BY MARK J. CRAWFORD
Telegraph Editor
Bradford County Fire Rescue Chief Ben Carter received the go-ahead he needed to establish a Community Resource Paramedicine Program to address substance abuse disorder and drug overdoses.
He introduced county commissioners to the concept earlier this month, modeling his proposal after a successful program funded by the city of Gainesville. Carter’s program will be paid for with opioid lawsuit settlement funds.
The Bradford County Health Department, Meridian Behavioral Healthcare and Purpose Behavioral Healthcare also talked about what they could do if granted the funds. Carter expressed willingness to work with all three to provide paramedicine services.
In addition to providing help to those with substance use disorder — including preventing overdoses — Carter hopes to reduce the reliance on emergency services, which adds strain and expense to the system.
“The Community Resource Paramedicine Program is an innovative and community-centered approach that focuses on prevention, education and support with the goal of reducing the incidence of opioid and substance misuse. Through strategic partnerships with health care providers, social services and community hubs, we aim to establish a network that provides targeted interventions, ongoing support and resources to individuals struggling with addiction,” he said.
“By leveraging the skills and compassion of our first responders, we can extend our impact beyond the immediate crisis response, actively engaging with residents to create lasting, positive change.”
Carter called opioid use disorder and substance use disorder critical public health issues, and the county must adapt to address these illnesses. In doing so, they can save lives and “strengthen the fabric of our community,” he said.
The care offered to patients through the Community Resource Paramedicine Program will be tailored to their needs, focusing on connecting them to resources and support to overcome the disease of substance abuse.
“Our goal will be to minimize barriers to care by tackling major issues such as stigma, whether it be the patient’s first virtual counseling session or getting them admitted to the residential therapy, we are with them every step of the way, reassuring them they’re not alone in their fight against addiction,” he said.
In 2023, Carter said fire rescue interacted with 110 patients who admitted to illegal substance use. They administered Narcan to 63 overdose patients, many of whom might have died without intervention. State statistics from 2022 included eight overdose deaths in Bradford County and 66 drug-related emergency room visits. More than 4,300 patients, he said, were prescribed opioids, exposing them to danger if they are not taught how to manage their medications.
When people are unaware of the resources available to them or fear the stigma of admitting their addiction, they tend to rely on EMS when in crisis, Carter said. When experiencing side effects, overdose or withdrawal symptoms, EMS is contacted. Responders treat the patient, and if necessary, transport them to the emergency room, unless the patient refuses. Emergency rooms deal with acute symptoms and release the patient, perhaps handing them a flyer about resources for addiction. With no follow-up care, this becomes a cycle, straining fire rescue resources and dollars.
Carter said a single patient called EMS 54 times in 2023. Based on the cost of a single ambulance response ($730), the calls cost more than $39,000. Expanding the scope to include patients who called EMS more than 12 times over 12 months yielded 30 patients making a total of 617 calls and a cost of more than $450,000.
Because these patients have a higher probability of being uninsured, Carter looked exclusively at uninsured transports, which totaled 279 patients last year. They were billed more than $249,000, and EMS received just over $2,000 in payments. The fee collection rate was less than 1%.
“It is a high goal, but if we can reduce the cost of our repeat users — many of whom are (opioid use disorder) and (substance use disorder) patients — by 55%, that one achievement alone will save Bradford County $247,725, which would completely offset the county’s debt for transporting uninsured patients,” Carter said.
His plan includes promoting one of his paramedics to coordinate the paramedicine program within the department. Patients would be referred from a variety of sources, including EMS encounters, emergency rooms, pharmacists, law enforcement, the school district, etc. The coordinator will build relationships with resource providers to whom patients would be joined. They will be proactive, offering substance abuse education and prevention. They would distribute overdose prevention kits, connect patients to medication assisted therapy and provide follow-up care and monitoring for patients receiving medication assisted therapy. They would coach patients in the use of communications technology and arrange transportation to and from appointments.
These were just some of the potential services Carter listed, including the refurbishment of the library’s former bookmobile into a community response unit for public awareness at special events and free Narcan distribution.
“This program represents a crucial step forward towards fostering a healthier, safer and more resilient community. The dedication of our paramedics, collaboration with health care professionals and the integration of innovative strategies will undoubtedly make a meaningful difference. We believe that by investing in the well-being of our community members, we’re not only saving lives, but we are also contributing to the long-term prosperity and vitality of our community,” Carter said.
Most commissioners agreed, voting 3-1 to award the opioid dollars to the program, requesting regular progress reports as the county is responsible for the use of the funds.
Commission Chairwoman Carolyn Spooner cast the dissenting vote, as she thought the money would be better used by local mental health providers like Meridian, funding their ability to provide substance abuse services here in Bradford County. Despite imploring her fellow board members, she was unable to convince them. She ended the meeting with a public apology that the county was “missing the boat” and failing to maximize the use of the available funds.
