Since 1878, the Alameda Fire Department (AFD) has been at the forefront of fire and emergency services. Their firefighters are invested in the community and recognize the diverse needs of the inhabitants of Alameda. As such the AFD was selected to participate in a two-year pilot project, funded by a $1.2 million grant, from the California Health Care Foundation and the California Emergency Medical Services Authority, to develop one of the very first Community Paramedic (CP) Programs in the State of California. Alameda Fire is one of 13 agencies within the State that is analyzing the effectiveness of Community Paramedicine, new and evolving models of community-based health care in which paramedics function outside their customary emergency response and transport roles.
Traditionally, paramedics have been, by necessity, reactionary in their response to calls for assistance. The CP Program expands on this role by being proactive in promoting health and well-being among at-risk populations through the utilization of house-calls to chronic patients and frequent ER users.
The Support of Alameda Health System
Their firefighter/paramedics enrolled in the program have been educated in accordance with a national curriculum provided through a 6-week program at the University of California at Los Angeles (UCLA) School of Medicine, which holds the distinction of being among the first, largest and best paramedic programs in the world. In addition the CP Program has partnered with Alameda Health System (AHS) to provide training in programs such as substance abuse treatment, tobacco cessation, and counseling. As the pilot program continues, AHS will offer to provide more support including internship opportunities with our team, nurse mentors for ongoing support, as well as the sharing of resources.
A New Innovative Model of Care
The CP Program provides a new, innovative model of care: identifies gaps in health care service delivery within our community, facilitates the connection of clients to existing resources, mitigates rising health care costs, and shifts the focus from fee-based to a value-based model of health care.
The focus of the program is to connect at-risk populations to appropriate resources in order to decrease reliance on emergency medical services as a primary source of health care. These populations include the elderly, the homeless, those with substance abuse problems, individuals who suffer from severe and persistent mental illness, and people without medical insurance.
For Alameda specifically, the program will focus on the “Chronic Six” post hospital discharges and frequent 911 users, aka “familiar faces.” The “Chronic Six” includes: Myocardial Infarction (MI) “heart attack,” Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), Diabetes Mellitus (DM), Pneumonia (PNA), and Sepsis.
The results of the study will be measured by the University of California San Francisco using the following data collection points:
Heath of the population (pre/post health questionnaire)
Reduction of 911 use, ED and hospital stay time
Reduction of EMS/health care costs
Post CP program satisfaction survey
The goal result is improved services for those at risk and overall decreased health care costs.
As Alameda Fire Chief Doug Long explained, “I believe that Community Paramedics will be an integral part of health care delivery in the future with the implementation of the Affordable Care Act. I am confident that our pilot project will be a resounding success”.
The Community Paramedic services are free to those who qualify and enroll in the program. Since its implementation on June 1, 2015, the AFD Community Paramedics have enrolled over 30 community members into the program.
Services include: medical assessments, chronic disease support, medication reconciliation, collaboration with primary care physicians, home safety assessments, physical therapy referrals, nutrition and dietary support, transportation referrals, connection to financial management services, psychosocial assessments, substance abuse treatment support, smoking cessation assistance, social network assessment, and much more!
While hospitalized, her physician indicated that she was not going to survive if she didn’t start fighting.
“The program was a turning point for me…I decided to live and get well enough to be discharged from the hospital.”
Within the first 30 days the patient received food and transportation referrals, medication reconciliation, and vital signs monitoring. Before her enrollment in the CP program she had experienced 2 ER visits and 2 hospitalizations, after CP enrollment she had zero readmissions and later was voted “Best Visual Artist” by Golden Gear Awards at Rhythmix Culture Works.