Medically assisted treatment launched
BY MARK J. CRAWFORD
At the May 6 meeting of the Bradford County Commission, Lt. David Weeks of Bradford County Fire Rescue provided an in-depth update on the county’s Community Paramedicine Program.
The initiative, launched with funding from opioid lawsuit settlements, aims to reduce emergency room visits, improve chronic disease management, and combat substance abuse through mobile, proactive care and support services.
“It’s been a very busy year. It’s flown by, and we’ve made a lot of progress, and I’m happy with where we’re at,” Weeks told commissioners.
Weeks had personally responded to 302 calls for service — patients in need of a growing number of services. The scope of the program continues to grow to meet new needs such as diabetes and blood pressure monitoring, assisting with wound care and transportation, and helping patients communicate with providers through telehealth.
Helping patients with chronic disease management reduces trips to the emergency room. Weeks said they redirected more than 50 ER trips during the year to alternative care. This included 28 telehealth consultations.
One case involved an elderly man with severe diabetes, living alone without running water, electricity or adequate food. He was noncompliant with his medications. All of this resulted in him calling 911 eight times in three months.
The Community Paramedicine Program got him out of the unsanitary and unsafe conditions he was living in to temporary housing with the help of Elder Options and the Department of Children and Families. Suwannee River Economic Council was able to provide food. Dr. Matthew Odom, the county’s medical director, provided the needed prescriptions through a telehealth visit. Through further work with social services, the program got the patient placed in an assisted living facility.
Weeks even met the patient at the DMV and helped him through the process of obtaining proper identification, and then they assisted with the paperwork necessary to reinstate his health insurance.
Weeks discussed the popular Matter of Balance courses that train people in fall prevention. The paramedicine program also performs in-home fall assessments and works with local church group volunteers on improving accessibility, installing or replacing wheelchair ramps and making other home modifications. Patients are connected with rehabilitation services when needed.
The founding reason for the Community Paramedicine Program and the source of its funding is treating substance abuse and reducing drug overdoses. Five publicly accessible Naloxone cabinets are always stocked around the county, and the team has also held community training courses for the use of Narcan to prevent overdoses. They’ve also educated the public at multiple events. Weeks said 500 Narcan boxes and 125 Narcan kits have been distributed.
Here Weeks shared the story of the of their first substance abuse patient, a 34-year-old man referred to the paramedicine program following an overdose. The team connected him to a primary care physician (his first visit in 10 years), reestablished his insurance and his medically assisted addiction treatment and helped him pursue a job through CareerSource. They even helped him reconnect with his family so he could begin repairing those relationships. And when he moved to Alachua County, they placed him in contact with the paramedicine program there to ensure continuity of care.
According to Weeks, the Bradford program has graduated to medically assisted treatment for those with substance abuse disorder.
“This is kind of the next thing in community paramedicine. If you look around the other counties, everybody’s starting to do it, because the science and the stats are there that this is really what makes a difference for these patients,” he said.
Patients can refer themselves or be referred by a medical provider, a family member or a friend, etc. A meeting with the patient determines eligibility. Once that is established, treatment begins.
“I can tell you our first patient that we treated in the program we met at his residence using our Mobile Health Unit, the bookmobile that we’ve renovated,” Weeks said.
For addicts experiencing withdrawal symptoms from abstinence, medication assistance can help keep them from relapsing. Doses take place every day according to a set schedule, with vitals checked before and after treatment. Treatment consists of Suboxone via a sublingual film placed under the tongue. Patients are observed for adverse reactions or determine if another dose is needed.
From the very first dose, patients are also set up for treatment for behavioral health with Meridian as well as a primary care provider such as Palms Medical or the health department. Willingness to participate on outpatient recovery is a requirement of the medically assisted treatment program.
“The person really has to be willing to get help, and they have to want to be able to heal,” Weeks said.
Weeks previewed upcoming initiatives, including integration with CarePortal. Sometimes funding the program taps for problems like utility payment assistance runs out. With CarePortal, verified needs can be placed online where registered churches and other organizations can offer to meet those needs directly.
Another goal is the addition of a social worker or case manager who can help keep pace with growing demand.
“As the program builds, we’re bringing on more and more patients, and I want to make sure that we’re able to keep up and continue to provide that good level of care that we’ve come to see,” Week said.
Part of the expansion will be within the medically assisted treatment program as word spreads about its availability.
“I’m very happy with where we’re at. I think we’ve made great progress in just a year and I’m very excited about this next year. We’ve got some big things planned,” he said.
In addition to local public awareness efforts, the team is also sharing the community paramedicine message at events like the Biannual Rural Mental Health and Substance Abuse Panel. Later this year, they have been invited to present at the Regional Drug Epidemiology Network.
