Powell Valley Healthcare has launched a community paramedic program, one of three currently operational in the state of Wyoming.

Jess Mathews, community paramedic coordinator at Powell Valley Healthcare, gave a presentation on the program at the Powell Hospital District Board of Trustees meeting last month.

A community paramedicine program, Mathews told the board, utilizes emergency medical system personnel to deliver healthcare services in situations other than emergencies. The programs are designed according to the needs of the community where the programs are run, so they look different in every community. Cody and Douglas have their own programs, and Gillette is in the process of creating one, Mathews said.

“So Cody’s program is different from Powell’s program, which is different from what Douglas is doing. And that looks different from what Gillette’s will look like,” she explained, speaking after the meeting.

Community paramedics approach healthcare differently from traditional paramedics.  A paramedic deals with patients’ immediate, often emergency needs; they may look at the help they need in terms of minutes or hours. The community paramedic looks at needs over months or a year.

“It’s a different angle of looking at the patient,” Mathews said. “So we’re not looking at the patient as an emergency. We’re trying to look at them in a more holistic manner, and we’re looking at them with their entire medical team.”

That includes the person’s primary care physician, any physical or occupational therapy they receive, and coordination with any home healthcare workers.

It’s a “bigger, broader approach to making sure they have all the care they need and keeping them as healthy as possible,” Mathews said.

Community paramedics provide medical services, such as the management of post-surgical patients, monitoring chronic diseases and prescription drug education.

As telehealth services increase, the community paramedics can facilitate these sessions by taking the patient’s vitals, relaying them to the provider and helping the provider with the diagnosis.

“There are a lot of possibilities,” said Mathews.

Powell’s community paramedicine program has two branches. One side is a chronic care management program, run through Powell Valley Clinic. It deals with Medicare patients who see primary care physicians through the clinic. The other branch specifically caters to Wyoming Medicaid and self-pay patients.

“What Medicare and Medicaid want is to keep people out of the emergency room at the hospital and prevent them from having to come in by helping to manage their medical conditions at home,” she said.

The service they provide is also distinct from the services a nurse would provide.

“We are not home health,” Mathews explained. “There is a line in what we can do, versus what a home health nurse does.”

For example, a community paramedic wouldn’t have the knowledge for wound care like a nurse would. They can follow instruction from a doctor, but they can’t treat such a medical condition the way a nurse would. They also can’t provide hospice care services.

“Community paramedicine isn’t here to take over or duplicate services. We’re here to provide additional services or services that aren’t currently in our community,” Mathews said. 

Community paramedics have the associate’s credentials for an EMT, as well as an additional 14 to 16 college credit hours and 240 hours clinical time. Currently, Mathews is the only paramedic on PVHC staff with these community paramedic credentials, but two other EMTs are training for those credentials and are expected to complete the programs by the end of the year. Other EMTs at the hospital are performing health worker visits in the community as part of the program.

The charge for each community paramedic visit is $45.50. Very few private insurers currently cover community paramedic visits, but Mathews said they’re gradually opening up to it as more communities start their own programs.