People who call an ambulance for mental health emergencies or minor injuries may not get a ride to the hospital under a new program by Wake County Emergency Medical Services.
Wake County Commissioners approved an application Tuesday for a nearly $1 million grant from a Health Care Innovation Challenge program by the Center of Medicare Services.
The county will learn later this spring if it is awarded the funds to test the new ideas with the Wake EMS program.
Grant funds would go toward further implementing a three-phase Advanced Practice Paramedic program that was started three years ago. Wake EMS Director Dr. Brent Myers said the program was not fully completed due to the economic recession.
The end of the plan would “change the transport mechanism so that patients don’t necessarily have to go directly to an emergency department, but can go elsewhere,” he said.
Myers said this is the first time the grant has been open to EMS; it has been restricted to hospitals and physicians in the past.
Myers said the grant’s purpose is to demonstrate improved citizen health, improved health care from a systematic perspective, and a lower cost.
Increases in mental health and substance abuse referrals “directly from the street to appropriate facilities” will happen in the program’s first phase, Myers said. This is currently being done as part of a pilot program and is working very well, he said.
Myers said EMS had recently looked at “about 200 patients that we had referred successfully from the field, avoiding emergency department stays, taking them directly for mental health treatment.”
Of the 204, all but four were “successfully maintained” in mental health facilities, while the others required an emergency room evaluation, he said.
The second phase would address falls in assisted living facilities, Myers explained. Through a partnership with Doctors Making Housecalls, a protocol will be developed where an advance practice paramedic will evaluate patients at an assisted living facility, and work with a primary care physician group to come up with a treatment plan in lieu of always making an emergency department visit, he explained.
The third phase would offer lower-acuity patients hospital transportation “in something other than an ambulance,” Myers said. He said 30 to 40 percent of patients go to the waiting room after ambulance transport.
“So we feel like if they can go to the waiting room, perhaps they don’t need to be in an advance life-support ambulance for that short 20-minute ride,” Myers said.
Myers said they are “moving slowly and methodically” through each of the phases to “ensure safety first.”
Grant Application Approval for Community Transit Program
County Commissioners also approved an annual grant application for assistance for the Wake Community Transportation Program. The program provides transportation for disabled residents in the county.
The grant program is ongoing through the state Department of Transportation’s Public Transportation Division. The program provides administrative support at 85 percent and capital support at 90 percent.
Wake County Human Services Transportation Manager Don Willis said administrative funding supports three positions and pays for marketing materials, insurance and training. Capital funding will be replace 12 lift-equipped vehicles “to serve the disabled in our community,” he said.
The local match portions, at a total of $120,000, will come from user fees that sponsoring agencies use to purchase services from the program, Willis said.
Other Grants Accepted
The County Commission approved and appropriated two more grants as part of its consent agenda.
The first is a Shelter Plus Care grant from the U.S. Department of Housing and Urban Development (HUD). According to the agenda, the $1.1 million requested by the county will be used for rental subsidies for homeless people with disabilities.
The second is $180,000 from the Casey Family Programs for the county’s foster care program. This grant will pay for the first year of a three-year agreement between the two programs. The funding will help the county identify relatives of children in foster care to find permanent homes.
The agenda states that the county submitted a proposal to the Casey Family Programs to expand its Family Finding initiative, which started in 2008, in partnership with the state’s Division of Social Services and the Duke Endowment.
County officials proposed that Casey Family Programs continue these efforts with older youth while expanding to “identify, engage and support relatives immediately as children enter foster care or when children are at very high risk for entering foster care,” the agenda states.
