03/25/2025
Please take a moment to learn about some of the things we are doing here in Lisbon for our residents and community! A well written article by the Caledonian Record.
https://www.caledonianrecord.com/news/local/innovative-approach-to-ems-keeps-local-squad-healthy/article_61826ad5-4b40-5e8d-925a-458e2c1571b8.html
"Although several local towns’ Emergency Medical Services are struggling to maintain sufficient personnel levels, the Lisbon Life Squad has been bucking the trend. It also partners with several healthcare agencies to improve service.
In May 2023, Lisbon’s all-volunteer EMS implemented the Mobile Integrated Health (MIH) program.
To fill gaps in local healthcare, MIH was initially supported by a grant awarded to Littleton Regional Healthcare through the Strategic Population Health Activities for Rural Communities program, which expired in May 2023.
In June 2024, Lisbon EMS, Littleton Fire Rescue, and Linwood Ambulance were awarded $14,000 each from the Community Health Access Network to continue their MIH operations.
Additionally, in June, LRH was awarded a 3-year Northern Border Border Regional Commission grant, which keeps the MIH programs going after prior grant funding ran out and uncertainty arose about whether MIH could continue.
Importantly, Lisbon EMS stands out as one of the few services in the state that employs a diverse range of providers, including emergency medical responders (EMRs), emergency medical technicians (EMTs), advanced emergency medical technicians (AEMTs), and paramedics, said Audrey Champagne, chief of Lisbon’s EMS.
“Basically, most MIH programs in the past have been set up to be run by paramedics,” she said. “We’re unique in that we are also using our EMRs, EMTs, advanced EMTs, and paramedics for our MIH, and we’ve been successful in getting out to our communities.”
What is called an asthma grant through LRH allows Lisbon, as well as Littleton and Lincoln, to educate residents on asthma and chronic illnesses.
“It fits in with what they are trying to do,” said Champagne. “They had some money they were trying to use and it was just perfect timing for all of us at that point. We’ve been very successful with all of our visits. Basically, the idea is to keep community members that call 9-1-1 from having to call 9-1-1.”
That avoids hospital readmissions that aren’t always necessary by offering preventive care, follow-up visits, and chronic disease management.
“We do home visits at their release from the hospital,” said Champagne. “We check to see that homes are safe, that people have handrails if they need them, have heat and access to food, that they are able to organize their medications to be successful. Do they live alone or do they have people with them? When you go into a home you are able to take a look at those things to try to find ways where we can help them be successful in staying at home.”
In 2024, to deliver MIH services, Lisbon EMS partnered with North Country Home Health and Hospice (NCHHH) and others to conduct 60 home visits, which include several in the town of Lyman, which Lisbon’s EMS covers.
MIH works to improve access to care by making healthcare more accessible; enhance patient outcomes through personalized care plans and regular monitoring; efficiently use healthcare resources and avoid strains on emergency departments; coordinate care by integrating with other healthcare services; offer preventive service in the form of care, education, wellness checks, and early intervention; and offer a cost savings by preventing unneeded hospital visits.
“We can go in with orders from primary care providers or the emergency department staff,” said Champagne. “It’s mostly primary care. Sometimes, they say the person is housebound and ask if we can get blood labs. We send a member who has that within their protocol.”
The purpose of the visits runs the gamut.
“One of the beautiful things about it is we’ve developed relationships now with other services in the area,” said Champagne. “We really didn’t know how each other worked.”
In addition to NCHHH, Lisbon EMS partners include Ammonoosuc Community Health Services and primary care providers at LRH.
“We were working in a bubble not knowing how do we help this or that person,” said Champagne. “Now, there are contacts within each of our groups that we can reach out to if a person is struggling to pay heat or they need a wheelchair or they’re not able to shovel their walkway or maybe they need a fall risk assessment done.” One resident who was dying wanted to die at home but didn’t have any family.
“Once it got close to the end of his life, with Home Health and Hospice we were able to fill in some of the gaps where he was alone with some of our staff members with MIH to be able to stay at home those last few days and be successful in being able to pass at home,” said Champagne. “We’ve done all sorts of different things. We’ve worked with Veterans to Veterans. One woman was sleeping in a recliner and we and got her a hospital bed to be able to sleep comfortably in a bed.”
The program and its educational component have reduced the number of repeat calls made to Lisbon EMS by some residents.
Sometimes, it’s as simple as an EMS member picking up medication at a drug store. “Sometimes it’s just a matter of helping them find those resources,” said Champagne. “We’ve been lucky. We have a great team here. There are 25 members, and they are all mostly pretty active.”
That team consists of seven EMRs, eight EMTs, seven AEMTs, and three paramedics. Two on the team are younger members in an EMT-level class who have been shadowing their colleagues on calls and should be graduating soon.
As for emergency calls, Lisbon EMS in 2024 had 336, which is a lot for a small department, said Champagne. Those calls included 244 in Lisbon, 27 in Landaff, 29 in Lyman, four in Bath, 23 in Haverhill/Woodsville, one in Sugar Hill, three in Newbury, four in Littleton, and one in Franconia. Of that total, Lisbon EMS transported 119 patients.
“We provide EMS to Lyman and collaborate with Woodsville Ambulance for EMS responsibilities in Landaff,” said Champagne.
Some local employers are making it work for Lisbon EMS, notably New England Wire Technologies — where several EMS team members work — allowing employees to leave work and respond to calls. At the same time, a few retiring EMS members or those moving out of the area could turn Lisbon EMS successes around quickly, said Champagne.
As some towns struggle, however, she said it’s positive that more conversations are occurring about the future of local EMS.
Because calls are increasing, the population is aging, and many people moving to the region are older, she doesn’t foresee EMS calls decreasing. And unlike police and fire, EMS is not a state-required municipal service.
“If a town decides not to fund EMS or can’t find someone to provide EMS, a person could essentially call 9-1-1 and be told nobody’s coming,” said Champagne. “It’s one of those things you don’t think about until yourself, child, or mother is having a heart attack, falls off a roof, or whatever it is, and then you’re told there’s no emergency services and you need to load them in a car or whatever you can do and figure it out. I don’t think we’re there yet, but we’re not far from that either.” Because of a lack of volunteers, Franconia had to disband its life squad and contract with Littleton at a cost of more than $600,000 annually.
“Franconia is in a fortunate situation where they have a bigger tax base,” said Champagne. “If that happened to us, our town would never be able to absorb $600,000. We would have to go without because our tax rate is already crippling people.”
As Lisbon EMS remains boosted by committed volunteers, it is working on another effort in addition to MIH, a pilot program with LRH involving patient transfers out of the hospital.
“That’s another issue the area has,” said Champagne. “If you’re at the hospital and need to go to Dartmouth or Portsmouth or back to the Lafayette Center, to find an ambulance to transfer you back home or to transfer you to Portsmouth for a CAT scan, or a cardiac issue, or whatever it is you need, there’s a real shortage for that. We’ve done that for a month or two, and April will be the time they reevaluate how the pilot program’s been working. From our perspective, it’s been pretty good. Lancaster does a lot of that transport, but if [LRH has] multiple people that need to be moved or Lancaster’s not available, then they reach out to us.”
By law, an ambulance must have two licensed EMS providers to take a patient. “I can’t say enough about our people,” said Champagne. “They are great team members. Everybody supports one another. Everybody learns from each other, no matter what level they are. Their families have been hugely supportive. Without that, we would not able to move forward.”
Lisbon EMS has also ordered a new ambulance, which costs around $300,000 and will replace a 2016 model that has taken a toll from weather and winters. The new model, though, hasn’t yet made it to the assembly line.
“We do have a budget for the community,” said Champagne. “It has been approved by the town that 50 percent of what we bring in for our transfer money stays with department and 50 percent goes back to the general fund. Our 50 percent we put into a revolving revenue account. The goal for that is to use it for large items, like the ambulance, our cardiac monitor, and our stretchers. We’ve been able to save enough money from our split and donations from people that we believe we should have enough when our truck comes that we won’t have to ask the taxpayers to raise more money to help pay for that ambulance.”"
Although several local towns’ Emergency Medical Services are struggling to maintain sufficient personnel levels, the Lisbon Life Squad has been bucking the trend. It also partners with several healthcare agencies
