Rocky Boy EMS selected to provide in-home care

In Rocky Boy’s Indian Reservation and five other Montana communities, emergency medical services teams will soon be capable of providing non-emergency and preventative in-home care, a press release from Gov. Steve Bullock’s office announced Tudesday. 

Montana has revised its legislation and secured funding for a two-year pilot program to expand non-emergency services, the release says.

Bullock, a Democrat, is unning for president in 2020.

The six sites chosen for the pilot program, ii says, are Rocky Boy EMS, Great Falls Emergency Services, Jesse Ambulance in Broadus, Marcus Daly Memorial Hospital in Hamilton, Red Lodge Fire Department and Frances Mahon Deaconess Hospital in Glasgow. 

No Rocky Boy Health Board representatives were available to speak about the pilot program as of print deadline today.

The six EMS teams completed accredited training at Hennepin Technical College in Minneapolis, Minnesota, a week or two ago, Jim DeTienne, EMS and trauma systems section supervisor for Montana Department of Public Health and Human Services, said today. The next module of training will be completed online by the end of August or September, followed by clinical work in Great Falls hospitals and clinics, DeTienne added.

The training includes wound care, post-hospitalization follow-up, medication set up, home safety checks and other services in the home, the press release says, tailored to each community’s needs.

Emergency medical services are often called upon to provide such non-emergency care, but Montana teams’ responses have been limited by legislation and resources, DeTienne said.

The language of the previous legislation, DeTienne said, was created in the ’70s and specifically referred to emergencies. Concern that legal conflicts could arise if emergency medical services provided non-emergency services, he said, prompted officials to add a line stating that EMS and ambulance services can be used for non-emergencies.

“While the primary mission of EMS services has been to respond to 911 calls, many calls are for non-emergency events,” DeTienne said in Tuesday’s press release. “These non-emergency transports challenge Montana’s EMS services, which are struggling with limited staffing and resources, especially with volunteer services in rural communities.”

A representative from the Great Falls EMS team, one of the six communities chosen to receive non-emergency training and equipment, expressed hope that the pilot program would relieve some of those struggles.

“This is an excellent opportunity to implement a program that has shown to improve patient care, and also address challenges our EMS providers are facing,” Justin Grohs of Great Falls Emergency Services said in the release. “Our goal is to keep individuals in their home environment to improve health outcomes, remove barriers to health, and reduce unnecessary EMS transports and emergency room visits.”

To create the two-year pilot program, Montana Department of Public Health and Human Services secured $300,000 in federal and private funding, the press release says, including a grant from Montana Healthcare Foundation. Each of the six sites will receive $50,000 spread out over the two years for equipment and training expenses, DeTienne said.

Montana EMS teams already practice “Community Integrated Healthcare,” even before it was given a formal title, the DPHHS website says at https://dphhs.mt.gov/publichealth/EMSTS/chems/.

“EMTs who weren’t able to transport a patient, but then contacted the patient’s physician or a family member to follow up … who checked on a patient that they transported to the ER a day or two ago … who got a call from a neighbor and drove over to see if ‘Mom is all right’ … who drove by the drug store to pick up meds while transporting the patient back home or checked in their fridge to see if they had food and milk,” the DPHHS website adds, “were practicing community health EMS.” 

The new legislation and pilot program is an opportunity to formalize these practices, the DHPHHS website says.

“In any community, there are patients that fall through the cracks of other programs and EMS could be a solution,” the website says.

Community Integrated Healthcare may also present new funding models allowing emergency care providers to be paid for what they do and for EMS services to become more viable, the webpage says. 

At the same time, the page adds, Community Integrated Healthcare could provide a path for Emergency Medical Care Providers interested in community health who might be looking for a less time-consuming role. 

In addition to time-efficiency, preventative in-home EMS care may offer communities cost-efficiency, said Bullock, who signed Senate Bill 38 allowing EMS to provide non-emergency care under the regulation of the Board of Medical Examiners, the press release adds. 

Sen. Margaret MacDonald sponsored the bill, which passed during the 2019 Legislative session. 

“I applaud these communities for spearheading a new and innovative approach to engage first responders in delivering low-cost primary and preventative care,” Bullock said. “Improving the health of Montanans in the comfort of their homes can prevent costly complications down the road.”