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Frances Mahon Deaconess Hospital has been chosen to be one of six sites throughout the state to pilot a model of community-based healthcare designed to expand the role of EMS providers to deliver more effective and efficient non-emergency services. In addition to Glasgow, Great Falls Emergency Services, Jesse Ambulance in Broadus, Marcus Daly in Hamilton, Rocky Boy EMS and Red Lodge Fire Department were also chosen to participate in this program.

To be eligible to be a pilot site, EMS services had to apply, receive permission from the hospital and receive letters of recommendation from a variety of departments including cardiac rehab and social services. “I can’t say enough how everyone at the hospital has been supportive of us during this process,” stated EMS Director Connie Wethern. “Our CEO Randy Holom stated that community-based healthcare is the new wave of healthcare. So we at FMDH are one step closer to making history. Other states have enacted community-based healthcare so we know what works and what doesn’t work.”

As excited as FMDH and EMS services were to apply and be a part of the pilot for the state, Wethern admits she didn’t think they would be selected. “Our application was postmarked a day late and we were told if someone drops out we were next. When I received the phone call that we were ultimately picked, it was a madhouse! We had to quickly get registered for the program,” said Wethern. “We were so sure we weren’t going to get it, so it was just fate that we did. We will do the best we can through our scope.”

Three FMDH EMTs, Nicole Fercho, Kalu Rogenes and Wethern, are currently undergoing accredited Community Paramedic Technician training online through Hennepin Technical College in Brooklyn Park, Minn., with training expected to end at the end of the year. “Once the training is complete, the three of us will be endorsed as a community paramedic technician. This endorsement will be valid anywhere in the state,” explained EMS director Wethern. “By the first of the year we will be in the community’s doors.”

Upon competition of the program, the three accredited EMTs will be able to become a part of a patient’s home care plan in order to keep patients in their own home. The Board of Medical Examiners (BOME) of the Department of Labor and Industry is developing the standards while Medical Director Dr. Knierm looks at the goals of FMDH EMS services and what they want to accomplish to make the standards more personal to the community. Based upon the community needs and a particular patient’s care plan, EMS staff will be able to help patients access more appropriate care in non-emergency situations, which may include wound care, post-hospitalization follow-up, medication set-up, home safety checks and other services in the home.

“We are not just going to go into a patient’s home and do what we want,” stressed Wethern. “We will not make independent decisions. We will run on doctor protocols and patient’s care plan. We will work with other agencies to best help the patient. If a patient needs assistance with healthy diets, we will work with dietitians to help the patient. In other states where community-based healthcare has been enacted, data shows a decrease in continued clinic and ER visits. Our goal is to keep a patient home and healthy, to prevent unnecessary trips. We will become a part of the patient’s health care plan and perform actions based upon protocol.”

Once the EMTs are trained and put this program into practice, data will be sent to the state legislature so they know what’s going on and how the pilot is benefiting the community. “To me, if we help four to five people that don’t end up in the hospital, in the ER or the clinic, then that’s four to five people whose lives have benefited from the program,” explained Wethern.

The funding for the pilot program in the state is through the Montana Department of Public Health and Human Services (DPHHS) which secured $300,000 in federal and private funding for the two-year pilot, including a grant from the Montana Healthcare Foundation. All six sites received $50,000 each to cover training and equipment expenses. The new opportunity is the result of Senate Bill 38 that passed during the 2019 legislative session. The bill, signed by Governor Bullock and sponsored by Senator Margaret MacDonald, creates a provider status enabling EMS to provide Community Integrated Healthcare (CIH).

CIH programs across the country have demonstrated success in utilizing EMS responders integrated with the rest of the healthcare system to provide non-emergency and preventative care in patient’s home to keep them healthier, at less cost, and a decreased strain on the emergency medical system. In a press release, Governor Steve Bullock expressed excitement for the state in making history. “I applaud these communities for spearheading a new and innovative approach to engage first responders in delivering low-cost primary and preventative care. Improving the health of Montanans in the comfort of their homes can prevent costly complications down the road."