Community paramedicine pilot program serves nearly 50 patients in first month

LACONIA — The city's new paramedicine program has already served more than 40 people through its first month, Fire Chief Tim Joubert told councilors during a budget meeting Tuesday night. 

Councilors gathered at City Hall downtown on May 27 to review the proposed budgets of the fire and parks and recreation departments.

“This is something that I’ve been passionate about since I’ve been here,” Joubert said. “I feel like the community needed this program in place, this is the mobile integrated health program. For two years, I was knocking on every door to see if we could gain some traction and figure out how to make this work.

“The goal of this program is to treat people at the right place, at the right time, and try to avoid any unnecessary ambulance rides and emergency room visits.” 

Firefighters worked with staff of the Partnership for Public Health, gave them all manner of data, and sought a three-year federal Health Resources and Services Administration grant worth $450,000.

“It funds it in full for three years,” Joubert said.

Since April, the new community paramedic had seen 43 patients as of the meeting, though Joubert noted the number was actually 48, including what the program accomplished through Tuesday.

“Going to people’s homes, going to businesses, treating people where they really need to be treated. Working with other organizations like our VNAs and our other social services,” Joubert said. “We’re getting referrals now through [Concord Hospital-Laconia], we’ll soon get referrals from Health First and some of the other services in our communities — it is working and it is making a difference.” 

In September, councilors learned the city would pilot a community paramedicine program after receiving the grant funding the trial period. Describing the program as a modern-day approximation of the “rural town doctor”, Joubert stressed the importance of meeting patients where they are, often in their own homes, in reducing the volume of ambulance transport when not absolutely necessary. 

The program could also greatly reduce expenses shouldered by patients in need of medical attention, but not necessarily transport — ambulance rides can cost thousands of dollars — and could ease the burden on the city’s emergency services staff, and local and regional hospitals alike.  

One of the initial goals of the pilot program, PPH Chief Executive Officer Tammy Carmichael said last year, is to develop data on the efficacy of the program, and discern if EMS would be able to bill insurance companies. They’ll develop a plan beyond the first three years, and consider if expanding the program would be beneficial.

Two metrics likely to come under scrutiny are the number of preventive health care visits conducted by the community paramedic and community health workers — program organizers hope they increase — and the 30-day admission rate for individuals experiencing chronic disease, which the program aims to decrease. 

The target populations for the program include patients diagnosed with chronic conditions, frequent users of ambulance transportation to the hospital or emergency room, patients recently discharged from the hospital or others who have difficulty leaving their homes. 

“As we move forward, I’d just like to see when you give us the report [City Manager Kirk Beattie] puts together monthly, I’d like to see a breakdown,” Ward 2 Councilor Robert Soucy said Tuesday. “What kind of calls were they on? I know the paramedic goes out, how many cases have you got to send an ambulance out afterwards because you requested one for one reason or another? Just looking at data.”

“With some of the potential federal cuts taking place, some social services are going to have a reduction in funds, and this program is going to become even more valuable,” Joubert said.