‘The ladies in pink’: Presidio EMTs change lives with new at-home healthcare service

Presidio EMTs Ana Medina (left) and Jesseca Murillo (right) are leading a revolutionary mobile healthcare service serving locals at home. Photo by Sam Karas.Presidio EMTs Ana Medina (left) and Jesseca Murillo (right) are leading a revolutionary mobile healthcare service serving locals at home. Photo by Sam Karas.

PRESIDIO — On Monday, representatives from Big Bend Health joined Presidio Community Paramedics Ana Medina and Jesseca Murillo at an open house held at the fire station to encourage locals to sign up for a new mobile healthcare service. The grant-funded program allows Presidio EMS staff to make house calls for those who want help managing medications, are monitoring chronic conditions or simply want a routine check-up in the comfort of their own homes. 

The program received funding last February as part of a $5.5 million grant from the USDA to improve healthcare access in south Presidio and Brewster counties. The grant has already opened a new clinic in Presidio — and launched the new home health service, an experimental community paramedicine program that allows EMS to make preventative healthcare visits, rather than solely responding to emergencies. 

The program officially launched in October 2023. In less than three months, Presidio EMTs have made over 100 patient contacts. “It’s growing faster than we expected,” said Ivette Lujan, who serves as the scheduling coordinator. 

Lujan works out of City Hall Monday through Wednesday. She says that one of the more gratifying parts of her job is explaining that the program has few strings attached — it’s free of charge for anyone who lives in Presidio, Shafter or Redford. “It’s not just for the elderly, it’s for everyone,” she explained.

Big Bend Regional Hospital District Grant Administrator Lynette Brehm — who helped prepare Presidio’s successful grant application — said that the goal was to reduce the strain on EMS providers by encouraging people to reach out before their conditions become life-threatening. “Sometimes you don’t know, ‘Is this normal? Is this not normal? Do I call the doctor or do I not call?’” she said.

In an update to Presidio City Council back in December, Brehm affectionately referred to community paramedics Medina and Murillo as the “ladies in pink,” after their bright scrubs. She attributes much of the program’s success to their skills and dedication. “They’re very passionate about this program; it’s close to their hearts.”

Murillo explained that she and Medina chose their colorful outfits as a way to celebrate their new roles. When they worked “on the box” — in the back of the ambulance — they were required to match other EMS staff with blue polos, tactical pants and sturdy boots. 

She liked getting the opportunity to show off her personal style. Her fellow EMTs also don’t wear scrubs, which she says are more comfortable and easier to throw in the wash. “When we got the opportunity to stand out, we thought, ‘Hey — let’s get those scrubs,” she said. 

Community paramedicine is a relatively new model, mostly tested in and adopted by rural communities. Presidio EMS has been experimenting by shifting staff members around: Medina and Murillo both have advanced EMT certifications and years of experience. Their colleagues with paramedic certifications — the next rung on the EMS ladder — work strictly on ambulance calls. 

Medina and Murillo work in mobile healthcare Monday through Friday, seeing up to five patients a day. Calls are typically an hour, but can stretch longer if the patient is a first-timer. With new patients, they have to make a series of decisions about what kind of care each individual needs and how frequently they should be seen. They have to be prepared to meet a range of healthcare needs, from folks recovering from intensive surgery to pediatric patients who need an occasional check-up.

Though their new position doesn’t require the same extreme adrenaline as responding to an emergency call, they’ve found their new roles take an emotional toll. Both Medina and Murillo are from Presidio; very few of their patients are strangers. Making home visits to people who may struggle to care for themselves requires a complicated balance of vulnerability and trust. 

The two got very attached to one of their first patients, an elderly man who helped them set protocol and helped them through the early days of the program. One day, they came to check up on him and noticed something was wrong — they took vitals and immediately called their EMS colleagues to take him to the hospital. 

They had launched the program with this particular patient in mind — they felt that he was a perfect fit and would thrive under their care. To make him feel more comfortable, they packed up some of his belongings to go to the hospital in Alpine with him. 

The next day, they got the news that he had passed away. The loss hit Medina harder than she expected. “I think it got us both,” she said. 

Murillo explained that EMTs have to be psychologically tough to be able to do the job, but she hadn’t been expecting to work through complicated emotions so early in her new position.  “With EMS, we always have that one call that kind of breaks you, but it usually takes a couple of years,” she said. “Community paramedicine is a completely different experience than being in the back of the box: we get to be with the patient a little bit longer, we’re going into their homes. We’re making a stronger connection.”

The upside of that strong connection is that Murillo and Medina are able to offer extremely personalized care to folks for whom going to the clinic isn’t an option — whether they don’t have transportation or childcare or simply can’t afford it. 

A major component of their job is educating patients about how to take care of themselves, but through building a strong bond they’re able to track progress and adjust accordingly. Part of their training involves keeping tabs on a patient’s psychological state — if they seem depressed or anxious, community paramedics can offer mental health monitoring and treatment in addition to their regular duties. 

The program’s early success is due — in no small part — to Murillo and Medina’s compassionate bedside manner and medical expertise. They feel that their involvement in the program is more than just a job. “It’s new, and we’ve pretty much had to do everything from scratch,” said Medina. “I think it’s pretty cool to be helping out our community and those patients who really need it.” 

If you or a loved one would like to receive mobile healthcare through the community paramedicine program, call 432 229 2023.