Community Paramedics Improve Patient Quality of Life and Reduce Health Care Costs
Tracey Martinez, PIO San Bernardino County Fire, Public Information Office
In January 2015, San Bernardino County Fire (SBCoFD) was chosen to conduct one of 13 pilot projects in California aimed at studying the value of community paramedicine. Community paramedicine (CP) is an innovative model of care services that uses paramedics and emergency medical services (EMS) to treat local patients and meet their health care needs directly in their homes. For this study, SBCoFD has partnered with Rialto Fire Department, San Bernardino County Department of Public Health, Arrowhead Regional Medical Center (ARMC), and the Inland Counties Emergency Medical Agency (ICEMA) to provide post-discharge follow-up visits to patients with congestive heart failure (CHF) in Fontana, Hesperia, and Victorville. “Community paramedicine is the next innovation in healthcare,” stated Fire Chief Mark Hartwig. “The goal of this program is to augment the patient’s current plan of care with resources currently established within the community which will provide the patient with the education and tools to maintain and improve wellness outside the hospital.” The pilot project’s objective is to reach out to CHF patients within the first 48-72 hours of being released from ARMC and improve the quality of life for the patient by decreasing the rate of readmission to the hospital and reducing the need to access 911 for non-emergencies. A statewide evaluation of the pilot project found that community paramedics identified 129 post-discharge patients (14 percent) who misunderstood how to take their medications or had duplicate medications and were at risk for adverse effects (Coffman, Wides, Niedwiecki, & Geyn, 2017). The evaluation also found that four of five post-discharge pilot projects achieve cost savings for payers, primarily Medicare and Medi-Cal due to reductions in inpatient readmissions within 30 days of discharge. Hospitals realized savings as well by lowering their risk of being penalized by Medicare for having excess readmissions. The community paramedicine pilot projects also accumulated savings for parts of the health care system due to fewer ambulance transports, emergency department visits, and hospital readmissions. Thus far the pilot project has shown that EMS and paramedics can facilitate more appropriate use of emergency care resources and/or enhance access to primary care for medically underserved populations when they function outside their customary role as an emergency transportation service. In preparation for this project, SBCoFD specially trained 17 firefighter paramedics in CHF patient assessment, medication reconciliation, laboratory evaluations, and home safety inspections. State officials have extended the project through November 2017. SBCoFD has enrolled 179 post-discharge patients since 2015 and expect to enroll up to 300 before the end of the project. During a visit, SBCoFD Community Paramedics perform a detailed physical assessment on the patient and ensure they are maintaining or improving their post-discharge status. They also will consult with the patient and/or caregiver to ensure the patient understands their condition, is eating properly, and knows how to take prescription medications. Visits also include a home safety check to reduce risk of accidental injury and to avoid potential emergencies. San Bernardino County is home to one of the largest per capita populations of CHF patients in the U.S. Sufferers of this condition who are unable to properly have their disease managed depend on the emergency medical system (both 911 and emergency departments) to keep their condition in check; community paramedics help address the healthcare needs of this population.
Mormon Monument returns to its home
By Terri Hill
Within the plans for the widening of highway 138, provisions were made to replace the Mormon Monument, erected in 1937, which would be displaced during construction. The replica monument was erected on February 24, just east of Hess Road. Atop a stone pedestal sits an authentic wagon wheel, which, according to Mark Landis of historyinca.com, is mounted so that the Mormon Trail pass of 1851, on the ridge to the north is lined up when you sight along the two outer edges of the metal rim. Landis points out that this is similar to the previous wheel's alignment. Cal Trans has hosted public meetings, first monthly – now bimonthly, since the SR-138 West Widening Project began. Armed with maps and statistics, contractors and Public Information Officers (PIOs) give updates on progress, and field questions and concerns from residents and commuters impacted by the construction. At the early community meetings, Harold Gabriel, of Wagon Train Ranch in Phelan, expressed his interest in being the contact for the Monument project. Caltrans made decisions about the monument with his approval, and accepted his changes to the project. The resulting effort is the monument as it now stands, with a new graphite replica of the original plaque, and a new replica wagon wheel on top. Gabriel is currently storing the original monument. The original wheel was stolen sometime before 1979, making this the second replacement wheel. Historian Marilyn Wells explained in an email, “The original monument was built in 1937 and sponsored by the San Bernardino Stake of The Church of Jesus Christ of Latter-day Saints (Mormons). In 1937 some of their congregation were literally "Sons of Mormon Pioneers" who had settled the San Bernardino Valley, as it says on the plaque. Private donors from The Church paid Harold (Gabriel) to purchase authentic wagon wheels to put on the replica and on the original monument, and granite plaques to replace the bronze plaque, as bronze plaques are routinely stolen now all over the U.S., for both the original monument and the replica.” The plaque reads: IN JUNE 1851, 500 MORMON PIONEERS CAME THROUGH THIS PASS TO ENTER THE SAN BERNARDINO VALLEY WHERE THEY COLONIZED AND ESTABLISHEDD A PROSPEROUS COMMUNITY. ERECTED BY SONS OF MORMON PIONEERS MAY 15, 1937 The wrightwoodcalif.com history of the Swarthout Family in the Cajon Valley, tells the story of the Mormons’ struggle to cross into the San Bernardino Valley from the High Desert. A wagon train of 500 settlers had come across the rough terrain of the Mojave Desert and then faced a series of box canyons (Cajon is a Spanish word for box, or crate). The gap in the rocks, at the northwest side of the current Cajon Pass, was too narrow to bring the wagons through. After toiling with axes, to widen the gap for passage, the men found it was still not wide enough for the wagons. They then began to dismantled the wagons, and carry them in pieces through the narrow gap they had made. After reassembling the wagons, the group traveled through the area that is now State Route 138, and along the rock formations now known as Mormon Rocks. A formal dedication ceremony will be held in September or October, following the completion of the widening project in August, when milder temperatures can be expected.
Highway 138 closed for 11 hours after an accident in Llano
Saturday, March 11, 2017, a man and woman were killed and an adult and two children were critically injured in a violent crash on State Route 138 in Llano. The crash on the 138 at 175th street E. around 6:45 p.m. prompted the CHP to close the highway through 5 a.m. Sunday. The CHP says that a man in a Chevrolet Camaro was speeding when the driver lost control at the curve and spun into oncoming traffic. The Camaro then collided head-on into a Ford Fusion carrying four occupants – male driver, 31 and two girls, ages 4 and 10 suffered major injuries. The collision with the 2012 Fusion split that vehicle in half. According to the coroner’s report the Camaro driver, 22-year-old Jesse Sandoval of Lancaster and a female passenger, 29-year-old Miriam Contreras of Palmdale died on the scene. The two children were airlifted to Northridge Hospital Medical Center. The Fusion’s driver, a Palmdale resident, was transported to Antelope Valley Hospital. A chain-reaction occurred and a third car was involved in the crash. A driver of a 2007 Chrysler PT Cruiser hit the Camaro amid low visibility.Pedestrian killed on 138
On 03/11/2017, at 4:44 AM, officers from the California Highway Patrol and paramedics from the San Bernardino County Fire Department responded to a vehicle versus a pedestrian on State Route 138 east of Scrub Oak Rd., in unincorporated Pinon Hills. Jeffery Ballard, a 45-year-old male resident of Pinon Hills, was a pedestrian who was crossing the roadway outside of the crosswalk and was struck by a vehicle traveling west. Ballard was pronounced dead at the scene from his injuries. The California Highway Patrol is investigation the collision. [031217 1700 TC].Jose Garcia pleads guilty
In August 2016, a female juvenile victim disclosed that Jose Garcia, who is a relative of the victim, had been sexually molesting her for approximately two years. Detective Osvaldo Pelayes and Deputy Wendy Perea conducted the investigation and were able to gain enough evidence to obtain a search warrant for Garcia’s residence. On September 1, 2016, detectives served a search warrant at Garcia’s residence and located numerous handguns and other evidence pertinent to the case. Jose Garcia, who is a convicted felon, is not allowed to possess firearms. He was not home at the time of the search, and an arrest warrant was issued. On Wednesday, December 7, 2016, members of the San Bernardino County Sheriff’s Specialized Enforcement Division located Garcia in the parking lot of Stater Bros. grocery store in Phelan. They attempted to contact Garcia, but he evaded them, ramming several vehicles, including a sheriff’s vehicle. Garcia fled to his residence and was subsequently taken into custody without further incident. It was later learned the vehicle Garcia was driving had been reported stolen. On March 1, 2017, Jose Garcia pled guilty to 6 felony counts, including assault with a deadly weapon other than a firearm, evading, vehicle theft, felon in possession of a firearm, vandalism and lewd acts on a child. Two of these convictions are felony strikes. As a condition of the plea, Garcia will be required to register as a sex offender for life. He is set for sentencing on March 27, 2017, at the Victorville Courthouse. Anyone with information regarding this crime is urged to contact Detective Osvaldo Pelayes at the Victor Valley Sheriff’s Station at (760) 552-6801. Persons wishing to remain anonymous can report information to WeTip by calling 1-80! 0-78-CRIME, or by accessing the website at www.wetip.com.Timberline Lions Roaring Bingo - A Great Success!
Thanks to everyone who came out and made this night a success! A good time was had by all. A big thank you to Michelle for calling bingo to a packed house. After a few technical issues to begin with, Ms. Michelle soon found her rhythm and calling the number like a professional caller. In addition thanks to all the volunteers and supporters that help make this event a joy to be part of. It was especially fun to spend time with other neighbors and share with family and friends. Everyone had a great time. Not only was it a fun evening, but the Lions also managed to raise very necessary funds which will be allocated to their general funds for various charities the Lions support. Their next Bingo tournament will be April 8th. Bingo will take place on the second Saturday of every month from 5:30-9:00 pm with the first game starting at 6:00 pm. The Club appreciates your continued support in their efforts to strengthen our communities!
Lions help where help is needed. Timberline Lions is a leading service and networking club in the vibrant and diverse Tri-Community serving Phelan, Pinon Hills and Wrightwood. Get connected with your neighborhood and volunteer. Volunteers will fulfill a variety of roles with the Lions club, such as assisting in the vision screening program, fitting recycled eye glasses to the needy, reviewing scholarship applications, coaching high school students, or serving on a committee for: • Easter Breakfast • Bingo • Student Speaker • Scholarship • Firemen’s Ball • Vision Screening • Telephone Directory • Leos Club at Serrano • Man Booths at community events • Cook meals at the various meetings • Collecting lightly used coats for the needy • Helping victims in a disaster
Maybe you have an idea on a project that may help your community. If you have a passion toward a new community service - bring your idea to their next meeting. Community service-minded men and women volunteers are always welcome. Being involved in Lionism is like a journey. Regardless of the initial calling, most members recognize early on in the journey the powerful self worth one gets from becoming a part of something bigger than yourself. The Timberline Lions is devoted to the Tri-Community for over 60 years and strives to make their neighborhoods a better place to live. They meet at the Wrightwood Community Building every 3rd Thursday (tonight 3/16) at 6:00 PM. If you're interested in being invited to join the Timberline Lions club please contact via email at email@example.com or contact one of their members at (760) 249-3245. It's so easy to start getting involved, as a leader in your community, a friend to people in need. Visit their facebook at timberline-lions-clubOPINIONS Tri-Community Thoughts By Al Morrissette
Dirt Road Repair
Each year winter storms create concerns for the maintenance of dirt roads in Phelan and Pinon Hills. Some residents think that the County has some form of obligation to maintain or repair these roads and look to the County to repair the storm damage to the roads. For the County to maintain or repair dirt roads the road must be a part of the maintained system. With little exception dirt roads are not within the County jurisdiction and are considered privately owned but public accessed roads. A brochure available from the County, which explains the whole matrix of maintained and non-maintained County roads plus the differences between dedicated and non-dedicated roads, states, “Non County maintained public easements, by definition, are not maintained by the County. The public and property owners are encouraged to resolve access and maintenance issues among affected parties,” adding, “Cases involving roads with no public dedication are private matters and property owners should be directed to pursue their legal rights as appropriate.” Thus confusion over dedicated/maintained and non-dedicated/unmaintained can occur when residents panic when roads are washed out or have other problems. This is because they believe that the easements required for future use and dedication make the dirt road system part of the County. That is not the case. Unless the County accepts a road into their system, the maintenance and repair of the road is upon the property owner. As a property owner, you are liable for the road within your portion of the easement. If a group of neighbors wish to have their road or a system of adjoining roads become dedicated they can apply to County Special Districts for a Feasibility Study that will include a property tax assessment to cover the cost of the road improvement and maintenance. This happened in the Oak Springs Valley section of Pinon Hills on June 3, 2003 when residents established Special Districts CSA 70 G. It consists of 7.35 miles of dirt roads, and part of the establishment of 70G was to have some roads paved while others remained dirt. There are 464 parcels involved and that annual cost is $375 per parcel. The cost of the improvement zone study starts around $1,000 and can be more, plus this cost is the responsibility of the applicant, not the County. The average time to create a district is around a year and the district can only be formed through voters during a general or special election and must be approved by a minimum of 66% of the voters who participate. If you want to know more you can contact Special Districts at (909) 387-5940 or go to the County website: http://www.sbcounty.gov.Journeys by Michael Palecki
Congressional Budget Office Bomb
So much for Donald Trump’s pre-inauguration promise when he told the Washington Post, “We’re going to have insurance for everybody and that coverage will be much less expensive and much better.” But then who do you believe when Democratic and Republican politicians alike and their staff members and their families all have health insurance subsidized by U.S. taxpayers? When you add law enforcement officers, firemen, members of the military, judges, school board trustees and a plethora of other positions to the mix, the numbers dwarf those the Congressional Budget Office (CBO) estimated, on Monday March 13, would not be covered by the GOP healthcare plan, known as the American Health Care Act (AHCA) and nicknamed “Trumpcare.” In the long awaited report published by the CBO and Joint Committee on Taxation, it was reported that the AHCA would not cover 24 million Americans while reducing the federal budget by $337 billion in the year 2026. In comparison, the current Affordable Care Act (ACA)-pronounced the same as AHCA with or without a tongue depressor, but known as “Obamacare”- is reputed to have extended health coverage to 20 million previously uninsured Americans with a $130 billion reduction to the federal budget by 2025. Any way you look at it, what is saved on healthcare in the next nine years will be eclipsed by a proposed $486 billion increase in defense spending. As for the CBO report, Health and Human Services Secretary Tom Price commented on Monday, “We think the CBO simply has it wrong.” That was a repetition of GOP criticism to the 2010 CBO analysis of Obamacare, in which expectations did not match results. In regards to the present and past reports White House press secretary Sean Spicer remarked, “We don’t believe it. Look at the CBO past score of Obamacare.” However, the CBO is the only independent scorekeeper that is considered relevant when lawmakers formulate new policy, and current Director Keith Hall is a former George W. Bush White House official who received his current position with Paul Ryan’s and Tom Price’s support. Let’s be candid here, recent decisions by the Electoral College and the CBO have been unpopular, but neither side of the aisle has any intention of addressing a change. Those who have healthcare insurance provided by their employers, who can negotiate medical and pharmaceutical costs, are fortunate. In the meantime, those who do not have health insurance, those who are unable to leverage reduced medical costs, are left to founder. In countries around the world that have government-subsidized healthcare, wellbeing and productivity exceed the situation here in America. Politicians should be reminded who pays for their health insurance and extend common decency to their constituents.Have You Ever by John Cromshow
The High Window
Have the trials and tribulations of everyday life gotten you down? Too much fake news, too many alternative facts, and too many unanswered questions? Why not forget the ongoing reality show and escape into a good book? I'm just finishing The High Window by Raymond Chandler. It’s a mystery novel set in the Southern California that used to be. His insights into human nature sometimes rise to the level of poetry. Consider this passage toward the end of the book. Private Eye Phillip Marlowe is speaking to a man who doesn’t want to speak to him. "She's a cold ruthless grasping woman, but hurting you would make a wildcat out of her. She wouldn't care what happened." Marlowe hints at the truth and begins to unravel a sticky web of lies. The man freezes. "He didn't move. His hands were rigid with strain on his knees. His eyes almost disappeared into the back of his head. They were doomed eyes." When I read the above passages to a friend he repeated, "doomed eyes." It's an image that stays with you. Chandler knows how to build tension like no other author I've read. True, there are some spy novels that have you at the edge of your seat, to use a common phrase. Chandler avoids clichés. In his inimitable style he describes the interaction between these two men so skillfully that you can almost hear their hearts beat. You know something is about to happen. Raymond Chandler plies his unique gifts in his vivid description of settings. Pasadena on a hot day is cooler inside a huge house with a stained glass window the size of a tennis court. He turns his attention to Bunker Hill in Los Angeles. He describes the once grand homes, and cheap apartment houses, and the people who live there. Chandler has a wry sense of humor. Characters call him a tough guy. He brushes it off. Usually, he pokes fun at them or sometimes himself. There is an element of the autobiographical when Marlowe reaches for a bottle. Chandler had a drinking problem. In 1961 I visited Bunker Hill with my uncle who worked for the California Division of Highways. It was much as Raymond Chandler had described it. The Dorothy Chandler Pavilion (no relation), which would transform downtown, existed only in blueprints. That's another story. Have you ever read The High Window? Please email firstname.lastname@example.org.