Sponsored Content
It might start with a 911 call, but for the Cape Fear Valley Health’s Community Paramedic Program, they are on the ground to give more than a normal emergency response and transport.
The team of four community paramedics, one social worker and one peer support specialist are trained to help fill in the gaps in care and reduce trips to Cape Fear Valley Health’s emergency department. Whether at home or through referrals to one of their vast community partners ranging from mental health agencies to county resources, the paramedics work outside the hospital, meeting patients where they are and giving proactive patient care.
Lead Community Paramedic Tara Tucker, 51, knows exactly what is needed as a behavioral health community paramedic, especially when it comes to at-risk patients who call emergency services.
According to the Cape Fear Valley Health website, the goal of the Community Paramedic Program is “to improve patient care by providing community paramedics to serve as an advocate for the patient at all times.”
“Sometimes it’s like I’m the conductor and I’m connecting the dots,” Tara said.
She assists by helping patients schedule appointments, assessing any in-home risks, educating the patient on their condition, assisting in medication management, allowing for in-home care testing, and navigating community resources.
“Sometimes I just find people need someone to hold their hand and navigate them through our health system,” Tara said. “Once we give the roadmaps, it makes it all so much easier to connect with the services they need and the relationships we build helps us figure out where they need to go.”
Tara said her path started after she graduated with an undergraduate degree from UNC-Chapel Hill in recreation therapy in 1995. Her first job was working in a locked psychiatric ward at the Moses Cone Health System inpatient behavioral health department in Greensboro, North Carolina.
Lately, she has been speaking at health conferences all over the country including Ohio, Maine, Pennsylvania, and throughout North Carolina to share what she has learned as a subject matter expert. She has been invited to speak at audiences in Kentucky and New Jersey as well.
“My background is mental health and substance use,” Tara said. “When I went back to school to get medical training, I was able to see the vast disconnect between mental health and first responders.”
She said first responders are trained to address traditional emergency medical issues. However, she has been able to have a different perspective to look not only at physical health, but also emotional, social, mental, and behavioral needs.
The Community Paramedic Program includes medical teams to reach people with chronic health issues such as chronic obstructive pulmonary disease (COPD) and congestive heart failure, according to Tara, but her team works on the behavioral health side.
The program focuses on what are known as “social determinants of health,” Tara said. These are non-medical factors that affect individuals’ health, for example, like “being unhoused, or being homeless, or having psychiatric issues without getting regular therapy or needed medicine,” she said.
Tara said that her team helps decipher if people are calling 911 for medical reasons, or if they need more resources like getting food or managing diabetes.
“We are able to have a different perspective with the ‘whole person’ approach,” Tara said. “Sometimes we find that they are calling 911 because they don’t have a primary care doctor or don’t know where or how to get help. We can assist with getting those who call with the resources they need.”
That “whole person” approach could include understanding that someone needing help managing diabetes might also need resources to get their prescriptions filled or transportation to appointments, she said. Or those dealing with addiction might not know the available resources, even without insurance, which leads to frustration, she added.
Getting to the root of an issue is important, Tara said.
“The behavioral health system is so vast and disconnected,” she said “We sometimes hear that someone wanted to get better, but they didn’t know how. That’s where we try to help.”
This “whole person” approach is something Tara said she learned in her first job at the inpatient behavioral health department in Greensboro.
“It was when case management was a new concept,” Tara said. “We made sure things were lined up for patients before they left the hospital, giving them a list of resources with phone numbers to call. When I left, I started working with an ACT team (Assertive Community Treatment) and started seeing the actual resources in person.”
After 10 years working with ACT in Greensboro, which Tara said was “like a hospital without walls” with case workers, nurses, and other medical professionals, she went back to school at Lenoir Community College to become a paramedic in 2011.
“I was able to take the training I had, that most paramedics do not have, to build relationships and get all partners working together,” Tara said. “And when community partners come together, the impact grows exponentially.”
She said that the community partnerships and the relationships made are the most profound and important piece to the program.
“It’s all about relationships,” Tara said. “Once we get that first situation, the medical crisis, resolved, we can then follow up and find out what the needs are to link them with the resources from the relationships we have built in the community.”
She said it is that first step, that first door, is imperative to helping the community paramedic team facilitate the hundreds of referrals they receive a month from police, fire, and emergency services departments so they can serve as many people as possible.
“We try to find those gatekeepers,” Tara said. “We had one man who we heard about through 911, and he went from hopeless and unhoused to getting a job within three weeks. He took the roadmap we laid out and did everything on it. This is why we do what we do. He was able to turn his life around.”
Fayetteville resident Erica Lugo, 37, is sober due to Tara’s efforts.
“I should not be here,” Erica said, as she spoke about her prior addiction to OxyContin and fentanyl.
She said she decided last September that she needed to live for her son and for herself. At that point, she tried to quit cold turkey and began to go through harsh withdrawal symptoms, she said.
“I felt like I was dying and my son called 911,” Erica said.
She recalled her first visit to the Cape Fear Valley Health’s emergency department being short, as her immediate symptoms were treated and she went back home. The next night, still feeling ill, she said she returned, but this time a paramedic contacted Tara, who was in the waiting room ready to meet with Erica when she arrived.
“She was like an angel sent from heaven,” Erica recalled. “If it weren’t for her, I wouldn’t be here today.”
Erica said that Tara set up her first appointment to help her on a way to get clean, came to her house, drove her to it and still calls her monthly to see how she is doing.
“I have my nine months chip now and I know there is a purpose for me still to be here,” Erica said.
Tara said the paramedics help create safety nets through community partnerships and relationships, which help assist those who need them with resources to make their lives better.
“For instance, we may have a hundred calls of suicide ideation or attempts each month through 911, but when they go home, those problems still exist whether it’s addiction, an ended relationship, or financial issues,” Tara said. “We can’t stick our heads in the sand after they leave our care.”
One of the ways that Tara and her team are building those nets is by creating community partnerships, including suicide prevention and addiction recovery groups.
For example, Tara works with Broken Chains JC, a fellowship of bikers and motorcycle enthusiasts that has a mission to offer hope in healing through a Christ-centered recovery process. The faith-based group is now in all 50 states and 15 countries, and has 6,000 members, according to Jeff Stultz, founder and national director.
He and Tara met at a community event a little over a year ago and realized they could work together to serve the community.
“No one across the nation has thought about pairing paramedics with bikers, but we did,” Tara said. “We found awesome partners. They reach those local recovery communities we serve with a support system and sober activities.”
Jeff, 61, is a motorcycle group member who speaks through experience and recovery.
He started Broken Chains JC in Cumberland County, he said. Jeff is 17 years sober.
“There’s a segment of the population that responds to people like me,” Jeff said referring to his long hair and tattoos. “People in suits, or even uniforms, can be perceived as scary or judgemental. You don’t even recognize they are trying to help you.”
Jeff graduated from Seventy-First High School in 1981, and joined the U.S. Army shortly after, following in his father’s footsteps.
His road to recovery and sobriety is a long way from his days in the Army and riding with a motorcycle club in his early 20s “that took me down a dark place.” At that time, he also began using illicit substances, he said.
Jeff eventually went AWOL from the Army, turning himself in later. He recalled a period of experiencing homelessness and substance use addiction as among the lowest moments of his life, he said.
“We talk the talk and want to help keep people alive until they are ready to live,” Jeff said.
His group offers two recovery support groups, which Tara refers to often along with a fuller list, which participants can choose from.
One is Celebrate Recovery, which meets every Friday at 6:30 p.m. at 455 Rock Hill Road, Fayetteville at the Freedom Biker Church. The other is Recovery Alive, which meets at 5:30 p.m. every Monday at Arran Lake Baptist Church, 1130 Bingham Drive, Fayetteville. Recovery Alive’s sessions begin with a free dinner, worship, and group sessions and include free childcare.
Tara said that most participants start trying to get help through their church clergy so she has begun partnering with the faith community to train and partner.
She emphasizes recovery options, which can be faith-based or secular, she said, providing participants with agency of choice.
Another one of the ways that Tara and her team are helping is by hosting a Mobile Outreach Unit event every third Thursday from 10 a.m. to 2 p.m. at the Kingdom Impact Global Ministries Church at 2503 Murchison Road in Fayetteville. Resources with over 70 community partners are available with a free lunch, medical screenings, laundry services, free haircuts, HIV and hepatitis C testing, and more.
“Some take for granted what just a simple haircut can mean to someone,” Tara said. “It takes all of us working together and there are a lot of providers coming to serve.”
To learn more about the Cape Fear Valley Community Paramedic program including how to get involved or support, visit capefearvalley.com/emergency-services/community-paramedic.html.
Read CityView Magazine’s “Back to School” August 2024 e-edition here.
