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Community Paramedic Program Aims to Ease ER Overcrowding

During a recent shift, American Medical Response paramedic John Perino was dispatched to a residential care home where a woman was experiencing a psychotic episode; she’d torn down blinds and was trying to break the window.

Perino evaluated her and cleared her to be taken directly to the county’s crisis center, bypassing a trip to an emergency department.

“It is not uncommon for that patient to go to the ER and end up sitting there six, seven, eight hours before being transported to the behavioral health center,” Perino said.

She’d be triaged behind patients with immediate medical needs but still take a bed in the emergency department while waiting, adding to the backlog.

That is the route ambulance companies in California have to take under current state regulations. Paramedics must transport people to hospitals first so that they can be medically cleared by a physician, said Mike Corbin, clinical manager for American Medical Response Stanislaus County.

But California’s Office of Statewide Health Planning and Development, through a pilot program, is allowing five AMR paramedics in Stanislaus County to sidestep state regulation to help better serve the mentally ill here and ease the burden on overcrowded emergency departments.

Called community paramedics, the senior AMR paramedics taking part in the program were selected by a panel of health officials and underwent nearly 200 hours of additional training. They work under the auspices of the medical director of the Mountain Valley Emergency Medical Service agency that serves Stanislaus County, Dr. Kevin Mackey.

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