Tangye Beckham, NRP, is the EMS coordinator and CHIPP Director for the Rio Rico (Ariz.) Medical Fire District, where she runs the district’s Community Integrated Paramedicine program. Although the program looks like many mobile integrated healthcare–community paramedicine (MIH-CP) programs in some ways (e.g., it’s a relatively small program run by a relatively small agency to meet its community’s chronic-care needs), it stands out by incorporating a practice around caring for patients suffering from dementia.
“Other [community] paramedic programs are targeting the behavioral health component, opioid abuse and substance abuse … We’re different because we target not only the behavioral health piece, but we also target the chronic illness and disease…[including] individuals with Alzheimer’s, dementia and Parkinson’s” says Beckham.
Most MIH-CP programs enroll patients in one of two ways: 1) a hospital or the fire/EMS agency that sees the patient so often that they refer the patient to an alternate care modality; or, 2) the patient is seen at the hospital and, upon discharge, falls into one or more categories that have been deemed appropriate for a watch program, usually to avoid recidivism (i.e., readmission within a given period, usually 30 days). But dementia patients are different—tragically. Depending on when the symptoms occur and their progression, patients may live alone (e.g., until the disease progresses to the point where someone suggests a live-in facility) and not be checked on for an extended period.
If a dementia patient is having a good day, they may not even appear sick. Therefore, these patients fall into cracks in the healthcare system since they are too ill to be self-sufficient but not ill enough to be in managed care programs.
According to Beckham, “They live alone—that’s what they do. We have many people within our community who are living alone with Alzheimer’s, which is unsafe for many reasons, and they basically can’t afford to pay for memory care facilities, and they don’t qualify for the state program, which is the Arizona Long Term Care System.”
Beckham continues, “If you ask what keeps me up at night, it’s knowing that these people have worked their whole life, and they have a pension—and because of that pension they’re disqualified from receiving service unless they pay outright for it.”
Rio Rico’s Community Integrated Paramedicine program bridges this gap, filling a crucial role in a largely rural community near Arizona’s southern border, where the community supports a range of populations—Mexican immigrants alongside retirees looking for the relaxation of desert living—blended together.
Beckham recently won her service a “Treat & Refer” authorization from the Arizona Department of Health Services, opening funding opportunities while also requiring that the department provide advanced analytics about the success and progression of its industry-leading Community Integrated Paramedicine program.