Community Paramedicine

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

One area where access to care is a problem is in the rural communities. Healthcare professionals including physicians, nurse practitioners, and nurses all affect the quality and cost of care (Derksen, & Whelan, 2009). Going forward importance needs to be placed on using recourses more efficiently and effectively; these resources include but are not limited to tests, prescriptions,

A team of researchers from The George Washington University in conjunction with key leaders – evaluated the Detroit area to assess the state-of-healthcare deliverance to those in need. The problem was presented in a clear and concise manner: The uninsured and poor had limited to no access to the care they needed. Many resorted to the Emergency Department (40% of admissions were non-emergent), leading to overcrowding in the hospital. Those that are part of the safety net are providers of the poor and vulnerable populations: hospital systems, clinics, volunteers, primary care workers, and prevention workers that are there to prevent the overflow and influx that we see in the assessment. We will be addressing our main stakeholders, the

One of the primary goals of the Affordable Care Act (ACA) was to provide affordable health care coverage and increase access to affordable health care to the community. Unfortunately, since the passage of the ACA, while there has been an increase in the number of people with health care coverage, those same people do not necessarily have access to affordable health care. Currently, the public views the Emergency Department (ED) as a safety net by the community it serves; as demonstrated by the increasing number of people who continue to seek treatment in the ED for non-urgent problems. Utilization of the ED for non-urgent care contributes to the rising costs of healthcare as treatment in this setting can be upwards of three times the cost

The enactment of the Affordable Care Act (ACA) has significantly reduced the rate of the uninsured, yet those who do not fit within the parameters of the ACA still face many obstacles in obtaining necessary healthcare. Those without insurance must rely on “locally organized [systems] of health care delivery intended to fill gaps in access to health care services for uninsured… and other vulnerable populations in medically underserved communities” (Liebert and Ameringer 2013)—understood as health care safety nets. Healthcare providers within these systems include emergency rooms, community health centers (CHC), federally qualified health centers (FQHC), and free clinics. (Liebert and Ameringer

This program will help to bring healthcare education services closer to the people in my community. Personally, I encountered many challenges in my childhood due to poor health care services in the community. The idea of having access to a good healthcare provider was unheard of in the Latino circle because they were unreachable and expensive. Secondly, affordability of the healthcare due to high costs of having health insurance was also popular among the Latino community. For those who could access medical facilities, the challenge was related to the health insurances did not cover all their needs. These challenges were too pronounced. They influence my desire to enroll in this program because I seek to change the situation back at home. Through

The Partnership for Patients, a voluntary program under The Affordable Care Act’s main goal is to reduce hospital acquired illnesses, medical errors, and complications due to care. This partnership will involve the complete healthcare team; patients, their families, physicians, nurses as well as the federal, and state governments. This group will to work together to improve the safety and quality of the care being given to the patients and decrease readmissions.

With the huge shift in the U.S. healthcare system, healthcare services are now trending towards value-based outcomes.1 With passage of the Affordable Care Act (ACA), it has become increasingly important to improve quality of care while simultaneously reducing health care costs.2 Pharmaceutical care services are one of the key components that has an essential impact on optimizing therapy outcomes; minimizing cost and enhancing quality of life of chronically ill patients. Community pharmacists are the third largest healthcare provider group in the world after physicians and nurses.3 Despite the fact that many studies have shown that community pharmacists’ provision of direct patient care can lead to improved patient outcomes and reduced health care costs. However, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals.3 Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening primary care delivery across the health system.

Lakeland Regional Health was number one in America for the most Emergency Room visits March 2015-2016, even so they re-direct on average 260 uninsured and Medicaid patients a month to their Family Health Clinic for non-emergent care. The Affordable Care Act, though providing insurance benefits to many who could not afford insurance in the past, has not changed the quantity of patients utilizing the emergency room for primary care mostly due to the overwhelming need for more clinics that accept Medicaid, Share of Cost, and the uninsured.(2) Patients have often commented that it is cheaper to pay the penalty on their taxes each year over applying for the ACA insurance. The deductible and out-of-pocket for the insurance generally matches but the limits are often well above what the patient can afford to pay, and insurance does not pay until they have met that deductible amount. The question is not about providing care to the patients that arrive in the emergency room, but to offer a screening process to ensure that the emergency room is available for true emergencies, and that the safety of patients are considered and the delay of care is as short as possible.

The healthcare service at Kansas City rescue mission is setup like a doctor’s offices. The clients would sign up to be seen by the nurse and once they come into the nurse’s office, I would interview them while charting the subjective data and then perform a focused assessment based on what the client came in for. I would then make a recommendation, educate, or give over the counter medication to the client under the supervision of my preceptor.

The United States health care public safety net system largely provides healthcare services to the uninsured and the under insured. However, this vulnerable population still cannot access adequate care and compared to the privately insured population, the uninsured receive less preventative and specialty health care services. The need for safety net providers to improve the delivery and access to care has led to increased funding through the Patient Protection and Affordable Care Act (PPACA) as well the expanded community health centers (CHCs) (HealthCare.gov, 2010). Following the passage of the PPACA and increased federal support for the CHCs, the American public health care system witnessed significant changes. Some of these changes include increased access to healthcare, restructurings of private health coverages and containing Medicaid and Medicaid ().

The millions who remain uninsured will still depend on overcrowded emergency rooms for routine care.Ultimately, the ACA coverage expansion will not be sustainable until policymakers and stakeholders take meaningful steps to reduce the rate of growth in medical costs.An estimated 60 million individuals are considered medically underserved as a result of a combination of elevated health risks and a shortage of primary health-care professionals(National Association of Community Health Centers,2007). To begin to more rapidly alleviate this shortage in advance of the implementation of the health insurance coverage requirements, the Act invests in a major expansion of community health centers and the National Health Service Corps. Over the fiscal year (FY) 2011 to FY 2015 time

Originally the thought of sending stationed paramedics out into the community for scheduled visits with the homebound, or recently discharged patients sounded like a solid proposal. Having paramedics check on wound care, medication administration and general wellness of patients is a positive step to reduce unnecessary trips to the emergency department, clinics and doctor offices. However, the cost of these services would then lie solely on the ambulance services, using their employees, the gasoline and the wear and tear on the vehicles, when these services actually gain nothing financially from the home visits. In order for all services to benefit, the emergency services agencies would need to enter into agreements with the insurance companies

The first issue seeks to discover how to effectively work “together to improve the quality and affordability of health care” (Read, 2012). Quality and affordability of health care in the community was an issue that arose frequently throughout the community health assessment process. Trends in health care, such as the Affordable Care Act and health care reform, were considered to be major forces of change in the quality and affordability of health care in the community. Furthermore, a community health survey showed many local residents expressed dissatisfaction with health care in the community and concerns about being able to pay for needed care. A survey of Central Washington University faculty and staff revealed similar concerns.

Our mission is to provide great healthcare and clinical services that promote the health and safety of our community. We are patient centered with a focus on prevention. Through efficient use of office staff and medical technology, we are able to offer exceptionally accessible and personal care in a comfortable atmosphere. We are here to serve you and your entire family from infants, toddlers, school-age children, teens, young adults, pregnant women, and adults.