According to the Health Resources Services Administration, as of 2023, 72 of Arkansas’ 75 counties are partially or fully considered Health Professional Shortage Areas. More than 500,000 Arkansans live in HPSAs. Nationwide, by 2034, the Association of American Medical Colleges projects a shortage of between 37,800 and 124,000 physicians. Some states, including Arkansas, have begun to implement solutions to this primary care shortage, such as bolstering the responsibilities and skills of nurse practitioners. Ryan Cork, executive director of health care for the Northwest Arkansas Council, and his colleagues have implemented a plan to help patients still receive care despite the shortage while lessening the burden on emergency departments.
House Calls by Community Paramedics
Medics trained to and qualified to treat wounded service members will begin making house calls to sick patients in Northwest Arkansas if a new pilot program gains traction. Ryan Cork, a Navy veteran and executive director of the Northwest Arkansas Council’s health care transformation division, local veteran Matt Hesse, and Bella Vista Fire Department battalion chief and paramedic Ronnie Crupper are all working on starting a community paramedics program in Northwest Arkansas.
Only 50 cities in the U.S. have implemented such a program, which recruits trained medics who are leaving the armed services. Cork hopes these medics will find jobs as emergency technicians in Northwest Arkansas and that those needing further training will attend NorthWest Arkansas Community College (NWACC). As emergency techs, these trained combat medics would go into the homes of veterans needing medical assistance when a clinic is unavailable and the condition is not severe enough to warrant an emergency department visit. While their initial service areas are Washington and Benton counties, this program could easily be replicated in other counties throughout the state.
The program aims to lessen the load for overbooked urgent care clinics and hospitals and to help patients who cannot travel to appointments. Cork gave an example of how this program would benefit the community: the goal is to save a single parent of three children from having to take all three on a trip to a local ER when one of them falls seriously sick, and the family struggles to get in touch with a doctor.
The goal is to save a single parent of three children from having to take all three on a trip to a local ER when one of them falls seriously sick and the family struggles to get in touch with a doctor.
Veterans lose their certifications if they don’t keep up with continuing education opportunities. This program would allow veterans to keep their certification and benefit the community at the same time. The Little Rock Air Force Base (LRAFB) recently inactivated the 19th Medical Support Squadron, leaving around 120 personnel to work with another squadron of the LRAFB. Through programs like the one the Northwest Arkansas Council is proposing, 120 personnel would be able to continue their certification and help the community.
A Familiar Structure
The program is designed to allow veterans to continue practicing directly after serving active duty as a medic.
“You would have at least gone through EMT training as an active-duty medic,” Cork says. “So, if you have your certification when you get out, you would have to take the performance agility test (PAT), a requirement for applying to any firehouse.” If needed, the program would also require veterans to take classes at NWACC. After passing the PAT, veterans would then be able to apply at a local firehouse as an EMT firefighter. "The idea is that you’re serving the community again in a familiar environment,” Cork says. “You’re in a uniform, there are men and women serving, and you’re in a unit, so it’s a familiar structure to the military.”
Enrollees in the program would be going to school to earn their continuing education credits while also working nights and weekends at the firehouse. The post-911 GI bill would pay for veterans' schooling, while their salary from working as an EMT firefighter would pay for everyday expenses.
While Cork says the goal of the program is to become a community paramedic, there are other options members could take after 18 months of training that still greatly benefit the community:
- stay at the firehouse and rise up in the ranks;
- look for a job at a local hospital; or
- roll over into working as a community paramedic delivering at-home care.
Lessening the Burden on Hospitals and Emergency Departments
The community paramedic program is designed to supplement care, not replace it. Community paramedics perform home visits to address minor health issues, not life-threatening concerns.
“Say you have a fishhook in your hand, and you can’t get it out,” Cork says. “If you can’t afford to go to the ER or you don’t want to drive 30 miles to your nearest hospital, a community paramedic could come to your house and see you with physician oversight over Zoom.”
Paramedics are still operating within Arkansas law, and the home visiting services are at no additional cost to clinics, hospitals, or patients. Through home visiting programs like this one, paramedics are decompressing ambulance and emergency department services.
“Around 45% of patients seen in the emergency department have non-life-threatening issues,” Cork says. “You always hear patients saying, ‘I waited for three hours at the emergency room’ because they had a minor health issue instead of a more serious condition. Now, minor health issues can be solved with a primary care physician and a paramedic through this home visiting program. There’s no more waiting in line,” he adds.
Now, minor health issues can be solved with a primary care physician and a paramedic through this home visiting program. There's no more waiting in line.
Additionally, money flows back into hospitals and care teams that the patients belong to.
“We still transfer the medical records to the hospitals or physicians that the patient sees. We’re not taking away from any business at the hospital,” Cork says. “We’re trying to supplement the services offered by the state of Arkansas to practice and deliver.”
Other Specialists Can Get Involved, Too
While there are other community paramedic programs, such as the North Arkansas Regional Medical Center Community Paramedic Program, in Arkansas and across the U.S., there has yet to be an established statewide plan.
“I myself was a Navy corpsman. When I got out, I had no idea what I wanted to do and how to continue medical services. There was no established pipeline for how to continue my services to the community. We’re trying to change that,” Cork says.
When I got out, there was no established pipeline for how to continue to offer medical services to the community. We're trying to change that.
There are even plans to allow medical residents a chance to fellowship by working as community paramedics through Cork’s program. While the program is currently marketed toward combat medics, Cork says the program can apply to anyone.
“From our end, there are no disqualifiers. All you have to do is pass the school requirements and pass the PAT so you can begin applying to local firehouses.”
The program has been approved and set up in Northwest Arkansas, but Cork has already begun meeting with the Arkansas State Chamber of Commerce to expand the services statewide. “It may seem ambitious when the right folks across the state have not yet bought in,” Cork says.
“But, if we can get this in front of the right people with the right message, we can replicate and scale this model across the state.”
In a state like Arkansas, where many rural communities cannot afford to drive to the doctor, Cork thinks that message will hit home. “This is a great program for small towns that can’t afford to keep their hospitals open. There’s a need out there to take the burden off EMS and hospitals, which are already understaffed as it is. This is a supplemental, add-on, no-additional-cost service that could offer respite.
Any veterans, retired nurses, or other part-time health care professionals interested in becoming community paramedics through this program can contact Ryan Cork via email at
“If you’re interested in helping out, I encourage you to get in contact with me. Please help us get this thing off the ground and do good work across the state. Let’s make a difference in our community together,” Cork says.
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Ryan Cork is the executive director of health care for the Northwest Arkansas Council. Ryan’s focus is on supporting the health care system in our area and ensuring its future development to keep our population healthy and strong. His vision is one where all members of the NWA community have access to world-class health care. Before relocating to Bentonville, Ryan held leadership positions in strategy and finance for health care operations in academic, domestic, international and military settings.
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