The discussion on the table was about the change in services and hours that Ocracoke Health Center will be adopting soon. (Confused? Read Jenny’s excellent article here and the OHC press release here.) At their April 24th meeting, the OT board heard a request from OHC for $89,500 to fund the center’s extended hours and triage nurse phone service. The OT board want appropriations to fund after-hours care, which they see as a much-needed service to the island. A motion was made by Martha Garrish and approved by all that the OT board is not comfortable funding the OHC and would like to the center to restore services to what it has been historically.
Enter Hyde County EMS.
If the Health Center stuck to their current hours (8am – 5pm), the Hyde County EMS could step up to the plate and offer after-hours care. To do that, they’d need $180,000 from OT funds, which would pay for four more fulltime paramedics on the island and a second ambulance year-round. (Now we only have a second ambulance part-time during the summer.)
As Justin Gibbs explained, calling 9-1-1 is a perfectly acceptable way to get health care, even if you’re not dying. Who knew?
A call to 9-1-1 does not necessarily mean an ambulance or helicopter ride. “We have the ability to assess the situation,” he said. “We can treat and release as well.”
Justin is motivated to start a “community paramedicine program,” a system that he’s researched and thinks would work wonders for Ocracoke and Hyde County.
“It’s a great service for older folks, or people with chronic conditions,” he said. “We could do check-ups in people’s homes, make sure they’re taking their medications. We can check blood pressure, do wound care, and follow-up care.”
Justin is also working on getting state approval for his paramedics to do suturing so that an after-hours cut would not mean a trip to Nag’s Head.
The $180,000 needed to add four more paramedics to Ocracoke’s team would be in addition to the $1.5 million the county spends on EMS services.
If you do call 9-1-1 (and it really is okay!), the dispatcher will assess the situation and help decide if you need an ambulance or just a visit from a paramedic. They could be available for all the situations that Ocracoke used to use the 928-SICK line and after-hours care for: babies with fever, people with pain, rashes, vomiting, etc.
“We only charge patients for transport,” Justin said. “Or if we treat and release. Assessment is free of charge. If we use something from our expendable supply to treat you, then there’s a minimal charge of about $200.”
Hyde County EMS uses a third party billing system that files health insurance claims for patients.
“I would never think I could call 9-1-1 unless I thought I was dying,” said Martha, while everyone nodded in agreement. “We have services available, we just didn’t know it.”
Community member Darlene Styron suggested a public meeting to help educate the public about the ways EMS can meet community needs. A certain newspaper reporter suggested she could write articles to that effect as well.
Hyde County EMS has 1.5 years to vacate the building behind the Health Center. Justin says that they’ve outgrown that facility anyway (“Our ambulance sits outside in the weather 365 days a year.”) and he would like a space that would help EMS expand services.
“We could maybe build something by the airport,” he said, imagining a space where he could stabilize patients, and provide emergency shelter and rations in times of need. The county could also use a place to store dead bodies (now they keep them in the air-conditioned ambulance, tying up the vehicle for other use.) He will pursue grant funding for the dream facility.
Justin said he thought it would only be a matter of weeks before he could have the extra paramedics working (and living) on Ocracoke. Apparently, there are people in the paramedical field who really want to move here.
OT board members were impressed with Justin’s presentation.
“It’s refreshing to me that you really want to do this,” OT board chair Wayne Clark said. “It’s very positive that you’re figuring out a way to meet our needs.”
The board concluded that the $90,000 that Ocracoke Health Center was requesting could be better spent on augmenting our EMS services.
“Ocracoke has more need of 24/7 coverage rather than extending hours for doctor’s visits,” said Wayne.
“The triage nurse service that OHC wants to have is a duplication of the EMS role,” said Martha.
Last year, Ocracoke Health Center received $147,000 in OT funding. The OT board decided to think of the request from Hyde County EMS, not as $180,000 increase in spending, but as a mere $33,000 increase to insure good health care on the island. Although, this spending does put the OT board $68,000 over their OT revenues from last year, the board decided it was worth it to dip into their extra fund of over $280,000.
Martha made the motion, which passed with all in favor, to grant EMS $180,000 to staff paramedics for Ocracoke.
All of this is a recommendation only; the Hyde County Board of Commissioners will vote on this spending at their next meeting on Monday.
Stay tuned for more information about OT grants for this year.