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Milton and Mane
Welcome to Milton and Mane, the City of Milton, Georgia's official podcast—a dynamic space where community connection meets insightful conversation. Whether you're a resident, local business owner, neighboring government official, or a curious listener from afar, this podcast is your gateway to understanding Milton on every level.
Each episode is designed to bring you closer to the heart of our city, offering behind-the-scenes stories that humanize the people who keep Milton running. You'll gain valuable insights into local government operations, discover new opportunities, and hear from the voices that shape our community. Expect to learn about our rich history, stay updated on future developments, and explore the vibrant arts, culture, and sustainability initiatives that make Milton unique.
Join us as we celebrate our community, encourage civic engagement, and share inspiring stories that resonate beyond our city limits. Subscribe today and be part of the conversation that's building a better Milton, one episode at a time.
Stock Music provided by ikoliks, from Pond5
Milton and Mane
Caring for Our Community: Inside Milton's CARES Program
In this episode of Milton and Mane, we take a closer look at the CARES Program, a vital initiative designed to connect Milton residents with essential health resources. Join us as we explore the impact of community paramedicine, the power of proactive care, and how this program is redefining public safety. Guests Mark Haskins and Derek Hoffmann share their insights on bridging the gap between emergency services and preventative healthcare, highlighting real stories that showcase the program’s effectiveness. We also address common misconceptions about emergency calls and discuss how wellness visits and local partnerships are making a difference.
Tune in to discover how Milton’s CARES Program is shaping a healthier, safer community—and how you can be a part of it.
Learn more about CARES: https://www.miltonga.gov/government/fire/milton-fire-cares
PulsePoint Information: https://www.miltonga.gov/government/fire/pulsepoint
How to get in touch of Derek Hoffmann: The CARES program is generally staffed between 8 a.m. and 5 p.m. between Monday and Friday. Those with questions or seeking more information email derek.hofmann@miltonga.gov or call 770-686-0948
With the community in mind, this podcast explores the stories, people, and initiatives that make our community unique. Each episode offers insights into local government, highlights Milton's history and future developments, and showcases the vibrant arts, culture, and sustainability efforts shaping our city. Join the conversation, celebrate our community, and discover how we're building a better Milton together.
Do you have an idea for an episode or would like to request a specific topic to be covered? Email Christy Weeks, christy.weeks@miltonga.gov
Learn more about the City of Milton at www.miltonga.gov.
Welcome to Milton and Maine, the official podcast for the city of Milton. We want to bring you closer to the heart of our community through stories that inform, inspire and connect. Each episode offers a behind-the-scenes look at the people, projects and priorities shaping Milton, covering everything from local government and future development to arts, culture, sustainability and public safety. Whether you're a resident, a local business owner or just curious about our city, this is your front row seat to what makes Milton special. Hey, everyone, glad you could join us. I'm your host, christy Weeks, the communications manager for the city of Milton, and today we're diving into an incredible program that truly embodies the spirit of service and care in our community Milton's Fire Rescue Cares Program. Joining me today are two amazing guests who play vital roles in this initiative Mark Haskins and Derek Hoffman. Mark Derek, welcome to the podcast.
Speaker 2:Thanks for having us Excited to be here.
Speaker 1:Glad you could join us. So before we get into the details of the CARES program, can you both share a little about yourselves your career in fire, how you came to Milton Sure, All the things.
Speaker 2:I guess I can go first. So, yeah, I've been with Milton for almost 14 years now, started back in early 2011. So this was my first fire department job. After the economy kind of tanked back in 08, 09, I was thinking, well, what can I get into that might be a little bit more stable? Ended up getting my EMT and my paramedic and then I got hired at Milton Fire Rescue right after I got those. So, yeah, I've been in EMS for about 17, 18 years somewhere in that ballpark and then now with Milton going on just about 14. So it's been good, been a good experience for me. I love working here. The community's awesome. They treat us so well.
Speaker 1:Milton does like their fire department.
Speaker 2:It's been. It's been good. They, they really do take good care of us. You know dropping stuff off at at the fire station constantly and then just you know when we're on calls or if we're out and about in the community. It's been good. So, yeah, I've. I've worked my way up from firefighter to driver to captain and then recently got promoted to division chief about three or four months ago. Oh, congratulations. So I'm over the medical services division here at Milton and CARES is part of that. So we do anything medical-related training, our logistics equipment, every one of our apparatus is outfitted with medicine and all of the medical equipment to handle a call that an ambulance would arrive at.
Speaker 2:So our division handles the training and logistics and licensing with all of the medical equipment to handle a call that an ambulance would arrive at. So our division handles the training and logistics and licensing with all of that.
Speaker 1:So, and unlike other fire departments and you guys can correct me if I'm wrong all of our firefighters are at least EMTs, if not paramedics.
Speaker 2:That's correct, yeah, so, and I don't think that's common across everywhere, is it?
Speaker 1:Is that a thing?
Speaker 2:It's not in every single fire department in Georgia, correct, but it's moving that way because the majority of calls that we end up running as a fire department they're medical calls. So I think most progressive communities see the need to have at least the level of EMT training for all of their employees. That makes sense.
Speaker 2:But we're a little bit above that, because each of our apparatus are equipped with advanced life support equipment. So that's where the paramedics come into play. If you think of a paramedic, they're kind of like a nurse in the field. We can give medicine. There's certain things that we can do with regards to cardiac monitors. We can defibrillate people, we can read heart rhythms, we can intubate people. There's things like that that paramedics can do that EMTs can't. So we have to have a paramedic on each of our apparatus in order to sustain that ALS certification.
Speaker 1:How about you, Derek?
Speaker 3:I started in EMS about 10 years ago. First got my EMTT worked on an ambulance for a little bit. After a couple years went and got my first fire job at a not a Milton at a different department. From there worked my way into Milton. Been in Milton now for about seven years. Worked in a bunch of different sectors in EMS. I've worked at racetracks, I've worked at special events, all over the place. I worked at Whitewater a bunch of places to gather experience and different clientele I've seen all over the place. So different populations.
Speaker 3:I've got a little bit of variety in my experience as far as pre-hospital medicine.
Speaker 2:So Derek and I were on the same crew for a little bit we were. He was my captain.
Speaker 1:And here you guys are again working together.
Speaker 3:Correct. Yeah, yeah, I got my paramedic here with Milton and thankfully, because of the CARES program, we saw the expansion, so went on and got my registered nurse.
Speaker 1:Right on.
Speaker 3:Been registered nurse now for about six months.
Speaker 1:Oh, congratulations Relatively new.
Speaker 3:Yeah, still got fresh numbers.
Speaker 1:It's really time to talk about the basics of CARES and how this program came about. And for those who may not be familiar our listeners that might not know can you explain what the CARES program is and its overall mission and how it came to be?
Speaker 2:Sure. So CARES is an acronym. It's Community Advocates for Referrals and Education Services.
Speaker 1:Okay.
Speaker 2:That's what it stands for. In Georgia it's still not that common to have community paramedicine programs. There's not a lot, I mean, would you say maybe 10, 15?.
Speaker 3:Yeah, in the state In the entire state.
Speaker 2:So it's not that common. And usually when people would think of a community paramedicine program nationwide, they kind of stem out of the necessity to reduce 911 frequent flyer callers. You know you have people that just will abuse the 911 system and they call for trivial things or they just they tax the system. So you're taking these fire engines and even ambulances out of service to respond to calls that aren't all of that important, right? But maybe the people just don't have a way to get to the hospital or maybe they just don't know what to do. You know there's different reasons people call 911. Milton's a little different. Our demographics in our city it's not low income or there's not much of an indigent population. There's not a ton of homeless here. So what we had to do is identify a need that was a little bit different than most community paramedicine programs and then see if that could be filled within the city.
Speaker 2:So around maybe 2020, 2021, we had our previous medical services officer. He would visit certain people in the community on a semi-regular basis, just checking in with older ones, making sure they were okay, if they were taking their medicines properly, things like that. So the program started a little bit to evolve then, and then we decided to try and expand it in late 2021. And that's when we started having part-timers. That would work the CARES program. But we rebranded it and we were able to kind of identify, from its infancy stages to that point, what might work for our city versus what was going on. It had to be more than just maybe visiting some older ones here and there to see how they were doing. So we saw that, okay, there's a need in our community to kind of fill in that gap between people accessing the 911 system or accessing a hospital. And then what do I do when I get home?
Speaker 1:Right, that's a big one.
Speaker 2:Yeah. Or what do I do if grandma or grandpa needs to go to a rehab center, or they need to go to assisted living, or maybe they need in-home hospice or they need in-home healthcare, or they've sent me home with all of these instructions on this discharge paperwork and I don't know what any of this means. What does this medicine mean to me? Or how does it interact with other medicines? Because you sit there and you listen to the doctor when they discharge you Right, but who's taking that in?
Speaker 1:Nobody.
Speaker 2:Yeah.
Speaker 1:That's a lot of information coming at people that's really hard to process on the spot.
Speaker 2:Right, and it's a difficult time in life. You're stressed out, right, stress on the spot, right and it's. It's a difficult time in life you're stressed out, or if you don't have someone that's a medical professional with you, that's listening, that can explain all that to you later when you get home, you just don't really know how to navigate that stuff. So that was part of it. We're like how can we bridge that gap and help our community understand what to do when they get back home? Or or do I really need to call 911 before, right? So if people have questions, this would be a needed program for us. So that was part of it.
Speaker 2:Part of it, too, was education in general, because part of CARES stands for education services. So people in the community, when it comes to CPR, stop the bleed. You know we have a babysitting class. There's different education services that we know that we could provide, that people are interested in the community. So we saw those needs and we figured we could rebrand it, identify those needs and then figure out a way to fill it. And then Derek got the full time job. Was it? Here I am?
Speaker 1:And here I am.
Speaker 2:he says yeah, it was the end of 2022.
Speaker 3:Yeah, october, yeah so that. So I started uh kind of the full-time role of it. Obviously I had my own ideas. Uh, before that I was on the engine in Milton for quite a bit of time so I got to see live what I thought the program needed and how we can expand what Mark was going off of to meet those core measures.
Speaker 1:And we're going to talk about all the pillars individually as we go along. But what was it that grabbed your attention with this particular program?
Speaker 3:So what grabbed my attention was how we could mold it. Essentially it's infancy and we can create what caters to Milton. Like Mark was saying, with community-based medicine programs. Every city's got their own thing. What Alpharetta has their own program, even being next-door neighbors, theirs probably isn't going to work in Milton, and vice versa. So it's all unique as far as what demographic you're dealing with, what population density you're dealing with, what kind of diseases are usually present in that community. So there's a lot of variables that play into it. And so when I took it over, kind of like I was looking to see what can I do as an individual to help out the city and help out the community From there, I kind of like launched it and made these different that we're going to talk about, um, and kind of expanded from there. Before we were targeting just a kind of a high-risk population and now we've opened it up to different programs, different things that people might need.
Speaker 2:Yeah, I think we started with just that. I think too, and I don't want to speak for you, but it's exciting to build something from the ground up. So I know Derek. He loves change, he likes to be able to.
Speaker 1:Wait a minute and you're part of the fire department.
Speaker 3:I know he's a weirdo. Is that even allowed? You can ask me about my bags.
Speaker 2:No, you've got to have somebody that wants to be able to change and adapt, especially when you're building a program kind of from the floor up, because what you think it needs initially, it changes it.
Speaker 1:Does you need to be?
Speaker 2:adaptable.
Speaker 1:You have to be flexible, so Derek's very good with that, so, and helping to build something from the ground up that's fabulous and that's kind of what Parks and Rec, when we had them on, they talked a lot about how I have the ability to build this program and that's the beauty of a lot of things in Milton, because we are a relatively new city and so a lot of these things that are evolving are coming from the ideas and the passion and the drive of those within the city, which is an amazing thing to see, and I feel like Milton is very connected in their purposes and it's all very, very community driven.
Speaker 2:Yeah, and we had a lot of support too from our fire chief. You know he was big in wanting to create a beneficial community paramedicine program. I think he saw how it was operating before and knew that there was room for growth within that. So you know, we've always had the support of our fire chief. We had the support of our city leadership and council. I mean, they've been great. I think that we've given them some feedback on what it is that we do and that's really helped them to see the need for it. But they've been nothing but supportive too. So it's nice to again. I talked about the community taking care of us, but city leadership takes good care of us too, and they've been a big part in helping us get this off the ground and grow.
Speaker 1:Well, that's amazing. I can't wait to hear more about it, because I'm relatively new to the city I've only been here since July of last year so for me to get to understand and know exactly what you guys do, I know it'll be beneficial for me as well as the listeners. The way things generally go is people know and a lot of people don't know, right Correct. So the point here is to spread the word of the resources that we have available to this community.
Speaker 2:Right, and I think that's a good point too, because this is not just for an older population. Anybody can access this information, and it's beneficial for a wide swath of the population in Milton. So when we talk about it, I hope our listeners will see that.
Speaker 1:Yeah, with that being said, let's get into it. Let's break down these three objectives response, education and prevention and I really want you guys to be able to explain what they mean, how you've been able to as you've already mentioned, make them evolve, develop them and to support the, the true mission of cares. So let's go with our first response response.
Speaker 2:You want to start go?
Speaker 3:ahead yeah sure, I'll do do my pillar here. So, uh, response is one of the pillars that we use. It's essentially what you would think of as a typical 911 call. So I normally respond in a pickup truck, no fire engine, no ambulance, but with lights.
Speaker 2:Oh yeah, with lights, for sure Lights and all the equipment, All the fun stuff. Yeah, he has all the equipment on him.
Speaker 3:So my truck is ALS equipped, so Advanced.
Speaker 3:Life Support Unit and you've got me as a paramedic slash rn responding to the call. Two benefits to that is I'm in a pickup truck, not a giant fire truck, so I can get through traffic a little bit easier and usually get to the the incident much faster. You know, and kind of figure out what's going on from there, essentially start the triage early, figure out that's going to be a life-threatening emergency. Do I? I need more people? What do I need, or is this maybe something I can handle on my own? So a benefit to that is, if something okay, I can take care of this on my own, we can cancel the fire engine coming and kind of saving a little bit of dollars as far as fuel wear and tear and hopefully have those engines available for other incidents that might pop up Right.
Speaker 2:You get just to build on what Derek said there on an engine, if you have three or four people on the engine and we also have a rescue apparatus, which is extra manpower in our city for higher acuity medical calls, both those apparatus are dispatched so you can have six people rolling to the scene. And then if Derek can pick up that call he listens to the radio when he's on shift and he listens to it and if he's nearby the call or if it's something that's either right in his wheelhouse where it might be a typical cares patient or a high acuity call, he'll inform dispatch hey, I'm going to respond to this call with engine 44 and rescue 42 or whatever other apparatus are going.
Speaker 2:And if he gets there first and realizes, okay, this isn't super serious, amr, which is our ambulance agency they're contracted to deliver ambulance services to North Fulton and to Milton If they're on their way and they're just a minute or two out, he can say, okay, engine 44, you can stand down and go back in service. And then now they're available. If a fire tones out or if another medical call tones out, right, they're not at a call being used up within the 911 system, they're available to respond. So that helps out the entire community. So that's not all of Derek's day is responding to 911 calls, but that fills in those gaps, right, he's always listening to the radio, he's always kind of out there just driving around the city and he can pick up these calls and keep these other apparatus in service.
Speaker 1:So it's a nice— Responsible management of resources is what it sounds like to me.
Speaker 2:And then he was talking—when he's on scene, there's other benefits, absolutely, yeah, so like to me. And then he was talking when he's on scene there's other benefits, absolutely yeah.
Speaker 3:So like the second part to me, going to 911 call is, this is how I meet most of my patients.
Speaker 1:Right.
Speaker 3:And literally that's the first. You know they always say 10 seconds right To make an impression. So that's where you kind of start meeting that person, you build that rapport and kind of see how these people are living right the worst day of their lives to call 911. So I get to see your worst day and see how things are for you. What can I do to fix this already? So I'm already thinking of what can I give them. What services can I provide.
Speaker 3:So it's kind of like a it's an assessment period, yeah exactly A big one and that kind of helps speed up the process. So by the time you know they get out of the hospital or they get back home, I'm able to have those resources ready, facilitated for them kind of ready to go, so that way, there's no waiting period and, yeah, it's just building that patient rapport, like having a continuum of care.
Speaker 3:The way I always like to look at it, and even some of our part-time people that I talk to, is you treat somebody with respect and you treat them correctly, provide great care.
Speaker 2:They don't want to see you again.
Speaker 1:Right.
Speaker 3:Go to the doctor. If you have a doctor that's a jerk to you, he's not going to want to see him again.
Speaker 1:Yeah, that's a big check mark for me.
Speaker 3:Exactly I've changed.
Speaker 1:I've changed several because of a bad bedside manner.
Speaker 3:Exactly, and that's one of the keys to the thing is having good bedside manner and really helping out figuring out what these people need.
Speaker 2:Right. He builds that relationship right from the first visit.
Speaker 1:So if he's the first one, that shows up.
Speaker 2:They see Derek. First he builds a rapport with them and then they're happy to see him again after they get discharged. Yeah Right, because we try and follow up One of our goals. We have goals for each year. Because we try and follow up One of our goals, we have goals for each year. One of our goals for 2025 is following up on our citizens that had to access 911.
Speaker 2:Whether they're discharged from the hospital and come with orders, or maybe they just visited the ER and then they get back home, we're going to pop in on them and just see okay, how are you doing? Is there anything that we can do for you now and get some feedback from them, even if it's just a regular 911 visit? So when we were talking before about how this program is really for anybody in the community, that's what we mean. You know, maybe it was just your son or daughter had a sprained ankle. You took them. They went by ambulance to the hospital. Well, now we show up the next day when they're back home. Is there anything else that you need? Did you understand everything?
Speaker 1:at the hospital, any services that you need and we can just build on that initial relationship. Oh, that's amazing because that goes way past just your elderly population, that's. You know, you think about a single mom or a single dad who's dealing with something with their child, whether they're sick, they're hurt, they've got chronic issues, they're hurt, they've got chronic issues, and to have somebody show compassion and care and follow up it means a lot and I don't think that happens enough in our world today.
Speaker 2:Hopefully that's something as we grow, you know, and Derek's just one man, though he does a great job Are we cloning?
Speaker 3:you now?
Speaker 2:Yeah, I need a clone, but as he gets out there and, depending on how busy the previous day was with 911 calls, we're going to try and pop in on those people again.
Speaker 1:I love that. Were you going to follow up with that?
Speaker 3:No, I was just going to say, yeah, that's kind of the thing about the response pillar. Some people are like, oh it's just running, 911 calls response pillar, Like. Some people are like, oh, I just just running out of one calls.
Speaker 1:It's a little bit beyond the 911 call. So outside of 911, is there a number somebody can call if they don't want to call 911 and still access a cares?
Speaker 3:So I'm glad you brought that up.
Speaker 2:Yeah, we're in 2025. We just talked about goals. One of our programs we want to roll out is a nurse information line.
Speaker 1:Ah right, so I was supposed to bring that up later, but this is a perfect time to bring it up.
Speaker 2:So you know, derek went ahead and went through all of the schooling to become a registered nurse, right, and so we mentioned that like a paramedic is kind of like a nurse on scene, but the nursing component of what it is that they can offer to our citizens is it's a little bit different from a paramedic.
Speaker 3:They're big into patient assessment, education right there, yeah, so I put it this way the nurse, I will holistically look at you, figure out every aspect to get you back to your independent state. The paramedic is hey, if you're in an emergency situation.
Speaker 2:I have all the skills right now.
Speaker 3:Yeah, exactly, so a little bit of both worlds per se, yeah.
Speaker 2:So, derek being a nurse, we thought, well, okay, how can we offer that to our citizens, right?
Speaker 2:To take advantage of this certification that he's got. So we're going to roll out a nurse information line. You know, sometimes it may not be exactly like an insurance provider. Sometimes they have a nurse information. You call the nurse if you have questions about XYZ, so it's something similar to that, but he's going to be able to maybe answer questions that they have that are health related. Maybe they have questions about their medications or maybe they have questions about their discharge paperwork, any of their doctor's orders or just what to do.
Speaker 1:Yeah.
Speaker 2:Right now. This is not emergency. There's an emergency. We want you to call 911. Absolutely so these are questions that our citizens in Milton might have. It'll be a free service, so we're going to want them to call Derek, ask what, and while Derek is on shift he'll be able to answer those questions. So if he's obviously he doesn't work 24 hours a day, seven days- a week.
Speaker 1:You don't, oh, we're going to have to clone you. That's what I said. That's coming up.
Speaker 2:So we'll have the ability for them to leave a message and then he can call them back when he's on shift. But it'll be another nice added feature for our citizens to be able to have a resource to connect them to answer questions that they might have. So we're going to call that our cares nurse information line and we want to roll that out in 2025.
Speaker 1:I love that.
Speaker 2:So we might need your help with that being our communications.
Speaker 1:Yeah, absolutely, we'll circle back on this and make sure we get all the information out on it, cause I think that's a super useful service. There's days where you have questions. You don't want to haul yourself into the urgent care because it's not an urgent care matter. But who do you talk to?
Speaker 2:And two. As you probably know, you call an insurance company to get those answers and either you get put on hold forever or you weave through the navigation system before you find actually somebody to talk to, and basically this is just going to be Derek's work cell. So, that's like a, it'll be a direct line.
Speaker 1:Can I get that number? I might need it and if he can pick up he'll, he'll talk to him right then and there.
Speaker 2:So I think that's just a more personal service.
Speaker 1:Efficient? Yeah, yeah, cause it's hard. I mean, medical situations are hard and my parents are older and if you ask my mother and mom I love you, I promise I do but if you ask her what she's taking and why, most of the time she can't remember why, but it's in her lineup. So then I have to go and do all the background because I want to make sure that she's taking what she's supposed to be taking when she's supposed to be taking it, and I'm not a medical professional.
Speaker 2:I mean, I watch a lot of medical shows. I watch you know Grey's Anatomy.
Speaker 1:Technically I'm sort of a medical professional. I've watched the whole season.
Speaker 3:Don't shark flatline.
Speaker 1:So that's amazing. I love that that's coming out and we'll be sure to keep everybody posted on. When that's live, we'll bring you guys back and you can talk about that. And, by the way, any of the information that we provide here as far as website and numbers to call and questions, I'll be sure to include in the show notes so people will have access to the information. Awesome, perfect. So I do want to ask a quick question about home visits.
Speaker 3:Yes.
Speaker 1:And that's something that you do Correct, but can citizens request a home visit that kind?
Speaker 2:of ties into that other arm of prevention. Okay, so maybe you could talk about like our wellness visits.
Speaker 3:and yeah, absolutely so we have like a prevention pillar that we call it kind of. In this pillar we're a little more proactive rather than reactive. Yeah right, because it's not an active 911 incident and we're trying to avoid that. So we have a few little programs that we've added as this program has grown. First one I'll talk about is like the wellness visit. Essentially those are just I'll come by your house, just nonchalant, show up in my pickup truck, no lights, no sirens, you know neighbors not coming up Right.
Speaker 1:Just something very nice and easy. Don't want to alarm anybody.
Speaker 3:Exactly. I'll come in depending on the condition. Usually I grab your baseline vital signs. If you have any cardiac conditions, we can do an EKG on scene, check your blood sugar If. If you have any cardiac conditions, we can do an EKG on scene, check your blood sugar If you're diabetic. Just a slew of things are within my scope and we'll follow up monthly and we'll just kind of watch to make sure there's nothing that's going to change. So essentially right, like how long is this visit you go to a doctor? So we usually do those monthly. We have like a set list of people we'll contact and again, they just kind of flow down the line there if they need resources at some point, easy we already know them right, we can get it for them.
Speaker 2:It's kind of building off of what we talked about before that original community paramedicine program. There was a list of certain people that just they would get visited on a regular basis, maybe once a week.
Speaker 1:Is that their request, or is that?
Speaker 3:so normally it is their request. Okay, can be family, family, it can be family as well. Correct? Ultimately, the person has to say yes, but also part of it too is we'll go in there like smoke detectors, right? So it's not just all medical, but I mean, I'm still a firefighter.
Speaker 1:So it's second nature.
Speaker 3:Yeah, right, do smoke detectors, carbon monoxide detectors.
Speaker 1:Make sure those are working look at the house.
Speaker 3:Make sure there's no gas leaks right, no holes in the roof kind of those safety issues, exactly just environmental factors. Okay to look for to make sure that if you have asthma and you haven't changed your air filter in two years, then yeah, maybe something to do that might think about that one yeah that's kind of the uh in a nutshell what the wellness component is on our prevention pillar. The other one we added fairly recently we actually teamed up with Northside Forsyth on this one is the hospital to community transition program.
Speaker 1:Right on, tell me about that.
Speaker 3:So that is normally when somebody gets discharged from the hospital, like Mark was talking about. You get all this discharge paperwork, take this medication, take this, go fill it at this Walgreens. Blah, blah, blah.
Speaker 1:All this stuff that don't wash this until don't take the bandage off till and you have a whole novel to read right Right.
Speaker 3:So the whole component of that is for us to follow that plan that the doctor discharges you with, essentially called a care plan and we'll design our own care plan as well, to be have an individualized part, and again it's kind of a nursing component that we add to it, but we have an individualized care plan that we'll follow as well and have the patient make sure they meet their goals.
Speaker 3:Uh, usually we try to set it up between 30 and 90 days for them to meet the set criteria and we hope you know at that point that the idea is to get you back to the state you were before you went to the hospital right so, following everything they give you at the hospital, all these new medications, all this, and that we'll follow up with the person.
Speaker 3:And it really depends on the person. Everybody's going to be different. Some people are going to be hey, everything looks good. I only got to visit you like three times. It looks like you're getting everything. You understand it. You know, if you need me again, here's my number Some people they got to stay for 90 days and you know, continually just reinforce education, make sure the medications are going, get them additional resources if they need it. So that's kind of what the hospital community transition is.
Speaker 1:And resources. I feel like people's access to that, especially some populations that may not be tech savvy. So finding resources isn't opening up the yellow pages anymore, correct, you know what I mean. So where do they? If they don't have family that's close if they don't have neighbors checking in on them, where do they find these resources? So it's really hard. It becomes a brick wall. Just again, talking to my parents, they're semi-tech savvy, but still to use the Google. You know what I mean. It's a whole different ballgame in accessing the services that you need.
Speaker 2:Right ball game in accessing the services that you need Right and you're trying to find maybe rehab facilities for or PT OT.
Speaker 1:How do you know?
Speaker 2:Yeah, and then as it moves on down the line. Maybe assisted living, specialized nursing care, you know. So there's all of those different resources and that those are just a few and the sad thing is is a lot of them are for profit. So you know you're kind of worried about is it a sales deal, you know right. So how do we find the best care for them? So Derek has made all sorts of connections through this job that he's been in for the last two or three years now, where he's able to line up people with the right people and you don't have to just google it and hope that the reviews are good all in itself, yeah and he was mentioning that that hospital to community transition program it's.
Speaker 2:It's established with north side for scythe. But we also just recently met with wellstar north Fulton and they're creating the same thing for us. So those we found are the two highest frequency hospitals that are utilized in Milton. So the vast majority of people go to Wellstar North Fulton but there's a good chunk that go to Northside also.
Speaker 2:So if we can kind of get an agreement with both of those to give us discharge follow-ups. It's beneficial for the hospital, right? Because if the hospital has readmissions within a certain amount of time, that doesn't look good for them, right? Imagine if they just, yeah, they discharge you and then now you have to go back to the hospital later in the day or the next day. They don't want that, so they want to utilize us to be able to stop in to help to reinforce those discharge instructions.
Speaker 1:Right, because then you start seeing the backup in the ER.
Speaker 2:Yes.
Speaker 1:Right, and you had talked earlier about the difference between a paramedic and a nurse, and the first thing that I thought of is when we go to the ER, we're not going to get a diagnosis. Most of the time, they're there to make sure you're stable and to fix the immediate issue and not to give you the full diagnosis and that and that's hard, for I remember having issues with kids when they were little and I was like but you didn't tell me what's wrong and they're like check with your doctor specialist specialist specialist, your specialist.
Speaker 1:Here's a number and you can get in in six months.
Speaker 2:Yeah, you know as Derek. So he's doing regular wellness checks with people as prevention. He's doing this hospital to community transition, which helps prevent further issues. Then, on top of that, he's partnered with Milton police, where Milton Police are oftentimes exposed to maybe other issues that people have that are different maybe from a physical problem, maybe they're having a mental health crisis. So they run across more of those people on those to make sure that they also get the resources that they need, which hopefully then prevents greater issues in the future or prevents them from having to continue to access the 911 system. Right.
Speaker 1:And what does that look like for you, Derek, when you get called in on those?
Speaker 3:So usually I'll get sent from PD. They'll send a request either through the form that we have on the internet or, uh, kind of talk a lot with officer tidwell. Yes, she's um in charge of that whole component, so she'll might send me a referral from there. Um, usually, me and her will team up and kind of either go to the person's house it depends how they they want to be contacted, right right not everybody wants us showing up at their house necessarily phone's fine, you you know, or email, we'll get them the information they need and send it over.
Speaker 3:Just make it as seamless and easy for them as possible, because we're not trying to make more stress for anybody here.
Speaker 1:Right, right. Remove the element of shame that often is coupled with mental health issues. Absolutely yeah.
Speaker 2:Remove that stigma from there.
Speaker 1:Yep.
Speaker 2:That's the nice thing about that that tide is kind of changing with the way that people view. You know our mental health, mental health and physical health. It's just both aspects of our health.
Speaker 1:Absolutely.
Speaker 2:If we can have the right resources for either one, we take advantage of it and there should be no shame in asking for it.
Speaker 1:So is there anything else on prevention that you since we're on that topic that you want to throw in there?
Speaker 2:I think those are the big four that we were talking about, right, that that hospital to community transition, those wellness visits that we do regularly, that mental health co-response, and then folding in now this nurse information line, right. We hope that those four things will hopefully prevent either people's issues from getting worse or maybe prevent them from having to access 911, right and just really help them out. And then, if we fold a part of that personal care in with the next pillar that Derek was talking about, education, because education, you know, that's a big part of CARES education services, so we offer classes, but also part of education is personal. So people need education about their disease process, they need education about how to care for whatever's going on, or education about their medicine regimen, anything like that. And that's what Derek provides on a one-on-one level in addition to education.
Speaker 1:Which is so much more consumable than being inundated as you're being discharged from somewhere.
Speaker 3:Absolutely. A lot of what my patients hear is like yeah, I got the discharge paperwork. Nurse came by, told me this, this and that I was more concerned about why my monitor, why the monitor was beeping next to me in the bed um, yeah, you know why I was tangled in this and this and that. So yeah, having that reinforcement as well, like just so individualized education. Okay, what did you hear about what the nurse said? I would go ahead and reinforce it.
Speaker 1:Right. Well, and that's something else to look at is when you go to the hospital or you're in the ER, the people who are giving you care see this stuff every day. It becomes part of their every day. So they kind of lose sight. Sometimes not all, not all, I promise ERs, I'm not dogging on everybody they lose sight of the fact that maybe the person sitting there is not as familiar and may not know. You know, I remember an instance with a grandmother being in the hospital and we were all waiting and waiting and waiting for test results to come back hours and hours. And so when I went and found the nurse, she's like oh well, everybody went home. I go, excuse me. I mean, every family's got that one member who loses their mind on the floor at some point and rallies everybody up for answers. That was me. I had everybody in there and I said my grandfather, who's 90 is standing here, has been here for hours and you guys haven't updated us at all about any of it.
Speaker 2:You know they just hospitals are notorious for that yeah, one way to look at it too.
Speaker 3:And you know I can say this. You know, freshly I did a bunch of clinicals as a nurse and I did a lot of clinicals as a paramedic so I got to see both sides of the world, per se, I will say on the nursing side, especially in the ED. They call it chaos coordination for a reason.
Speaker 1:Right.
Speaker 3:There's usually it depends on the hospital right the nurse-to-staff ratio. Sometimes you have one to four, one to five, sometimes it's one to two if there's critical patients. So looking at that and looking at what CARES does right, a lot of what we do on CARES is one-on-one. That's the ratio I always deal with. Normally In the ER setting or hospital setting they're dealing, you know. I've heard some places in COVID they had 15 patients and they're dealing. You know, I've heard, I've heard someplace in COVID they had 15 patients.
Speaker 1:And they're busy, I get it. They're not there just to coddle me and make me feel better, I get that. But sometimes a little insight as to what's going on around you is game changing.
Speaker 3:Absolutely.
Speaker 1:Wow, I like the individualized. So you've we've talked prevention, we've talked response. That leaves us education and you've touched on it a little bit. So why don't you guys go ahead and get into that topic? Let's see what's what?
Speaker 3:Yeah, Like we just talked about kind of self-education. We do a lot of that. It could be medication, could be a disease process, like Mark was saying.
Speaker 2:Again, big component is education, if you're educated you know what's going on.
Speaker 3:Hopefully that is preventative right so you know, again, being proactive instead of reactive in all these situations. Um then, the other component of the education is we do a lot of community education per se. That's what we call it. So that is your cpr classes. Stop the bleed classes we have the safe sitter class. I think we all know what cpr is. Tell us what. Stop the bleed classes.
Speaker 1:We have the safe sitter class. I think we all know what CPR is. Tell us what stop the bleed is. I think it describes itself, but just in case, let's see what you got.
Speaker 3:Well, like you said, it's literally stop the bleed techniques. But to dive in a little bit deeper in the class you'll learn how to pretty much bandage a wound. You'll learn the different degrees of a wound. You'll learn how to apply a tourniquet. In my class I have people apply tourniquets themselves to see how much, how painful it could be, right, the importance of it. And we do have actually a dummy arm that she kind of throws blood out. So you know, show you how to pack a wound.
Speaker 2:The thing about that is, sadly, in the world that we live in now that that's an issue right. Right, we have active shooter scenarios that people are worried about. So if you think about that, in an office-type setting, a school setting, even within our city government, at the courthouse or at city hall, anywhere where you have a large group of people, these classes then teach those that are on scene how to mitigate injuries so that the people can basically stay alive until they can get definitive care at the hospital.
Speaker 2:So some of that Derek's talking about. Right, Do you know how to apply a tourniquet? Do you know how to stop active bleeding from a gunshot wound? There's different stop the bleed kits now that are more commonplace. They're posted oftentimes next to AEDs at different office parks or in city buildings. We have stop the bleed kits.
Speaker 1:I think we have one.
Speaker 2:We do Right here in City Hall. We have stop the bleed kits posted on each floor at City Hall and then also next to the AEDs at the courthouse. So that's something that anybody in the community can take advantage of. It's a free service. We offer those classes. Normally those are during business hours. But yeah, there's large office parks down off of Deerfield Parkway. There's office buildings even right in through here in Crabapple where you can receive that sort of education, that sort of training, for free. We'll come in, we'll come to your location and teach.
Speaker 1:And so organizations can reach out to y'all and get it scheduled and get their employees their staff trained.
Speaker 2:Yeah, we do those CPR classes again for businesses, homeowners, association groups, your softball team, your kids' soccer team coaches. That's one thing that we do every year is we partner with Parks and Rec to teach the coaches that come out to all of our city facilities so teach them CPR. We can teach them stop the bleed too.
Speaker 1:So I think it's important to note that the CPR classes yes, they teach you CPR, but they do not give you a certification. Is that correct, that is?
Speaker 2:correct. We offer the same sort of training though. Yeah, because we want everybody in the community to know how to do CPR, so we offer the same class for free, just to make sure that everybody's trained in how to operate CPR and an AED, and then, when they're done, we try and get them to sign up for the PulsePoint app, which is a local application, go ahead and talk about it.
Speaker 1:Let's go.
Speaker 2:Within our city where it will alert you if someone's experiencing cardiac arrest within the locality. So the whole point of PulsePoint, of that app, is to get whoever's trained on CPR to the person experiencing cardiac arrest the fastest. Sometimes that's the fire department crew coming from the fire station, but sometimes it's just the person within the building that you're in in a public place, that you all of in a public place that you all of a sudden find out on the second floor of city hall someone's experiencing cardiac arrest. And if you've got that pulse point app, well now you just walk upstairs and you start CPR.
Speaker 1:And it'll send you notifications.
Speaker 3:Yes, or is it?
Speaker 1:something that you have to keep open.
Speaker 3:It'll send you a notification, kind of like a text message. Oh, I got you literally pop up and it will ask you if you want to respond and click yes. It'll literally Google map walk you to the location, right to the person.
Speaker 1:It's so amazing and I will be sure to include PulsePoint in the show notes because I think that's important to highlight that we do have that program and it is available and it's a free.
Speaker 2:Right, it's a free service service. So yeah, we, what we do is at the end of each of our CPR classes we we show a little slide about pulse point and we try and get everyone just to sign up for the app right down there. So the more people in the community we can have to sign up for, that, it's just going to be better for us long-term.
Speaker 2:I mean, hopefully we never have to use it, right it's our hope that, but you know we want to make sure that anyone who's trained in CPR is going to be alerted so that they can use it, because why get trained for it if you don't ever want to use it? But you want to be available just in case.
Speaker 1:Yep Like insurance Exactly, and we all love insurance.
Speaker 2:But we talked about Stop the Bleed and CPR. We also have a program that we just rolled out this past summer called safe sitter. So, and one of our we still have some cares part-time medics. Uh, they work for our fire department and they help fill in when Derek's off and he can't again he does get time.
Speaker 2:We want them to be refreshed at work, so when he's off, they'll fill in for him. Them to be refreshed at work, so when he's off, they'll fill in for him. And one of our cares medics, brandy Sadowski. She's a mom, so she went through the safe sitter course to learn how to be a safe sitter instructor and what safe sitter is is so you know if, if you're going to have or going to hire a 13 year old or 14 year old or 12 year old young lady to come babysit your children, you want to make sure that they know what to do in the event of an emergency. So that's what this class instructs them on is okay.
Speaker 2:What do you do if your child, if you see a child that's choking, you know, or something happens to them? How do you determine if it's a real emergency where you need to call 911, or is it something that you can handle, and if you can handle it, we'll show you how to handle it? So she teaches that right on. And then there's little stuff too.
Speaker 3:It's beyond just that, right correct yeah, there's um, like weather related emergencies, um proper technique to change a diaper because, yeah, surprisingly, a lot of people don't know and there's a lot of stuff you gotta look out for honestly you know and when doing doing that, just looking as a nurse the amount of infections and stuff that could happen from it, so very important. And then also it teaches business skills at the end. How to help out this person taking the class.
Speaker 2:How to negotiate your rate that's right. How to market yourself. Yeah if you've got a young one that wants to become a babysitter and they want to take that on in the summertime, she'll teach that class. Now there's there's a little cost involved in that. All of our other classes are free, but safe sitter provides books and curriculum and a certificate at the end. So I think it was at $75.
Speaker 3:It is $75.
Speaker 2:Yeah, that's the cost for that class, but we've been lining those up on every few months on a Saturday, so we've got some coming up for 2025.
Speaker 1:Yeah, perfect, and we'll keep those. Those dates are usually pushed out definitely on our website and I know it goes out on our Facebook page as well when those are available and, from what I understand, they fill up pretty quickly.
Speaker 2:Yeah, those get snapped up, usually within about a week. Which one SafeSitter, SafeSitter.
Speaker 1:Yeah, how many attendees do you have? Do you accept?
Speaker 3:So usually about 12. That's kind of our training room what can hold, and it's about an eight-hour class. We want people to be comfortable.
Speaker 1:Yeah, for sure.
Speaker 3:Kind of keep them fresh.
Speaker 1:And those generally take place over at 43? Correct Right.
Speaker 2:On a Saturday.
Speaker 1:We've kind of talked about all the pillars. Talked about all the pillars. Do y'all have any warm, fuzzy stories or any kind of most memorable moment that you?
Speaker 2:can share out of the benefits of this program. It's Derek, yeah, you should talk. Share that story about, uh yeah, I got you with the at the out-of-town mom it was police. Remember that she was calling the cops to get her a diet coke. Yeah, multiple times a day, like every day.
Speaker 3:No, yeah, this yeah chief griffin's gonna get me well, actually so not not to not to roast on bd though yeah, she called 9-1-1, um all the time, yeah, requesting a diet coke, and it got pushed to me because they were like oh, this sounds like your domain, let's go see. So I go over there to her house and kind of see what's going on, because this obviously is really not one for a. Diet Coke, necessarily right.
Speaker 1:Probably not your first option. Maybe to some people it's an emergency, but yeah right.
Speaker 3:So you know it's a way to raise the suspicion, like what's going on?
Speaker 3:Right. So I go over there and kind of talk to her a little bit and try to see what's going on. And you know she told me a story about how police would bring her a Diet Coke all the time. So I did call the police department, you know, and I was like hey, do you guys know this address at all? And they're like I have no idea what you're talking about. So there's a little bit of race suspicion there. And kind of looked at her medicines, you know, because she's like I need this Diet Coke to take my medicines. That's essentially what it was.
Speaker 1:Right.
Speaker 3:So I was taking a look at her medicines and kind of going to start putting a picture of the medical history from there. So I would ask her to leave. At the time she had renal issues, I think.
Speaker 3:So I was like, okay, hey, diet coke probably not your best, yeah, sodium, you know, we know you too well, but I'm telling you you need water. And she's like well, I don't like water. I'm like, well, unfortunately, it's gonna be your best thing. So you know, I talked to her a little bit and I found out she lived by herself, got got to know her a little bit more and kind of get her social what we call the social assessment okay and kind of like understand her family dynamic. Where's her closest family? Who did we need contact in case of emergency? And she was a little bit on the older side so she was like no, I live alone. I looked at the house. I could see obviously some damage, like there was.
Speaker 2:She wasn't able to get up either, right to like go get her own water, to get her own. Yeah, she was stuck in a chair.
Speaker 3:So yeah, so yeah, deep, diving into it more, and it got her the water and was like hey, I think you should go to the hospital just to get checked out, like, are you able to get up? And she said no, and unfortunately, in ems pre-hospital medicine if a person is technically alert and oriented and we ask them a series of silly questions and and they can answer them, then we have to go abide by what they say. We can't take anybody.
Speaker 2:You can't force someone to go to the hospital, even though if you feel medically, yeah, it would be in their best interest.
Speaker 3:Yes, so we obtained the refusal and I was like here's my number If you need to call me, yada yada, so I get a call next day. Same exact thing, and she was a little more irritated this time by me saying I'm not bringing you a diet coke. We already had this this bring you some water yeah, so I went over there and brought her water. Um kind of noticed that she hasn't moved in from her location. Um, from there looked a little bit deeper and saw her ankle looked a little bruised.
Speaker 3:She had been again. She hasn't moved, so she had been soiling herself in there, first thing that you know. I kind of thought was, okay, she needs to get to a hospital, something is not right, and kind of started going down the line, went down the A&O times again and she still denied, denied, denied, you know any transport.
Speaker 3:So I was like, well, at least let me clean you up and get you fresh clothes at minimum yeah so we did that, got her all cleaned up um, got her situated and I was like I need to call somebody because I can't just leave this person here yeah you know, and she got angry I.
Speaker 3:I get it, you know it's fine, but I called her daughter and her daughter was actually out of state and was like I'm coming down right now. So she came down within the next day. She was at the house, she called me and she's like hey, how do I facilitate getting her taken to the hospital Because we're not doing this? You know there's something is not like her and I told her okay, this is what I suspect is wrong with her as a uti, just based off all this information you've been giving me and at this point, her mental status has been altered because, it's progressed to a point.
Speaker 3:So eventually we got her there. We got her to the hospital, yeah, diagnosed with the uti so, and kind of facilitated her getting to an assisted living facility, explained to the daughter like, hey, let's take care of all the house stuff and what can we do to help you in?
Speaker 1:that aspect.
Speaker 3:And yes, I would say she's one of the success stories that unfortunately, we caught that one.
Speaker 1:Somebody else would have skated past it and taken the no.
Speaker 2:thank you Well the daughter never would have even known right.
Speaker 2:The mom wasn't calling the daughter. The daughter was completely in the dark as to what was occurring. She was just going to keep calling for a Diet Coke every day. I think what was happening is she had a personal number for one of the police officers and so whenever he was on duty he was just bringing her a Diet Coke. But it's just, Derek identified a need, he took care of her, not just getting her the referrals, but I mean he physically cleaned her up, helped her out, called her daughter in another state, informed her daughter of what was going on, who came down the very next day and then made sure that her mom was taken care of.
Speaker 2:So that kind of yeah, it gets it all the way, from the very beginning to the very end, um of of the care that she wasn't getting, helping her daughter navigate through all of it and then get the care that she needed. So that stuff like that it happens, you know, on occasion and UTIs.
Speaker 1:I'm not going to lie, they're tricky because, nobody's going to immediately go. Oh, it's a UTI and it does cause confusion and at one point, like with my grandmother, she, she, couldn't speak. Right, she had one so bad that she could not even speak, so she couldn't advocate for herself.
Speaker 1:If they're not treated, those people will die yes, even though we all know it still happens. And now we got to take grandma back to the hospital. Well, it's a utah and she's like well, I drank my water. She had one little bottle, not gonna lie, she had one little bottle that had water in it and she would sip on it and so we're talking made of all of eight ounces in a day, but I've been drinking water all day.
Speaker 1:Okay, you need like eight of those exactly a minimum a minimum right, and even then it's still hard to keep an older person hydrated absolutely yeah, and that's the other thing too.
Speaker 3:You know, the older you get, things break down a little bit more. So you know, it's kind of like an older car sometimes a little bit more effort, yeah, a little more maintenance, exactly.
Speaker 3:So, yeah, you know another story. Um, you know this was a lot shorter, but um, kind of like showing a little bit on the response side is. You know, I responded to a 911 call an actual um event for a low blood sugar incident. Uh, found out the crew's been there the night before for the same issue. So we fixed her up, got her um, you know the glucose she needed to get the blood sugar back up.
Speaker 3:Um, however, vital signs were trending towards what we thought was sepsis oh so we were very concerned for her and she didn't want to go to the hospital. And there was again doing social assessment, being there with a family member and explaining like, hey, this is, this is what's going on. And you know, I was able to release the engine because and the rescue at the that time- I got this one yeah.
Speaker 3:We're somewhat stabilized right now. Um, really, what she needs to do to go to the hospital? Um, even the ambulance had to leave at that point and I stayed on that scene for four hours with her um, giving her education, giving her the different things that we're looking at and really explaining to her deep down.
Speaker 3:you know pretty much almost a physiology class with her about kind of what's going on in the body right now. This is why you need to go to the hospital. Thankfully, eventually she went and yeah, she had to go to ICU. She was in a septic shock.
Speaker 1:Oh, my goodness.
Speaker 3:Caught that one before it came into rest.
Speaker 2:But now she's doing well, she's out so he has the ability or the freedom with his schedule to spend extra time with people. Right, you can't keep a fire engine on scene for someone who doesn't know if they want to go to the hospital or not for four hours, right you? Just, we don't have that ability or that luxury. So it really is. And then, through the relationships that he builds when he's on scene, he's able to build trust so that they eventually make the decision that would be best for their long-term health.
Speaker 1:Because somebody took the time to talk to them and not lecture them and not push them and tell them what they're doing wrong, because nothing will make somebody dig their heels into the sand more than somebody telling you you're wrong. I'm right, you've got to go 3,000%.
Speaker 3:Wow, exactly. And you gotta, you gotta meet people that were there. Right, you do.
Speaker 1:I love it. Is there anything else you guys want to include in this for our listeners to know about the program? I again, all the information will be in the show notes. I want to make sure we didn't forget anything.
Speaker 2:I think we've covered it well. It's just I want to encourage anybody within the community is just, don't feel bashful about reaching out. Yeah Right, you know there's. There's easy ways to get in contact with us. If you go on the website and search cares, you're going to find an email address, derek's work cell phone. If you you know you yourself or you have a family member or you're just having a hard time figuring out what to do when it comes to what resources you need to take care of your health or any sort of education that you feel like you would like for yourself or for your business, just feel free to shoot us an email, give us a call. We'll talk about it. We'll do our best to help.
Speaker 1:I love that. This is amazing. I'm really impressed because, as I said, I'm kind of new and learning, and I'm really impressed with the level of care that you all are able to provide the community, because they deserve it that you all are able to provide the community because they deserve it Absolutely. We love it Perfect. Mark Derek, thank you so much for joining us today and sharing all the incredible work you're doing through the CARES program. It's very clear that this initiative is making a profound impact on our community and we're so very grateful.
Speaker 3:Thank you, Thank you Kristen.
Speaker 1:And to our listeners. Thank you for tuning in. If you'd like to learn more about the CARES program or get involved, be sure to visit the CARES page on. Visit us online at wwwmiltongagov for resources, news and upcoming events. Until next time, thanks for being part of the conversation and we'll see you on the next Milton and Maine.