Pitt County’s rural north end – including Pactolus, Belhaven, Belvoir, and Bethel – is an especially vulnerable spot for residents, especially in times of need. The area is underserved from a health and wellness standpoint and chronic patients are prone to repeated visits to the ER. A pilot, community paramedic program from the county’s emergency services department hopes to confront and reduce that problem at the source and it’s scheduled to serve about 20,000 people. It’s a nationwide trend that started picking up steam over the past decade. Chris Thomas has more on what the program may offer Pitt County residents.
Late last year, Pitt County received a grant from Vidant Medical Center totaling just over $100,000 with an official check presentation at the Pitt County Board of Commissioner’s meeting earlier this month.
Through that grant, Pitt County EMS Coordinator James MacArthur hopes to take an unconventional approach to emergency care.
“We have a paramedic that is out in the community, taking referrals from both EMS providers and from hospital discharges – patients that have been seen at the hospital and reaching out and enrolling them, contacting them, and being proactive.”
The program is directed, primarily, toward patients who have chronic conditions and are repeat visitors to the Emergency Room, in an attempt to save time and money.
Some solutions may include things as simple as making sure participants are taking medicine, checking for at-home risks, and other basic actions meant to prevent future 911 calls.
“And so if we can help to manage that, that’s a really low hanging fruit that doesn’t require a lot of effort (or) time that we can hopefully help those people maintain that level of health.”
Not unlike other areas in the rural south, the biggest problem for health professionals in Pitt County is fighting high blood pressure and diabetes. MacArthur says average emergency response times to the northern part of the county is about 9 minutes, on par with the rest of the county – but the area targeted by the new program is north of the Tar River. It’s prone to flooding and getting to patients through the area’s winding, country roads can be especially challenging.
“The proportion of those people in the northern part of Pitt County with multiple risk factors for significant illnesses is higher but part of that is because…the density is lower. Part of that is also because…economically, the residents in the northern part of the county tend to be economically challenged and have less access to health care resources.”
The county’s search process has begun and MacArthur hopes to have position filled by mid-February. But he says there are still some holes that need to be filled before the program is officially rolled out in March – including the community paramedic’s requirements and how closely they’ll work with the mind as well as the body.
“Many law enforcement officers are trained in crisis intervention and crisis awareness…one of the things that’s happening in a lot of places, and Wake County has done it with their paramedics, and we are exploring here, is allowing – or having our paramedic, this community paramedic – trained in crisis intervention to be able to work with those folks and hopefully connect them with the right services.”
Regardless, local health professionals like Merredith Lovely, the county’s paramedic supervisor, are enthusiastic about the project.
“What we’re hoping and what we’ve heard from other counties that are having success with this program – that’s really going to help alleviate some of the readmission and…maybe the more chronic or more frequent calls for these at risk or higher at risk patients.”
There are community paramedics in Lenoir and Johnston Counties but this would be a first for Pitt County. Lovely is familiar with the target area since she primarily works with the EMS squad in Bethel. It’s her hope this will help bridge the quality of life gap between the county’s urban and rural populations.
“…I really hope, for the patients’ wellbeing, it helps alleviate emotional and physical and financial burden that…all these readmissions and stuff like that that’s creating for them personally.”
According to the latest figures from the Kaiser Family Foundation, inpatient care costs at for-profit hospitals in North Carolina are $1,606 per-day, on average – $586,190 per year.
Pam Cowin, nurse administrator at Vidant Medical Center.
“So we do look at it from that standpoint of return of investment in reduction in readmissions and unnecessary emergency department services and then we do look at it at it in the long-term, improved wellness and preventative care – things like vaccinations and advance directives”
Community Paramedic programs are becoming more popular in rural areas that don’t have immediate access to medical facilities like hospitals. But like the program in Pitt County, the nationwide trend is in its earliest stages and it’s too early to tell the overall impact they’ve had on economically depressed areas.
I’m Chris Thomas.