Community health program moves forward, fire department gets new truck

LACONIA — The fire department is getting some new digs. 

City councilors on Dec. 9 approved a request to bond for a new ladder truck and to accept grant funds to get the forthcoming community paramedicine program up and running. 

The city’s community paramedicine program will be operated in a collaboration between the fire department and Partnership for Public Health, and will allow for a trained provider to better intervene in cases when full-blown hospital care may be unnecessary, ultimately saving patients and providers cost and improving outcomes.

The fire department was awarded a Community Paramedic Program grant of up to $450,000 to fund a Collaborative Mobile Integrated Health Program between the fire department and PPP. The Health Resources and Services Administration Northern Borders Grant was awarded to fund the entire three-year pilot program. 

The first year is projected to cost $190,000 and the second and third years $130,000 each. 

Modeled loosely after the tradition fulfilled by rural town doctors, a paramedic working for the Laconia Fire Department will deliver care to patients, sometimes in their own homes. The program could reduce costs greatly for patients who are in need of medical attention but not necessarily ambulance transport, therefore easing the burden on the city’s EMS and hospital system.

The first three years of the program will include a focused effort to develop data on its efficacy and to figure out if EMS will be able to bill insurance companies. They may develop a plan to expand the program further than three years if it is deemed a success.

In Laconia, a large portion of medical transports are provided to patients who frequently use the service, who may be able to avoid such ambulance rides with proper care and prevention. That would, in turn, free up other ambulances to transport critically ill and injured patients. 

“I just want to say that this is a great program and a great opportunity for the City of Laconia,” Ward 6 Councilor Tony Felch said.

Councilor Bruce Cheney (Ward 1) said he’s in strong support of the program.

“I first started talking about a program in Concord called Paramedic Intercept, which is the same sort of program, and I’ve been a strong supporter of the idea,” Cheney said. “Councilor Felch and I have both championed this repeatedly over the last several years and I’m thrilled to see it come to fruition, I really am. I mean that sincerely, thank you.”

Fire Chief Tim Joubert presented the burgeoning program to the city council in September. Two primary metrics organizers will be paying attention to are the number of preventative health care visits by community health workers and a potential reduction of the 30-day readmission rate for patients with chronic diseases.

In the period between 2021 and 2023, 51% of medical incidents occurred at properties operated by Laconia Housing, 16% at Taylor Community and 14% at Genesis Laconia Rehabilitation Center, along with visits to St. Francis Rehabilitation and Nursing Center and other locations.

EMS transport and hospital emergency room visits are expensive. Basic life support transport costs, on average, $1,313 per trip, and advanced life support transport can range between $1,894 and $2,787 per trip. The average emergency room visit will cost a patient $2,400.

And city councilors also moved forward on the fire department’s request to bond for a new ladder truck. The department hopes to replace 13 Ladder 5, which is 26 years old, in poor condition, and can no longer pass annual safety testing.

Councilors approved a bonding effort of $1.725 million.

The total cost to the city will be dictated by interest rates at the time a bond is secured. Based on current interest rates, the interest cost over 20 years is anticipated to be about $840,000.