Deer Isle’s Memorial Ambulance Corps Is a Case Study in Community Paramedicine

House-call doctors might be a thing of the past, but house-call EMTs have started helping to fill the void, especially in underserved communities.

Walter Reed and Genice Billings with their Memorial Ambulance Corps house-call vehicle
By Nora Saks
Photos by Dave Waddell
From our March 2024 issue

Dennis Eaton, an 82-year-old Deer Isle native, army veteran, and lobsterman, started having trouble managing his diabetes and back pain years ago. Keeping track of his small mountain of medications grew into a major challenge. “I couldn’t do it,” he says. “I get too nervous.” His legs became so swollen, he could barely get around. A hundred miles from the nearest VA hospital, Eaton resorted to calling 911 on several occasions.

Walter Reed (left) and Genice Billings (right) pay Dennis Eaton a community-paramedicine visit.

Difficulty accessing health care is an increasingly common problem in rural towns, for a variety of often-overlapping reasons: health-center closures, medical-staffing shortages, higher rates of poverty, lower rates of being insured, sheer distance from resources. To help address the issue, Memorial Ambulance Corps, the nonprofit provider of emergency medical services to Deer Isle and neighboring Stonington, joined a growing number of groups in Maine offering what’s called community paramedicine, premised on the idea that EMTs and paramedics, by providing nonemergency in-home care, can help keep people from getting to the point when they need to dial 911.

Now, Eaton has been checked on every Wednesday for the past three years by Walter Reed, an EMT, the director of Memorial Ambulance Corps, and a remarkably spry 81-year-old. A visit with Eaton typically entails some chitchat and jokes as well as some checking of blood-glucose levels and organizing of medications. “It takes an awful load off your mind,” Eaton says. “I know these folks, and they know what they’re doing.”

Soliana Goldrich, community-paramedicine coordinator at the Maine Emergency Medicine Services bureau, oversees programs across the state. “It really allows for a more flexible model of care, meeting patients wherever they’re at, whether that’s on the street or in their home,” Goldrich says. Each EMS can tailor its offerings to local needs, but in general, community paramedicine connects patients — referred by doctors — with follow-up evaluation and care at no charge. Since the idea was first piloted here in Maine, in 2012, the number of providers has risen to 21.

Even though the program is free to patients, it’s expensive for the mostly volunteer emergency services. Currently, grants and donations are helping to keep many of the providers going. About half of community-paramedicine patients are on MaineCare, the state’s Medicaid program, and Goodrich hopes that, in the near future, MaineCare will begin covering the visits and that private insurers might then follow suit.

On Deer Isle, Reed thinks of himself as doctors’ eyes and ears in patients’ homes. His Memorial Ambulance Corps now conducts about 1,000 community-paramedicine visits a year, and the EMTs might conduct home-safety checks or fall-risk assessments one time, then help arrange transportation to appointments, pick up prescriptions, or make sure people have enough heating fuel another time. “We’ve fixed birdfeeders, and we’ve shoveled snow,” Reed says. “We do what needs to be done.”

Since Reed started paying weekly visits, Eaton has gone from hardly being able to move to rebuilding his lobsterboat and splitting wood. His diabetes is under control. He’s talking about fishing again if he can enlist a good sternman. He now finds himself in the unusual position of being glad about EMTs coming through his front door. “I look forward to having company,” he says. “I think they oughta do it twice a week.”

From our special “Welcome to Small Town, Maine” feature, highlighting some of the challenges and charms of small-town life and people who are passionate about their tight-knit communities. Find a few “Welcome to Small Town, Maine” stories here on the website, and pick up a copy of our March 2024 issue to read them all!

May 2024, Down East Magazine

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