Welcome to a special episode of Ability Radio, brought to you by the Disability Rights Center of the Virgin Islands. Join host Kishma B. Francis as she sits down with three extraordinary women: Jacqueline Greenidge-Payne, Kami Mead, and Dawn O'Bryan, to discuss the impactful Mobile Integrated Healthcare (MIH) program.
Jacqueline Greenidge-Payne, the Director of the State Office of Emergency Medical Services and a Vanguard Award recipient, shares her inspiring journey from a nurse to a paramedic, highlighting her exceptional 35 years of service. Kami Mead, a dedicated nurse practitioner with over 25 years of experience, and Dawn O'Brien, an advocate with the Disability Rights Center, also share their experiences and roles within the MIH program.
The conversation delves into the inception of MIH post-Hurricane Maria in 2017, its mission to provide holistic healthcare services to the community, and the extraordinary lengths the team goes to ensure the well-being of their patients. From medical care to home safety and even yard maintenance, the MIH team truly exemplifies community care.
Learn about the critical support from organizations like Pafford EMS and the community health clinic and discover the future aspirations for expanding this state-of-the-art program. Don't miss out on this heartwarming and informative discussion!
For more information, visit the Disability Rights Center of the Virgin Islands on their YouTube channel or at www.drcvi.org.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
The views expressed on this program are not necessarily those of WTJXs board,
staff, or underwriters.
Good day and welcome to Ability Radio. My name is Kishma B. Francis. I am one of your hosts.
Ability Radio is brought to you by the Disability Rights Center of the Virgin
Islands. We have two locations, one on St.
(00:25):
Croix and one on St. Thomas. Today I'm in the studio and I'm in the studio with
three amazing women, Jacqueline Greenidge-Payne and Kami Mead and Dawn O'Bryan.
So today we're going to have a conversation about MIH. They're going to tell you what the acronym is.
(00:47):
But first, we want to know more about these women.
So without further ado, Jacqueline, can you introduce yourself?
A blessing of morning to the community.
I am Jacqueline Greenidge-Payne. I am the Director of the State Office of Emergency Medical Services,
(01:08):
and I am one of the Program Managers for the Mobile Integrated Healthcare Community
Power Medicine Program.
And Jacqueline is not even going to say this, but I will say this.
She won a Vanguard Award.
And if you could just tell the community what the Vanguard Award is and the
(01:30):
criteria that had to be met to gain this award.
Well, the Vanguard Award recognizes women in the emergency medical services
field that are trailblazers within that field and develop the field that they're in.
And the minimum criteria is you have to have had 35 years of exceptional service.
(01:54):
So I am the 2024 recipient of the Vanguard Award. horn. And this is a big deal.
She didn't want to toot her own horn, but I will toot it for her because I think
Jacqueline does a really great job.
You know, when you see her, she's on the go.
She's on the go. But, you know, you tell her, hey, and she'll come back to you.
(02:15):
But she's always on the go. We also have Kami Mead.
Good Morning. My name is Kami. I am the nurse practitioner for the Mobile
Integrated Healthcare Team.
I've been a nurse for a total of 25 years, and I've been a nurse practitioner for over 10.
I've worked in a multitude of different areas of medicine, including emergency
(02:37):
and hospitalist, and this is by far my favorite area of healthcare that I've
ever done. It's an honor.
Nice, nice. Welcome, Kami. And last but not least, we have Dawn O' Bryan.
She's not a stranger to any show that I've done.
Good morning. Good morning. Dawn O'Bryan. I'm also with the Disability Rights
Center for the VI. I am an advocate.
(02:59):
I do community outreach. So many times I'm out in the field meeting people,
getting to know some of the individuals who are in need of services and making
friends with individuals who we can support and also provide self-advocacy. So...
(03:21):
Glad I'm here with all these wonderful women. And we're going to hear about
great things that are happening in the VI.
Yes, great things. And I know I just want to say first, Dawn and I,
for the listening audience, where we're in our expo shirts.
And we have been to both expos that has been put on by EMSC.
(03:43):
And they were awesome. The one is St. Thomas and the one is St. Croix.
So we just had to put that plug in there. That's right. So, Jackie.
Can I call you Jackie? Everybody calls me Jackie.
What led you into healthcare? It's been more than 35 years. What led you into healthcare?
Well, honestly, to tell you, I've been a caretaker all my life.
(04:07):
So, I didn't actually know my mom until I was 28 years old.
So, I was always the one that stood up, even though I wasn't the oldest,
and took care of my sisters along with them, taking care of me.
But one day my friend said to me, I was living in Texas, and she said,
Jackie, you're always taking care of people.
(04:29):
I'm going to this nursing class. Do you think that you should come and sign up and go with me?
And I'm like, oh, no, I ain't going to no nursing class, girl. I afraid of blood.
So she says, no, you got to come with me.
And I says, okay, I'm going to talk to my older sister and because I was helping
her out watch her boys, she was going away to school.
(04:49):
So she said, girl, the kids are going to be going to school. Try it out.
And so I went and I graduated as a practical nurse and I came out top of the class.
And I was the recipient of the Mary Eliza Mahoney Award.
She was the first African-American nurse. And so from then, I wanted a job in the emergency room.
(05:13):
Back in Texas, you had to be a registered nurse to walk in the emergency room,
and you needed to have a certificate for phlebotomy and EKG and all of this other stuff.
And so the only place I could get a job was in a nursing home, so I took the job.
I had gotten a $5,000 saving balance when I graduated top of the practical nursing
(05:34):
school, and I didn't do anything with it.
But one day, I was passing meds at the nursing home, and one of the student
nurses ran out and nearly knocked me over.
All the meds were in the floor, and I ran in the room, pulled the call button,
and the patient was in cardiac arrest.
So I had to put her on the ground because we didn't have the fancy beds.
(05:56):
I didn't know you just pull the little handle and the bed gets firm.
Oh, there was a board to put under her.
And so the paramedics came in while I was doing the CPR.
And then I said, hmm, I think that's the job I want.
And so, because I was like getting so attached to the patient.
So I figured, okay, if I become a paramedic, I'm just drop him off.
(06:19):
And nope, that was the wrong thing. And so I've been a paramedic ever since. Wow. Wow.
I love it. I love it. You started out one way, going into one field,
and then you just went to be a paramedic.
Kami, what about you? What led you to healthcare?
(06:40):
So ever since I was a little girl, I always wanted to help people and make a
difference in people's lives, but nobody in my family had ever even graduated from high school.
So being a nurse was, to me at that age, was unreachable.
I didn't think I would ever be able to be a nurse or to even graduate from any
(07:01):
college, to be honest with you.
But I ended up being a single parent when I was 22 and had to do something to
be able to take care of myself and my child. And I started nursing school.
I'll never forget when I was, you know, very young and just in nursing school,
the sight of blood would make me queasy.
And I was like, oh, my gosh, I don't know that I can ever do this.
(07:24):
But I did and I went
on to get my I graduated with an
associate's degree in 99 and then I
went on to do my bachelor's degree and graduated with honors and then I did
the master's program and graduated with honors with that as well so yeah thank
(07:44):
you nice so I am in the presence of women men who excel and go above and beyond.
And, you know, you guys, your grades, top of the class and not me.
I just graduated.
(08:05):
So I love your passion.
Because every time I speak with Dawn about Jackie, she's like,
and Jackie's doing this and Jackie does this.
And, you know, No, MIH is this.
So Jackie, can you explain to the listening audience what MIH is actually about?
(08:26):
Well, MIH is a program that helps to bring the human side back to our community.
We are in a community, and especially here in the territory,
where there is not a lot of resources for the elderly individuals.
(08:46):
And so this program is for us to be able to reach each person.
And the motto for our program is reaching a person.
One person at a time. So through the mobile integrated program.
We go out there and I don't really go in the field unless Kami needs me, but Kami does a lot of it.
(09:08):
When Kami wasn't here, let me tell you, we're going from eight in the morning to nine in the night.
And we go out there and we provide whatever each patient needs.
It's on an individual basis.
So one of the things we do is we make sure the first thing is safety of the
environment that they're in.
(09:29):
If it's not safe, we're going to make it safe.
We develop a care plan as to how, depending on what their medical history is
and what care we're going to give for them specifically.
If they don't have a healthcare provider, we would connect them to Department
(09:49):
Because our program is an extension of the Department of Health.
So we would take them to our primary
care clinic unless it's a specialist physician that they would need.
And so I will turn it over to Kami and she could say a little bit more about
what goes on in the field. Yes, Kami.
(10:09):
Yeah, so we go out and see patients in their home. We monitor their vital signs,
including their blood pressure.
For most people, we keep a log of all of their vital signs so that they have
a log to take to their primary care
so they know how their medications are controlling all of their diseases.
We also monitor their blood glucose if they're a diabetic. We do a lot of teaching on diet.
(10:37):
We also do a lot of wound care for people that need wound care services.
But on top of that, we help to also make sure that they have the medications
that they're prescribed, that we set up pill planners for them if they need that.
If they forget to take their medications, that helps them to remember to take their medicines.
(10:58):
And a lot of times we even end up going to the pharmacy, picking up their medications if they run out.
There's just a multitude of things that we do day
to day that you just wouldn't even think about just because of
we're going into the home and we're ensure that
they're safe in their home so we may end up cleaning up you know wiping down
(11:20):
tables and sweeping the floor and running errands for people so you just you
know you have to be able to wear a multitude of hats to do this job Wow. Wow.
And Dawn has been riding along with you guys.
So Dawn, where do you fit in in the MIH?
(11:41):
Well, it's really been an honor participating and driving along with the MIH.
I get an opportunity to see up close and personal how individuals who are either isolated,
individuals who don't have family members, individuals who have limited resources
(12:05):
to take care of themselves are now getting one-on-one treatment.
An individual like nurse, cammy, and a paramedic will come to the home.
They have a great conversation. They're like looking at them like if it's Christmas
time and someone's visiting them.
(12:26):
So they have conversations, they get their vitals checked, they get their glucose,
their blood pressure checked.
You know, sometimes if the apartment is a little untidy, they get a little spruce up.
The nurse will probably pick up their prescription, grocery shopping.
It's like an all-in-one.
(12:47):
Stop. And you just see the emotion on their faces.
I think every time I go to someone's home, I get goosebumps because it's a one
of a kind program that we so desperately need.
I think even if the hospitals were perfect up and running, this is still a program
(13:08):
that's necessary because individuals don't always have to recover in a hospital.
They can recover in the privacy of their home. And sometimes that's maybe even a lot better.
You have individuals who are getting wound care that possibly they might not
necessarily get the equivalent at the hospital because again,
(13:29):
they're getting this one-on-one.
Some individuals get home care visits once or twice a week, depending on the
severity of their illness.
And I think you get a chance to see the individuals just spark on their faces.
They look forward to the visit. They look forward to the interaction.
(13:52):
And many times it's not just the meds that's helping improve,
it's the interaction, it's the social interaction, it's the conversations.
So I love this program because I can see the benefits.
And for individuals who don't have a lot of funds, you know,
(14:12):
they have a limited income.
This is such a rewarding opportunity for them to feel like a human again,
because there's so many programs that are dwindling or broken and individuals
like Kami, they give their all.
And I think that's so important right now where everything in the background is disconnected.
(14:37):
And also my involvement is to let individuals know that they have their rights
are intact and they can reach out to the Disability Rights Center if they feel
they're being discriminated.
So I think I provide a vital component, and I really enjoy watching the transformation
(15:00):
and seeing people just feel good about that interaction.
So I have a question, Jackie. When was MIH started?
MIH started in September of 2017 after Hurricane Maria.
Oh, wow. Okay. I didn't realize it was that long. Okay. Yes.
(15:21):
So we were asked to go out with the American Red Cross when they were taking
out the orange buckets with the cleaning products.
And they didn't want to go door to door without having a medical team.
And so we went out door to door with them.
We really wanted to start this MIH program prior to the storm.
(15:45):
But after the storm, it gave life and birth because of what we saw.
And so that's how it started.
And then at the time, we had Pafford here. And so we were able to have five
teams of three people going out.
And within the time from September of 2017 to when they left in 2019,
(16:09):
we saw approximately 1,800 people on this island. Wow. On St. Croix alone? Yes.
Oh, wow. Oh, wow. And while Cammie and Dawn were talking about their experience
in the field, Jackie was over there shaking her head. Yes. Yes.
Yes. They're cleaning. Yes. Yes. They're doing other stuff. They're going for medication.
(16:32):
Yes. So they go above and beyond to assist these patients, right?
Yeah, it's basically whatever they need. We meet them where they are. Yep. Wow.
Even though I was pushing because they even cut their grass.
What? Yes, we've went out and done weed eating. We've sprayed weeds.
(16:53):
You just would not believe.
If we see something that needs to be done and it's going to benefit the patient,
we're going to go do it. Oh, yeah. Wow.
They go up in the house because the people have homes that are still leaking. They put tops on too.
Wow. Wow. I mean, that just sends something through me for the simple fact that
you guys are there to provide medical attention, but yet still you're doing
(17:17):
everything else that this person needs.
Well, how can you go out and see a patient that needs something and they don't
have family, friends, they don't have any kind of resources? You're not...
We can't just leave and they'll not be taken care of. That's awesome.
That's our first priority.
But one of the things that we need to look at is once we take care of their
(17:41):
physical needs, we just took care of their mental needs.
Exactly. Because then they don't have to worry about where am I going to get
that food? You make sure they have that food.
You know, where am I going to get my medication?
And many times the staff purchased
because when it first started you know i was
(18:03):
buying medication and appointments for the wound care and these things are extremely
extremely they're expensive expensive yes they are i know wow wow i commend
you guys because this is not only that you're you're addressing the physical,
you're addressing the need, but you're also addressing the mental without even
(18:28):
being, you know, doctors.
You find a subtle way to do it.
And I love it. I love it. So who qualifies to receive this service?
So right now, everybody that needs us qualify qualifying because we get referrals from the hospital.
(18:49):
We get referrals from APS. We get court orders from the court to go and do assessment and.
Care plans. And we get referral even from EMS.
So the main objective of this program is to reduce the return of acute status
(19:11):
patients back to the hospital.
So if they are released, the discharge planners from the hospital would identify
those patients because if they go back within 30 days of their discharge.
The hospital cannot collect from Medicaid or Medicare.
So that was one of our focus.
(19:31):
Also to reduce the emergency room overload and even to reduce the 911 calls.
Because if the ambulance go out to a home more than once in a week,
they would refer that person and then the team will go out and see what they
can do to help them to reduce so that the ambulance could be available for the emergency call.
(19:58):
So as it evolves, we adapt and expand to meet the needs of the community.
That's awesome. That's awesome. So it's on a referral basis or court-ordered, but anyone.
Wow. And I'll tell you, the few that we can bill for helps us to take care of
(20:20):
those that can't afford to pay.
Because right now, we're working very hard. Kami's working hard.
She has actually categorized all of the patients in our program for preparedness
for this hurricane season.
We know where they are, what category they're in, and we're just getting ready to pack a backpack,
(20:45):
not a backpack, but a tote for each one of them to make sure that they have
and identify who don't have anyone and who should be going to the shelter and
identify who our dialysis patients are,
making sure that they're on the master list for human service and Department of Health.
And so we're also working that angle right now. I love it. I love it. You're preparing.
(21:09):
You're preparing in the event something happens. So you're being proactive.
I love it. I love it. And that's a lot of work. Yes, it is.
And I know Dawn, she has, Dawn, help me out because I'm lost for words because this is a lot.
This is a lot that they do. It is.
And so every time I travel with them, I am in awe because it's really an amazing program.
(21:36):
My one wish is that they can get the types of funding that they need to expand
so there are more mobile units on St.
Croix and then expand to St. Thomas, St. John.
That's my wish.
And again, even if the hospitals are up and running, there's still such a need.
(21:57):
And also at some point in time, they can expand and maybe address new moms who
are coming out of the hospital that may need some services.
That would be another great opportunity. So there's a lot that they do.
There's a lot that they can do. But funding is definitely key.
(22:17):
Yes, funding is the key. Before we go to funding and we talk about that,
what type of certifications, licenses are needed for the MIH program?
Actually, most programs that run at MIH is run with a paramedic.
That's why it says mobile integrated healthcare community paramedicine.
(22:38):
But I found out when I went to Tennessee to get awarded, they rustled me quickly
into this MIH presentation. implementation.
And so then they said, oh my God, you guys program a state of the art.
And I'm like, what are you talking about?
We're still waiting on funding to run this program.
So they said, okay, well explain how your program run and then they'll see what I'm talking about.
(23:02):
So what we did is combine the nurse and the nurse practitioner and the paramedic.
Okay. So it's just not a paramedic going in the field alone.
We wanted to have the foundational nursing foundation in terms of the pathology,
(23:22):
pathophysiology, how the bodies work. Even though you're taught that in medicine,
paramedic school. But then you have the paramedic that if an emergency occur,
then both could come together and perform the skills and make sure that, hey, we save their life.
And so they just like the idea of how we put it together.
Because what makes it a lot easier is if you just run it with a paramedic alone,
(23:48):
then that paramedic has to go to the medical or director to sign off.
Whereas being in compliance with CMS and just making sure that everything flows,
the nurse, the RN and the nurse practitioner signs the care plan and then CMS
accepts that and they will pay for that.
(24:08):
So we want to make sure also it's not only that we're giving good service,
but that the documentation is so correct, you know, that there is no bounce back.
That everything is covered.
I like that. And it's like, it's efficiency.
Yes. I love it. I love it. So that's why they say state of the art. Okay.
(24:33):
Okay. Pat yourself on your back, Jackie and Kami and all MIH employees.
So are there any organizations or service providers that have been supportive
to your community efforts?
Well, I will tell you. Pafford EMS have been supported from day one.
(24:58):
If we need medication, we need supplies, we have a need, listen,
we can't refuse this client, but we're going to need another provider.
They'll send a provider to help us, and they take care of us.
That's good. That's great, actually. That's great. Because especially when you
(25:21):
have community relationships with different organizations like that, you know, it just stops.
The downtime is limited. So I like that.
So, also, go ahead. The community health clinic,
we need to give a big shout out to them and the doctors that our clients go
(25:42):
there when we make the appointment because now community health clinic becomes their primary home.
But even though that we can go out in the field and take care of them,
if anything is wrong, we just go back to the physician.
Tammy would consult with them and they would say, well, what,
That was to add to the care plan where they would assist with whatever we might need.
(26:05):
So we want to shout out to the Department of Health Primary Care.
And of course, the Virgin Islands Advocacy Program, because you all have made it so possible.
So many things that we have run into with our clients. And now,
when you hear Dawn, certain agencies will be like, we're going to fix it.
(26:32):
You know what? The good news is, so we have Jackie and Kami in the studio today.
And what we're doing is part one and part two, because we need to continue this
conversation. So, to be continued, but Disability Rights Center is located on St. Croix and St.
(26:52):
Thomas, and we bring Ability Radio to you so you can get some more information.
(27:17):
The views expressed on this program are not necessarily those of WTJAC's board, staff or underwriters.
Music.
The views expressed on this program are not necessarily those of WTJXs board,
staff, or underwriters.
Good day and welcome to Ability Radio. My name is Kishma B. Francis. I am one of your hosts.
Ability Radio is brought to you by the Disability Rights Center of the Virgin
Islands. We have two locations, one on St.
(00:25):
Croix and one on St. Thomas. Today I'm in the studio and I'm in the studio with
three amazing women, Jacqueline Greenidge-Payne and Kami Mead and Dawn O'Bryan.
So today we're going to have a conversation about MIH. They're going to tell you what the acronym is.
(00:47):
But first, we want to know more about these women.
So without further ado, Jacqueline, can you introduce yourself?
A blessing of morning to the community.
I am Jacqueline Greenidge-Payne. I am the Director of the State Office of Emergency Medical Services,
(01:08):
and I am one of the Program Managers for the Mobile Integrated Healthcare Community
Power Medicine Program.
And Jacqueline is not even going to say this, but I will say this.
She won a Vanguard Award.
And if you could just tell the community what the Vanguard Award is and the
(01:30):
criteria that had to be met to gain this award.
Well, the Vanguard Award recognizes women in the emergency medical services
field that are trailblazers within that field and develop the field that they're in.
And the minimum criteria is you have to have had 35 years of exceptional service.
(01:54):
So I am the 2024 recipient of the Vanguard Award. horn. And this is a big deal.
She didn't want to toot her own horn, but I will toot it for her because I think
Jacqueline does a really great job.
You know, when you see her, she's on the go.
She's on the go. But, you know, you tell her, hey, and she'll come back to you.
(02:15):
But she's always on the go. We also have Kami Mead.
Good Morning. My name is Kami. I am the nurse practitioner for the Mobile
Integrated Healthcare Team.
I've been a nurse for a total of 25 years, and I've been a nurse practitioner for over 10.
I've worked in a multitude of different areas of medicine, including emergency
(02:37):
and hospitalist, and this is by far my favorite area of healthcare that I've
ever done. It's an honor.
Nice, nice. Welcome, Kami. And last but not least, we have Dawn O' Bryan.
She's not a stranger to any show that I've done.
Good morning. Good morning. Dawn O'Bryan. I'm also with the Disability Rights
Center for the VI. I am an advocate.
(02:59):
I do community outreach. So many times I'm out in the field meeting people,
getting to know some of the individuals who are in need of services and making
friends with individuals who we can support and also provide self-advocacy. So...
(03:21):
Glad I'm here with all these wonderful women. And we're going to hear about
great things that are happening in the VI.
Yes, great things. And I know I just want to say first, Dawn and I,
for the listening audience, where we're in our expo shirts.
And we have been to both expos that has been put on by EMSC.
(03:43):
And they were awesome. The one is St. Thomas and the one is St. Croix.
So we just had to put that plug in there. That's right. So, Jackie.
Can I call you Jackie? Everybody calls me Jackie.
What led you into healthcare? It's been more than 35 years. What led you into healthcare?
Well, honestly, to tell you, I've been a caretaker all my life.
(04:07):
So, I didn't actually know my mom until I was 28 years old.
So, I was always the one that stood up, even though I wasn't the oldest,
and took care of my sisters along with them, taking care of me.
But one day my friend said to me, I was living in Texas, and she said,
Jackie, you're always taking care of people.
(04:29):
I'm going to this nursing class. Do you think that you should come and sign up and go with me?
And I'm like, oh, no, I ain't going to no nursing class, girl. I afraid of blood.
So she says, no, you got to come with me.
And I says, okay, I'm going to talk to my older sister and because I was helping
her out watch her boys, she was going away to school.
(04:49):
So she said, girl, the kids are going to be going to school. Try it out.
And so I went and I graduated as a practical nurse and I came out top of the class.
And I was the recipient of the Mary Eliza Mahoney Award.
She was the first African-American nurse. And so from then, I wanted a job in the emergency room.
(05:13):
Back in Texas, you had to be a registered nurse to walk in the emergency room,
and you needed to have a certificate for phlebotomy and EKG and all of this other stuff.
And so the only place I could get a job was in a nursing home, so I took the job.
I had gotten a $5,000 saving balance when I graduated top of the practical nursing
(05:34):
school, and I didn't do anything with it.
But one day, I was passing meds at the nursing home, and one of the student
nurses ran out and nearly knocked me over.
All the meds were in the floor, and I ran in the room, pulled the call button,
and the patient was in cardiac arrest.
So I had to put her on the ground because we didn't have the fancy beds.
(05:56):
I didn't know you just pull the little handle and the bed gets firm.
Oh, there was a board to put under her.
And so the paramedics came in while I was doing the CPR.
And then I said, hmm, I think that's the job I want.
And so, because I was like getting so attached to the patient.
So I figured, okay, if I become a paramedic, I'm just drop him off.
(06:19):
And nope, that was the wrong thing. And so I've been a paramedic ever since. Wow. Wow.
I love it. I love it. You started out one way, going into one field,
and then you just went to be a paramedic.
Kami, what about you? What led you to healthcare?
(06:40):
So ever since I was a little girl, I always wanted to help people and make a
difference in people's lives, but nobody in my family had ever even graduated from high school.
So being a nurse was, to me at that age, was unreachable.
I didn't think I would ever be able to be a nurse or to even graduate from any
(07:01):
college, to be honest with you.
But I ended up being a single parent when I was 22 and had to do something to
be able to take care of myself and my child. And I started nursing school.
I'll never forget when I was, you know, very young and just in nursing school,
the sight of blood would make me queasy.
And I was like, oh, my gosh, I don't know that I can ever do this.
(07:24):
But I did and I went
on to get my I graduated with an
associate's degree in 99 and then I
went on to do my bachelor's degree and graduated with honors and then I did
the master's program and graduated with honors with that as well so yeah thank
(07:44):
you nice so I am in the presence of women men who excel and go above and beyond.
And, you know, you guys, your grades, top of the class and not me.
I just graduated.
(08:05):
So I love your passion.
Because every time I speak with Dawn about Jackie, she's like,
and Jackie's doing this and Jackie does this.
And, you know, No, MIH is this.
So Jackie, can you explain to the listening audience what MIH is actually about?
(08:26):
Well, MIH is a program that helps to bring the human side back to our community.
We are in a community, and especially here in the territory,
where there is not a lot of resources for the elderly individuals.
(08:46):
And so this program is for us to be able to reach each person.
And the motto for our program is reaching a person.
One person at a time. So through the mobile integrated program.
We go out there and I don't really go in the field unless Kami needs me, but Kami does a lot of it.
(09:08):
When Kami wasn't here, let me tell you, we're going from eight in the morning to nine in the night.
And we go out there and we provide whatever each patient needs.
It's on an individual basis.
So one of the things we do is we make sure the first thing is safety of the
environment that they're in.
(09:29):
If it's not safe, we're going to make it safe.
We develop a care plan as to how, depending on what their medical history is
and what care we're going to give for them specifically.
If they don't have a healthcare provider, we would connect them to Department
(09:49):
Because our program is an extension of the Department of Health.
So we would take them to our primary
care clinic unless it's a specialist physician that they would need.
And so I will turn it over to Kami and she could say a little bit more about
what goes on in the field. Yes, Kami.
(10:09):
Yeah, so we go out and see patients in their home. We monitor their vital signs,
including their blood pressure.
For most people, we keep a log of all of their vital signs so that they have
a log to take to their primary care
so they know how their medications are controlling all of their diseases.
We also monitor their blood glucose if they're a diabetic. We do a lot of teaching on diet.
(10:37):
We also do a lot of wound care for people that need wound care services.
But on top of that, we help to also make sure that they have the medications
that they're prescribed, that we set up pill planners for them if they need that.
If they forget to take their medications, that helps them to remember to take their medicines.
(10:58):
And a lot of times we even end up going to the pharmacy, picking up their medications if they run out.
There's just a multitude of things that we do day
to day that you just wouldn't even think about just because of
we're going into the home and we're ensure that
they're safe in their home so we may end up cleaning up you know wiping down
(11:20):
tables and sweeping the floor and running errands for people so you just you
know you have to be able to wear a multitude of hats to do this job Wow. Wow.
And Dawn has been riding along with you guys.
So Dawn, where do you fit in in the MIH?
(11:41):
Well, it's really been an honor participating and driving along with the MIH.
I get an opportunity to see up close and personal how individuals who are either isolated,
individuals who don't have family members, individuals who have limited resources
(12:05):
to take care of themselves are now getting one-on-one treatment.
An individual like nurse, cammy, and a paramedic will come to the home.
They have a great conversation. They're like looking at them like if it's Christmas
time and someone's visiting them.
(12:26):
So they have conversations, they get their vitals checked, they get their glucose,
their blood pressure checked.
You know, sometimes if the apartment is a little untidy, they get a little spruce up.
The nurse will probably pick up their prescription, grocery shopping.
It's like an all-in-one.
(12:47):
Stop. And you just see the emotion on their faces.
I think every time I go to someone's home, I get goosebumps because it's a one
of a kind program that we so desperately need.
I think even if the hospitals were perfect up and running, this is still a program
(13:08):
that's necessary because individuals don't always have to recover in a hospital.
They can recover in the privacy of their home. And sometimes that's maybe even a lot better.
You have individuals who are getting wound care that possibly they might not
necessarily get the equivalent at the hospital because again,
(13:29):
they're getting this one-on-one.
Some individuals get home care visits once or twice a week, depending on the
severity of their illness.
And I think you get a chance to see the individuals just spark on their faces.
They look forward to the visit. They look forward to the interaction.
(13:52):
And many times it's not just the meds that's helping improve,
it's the interaction, it's the social interaction, it's the conversations.
So I love this program because I can see the benefits.
And for individuals who don't have a lot of funds, you know,
(14:12):
they have a limited income.
This is such a rewarding opportunity for them to feel like a human again,
because there's so many programs that are dwindling or broken and individuals
like Kami, they give their all.
And I think that's so important right now where everything in the background is disconnected.
(14:37):
And also my involvement is to let individuals know that they have their rights
are intact and they can reach out to the Disability Rights Center if they feel
they're being discriminated.
So I think I provide a vital component, and I really enjoy watching the transformation
(15:00):
and seeing people just feel good about that interaction.
So I have a question, Jackie. When was MIH started?
MIH started in September of 2017 after Hurricane Maria.
Oh, wow. Okay. I didn't realize it was that long. Okay. Yes.
(15:21):
So we were asked to go out with the American Red Cross when they were taking
out the orange buckets with the cleaning products.
And they didn't want to go door to door without having a medical team.
And so we went out door to door with them.
We really wanted to start this MIH program prior to the storm.
(15:45):
But after the storm, it gave life and birth because of what we saw.
And so that's how it started.
And then at the time, we had Pafford here. And so we were able to have five
teams of three people going out.
And within the time from September of 2017 to when they left in 2019,
(16:09):
we saw approximately 1,800 people on this island. Wow. On St. Croix alone? Yes.
Oh, wow. Oh, wow. And while Cammie and Dawn were talking about their experience
in the field, Jackie was over there shaking her head. Yes. Yes.
Yes. They're cleaning. Yes. Yes. They're doing other stuff. They're going for medication.
(16:32):
Yes. So they go above and beyond to assist these patients, right?
Yeah, it's basically whatever they need. We meet them where they are. Yep. Wow.
Even though I was pushing because they even cut their grass.
What? Yes, we've went out and done weed eating. We've sprayed weeds.
(16:53):
You just would not believe.
If we see something that needs to be done and it's going to benefit the patient,
we're going to go do it. Oh, yeah. Wow.
They go up in the house because the people have homes that are still leaking. They put tops on too.
Wow. Wow. I mean, that just sends something through me for the simple fact that
you guys are there to provide medical attention, but yet still you're doing
(17:17):
everything else that this person needs.
Well, how can you go out and see a patient that needs something and they don't
have family, friends, they don't have any kind of resources? You're not...
We can't just leave and they'll not be taken care of. That's awesome.
That's our first priority.
But one of the things that we need to look at is once we take care of their
(17:41):
physical needs, we just took care of their mental needs.
Exactly. Because then they don't have to worry about where am I going to get
that food? You make sure they have that food.
You know, where am I going to get my medication?
And many times the staff purchased
because when it first started you know i was
(18:03):
buying medication and appointments for the wound care and these things are extremely
extremely they're expensive expensive yes they are i know wow wow i commend
you guys because this is not only that you're you're addressing the physical,
you're addressing the need, but you're also addressing the mental without even
(18:28):
being, you know, doctors.
You find a subtle way to do it.
And I love it. I love it. So who qualifies to receive this service?
So right now, everybody that needs us qualify qualifying because we get referrals from the hospital.
(18:49):
We get referrals from APS. We get court orders from the court to go and do assessment and.
Care plans. And we get referral even from EMS.
So the main objective of this program is to reduce the return of acute status
(19:11):
patients back to the hospital.
So if they are released, the discharge planners from the hospital would identify
those patients because if they go back within 30 days of their discharge.
The hospital cannot collect from Medicaid or Medicare.
So that was one of our focus.
(19:31):
Also to reduce the emergency room overload and even to reduce the 911 calls.
Because if the ambulance go out to a home more than once in a week,
they would refer that person and then the team will go out and see what they
can do to help them to reduce so that the ambulance could be available for the emergency call.
(19:58):
So as it evolves, we adapt and expand to meet the needs of the community.
That's awesome. That's awesome. So it's on a referral basis or court-ordered, but anyone.
Wow. And I'll tell you, the few that we can bill for helps us to take care of
(20:20):
those that can't afford to pay.
Because right now, we're working very hard. Kami's working hard.
She has actually categorized all of the patients in our program for preparedness
for this hurricane season.
We know where they are, what category they're in, and we're just getting ready to pack a backpack,
(20:45):
not a backpack, but a tote for each one of them to make sure that they have
and identify who don't have anyone and who should be going to the shelter and
identify who our dialysis patients are,
making sure that they're on the master list for human service and Department of Health.
And so we're also working that angle right now. I love it. I love it. You're preparing.
(21:09):
You're preparing in the event something happens. So you're being proactive.
I love it. I love it. And that's a lot of work. Yes, it is.
And I know Dawn, she has, Dawn, help me out because I'm lost for words because this is a lot.
This is a lot that they do. It is.
And so every time I travel with them, I am in awe because it's really an amazing program.
(21:36):
My one wish is that they can get the types of funding that they need to expand
so there are more mobile units on St.
Croix and then expand to St. Thomas, St. John.
That's my wish.
And again, even if the hospitals are up and running, there's still such a need.
(21:57):
And also at some point in time, they can expand and maybe address new moms who
are coming out of the hospital that may need some services.
That would be another great opportunity. So there's a lot that they do.
There's a lot that they can do. But funding is definitely key.
(22:17):
Yes, funding is the key. Before we go to funding and we talk about that,
what type of certifications, licenses are needed for the MIH program?
Actually, most programs that run at MIH is run with a paramedic.
That's why it says mobile integrated healthcare community paramedicine.
(22:38):
But I found out when I went to Tennessee to get awarded, they rustled me quickly
into this MIH presentation. implementation.
And so then they said, oh my God, you guys program a state of the art.
And I'm like, what are you talking about?
We're still waiting on funding to run this program.
So they said, okay, well explain how your program run and then they'll see what I'm talking about.
(23:02):
So what we did is combine the nurse and the nurse practitioner and the paramedic.
Okay. So it's just not a paramedic going in the field alone.
We wanted to have the foundational nursing foundation in terms of the pathology,
(23:22):
pathophysiology, how the bodies work. Even though you're taught that in medicine,
paramedic school. But then you have the paramedic that if an emergency occur,
then both could come together and perform the skills and make sure that, hey, we save their life.
And so they just like the idea of how we put it together.
Because what makes it a lot easier is if you just run it with a paramedic alone,
(23:48):
then that paramedic has to go to the medical or director to sign off.
Whereas being in compliance with CMS and just making sure that everything flows,
the nurse, the RN and the nurse practitioner signs the care plan and then CMS
accepts that and they will pay for that.
(24:08):
So we want to make sure also it's not only that we're giving good service,
but that the documentation is so correct, you know, that there is no bounce back.
That everything is covered.
I like that. And it's like, it's efficiency.
Yes. I love it. I love it. So that's why they say state of the art. Okay.
(24:33):
Okay. Pat yourself on your back, Jackie and Kami and all MIH employees.
So are there any organizations or service providers that have been supportive
to your community efforts?
Well, I will tell you. Pafford EMS have been supported from day one.
(24:58):
If we need medication, we need supplies, we have a need, listen,
we can't refuse this client, but we're going to need another provider.
They'll send a provider to help us, and they take care of us.
That's good. That's great, actually. That's great. Because especially when you
(25:21):
have community relationships with different organizations like that, you know, it just stops.
The downtime is limited. So I like that.
So, also, go ahead. The community health clinic,
we need to give a big shout out to them and the doctors that our clients go
(25:42):
there when we make the appointment because now community health clinic becomes their primary home.
But even though that we can go out in the field and take care of them,
if anything is wrong, we just go back to the physician.
Tammy would consult with them and they would say, well, what,
That was to add to the care plan where they would assist with whatever we might need.
(26:05):
So we want to shout out to the Department of Health Primary Care.
And of course, the Virgin Islands Advocacy Program, because you all have made it so possible.
So many things that we have run into with our clients. And now,
when you hear Dawn, certain agencies will be like, we're going to fix it.
(26:32):
You know what? The good news is, so we have Jackie and Kami in the studio today.
And what we're doing is part one and part two, because we need to continue this
conversation. So, to be continued, but Disability Rights Center is located on St. Croix and St.
(26:52):
Thomas, and we bring Ability Radio to you so you can get some more information.
(27:17):
The views expressed on this program are not necessarily those of WTJAC's board, staff or underwriters.
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