NFIRSGram: Community paramedicine
This NFIRSGram explains the community paramedicine health care model and how to code paramedicine incidents in the National Fire Incident Reporting System (NFIRS).
What is community paramedicine?
Community paramedicine is a model of community-based health care in which paramedics work outside their normal emergency response and transport roles. This health care model maximizes the use of emergency care resources and enhances access to primary care for medically underserved populations.
Interest in community paramedicine has grown substantially in recent years, based on the belief that it may improve access to and quality of care, while also reducing costs. Community paramedicine programs are usually designed to address local problems.
The typical services performed are:
- Coordinating health services for patients/clients.
- Determining the need for, and providing referrals to, community resources (such as mental health, substance abuse, public health, and social services).
- Assessing safety risks for the community paramedic (for example, unsafe situations, animals, and diseases).
- Assessing safety risks for the patient/client (for example, disease, falls and environmental health hazards).
- Assessing the safety of the work environment.
- Educating on proper use of health care resources.
- Providing oral health education and/or screening.
- Educating on identified health care goals.
- Performing a physical safety inspection (for example, home, property and vehicle).
- Screening for chronic disease (such as diabetes, asthma and coronary artery disease).
- Providing service with the local public health agency (for example, immunization and disease investigation).
- Providing service with the local social service and aging agencies (for example, adult protection, child protection, senior services and housing).
- Participating in wellness clinics (such as immunization and screening).
Coding community paramedicine
Due to the service that is being provided, and the expected increase in this type of service, fire departments should report these incidents in NFIRS using the recommended incident type code of 553 – Public Service. Don’t group community paramedicine calls as nonreportable NFIRS calls, such as inspections or school visits. The codes in the 300 series suggest an actual emergency situation; whereas, the 500 series codes suggest a nonemergency service call (for example, assist invalid).
If the situation changes to an emergency while doing an assessment, the initial type of situation found changes to a 321 – Emergency Medical Services (EMS) Call. In the meantime, departments are also encouraged to use a plus-one code to further identify these incident types.
If the situation warrants transportation to an urgent care facility or to another emergency department, then the fire department can escalate the incident type to 321 – EMS Call.
- Keep it simple. Incident Type code 553 is a Public Assist (exclude service to governmental agencies).
- Try to avoid codes ending in 0. NFIRS users are encouraged and taught to avoid codes that end with 0 (Other). Using 550 — Public Service Assistance, Other — does not give any more insight that the calls are community paramedic calls. It is a “catch-all” when other codes in the group do not fit. If you use a code ending in 0, an explanation is needed in the Remarks section of the report.
- You may use a plus-one code with code 553 – Public Service, to separate community paramedic calls, if needed.
- If the situation warrants, escalate the community paramedicine call to an EMS incident type code, such as 321 – EMS Call.
Need more help coding community paramedicine incidents? Please contact the NFIRS Support Center: Monday – Friday between 8 a.m. – 4:30 p.m. ET, at 888-382-3827 or by email at firstname.lastname@example.org.