CPC Social Determinants of Health and Resource Coordination 2 — Questions and Answers

Question 1: Which federal program provides health insurance coverage to low-income adults, children, pregnant women, elderly adults, and people with disabilities?

Medicare
Medicaid (Correct answer)
CHIP (Children's Health Insurance Program)
TRICARE

Correct answer: Medicaid

Medicaid is the joint federal-state program providing health insurance to eligible low-income individuals across multiple categories. Medicare is primarily for adults ≥65 or with qualifying disabilities — not income-based.

Medicaid (Title XIX of the Social Security Act) is administered by states within federal guidelines and covers: low-income adults and families, children (in some states up to 138% FPL under ACA expansion), pregnant women, elderly (for LTC), and individuals with disabilities. Community paramedics frequently assist patients with Medicaid enrollment as part of care coordination, addressing a key social determinant — health insurance access. Medicaid expansion under the ACA increased eligibility in participating states; community paramedics should know their state's expansion status and eligibility thresholds.

Question 2: A community paramedic identifies a patient who frequently misses medical appointments due to lack of transportation. The MOST effective community paramedicine intervention is:

Prescribe telehealth-only follow-up
Connect the patient with non-emergency medical transportation (NEMT) benefits or local volunteer driver programs (Correct answer)
Advise the patient to use ride-share services at their own expense
Schedule all future care as home-based only without specialist involvement

Correct answer: Connect the patient with non-emergency medical transportation (NEMT) benefits or local volunteer driver programs

Non-emergency medical transportation (NEMT) is a covered benefit under Medicaid and many other programs. Connecting patients to NEMT or local volunteer transportation programs directly addresses the transportation barrier driving missed appointments.

Transportation barriers are among the most commonly cited reasons for missed medical appointments, particularly for Medicaid-eligible patients in rural or suburban areas. NEMT is a mandatory Medicaid benefit that covers rides to non-emergency medical appointments (physician visits, dialysis, pharmacy). Many states also have volunteer driver networks (e.g., ITNAmerica, local Area Agency on Aging transport programs). Community paramedics create resource maps of local transportation options and facilitate NEMT enrollment during home visits, reducing appointment non-adherence and hospitalizations.

Question 3: When using the PRAPARE (Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences) tool, the community paramedic is assessing:

Depression and anxiety severity
Social determinants of health risk factors (Correct answer)
Activities of daily living independence
Medication side effect profiles

Correct answer: Social determinants of health risk factors

PRAPARE is a standardized SDOH screening tool developed by NACHC (National Association of Community Health Centers) that assesses domains including housing, food security, transportation, employment, education, and social isolation.

PRAPARE (developed by NACHC and partners) is a validated, standardized social determinants screening tool that captures: race/ethnicity, farm worker status, veteran status, English proficiency, housing, housing instability, neighborhood safety, material security, transportation, social integration, stress, incarceration history, and refugee status. It is used in community health centers and mobile integrated health programs to systematically identify SDOH risk factors and link patients to community resources. Community paramedics complete PRAPARE during initial home assessments to guide resource navigation.

Question 4: Which organization administers the federal Supplemental Nutrition Assistance Program (SNAP), commonly used to address food insecurity in community paramedicine patients?

U.S. Department of Health and Human Services (HHS)
U.S. Department of Agriculture (USDA) (Correct answer)
Social Security Administration (SSA)
Centers for Medicare and Medicaid Services (CMS)

Correct answer: U.S. Department of Agriculture (USDA)

SNAP (formerly Food Stamps) is administered by the U.S. Department of Agriculture's Food and Nutrition Service (USDA/FNS), not HHS. Community paramedics refer food-insecure patients to SNAP enrollment assistance.

SNAP (Supplemental Nutrition Assistance Program) is administered by USDA's Food and Nutrition Service and provides monthly benefits via EBT cards to eligible low-income households to purchase food. Eligibility is based on household income and assets. Community paramedics identify food insecurity using validated screening tools such as the Hunger Vital Sign (a 2-question validated screen) and assist patients with SNAP applications or referrals to local food banks, Meals on Wheels (for elderly), and WIC (for women/infants/children). Food insecurity is strongly associated with poor diabetes management, delayed medication adherence, and hospitalization.

Question 5: Which of the following is the PRIMARY function of a 211 call center in community paramedicine resource coordination?

Dispatching emergency medical services
Providing free, confidential information and referrals to health and social services (Correct answer)
Coordinating hospital discharge planning
Offering direct financial assistance to patients

Correct answer: Providing free, confidential information and referrals to health and social services

211 is the nationally designated dialing code for free, confidential information and referrals to local social services including housing, food, utilities, transportation, mental health, and childcare — a key resource navigation tool in community paramedicine.

211 (administered by United Way and partner organizations) is available in most U.S. states and provides 24/7 access to a comprehensive database of local community services including: emergency food and shelter, utility assistance, healthcare access, job training, childcare, and crisis support. Community paramedics teach patients and caregivers to use 211 as a first-line resource and may call on behalf of patients during home visits to initiate referrals. Many 211 systems have integrated online databases (211.org) that community paramedics use to build resource lists for their service areas.

Question 6: A community paramedic identifies an elderly patient living alone who reports difficulty preparing meals and managing medications. Which program MOST specifically addresses these needs?

Medicaid waiver home and community-based services (HCBS) (Correct answer)
Social Security Disability Insurance (SSDI)
Medicare Part D
Veterans Affairs Pension

Correct answer: Medicaid waiver home and community-based services (HCBS)

Medicaid HCBS waiver programs specifically fund in-home support services — including meal preparation, medication management, personal care, and homemaker services — for eligible elderly and disabled individuals, allowing them to remain in their homes.

Medicaid Home and Community-Based Services (HCBS) waivers (Section 1915(c) of the Social Security Act) allow states to provide a range of services outside of institutional settings including: personal care assistance, homemaker services, meal preparation, medication reminders, transportation, adult day health, and respite care. They are designed to prevent unnecessary nursing home placement. Community paramedics often identify patients who meet HCBS waiver eligibility criteria during home visits and connect them to the state Medicaid agency or Area Agency on Aging for enrollment. Medicare Part D covers prescription drug costs — not in-home support services.

CPC Social Determinants of Health and Resource Coordination 2

Which federal program provides health insurance coverage to low-income adults, children, pregnant women, elderly adults, and people with disabilities?