’s house, you get worried about your neighbor. We don’t want to worry neighbors."
The staff will use other unassuming district vehicles. The program will be up and running by next fall. Start-up costs are estimated at $7000, which taxpayers will front.