2022 National Rural EMS & Care Conference
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2022 Conference
Thank you to everyone who joined us for the 2022 National Rural EMS & Care Conference! If you missed it, below is the full content:
State Director’s Panel
Sustainable Rural EMS: Navigating Change
We recently have had state legislation to create a new type of first responder for behavioral health. The new responder will be licensed similarly to an EMT under the state EMS office. The new responder will operate with EMS, local law enforcement, 988, 911, and local mobile crisis outreach teams for specialized care when a person is not in need of medical care or committing a crime. Utah is in the process of developing training and licensing requirements. We also were able to secure a CMS grant for $382, 601 for the project.
EMS Resources to Keep on Your Radar
This panel will showcase a few of the educational resources funded by FORHP that other EMS agencies may find helpful. The panelist will all talk a bit about their journey to develop their resource, the uptake since, and any future plans they have.
Medicare Rural Hospital Flexibility (Flex) Program EMS Supplement Update
The FORHP EMS Supplement recipients are in their final year. Each of the eight states will share a snapshot of their projects and insights for others considering taking on similar projects in the future.
The Value of EMS Leadership Training and Education
EMS leadership training & education has become an invaluable resource in our states and continues to be sought after and well received. In this presentation, Scott and I will present our ongoing initiatives to bring inspiring, quality, EMS leadership training & education to our rural EMS professionals. The State Office of Rural Health in Michigan has been funding EMS leadership academies since 2005 and the Kentucky Office of Rural Health began offering EMS leadership courses in 2020. Scott and I look forward to sharing the logistics and value of our unique EMS leadership programs with our fellow colleagues. This presentation will provide insight into the approach each office took and the ROI.
The National Co-Responder Consortium Facilitating a New Era of Community-Based Response to Substance Use Disorder
The deaths of George Floyd in Minneapolis and Walter Wallace in West Philadelphia strongly underscore the need for an alternative to a law enforcement response to individuals suffering from substance use disorders (SUDs) or mental illness. Communities are increasingly implementing co-responder models that pair behavioral health clinicians with police to respond to individuals in crisis. While police co-responder models have formed the majority of known efforts and will be a part of this initiative, there is a rapidly growing demand for non-police co-responder approaches, which is to say Fire/EMS paired with behavioral health professionals, social workers, and case management services. This session will provide information about the importance of a co-responder model for SUD, given that they carry the potential to relieve police officers from answering calls for service that are better suited for other Fire and/or EMS paired with treatment specialists or clinicians, while also avoiding the possibility of justice involvement due to the presence of the police. By combining resources in a more justice-oriented and symbiotic way, rural communities stand to benefit from co-responder models.
Using Data to Inform Community Paramedicine Sustainability: A Pilot Study
This presentation focuses on a data initiative in one county in Maine to document the use and value of Community Paramedicine. The project focused on patient health outcomes and the reduction in emergency department use and hospital readmissions.
Utah’s Crisis Response Technician for Behavioral Health Crisis
We recently have had state legislation to create a new type of first responder for behavioral health. The new responder will be licensed similarly to an EMT under the state EMS office. The new responder will operate with EMS, local law enforcement, 988, 911, and local mobile crisis outreach teams for specialized care when a person is not in need of medical care or committing a crime. Utah is in the process of developing training and licensing requirements. We also were able to secure a CMS grant for $382, 601 for the project.
Response Operations Innovation
Your ability to communicate is critical – especially during a crisis or a natural disaster. In this session, you’ll learn how FirstNet® can help coordinate your public safety response, so you can quickly gain access to the voice and data you need in an emergency. You’ll hear about the Response Operations Group (ROG), a dedicated team of former first responders available 24/7 to help with your emergency response. This team works with your agency to identify and deploy the best solutions based on your situation, drawing on a fleet of more than 100 dedicated deployable assets. You’ll hear about specific emerging capabilities on the FirstNet roadmap. And you’ll learn how your organization can own specific solutions today that strengthen your ability to connect quickly. This includes Mobile Broadband Kits, High Power User Equipment, and our Compact Rapid Deployable, which puts LTE broadcast capability right into first responders’ hands.
Enhancing Rural and Remote Communications
The FirstNet Authority is quickly approaching its tenth year of existence. During this time, the network has developed various devices to enhance and extend coverage in rural areas. This presentation will provide an overview of the FirstNet solutions to enhance and extend broadband services in rural areas.
A Simple, Low Cost, and Effective Way to Improve Rural Cellular Coverage for Public Safety
In this session, practitioners will discuss their experiences with “Power Class 1” or High-Power User Equipment (HPUE), which has been available to Public Safety users for about 1 year. This technology increases the power transmitted by cellular user devices from 200 milliwatts up to 1.25 Watts. This increase in power – which is unique to FirstNet Band 14 spectrum – has shown improved coverage and performance for responders, particularly in rural areas. Users will discuss both classic and innovative use cases in multiple fields. And they’ll talk about the future of this technology and how these innovations will impact public safety responders, especially when it comes to using equipment in remote/rural areas.
New Findings on Rural EMS Professionals Provision of Evidence-Based Care and Scope of Practice
Do rural EMS personnel provide care that is evidence-based and aligned with the National EMS Scope of Practice Model and EMS Compass performance measure standards? Learn about the results of a national study of EMS provider practices, followed by an interactive discussion of implications for health equity and high-quality care in rural communities. Background: This study used data from ESO Solutions, Inc., on EMS encounters from 1,056 rural and urban EMS agencies nationally to examine (1) whether EMS professionals provided evidence-based care according to performance measures for stroke, hypoglycemia, seizure, and trauma and (2) the extent to which EMS professionals performed interventions within or outside recommend scopes of practice. We found that urban were more likely than rural agencies to provide evidence-based care for the conditions we examined, though the responder’s level of experience also mattered. We also found that EMS professionals in rural agencies and agencies with unpaid staff were more likely to perform interventions that exceeded the recommended scope for the responding EMS professional. Our findings suggest a potential mismatch between EMS workforce skills and population health needs. Personnel in rural and lower-resource agencies, often staffed by EMTs and volunteers, need enhanced training and oversight to allow them to respond to community health needs while ensuring high-quality care.
Beyond Overdose: Why Community Paramedicine is Essential within Quick Response Teams
Huntington, WV is a community of 50,000 people in the heart of Appalachia. This community was experiencing the highest non-fatal and fatal overdose rate in the nation. Cabell County EMS was on track to run nearly 2000 overdose ambulance calls in 2017. This represented approximately 15% of the 911 calls that this county-based ambulance service ran in Cabell County.
The QRT (Quick Response Team) was developed as a collaborative effort to combat the ever-increasing opioid epidemic. The model utilizes personnel from EMS, Law Enforcement, Treatment Providers, and Faith Leaders. The team uses EMS data from overdose calls to proactively reach out to individuals who have survived an overdose event. They engage individuals where they are “literally”, reaching out to them at their residences or the location of the overdose. Since its inception, more than 1500 individuals have been identified as QRT eligible, and over 700 individuals have been personally engaged.
Through the assistance of the team, nearly 30% of those individuals have entered a formalized treatment program. The team assists with treatment options make initial phone calls, begins the intake process, and will provide (or make arrangements) for transportation to a treatment facility. This innovative concept promotes first-responders as part of the solution to this ongoing public health crisis. Our community has reduced non-fatal overdose ambulance calls by 40% between 2017 and 2018, with a continued decline into 2019. Also, corresponding provisional data from the CDC (for 2018), exhibited an approximate 24% reduction in fatal overdoses for Cabell County.
In addition, the team recognized very quickly that these individuals with substance use disorder don’t live in a vacuum. Many have associated health issues that need attention. With a Community Paramedic on the team, they were able to pivot to assist with co-occurring health issues. Initially doing education and distribution of naloxone, referral to harm reduction programs, then began doing even more community paramedicine activities. Our medic began cleaning and wrapping wounds, organizing pill dispensers, and assessing other needs during their visits. As we evolved we began doing community wellness clinics, opening the back of an ambulance, and setting up a tent. At these events, we were able to serve the most vulnerable communities, in high-risk areas. Our team would perform flu vaccines, HIV testing, naloxone training, and COVID testing. These were quite successful with plans to expand even further after our recent federal grant approval.
During this whole process, we have utilized Cordata as our primary client information resource. The team uses this program to enter demographics and narratives, track an individual’s process, receiving prompts and reminders about care. This has allowed us to have accurate data to present, and for our research partner to utilize for evaluation. In this way, we have objective data to support our efforts.
Tele-Medical Direction for Rural EMS Communities
In Rural Southern Arizona, the AzREADI project implemented a rural EMS tele-medical direction system with the goal of improving resource utilization and facilitating treat and refer protocols. This presentation will highlight how the system was implemented, data from two years of system operation, and the pearls and pitfalls encountered along the way.