Region to launch primary care pilot project

By Dave Flaherty/The Oshawa Express

After months of modifications and deliberations, regional council has approved primary care outreach program on a pilot project basis.

The decision is the end result of several detailed staff reports since last fall.

In November 2017, council directed staff to investigate the merits of the creation of a mobile health unit.

Subsequent reports were brought back in February and May, with the scope of the project switching to ‘paramedicine’ model.

At council’s June 13 meeting, Durham Region medical officer of health Dr. Robert Kyle stated he wanted to avoid the term “paramedicine” altogether.

“It may be misconstrued as this pilot project being part of the community paramedicine program funded by the ministry [of Health and Long-Term Care],” he said.

According to a staff report, the pilot project will provide primary care and social services to ‘priority populations.’

These demographics are seven neighbourhoods pegged as priorities in the region’s Health Neighourhoods Program, including five in Oshawa.

A rapid response vehicle will be used to transport supplies and will reach these populations at various sites.

In his report to council, Kyle notes the vehicle will not have space for clients to enter to receive service or treatment.

“Services will be provided outside the vehicle, where clients are located,” the report states.

The pilot project will operate five days a week from 8 a.m. to 4 p.m and will be staffed by a full-time advanced care paramedic and full-time social worker.

Potential services provided by the advanced care paramedic are referrals to health care supports such as mental, addictions, or medical treatment and wound care.

The social worker can provide a variety of emotional and mental health issues including assessment, crisis intervention, and substance abuse counselling.

A nurse practitioner will also be contracted through a yet to be determined community agency two days a week and provide services such diagnosis, ordering a diagnostic test, prescribing medication, foot care, and sexual health services.

The pilot project is set to run through Feb. 28, 2019, with an estimated budget of $290,000.

Continuation of the service will be subject to budget deliberations and evaluation of the first eight months of the project.

In his report to council, Kyle noted the pilot project would create some challenges.

“Since regional council has directed that costs be absorbed within the approved 2018 budget, resources must be diverted from existing programs and services as no provincial or outside funding is currently available for this pilot,” Kyle wrote.

Since 2014, Kyle says paramedic services has seen a 28 per cent increase in call volumes, and that diverting funds from the 2018 approved budget “will further impact capacity to manage current call volumes.”

He also surmised that outside funding will not be available from an external agency such as the Central East LHIN as applications for funding for a community paramedicine program have been unsuccessful.

Furthermore, Kyle opined there are several risks and limitations associated with the pilot project.

Risks he identified include the safety of staff and client, privacy concerns, objections to the program from local residents and business owners, and clients expecting services unavailable through the program.

In response to the concerns raised by Kyle in his report, Clarington Councillor Joe Neal asked him directly if he supported the program.

“I think this is the best alternative option,” Kyle stated at the June 13 meeting.

Neal said he could not support the program because it was coming directly out of property tax dollars.

“Now we’re broadening our services to include primary care,” he added, stating that to him, the province should be ponying up with the funding.

“The province has many revenue tools and we only have one.”