Community paramedicine in Frontenac County

Jeff Green | May 20, 2014

In an attempt to tap into a pool of $6 million that the Province of Ontario has earmarked for community paramedicine, Frontenac County has submitted an application for a $195,000 grant.

The largest portion of the grant, $116,298, would fund the one-year salary and benefits for a project developer, who will have the task of working with paramedic services and a number of community partners such as primary care physicians, community service agencies, the Local Health Integration Network, Kingston General Hospital, and the Community Care Access Centre to come up with a plan for enhancing the role of paramedics in Frontenac County and the City of Kingston.

According to Gale Chevalier, the deputy chief (Perfomance Standards) of Frontenac Paramedic Services, the likelihood is that an active or retired paramedic will be the person chosen to take on the project developer position because a full understanding of the roles and responsibilities that paramedics operate under are necessary to design the program.

“The amount in the project budget for this position reflects the average annual cost, including all benefits and payroll taxes, etc. for a paramedic,” she said, when asked about the cost of the position.

Among the first priorities of the program is to establish what is called a CREMS/PERIL program. CREMS stands for Community Referral by Emergency Medical Services, and PERIL stands for Paramedic Evaluated Risk of Independence Loss. The two related acronyms refer to the most direct form of paramedicine that is practised in other Ontario locations. While paramedics are doing their normal job of answering emergency calls, they use simple tools to find out if the patients could benefit from services such as Meals on Wheels or different kinds of home care. It would enable them, with permission from the patient, to make referrals to medical and social services. The referrals would likely to be followed up by the Community Care Access Centre

A related goal of the Frontenac Paramedicine proposal is developing links between paramedics and other health service providers. Another possibility envisioned by the proposal is home visits by paramedics for at risk clients. Also, wellness clinics, similar to one that is already in place on Wolfe Island, will be considered for the northern end of the County, where distance from health care services is a factor for some.

In presenting the proposals to Frontenac County Council, Paul Charbonneau, chief of Paramedic Services, said that before the proposal was written by Gale Chevalier, meetings were held with all the social and medical service providers in Frontenac County to make sure that the best use of resources is accomplished and that community paramedicine does not duplicate anything that is already in place.

“The biggest task will be to identify useful projects, and then if the money is there we will be ready to get this up and running. It's not that different from having an infrastructure project ready to go, so when a grant comes along you are ready to jump on it,” he said.

Council members, while supportive of the concept, were concerned that whatever programs end up being identified by the year-long initiative will need to be financed, as there has been no commitment for ongoing funding from the province.

“I would love to see this go but I would like to know why are we compiling information about something we won't be able to afford when the time comes,” said South Frontenac Mayor Gary Davison.

“If any of these initiatives lead to a decrease in ambulance calls, they will end up saving money,” said Central Frontenac Mayor Janet Gutowski.

Council approved the application, which goes in to the province this week. Gale Chevalier said she expects to hear back in mid-May whether the funding will be coming.

There are about 50 paramedic services in Ontario, and the project limit is $300,000.

“I know of some services that are not applying for the funding, and others that are submitting multiple applications,” said Chevalier. “One thing that is different about our application is the level of collaboration in our proposals.”