By John Hamlin
The News & Observer
SMITHFIELD, N.C. — After months of preparation, Teresa Wall
and Bradley Chestnut could not wait to punch the clock this week as
Johnston County’s first community paramedics.
“I think everybody involved is very eager for us to get started,”
Whereas most EMS employees respond to emergencies, the community
paramedics will spend their days working to prevent health crises
from occurring, said Johnston EMS chief Josh Holloman. That work
will run the gamut, Holloman said, and include helping patients
understand their doctor’s instructions and making sure they take the
“We think there will be medical needs, and we think there will be
social needs,” Holloman said.
Chestnut said it’s all about educating the community and giving
people the resources they need to lead healthy lives. Much of that
will involve connecting people with community services they might
not know about, he said.
On Tuesday, Wall and Chestnut began trading off working 12-hour
shifts, from 7 a.m. to 7 p.m. seven days a week. Both have worked as
Johnston EMS paramedics for years, and they underwent about a month
of additional training to prepare for their new roles. During that
time, Chestnut said, they got instruction from outside agencies,
such as Community Care of Wake and Johnston Counties and Johnston
Health’s Home Care and Hospice division.
Johnston EMS re-purposed one of its SUVs for the program and
labeled it CP-1 for “Community Paramedic One.” The truck will not
routinely respond to emergencies, but it does have a full set of
equipment in case it is needed on a call. That gear includes a heart
monitor, kits to aid children and burn victims, oxygen bags,
blood-pressure cuffs and medicines.
“If need be, we’re response ready for an emergency,” Chestnut
Wall took the first shift, and she had a list of names ready to
begin calling, she said. Once the program gets fully underway, Wall
said, Johnston Health will begin recommending patients to the
program, and they will start making visits to people’s homes.
The program will primarily target three populations:
high-frequency EMS users, defined as people who call 911 four times
in 30 days; high-frequency emergency room visitors; and people
discharged from hospitals who have a high risk of coming back within
30 days. Holloman said many people fall into two or three of those
The goal is to reduce the size of those three groups by 20
percent, Holloman said. Wall and Chestnut feel confidant they will
do even better, they said.
Johnston EMS won a $350,000 Duke Endowment grant to start the
community paramedic program, Holloman said, and that funding runs
through November 2016. Among other things, it covers fuel, medical
supplies and equipment, laptop computers and paychecks for Wall and
By the time the grant expires, Holloman said he expects to have
data showing the program saves more money than its costs. That
should give Johnston EMS a strong case to continue the program when
it asks the Johnston County Commissioners to pick up the funding, he
“If we can prevent a medical condition before it gets worse,
that’s the cheapest way, and not to mention the best way, for both
the patient and the system,” he said.
©2015 The News & Observer (Raleigh,