N.C. Agency Begins Community Paramedicine Program

BY: EMSWORLD / McClatchy

The Herald-Sun, Durham, N.C.

Dec. 19—DURHAM—Durham County Emergency Medical Services has added two white, blue and yellow Ford Expeditions to its fleet. While the vehicles are outfitted with ambulance gear, the paramedics who drive them will be on a different kind of mission.

Durham paramedics Michael Galie and Phil Keene will be driving the new vehicles. The vehicles are marked CP-1 and CP-2, CP being an acronym for Community Paramedics. Galie and Keene, who respectively have seven and 25 years of experience as Durham County EMTs, are the first paramedics who have been trained in the county’s new Community Paramedics Program.

While they can still answer emergency calls, as community paramedics Galie and Keene will be going to appointments they have made with patients who have already been served by an EMT. The program targets patients who frequently call 911, homeless people, people with substance-abuse problems, people needing mental-health services, as well as those who are underserved. The program also connects patients with mental health and substance-abuse treatment, housing, job training and other services.

The community paramedics are now training in the use of Naloxone (or Narcan) kits, which reverse overdoses from pain killers and other opiates.

“We’re able to be a little more proactive,” said Helen Tripp, program manager. With repeat callers, for example, EMT workers can “find out what it is they’re missing that makes them call 911 so much,” Tripp said.

The program has been operating for several weeks, and already two frequent callers who have received visits have stopped calling 911. The goal of the visits is to reduce repeat calls, keep patients from ending up in the emergency room or in jail, and work with these patients on better health for the long term.

The new vehicles and program were unveiled Tuesday at EMS Station 2 on Old Fayetteville Steet.

The Board of County Commissioners funded the $307,561 pilot program in its 2017-18 fiscal budget. Wilmington, Greensboro, Rockingham and Cabarrus County are among the North Carolina localities with similar programs. After the first year, the county will evaluate the program, according to county budget documents.

Community Paramedics services are available seven days a week, from 7 a.m. to 7 p.m. for any Durham County resident.


The program has several precursors. Durham’s EMS department has been working with a pilot program from the state that tries to divert patients from emergency rooms to mental health services, Tripp said. Durham’s EMS also has been working with the Familiar Faces program since 2008, said Brandon Mitchell, assistant chief for administration and finance with EMS. Familiar Faces tries to keep people with substance-abuse problems and mental-health needs from winding up in jail. Sixty paramedics also have been trained as members of the Crisis Intervention Team, also serving those groups, Mitchell said.


“This is the next step for us,” Mitchell said of community paramedics.


Galie and Keene have been getting training in wound management, in-home care, and Naloxone use, Galie said. They have been visiting other North Carolina cities to see how their programs work, he said.


“A lot of it’s just education,” Galie said of the home visits. “You do that in the emergency side, too, but you don’t have the time” to devote to education in emergency calls, he said.


Working in an ambulance is “a lot of sitting around waiting for calls,” Keene said. The Community Paramedics Programs offers “a different kind of care,” which includes talking with the patients and helping them find the help they need, he said.


“We’re not in so much of a time crunch” as with emergency calls, Tripp said. “A lot of this is about building relationships, which we don’t have time to do on an [emergency] call.”



Cliff Bellamy

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