North Dakota’s Health Services Committee www.legis.nd.gov/assembly/63-2013/committees/interim/health-services-committee as part of the legislative branch has been studying several issues including the impact of diabetes on the state, the need for a statewide stroke database, and how to further develop the community paramedic program to serve the needs of the state particularly in rural areas.
Studying diabetes and other issues in the state requires the Department of Human Services, State Department of Health, Indian Affairs Commission, and the Public Employees Retirement System to collaborate together on a report that is required to be submitted to the legislative management office.
The study on issues affecting diabetes must also develop information on the financial impact that diabetes is having on the state and localities. This information needs to include the number of lives affected by individuals with diabetes, the financial toll or impact diabetes and diabetes complications have on the agency, and the financial impact that diabetes complications place on the agency’s programs in comparison to other chronic diseases and conditions.
The report must also detail action plans for battling diabetes with actions that will need to be considered by the legislative assembly. The plans must specify ways to reduce the impact of diabetes, prediabetes, and related diabetes complications.
The statewide stroke database greatly needed by the North Dakota Department of Health www.ndhealth.gov needs to have complete details and statistics on stroke care. The information will help to coordinate plans with national voluntary health organizations involved in stroke quality improvement
The study on strokes also required to be submitted to the Legislative Assembly will help to provide information on how effectively stroke centers, primary stroke centers, hospitals, and emergency medical services are operating.
The requirement is to report data that is consistent with nationally recognized guidelines on the treatment of individuals with confirmed stroke within the state. The analysis of health information and data would be communicated to healthcare professionals within the state.
A third study was done on the feasibility and desirability of community paramedics to provide additional clinical and public health services particularly in rural areas. Information is needed on the effect of these services on the operations and sustainability of the current Emergency Medical Services (EMS) system.
The Health Services Committee received information from the State Health Officer regarding community paramedics. The Committee learned that EMS systems can function with volunteer personnel by responding to up to about 350 emergency calls per year.
However, fee-for-service systems are generally not sustainable until the service responds to at least 650 emergency calls per year. The Committee did learn that if the role of paramedics could be expanded to community paramedics, the fee-for-service EMS systems could likely be sustained.
The Committee also learned that appropriately trained community paramedics could provide billable services to include:
- Community med-level clinical evaluation and treatment
- Community level call-a-nurse service and advice
- Chronic disease management support
- Case management for complex cases
- Worksite wellness facilitation and onsite clinical support
- School wellness and mid-level clinical services