Rio Rico Fire Chief Les Caid

In this file photo, Rio Rico Fire Chief Les Caid speaks during a meeting on June 21, 2011 at Station 3

Rio Rico and Tubac firefighters regularly respond to 911 calls that have nothing to do with fire, but instead involve people who, for different reasons, have not received preventive medical care that might have kept them from having to call 911 for medical assistance.

In fact, according to Les Caid, chief of the Rio Rico Fire District, approximately 89 percent of calls to RRFD are for emergency medical services.

Given that reality, and the fact that today’s firefighters have the equipment and training to administer medical care in an emergency setting, RRFD, in partnership with the Tubac Fire District, is set to launch a new program meant to increase access to primary care for chronically ill people with limited or inadequate access to care.

The program, called the Rio Rico Community Healthcare Paramedicine Program, or RRCHPP, is set to launch in January 2014 with the first RRCHPP teams extending care to patients who live in rural areas of Rio Rico.

The teams will be made up of one paramedic and one emergency medical technician, but their primary focus will shift to non-emergency care. Team members will have received additional training specific to the program’s goals.

Personnel from RRFD and TFD will provide 10 hours per week of CHPP care to approximately 45 to 50 patients in the program’s first year. Participating patients will be identified by their primary care physicians, upon discharge from a hospital stay, and from the fire districts’ internal records of calls. Participation is optional and patients will be asked to sign a consent agreement on the first visit.

In addition to the benefit of preventing the patients’ health from deteriorating in the first place, the program offers a secondary benefit in cost savings for patients, insurance companies and the fire district that Caid says could easily be in the hundreds of thousands of dollars annually.

Caid cited the example of a patient with diabetes who has difficulty maintaining a steady blood sugar level and who was transported to the emergency room six times in six months. The cost of a single ambulance transport to Holy Cross Hospital can be $1,500 not including emergency room fees and doctor fees. If the patient is taken to a Tucson hospital, the cost is closer to $3,000 just for the transportation.

Home help

Another service the program will provide is environmental risk assessment.

For example, if a person suffers from chronic asthma, the CHPP team will determine if their environment is a trigger for the attacks by looking for specific problems such as accumulated dust, or signs of mold from water intrusion. The team could then direct the patient to resources that can assist with the necessary fixes, or just notify the patient of the findings if they have the resources to affect a fix themselves.

One of the biggest medical problems for the elderly is the danger of falls. Therefore, the teams will check homes to help make them safer and less likely to induce a fall, or suggest the elimination of sharp-cornered items that could cause serious injury in the event of a fall.

Since diet is inextricably linked to health, the teams will also connect those who need more healthy foods with community food banks, which are often well stocked with fresh produce.

Through training, education and inspections, fire departments have managed to reduce home and structure fires. Caid said RRFD’s hope is that similar health training and education efforts, along with inspectional healthcare visits will reduce the number of 911 emergency calls

“Our hope is that we can start a community dialogue on health care and share ‘best practices’ with patients and direct them to resources they may not know about that can assist them,” Caid said. “If we can prevent a 911 emergency call by preventative care then we are succeeding.”

While similar programs exist elsewhere in the United States, Caid said, RRFD is the first fire district to implement one in Arizona.

The RRCHPP is the result of more than two years of planning and study that, in addition to the fire districts, involved Carondelet Holy Cross Hospital, Mariposa Community Health Center, South East Arizona Area Health Education Center (SEAHEC), the University of Arizona College of Public Health, the University of Arizona Medical Center (UAMC) and Arizona Department of Health Services.

Program goals

According to RRFD Chief Les Caid, the goals of the Rio Rico Community Healthcare Paramedicine Program (RRCHPP) are:

1. Reduce avoidable emergency room visits for enrolled individuals;

2. Decrease the rate of hospitalization for the target population;

3. Identify and decrease the number of high-rate users of emergency medical services and Holy Cross Hospital’s Emergency Department;

4. Assign RRCHPP teams to specific individuals to develop relationships and trust as the teams assist them with their medical needs;

5. Provide each individual with a thorough medical evaluation and link to healthcare;

6. Work with the primary care physician and hospital to provide each individual with a written and actionable care plan based on assessment of health needs;

7. Develop partnerships with local healthcare providers;

8. Encourage improved health through preventative screening for common chronic conditions, and:

9. Link individuals with needs to additional resources and appropriate agencies or providers in Santa Cruz County or elsewhere.

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