Firefighter/EMT Daniel Montana loads medical equipment in a Port Angeles Fire Department utility vehicle that he uses in place of a full-sized ambulance to cover non-emergency 9-1-1 calls. (Keith Thorpe/Peninsula Daily News)

Firefighter/EMT Daniel Montana loads medical equipment in a Port Angeles Fire Department utility vehicle that he uses in place of a full-sized ambulance to cover non-emergency 9-1-1 calls. (Keith Thorpe/Peninsula Daily News)

Port Angeles paramedicine program fulfills need

EMTs providing basic care in non-emergencies

PORT ANGELES — The Port Angeles Fire Department has become proactive in helping those who rely on 9-1-1 for basic medical services.

The city’s Community Paramedicine program has saved at least $95,000 in its first six months and, more importantly, improved the lives of those who have fallen through the cracks and repeatedly use 9-1-1 for non-emergencies, Fire Chief Ken Dubuc said.

“The true benefit is those people’s lives are better,” Dubuc said Wednesday.

“If they’re not calling 9-1-1, if they’re not going to the emergency department, clearly they’re in a better place.

“That’s why we’re doing this.”

The city has partnered with North Olympic Healthcare Network, Olympic Medical Center, Peninsula Behavioral Health and the Lower Elwha Klallam and Jamestown S’Klallam tribes to offer community paramedicine.

Longtime firefighter/paramedic Daniel Montana was taken off his regular duties in January to become a dedicated com- munity paramedic.

Through referrals from his fellow firefighters, police or partner agencies, Montana provides a range of services to heavy users of the 9-1-1 system.

He is able to check vital signs, provide wound care, administer medications, assess general health and living conditions, review medication regimens and make referrals for needed services.

“By intervening in that way, we’re able to provide them with the resources that they need, with access to care that they need, perhaps with access to a primary care provider, or just some level of care that was lacking before,” Dubuc said.

“And by doing that, we cut down on the number of times that they access 9-1-1, or the number of times that they actually go to the emergency department.”

Montana, who joined the Port Angeles Fire Department in 2005, said his new assignment allows him to provide follow-up care to patients, many of whom are reluctant to ask for help or have no one else to call.

“In this position, I’m able to spend as much time as I need to [with patients] without being subject to other calls to help them manage their situation,” Montana said in a Thursday interview.

Montana said he helps patients solve problems and navigate a complex medical system.

“My job, how I earn my money, is by helping people,” Montana said.

“That’s a pretty cool job to have.”

In a Sept. 3 report to the City Council, Dubuc said Montana met with 78 individuals in the first six months of 2019.

Those contacts resulted in a 59-percent decrease in emergency medical services (EMS) calls and a 69-percent reduction in trips to the OMC emergency room.

Based on those reductions, Dubuc estimated that the pilot program saved $95,536 through July 1.

He added that his estimate was conservative because he attributed only 50 percent of the reductions in EMS calls and ER visits to community paramedicine.

“I’m extremely impressed by this,” Council member Mike French said after Dubuc’s presentation.

“I think that you’ve easily shown that this program sustains itself, not necessarily by saving money for itself, but for the community at large.”

By reducing ER admissions, for example, the program reduces OMC’s uncompensated care, French said.

“I think that the need is out there, and we’ve scratched the surface of what we can do by investing in upstream diversions and in prevention,” French said.

Montana works closely with the Port Angeles Police Department’s REdisCOVERY program, a partnership with the Olympic Peninsula Community Clinic in which a social worker is embedded with an officer to connect the homeless to services.

Amy Miller, who heads the REdisCOVERY program, accompanies Montana in the field on Wednesdays.

Montana said he and Miller communicate by phone throughout the week, bouncing ideas off each other.

“Amy is a great social worker, crappy paramedic,” Dubuc said Wednesday.

“Dan is a great paramedic, crappy social worker. So between the two of them, there’s a synergy that’s just incredible.”

Dubuc said it costs the fire department about $2,000 every time it responds to an EMS call. Montana is able to respond to his patients in a pickup truck, resulting in significant savings for the department.

Dubuc said the program is “keeping people from dialing 9-1-1, keeping people out of the back of medic units, keeping people out of the back of police cars, keeping people out of the emergency department and keeping people out of jail.”

“It’s more successful than I ever imagined it would be,” Dubuc said.

Dubuc has been meeting with the program’s partners to seek financial support for 2020.

He said it would cost $95,000 to $100,000 to backfill a full-time position to allow Montana to continue to work as a dedicated community paramedic.

“Really, what were were looking for, is enough money to backfill for the FTE (full time equivalent) that we took off the line starting in 2020,” Dubuc said.

“There is enough need out there.”

The Port Angeles pilot project is the only community paramedicine program on the North Olympic Peninsula and one of the few in the state.

“A lot of people focus on the dollar savings,” Dubuc said.

“The dollar savings are great. But really, the human impact, that’s really what it’s all about.”


Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 56450, or at [email protected].

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