Juneau community health program easing burden on hospital

A newly refurbished ambulance decorated with art from Tlingit artists Mary Goddard and Crystal Worl drives through downtown on August 28, 2020 in Juneau, Alaska. (Photo by Rashah McChesney/KTOO)
A newly refurbished ambulance decorated with art from Tlingit artists Mary Goddard and Crystal Worl drives through downtown on August 28, 2020 in Juneau, Alaska. (Photo by Rashah McChesney/KTOO)

A Juneau community health program has been easing the burden on the hospital’s emergency room during the current COVID-19 surge.

The program is called Community Assistance Response and Emergency Services or CARES — not to be confused with the federal COVID-19 stimulus law. Juneau’s CARES is run by Capital City Fire/Rescue. 

CARES started at the beginning of the pandemic to help provide in-house care to people with COVID-19 so they would not take up beds in the emergency room. 

“We have definitely limited traffic to the hospital,” said CARES Program Director Joe Mishler.

The CARES team did this with COVID-19 patients by monitoring people in their homes, helping them stay in quarantine and giving in-home COVID-19 tests.

The team also transports people to the hospital for monoclonal antibody treatment. 

Currently, the program is experiencing one of the busiest times it has ever had, according to Mishler.

“We’re pretty much overwhelmed with referrals right now,” Mishler said.

This is also in part because the program has expanded to help non-COVID patients. The program now serves two other groups of people — frequent users of the ER and patients being discharged from the hospital. 

Mishler works with the case manager at Bartlett Regional Hospital to identify these people. This is where a majority of referrals come from. Referrals also come from doctors’ offices, SEARHC, Juneau Public Health and ambulance crews.

If a patient is identified as a repeat user of the ER, usually by the hospital or the ambulance crew, they will be referred to the CARES team. 

“We’re working with those folks to figure out what their specific needs are,” Mishler said. “And try to help them with more appropriate care perhaps than using emergency services.”

The CARES program is not taking any duties away from ambulances and it does not take calls from 911. Instead, the CARES team focuses on serving the callers of 911 who do not have an emergency but do have medical needs. 

An ambulance will still arrive on the scene for all 911 calls. If the ambulance paramedic determines that the person does not require emergency care, at that point they will reach out to the CARES team. 

Additionally, the CARES team helps people get out of the ER sooner by setting up care at home, educating people about their medications and providing resources to people waiting for hospice to start. 

While the program started with the pandemic, Mishler said that he hopes to keep the program going after it’s over. 

“The program does not need COVID in order to justify it, put it that way,” he said.

Lyndsey Brollini

Local News Reporter, KTOO

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