community
september19
2019
Mist-Birkenfeld CHIPP Service
being called Mobile Integrated Health-
care (MIH) (also known as Community
Paramedicine), and successfully devel-
oped a program which Metro West EMS
personnel has been implementing for the
last three years in their urban setting in
Washington County.
The MIH concept uses EMS
providers to visit patients in their homes
and attend to their health, environmen-
tal, and social needs by assisting par-
ticipants with a variety of concerns,
including post-surgery follow-up, man-
aging prescriptions and over the counter
medications, mobility within the home,
wound care, and managing chronic ill-
nesses.
Metro West’s program, called
Mobile Health Partners, has quickly
grown into one of the largest in the
country, with eight full-time members of
a division solely devoted to community
paramedicine. “Metro West is really on
the cutting edge of this nationally,” says
Boxman.
Boxman is a former Director on
the Board at Mist-Birkenfeld RFPD, and
in July became a full-time, paid para-
medic there. He’s adapted the Metro
West MIH program to fit the needs of
Mist–Birkenfeld RFPD and their more
rural members. “Each MIH program is
unique and is created to meet the needs
of the community they are serving,” ex-
plains Boxman.
Mist-Birkenfeld’s MIH program
is called CHIPP, and is designed to help
improve the health of their residents
through home visits to participants iden-
tified as needing some type of medical
assistance. EMS personnel will work
with participants to assess their health
status and help determine their unmet
healthcare needs. EMS providers will
receive specialized training to help navi-
gate between the participant’s needs and
their healthcare services and resources
that might be difficult to access due to
living in a rural setting. The program is
free of charge to all residents who live in
the Mist-Birkenfeld RFPD and will use
staff already on duty when they are not
running emergency calls.
Boxman says the intention is not
to replace a participant’s primary health-
care resource, but instead help augment
their care. “What we’re really trying to
do is keep people at home, reduce their
9-1-1 emergency calls and hospitaliza-
tions, and do it in a proactive way,” he
explains. “We’re here to help close the
gap between them and their physician
and their other medical resources, which
is what we really need in this rural envi-
ronment.”
According to Boxman, MIH has
been a quickly growing segment of the
EMS industry across the country in re-
cent years, but has mostly been imple-
mented in urban settings. “I designed
our program out here to meet the needs
of our residents, because out here we
don’t have any doctors offices or clin-
ics, our EMS department is it. We have
people who go into town and have oral
surgery, or knee replacements, or an ap-
pendectomy - things that aren’t too se-
rious - and then they come home, and
they have a discharge plan. Sometimes
it’s confusing, they might have a lot of
medications they have to take at differ-
ent times of the day, they might have
trouble caring for the incision. We’ve
run a number of 9-1-1 calls recently
where people came home from a proce-
dure and they weren’t taking their medi-
cations correctly, or they weren’t eating
appropriately or drinking enough water,
or they aren’t healing correctly because
they aren’t changing their bandages, or
they weren’t following their discharge
plan.”
The CHIPP program will con-
sist of an initial screening to determine
a participant’s suitability for the pro-
gram, followed by the first CHIPP visit.
During that visit the EMS provider will
conduct a health history and intake in-
terview, inspect the home for environ-
mental concerns to prevent falls and in-
juries, and then develop a care plan, and
schedule subsequent visits. During visits
EMS personnel may make referrals to
other medical or social service resourc-
es. Once a participant’s needs are met,
they will “graduate” from the program,
although the program will conduct fol-
low-up phone calls for the next several
months to ensure the participant’s condi-
tion remains stable. Re-enrollment may
be considered if it’s found they need
continued care.
“Our plan with every participant
17
continued from front page
will be designed individually for them
and what their needs are,” says Boxman.
“We can be there when they come home
from the hospital, help them get com-
fortable and make sure they have access
to food and water, review their discharge
plan with them, make sure their medica-
tions are laid out according to what the
their doctor has prescribed, and make
sure they are set up for success right from
the beginning. Then we can go back, a
day later, and then three days later, until
they are healthy enough to be on their
own. Being enrolled in this program can
really give our residents and their fami-
lies some peace of mind that they aren’t
going to have complications.”
Boxman says the program
makes sense because of the rural setting
of the Mist-Birkenfeld district, which
has over 1,300 resident members and
covers 135 square miles. The emergen-
cy call volume at Mist-Birkenfeld RFPD
is low, which gives staff the ability to
spend time and visit district members in
their home and provide a variety of ser-
vices. “We have people in our district
who have chronic diseases like diabe-
tes, asthma or emphysema, and hyper-
tension, that may sometimes need help
when their treatment regiment changes,
and those are also people who might
benefit from this program, because we
can help them adapt to their new plan.”
When people in the District
do need to call 9-1-1 the wait time for
a response can take some time, which
is another reason a proactive program
like CHIPP makes sense. The program
hopes to also reduce overall healthcare
costs through better coordination of care
and the use of prevention and wellness
strategies.
In addition, Boxman says the
program will utilize a technique called
Motivational Interviewing designed to
encourage health promotion, positive
health behavior and wellness, preven-
tive and health maintenance practices,
and embrace self-care in order to mini-
mize relapses and future 9-1-1 calls. He
says the CHIPP program can help par-
ticipants look at diet and exercise, and
also provide social interaction for those
living alone.
Boxman notes that Columbia
County has a number of social service
resources that people may not know
about that the CHIPP program can help
refer and connect them to.
Boxman says 9-1-1 emergency
response will still be the primary respon-
sibility of Mist-Birkenfeld EMS person-
nel. The CHIPP program has been ap-
proved by, has protocols established by,
and will be overseen by, a Medical Di-
rector, just as all other EMS services in
the state of Oregon.
The program will be advertised
to the community through a variety of
methods, including a mailed newslet-
ter, a brochure that can be handed out,
discussions with patients and families
who call 9-1-1 for emergencies, and by
word of mouth. Boxman says he is also
discussing the program, and looking to
partner, with Columbia Pacific CCO, the
coordinated healthcare organization for
the Oregon Health Plan (Medicaid) in
Columbia, Clatsop, and Tillamook coun-
ties.
“We want to help people live
healthier lives, not just respond to their
chronic illnesses, or after a procedure,
or in emergencies,” says Boxman. “It’s
about helping people engage in wanting
to be healthier and take control of their
own healthcare.”
For more information about CHIPP
contact coordinator Larry Boxman at
(503) 755-2710.
NEW LOCATION
Don‛t worry.
We‛ll go to Meyer‛s Auto Body.
I hear they‛re out of this world.
Fresh Roasted Coffee
espresso • baked goods
Meyer’s
Auto Body
Open Every Day at 6:00 am
493 Bridge Street
VERNONIA • 503-429-0248
825 Bridge Street
503-429-0214
Church Directory
Church of Jesus Christ
of Latter Day Saints
Sunday Schedule:
Sacrament Meeting: 10:00 am
Sunday School & Primary: 11:20 am
Relief Society, Priesthood and
Young Women: 12:10 pm
Roger Cook, Branch President
1350 E. Knott Street
503-429-7151
Grace Family Fellowship
Sunday School: 9:00 am
Worship Service: 10:30 am
Thursday Prayer: 6:00 pm
Greg “Mac” McCallum, Pastor
957 State Avenue
503-429-6790
Nehalem Valley Bible Church
Sunday School: 9:45 am
Worship Service: 10:45 am
Tues. Ladies Bible Study: 9:30 am
Wednesday Service: 7:00 pm
Sat. Men’s Prayer Meeting: 6:30 am
Gary Taylor, Pastor
500 North Street
503-429-5378
Open Door Gathering Place
Service: Sunday 6:00 pm
Grant Williams, Pastor
375 North Street
503-702-3553
Bible Study:
Sunday 9:00 am at Mariolino’s
St. Mary’s Catholic Church
Sunday Mass: 12:00 pm
Fr. Josh Clifton, Administrator
960 Missouri Avenue
503-429-8841
Vernonia Christian Church
Sunday School: 9:45 am
Worship Service in Youth &
Family Center: 10:00 am
www.VernoniaChristianChurch.org
Sam Hough, Pastor
410 North Street
503-429-6522
Vernonia Seventh-day Adventist Church
Sabbath (Saturday) Services
Sabbath School: 9:30 am
Worship Service: 11:00 am
www.VernoniaSDAC.org
Larry Gibson, Pastor
2 nd Avenue and Nehalem Street
503-429-8301