Larresca Barker

Ultimately, that's really what a lot of QRT comes down to, is people want to have control over their lives, and sometimes their life gets unmanageable and out of control, and they need somebody to help them control it, and we give them kind of like a playbook.

Kristen Carpenter

Hi, I'm Kristen Carpenter, and this is Appalachian Care Chronicles, a podcast bringing you stories from every corner of West Virginia's health sector. Join me as we journey alongside a variety of problem solvers, change makers and daily helpers who are all working behind the scenes and on the front lines to care for our communities. Together, we'll explore what they do day to day, the steps that got them there and the whys that continue to draw them back. How, in the face of some of the most challenging situations possible, do they manage to keep themselves and the rest of us from falling apart? Far from predictable, the paths they've walked are full of twists and surprises, discovery and purpose. This podcast is for anyone who's ever thought about going into the healthcare field or has a passion for caring for others in times of need.

Kristen Carpenter

Our guests today are Larresca Barker and Whitney Maxey, both members of the Quick Response Team in Huntington. We rode along with them for an afternoon across the city as they checked in on folks who reportedly overdosed in the last few days. Larresca is a community paramedic, and Whitney is an emergency medical technician or EMT. We captured one of our favorite on the job moments to date, as these two definitely handled this interaction with a man they'd been assigned to check on they had a report he'd recently used fentanyl.

Whitney Maxey

Hi, we're the Quick Response Team. Oh, well, we just want to make sure you were okay first before this. And we have merchant if you want to keep it with you.

Male Community Member

Yeah, I'm having heart problems, I guess. I've had some kind of stroke or something.

Whitney Maxey

Keep it in case somebody needs it, or, you know, whatever you want to do.

Female Community Member

Only thing I told them is that he worked that day and I gave him some Narcan. He had already done this. This fell like three or four times before.

Male Community Member

Okay, my blood pressure is running 200 over right now, right now.

Whitney Maxey

Are you on medicine for it?

Male Community Member

Four different blood pressure pills, they can’t figure it out. They make it go up, then they make it go down, and they make it go up, drugs. And it's not drugs.

Larresca Barker

Sir, we weren't there, and we just got the report, and all we do is show up just to ask and make sure you're okay. Okay, yeah, yes.

Female Community Member

But they automatically whenever you say Narcan or this or that, they automatically. Because we have been users years ago. We've been clean for almost seven years. Okay, okay, we went to the methadone clinic and got ourselves clear, you know, I'm saying cleaned off the needles. Yeah, we've done step by step, so it's hard whenever you in pain and stuff. I mean…

Male Community Member

We got it under control. I mean, I used to shoot though, don't anymore.

Larresca Barker

We just want to be a resource to you guys. So do we do if something ever were to happen? We don't have to meet here. We can meet somewhere else, okay, like, we're like a tool. So if you want services any kind. You can call us and we'll help you get connected to that.

Whitney Maxey

Even if you need to set up with like a primary care physician or something,

Female Community Member

Every time you say that you're on methadone, they completely look over over what the main problem is. It's automatically methadone clinic. We got ourself off of it because it was a problem too. Um, but if we need you, we thank you for coming.

Whitney Maxey

Yes. And if you need somebody to advocate for you, if you have to go back to the doctor or to the hospital or something, give us a call. We'll come with you. We'll let them know, like, hey, look, this is not gonna yeah, we gotta figure it out. Sounds good.

Female Community Member

Yeah, that sounds good. Thank you.

Whitney Maxey

Yes, very welcome. Y'all have a good day. Thank you very much. Your kitty cat’s beautiful. Beautiful!

Larresca Barker

I initially, this is my feeling. I don't know it feels like he didn't really want us there, but she came out and she was like, you know, come in. And then she said that they've been going to the primary care physician. They used to be on methadone. And she feels like, and this is, this is true in a lot of cases. But she feels like, as soon as she explains to the PCP that they are in recovery and they were on methadone, that the physician is just quickly to just to write them off and not, like treat the other symptoms. So they were at an eight, at least he was, and then they came down to, like a four. It was, it was good, yeah.

Whitney Maxey

And a lot of times what we find is people were very adamant that, like, “Hey, I didn't overdose, or I didn't do this, right?” But coming from the world where we're knowledgeable about these things, we can tell they gave you Narcan, we can tell your mentation improved when you got the Narcan, or you became a living, breathing person again. And that indicates an overdose, right? But a lot of times, people are like, “No, that didn't happen. That didn't happen.” And we never call them on their their bull crap. We might explain what Narcan does and what it’s used for, but we never say, you know, that's not true, and people who are in recovery, especially if they relapse, that is just an insurmountable amount of shame that they're experiencing, so they don't want to share that with anybody, even people who can help them. But they do accept Narcan or fentanyl test strips, and that kind of clues you into like, “Okay, this is, this is what happened. Like they took the Narcan.”

Larresca Barker

Sometimes with that conversation, the person will see like, we're building a rapport here, and we're like, we're not shaming them, that they will eventually be like, okay, yes, this actually did happen.

Whitney Maxey

Literally, last week, a lady who we had went to visit the week before, she's like, “I didn't overdose. It was just crack. I accidentally got a hold of, like, some bad stuff that was mixed,” which is a plausible story. She called us back last week and was like, “Hey, I lied to you. It was heroin. I want to get into recovery.” So, I mean, it's just, it's kind of just building rapports and letting people know, like you are not in trouble. And I don't care what you're using or how you're using it. I just, yeah….

Larresca Barker

Yeah, we just want you to stay alive and make better choices.

Whitney Maxey

And especially if you, if you offer them the out, like, “Here, take this Narcan somebody or your neighborhood, neighborhood may need it,” then they'll keep it for themselves. So you just kind of offer them ways to work around the problem they believe exist in their head, which is, I don't want people to know this about me.

Kristen Carpenter

Quick Response Teams first started appearing around a decade ago, public health professionals, Behavioral Health Agencies and law enforcement officials were thinking about new approaches to help people get into recovery by following up with them after an overdose. Within three days of that overdose, the team makes a home visit to encourage the person to enter treatment for substance use disorder, as we heard earlier, they bring along the opioid reversal medication, Naloxone and other harm reduction materials too. The goal is to reduce overdoses by 20% and recurrent ones by 40%.

Whitney Maxey

Being an EMT, from my standpoint, is having the ability to respond to an overdose in real time. So we have a radio, we have like communications that are sent to our phones and stuff that allow us to see calls in real time that are occurring, and we're able to show up on scene and render aid, especially if, like, an ambulance hasn't made it yet or we're closer.

We're also adept at, you know, identifying if somebody looks like they need to go seek seek care. So whether they're in like, liver failure or they're having difficulty breathing, or they have wounds, and I think that's really important to bring, like, a medical knowledge to our clients, because oftentimes there's the people that seek care last and especially if they've had an overdose, they've been Narcaned and we're there to see them, even just a few hours later, we're able to tell them like, “You know you're at risk for overdosing again, even if you don't use” and provide them with tools that they need to to successfully navigate those few few days after an overdose. Ah, we have a whole two page list of services that we offer…

Larresca Barker

Food, toiletry items…

Whitney Maxey

…CPR training we do, housing referrals, Doctor referrals, transportation to appointment, same day, MAT, same day medicine for infectious diseases, point of care, testing for infectious disease… r

Larresca Barker

…shoes we have, like, flip flops downstairs, brand new, right? We used a pair last week for somebody that didn't have shoes on. We tried to tackle all the barriers, right? Like we want to reduce as many barriers as possible for somebody to get into treatment, and not just for them, but for us too, like when it's just easier all the way around, because we have tools, it works out best for everybody.

Kristen Carpenter

Larresca and Whitney also serve as advocates for people in the criminal justice system.

Larresca Barker

Let's say a client has pending charges. The client is in jail, and we've talked to the family many times, we'll go down to magistrate court and we'll wait, we'll talk to the victim advocates. We're kind of like a liaison, right? And we will, we're not going to persuade them, but we are going to let the patient or the client know, like, “Hey, this is not like, just get out of jail free card. But if you sincerely want help, like we are here for you, and we can help lessen your your stay at in jail, if you agree to the terms to go into treatment.”

I think we're kind of blessed in Cabell County, where our judges, they are very understanding of the situation as it, you know, pertains to drug use, and they, they don't want to lock people up, right? They want to give people a second chance. So we've seen that with our own eyes, right? Being being an advocate for somebody and showing up in court, even, in fact, one of the drug court judges knows us very well, right? And I think that partnership, working with us, it's, it's kind of amazing. I don't know if that happens anywhere else in West Virginia, and if it does, it's certainly not as good as we have it. I'm just going to boast there a little bit, but we certainly have helped people navigate getting out of jail, the going into going into treatment.

Kristen Carpenter

Sometimes the work involves building relationships in between moments of crisis.

Whitney Maxey

We go visit clients. They don't have to overdose, but we go visit clients in like, the hospital because they're sick, or we saw their chart and it said, you know, they had an infection in their leg and they're going to have surgery. And it truly is building friendships, not just like rapport, but like, genuinely enjoy having these relationships with people, just because you learn so much about people, and 95% of the people that we deal with have this significant trauma in their life, and they just need to feel like people care and genuinely care. You know, we're not just there because we're getting paid to be on the clock for it.

Kristen Carpenter

West Virginia needs great mental health professionals. If you're practicing in an underserved area and need help repaying your student loans, apply for the Mental Health Loan Repayment Program through the West Virginia Higher Education Policy Commission, visit CFWV.com to apply. That's C F W V.com.

Kristen Carpenter

Both Larisa and Whitney considered medicine early in life, but both also had a pretty rocky start to their careers. Larresca thought she wanted to be an OB-GYN in high school, but ended up dropping out of community college. She got married, had kids, and decided to go back to school. She felt adrift as she tried to figure out her path.

Larresca Barker

It was definitely like I just was this amorphous. “Where am I going? Like, wherever life takes me.” Like, there was no, like, clear direction, you know, I was kind of was like flailing a little bit, you know, but I was actually one of those people on like, government assistance, right? And a part of being on government assistance at the time was that you had to be doing something, whether that was work or school, you, like, had to show that you're doing something and where it was summertime, and I wasn't in school and I was not working. I don't know if I should say this. I don't I tell this story, just to kind of paint a picture, like we were taking, like, a typing class or something, and you have to be there from nine to four, Monday through Friday, and we're taking this typing class. And this girl leaned over, and she was like, How do you spell hair? And in that moment, I was like, no shade to this girl, right? Like she probably has circumstances I know nothing about, but I was like, I'm in the wrong place. And there was this giant gray binder, like, full of flyers and stuff about people that were hiring. And there was a flyer for Cabell County, EMS. I signed up, when I found EMS, it was like, “Oh, this is my calling. Like, this is fun.”

Kristen Carpenter

In 2016, Larresca got her associates in Paramedic Science and finished her Regents Bachelor's degree. Just two years later, she got into grad school in 2022 and earned a Master's in Public Health from Marshall University.

Larresca Barker

It was like the career that I didn't know I wanted, and it wasn't until I was in it, I was like, “Oh, this is this is perfect, like, I'm not seeing in an office.” And it like gave me structure, but also independence. It's perfect. I thought, like, “Okay, since I finished my RBA, I wanted to go to grad school.” The opportunity presented so far I could get a scholarship to go. And I was like, “Oh, well, if I get the scholarship, like, I can't disappoint these people that have paid for me to be here. So I'm just gonna, I'm gonna do it even with EMS. I'm like, I don't deserve to be here. I'm like, I don't feel as smart as the next person next to me.” And I think that, just like with age, in a lot of self reflection, you know what, I deserve to be here, just like anybody else.

Kristen Carpenter

Whitney used to play doctor as a kid, and even set up a medical office in the bedroom she shared with her sister in ninth grade, she shadowed a neonatologist. but a few years later, she got pregnant and had her first child at 17. She graduated early and scored so well on her college entrance exam, she went straight into nursing school at Marshall, but she got pregnant halfway through nursing school and dropped out. Years later, she found herself in an abusive relationship. She was working in retail while tending to her infant son and his major health challenges.

Whitney Maxey

He had three open heart surgeries and the first year of his life and bleeding disorders, and, you know, oh my gosh, all kinds of things. So he and I lived in Cincinnati at the Children's Hospital for like, the first year of his life. Came back. Was fighting my own demons, abusive relationship continues, we end up splitting and then decide that I'm going to move back home. I'm on public assistance at this point, I didn't have a direction in life. All I knew was I was disappointed in myself, and I knew I could do better. I was teaching my kids to do better, but I had to, I had to, like, work on myself hardcore for things to get better.

Kristen Carpenter

Then came an intervention from her best friend's mom, who also was one of her former teachers.

Whitney Maxey

She took me down to Cabell County EMS headquarters and set me in a chair in front of Gordon Mary, who is our director, who who was very good friends with my good friend, and she said, You need to let her in this class and give her a job, because I didn't know what I was doing.

I was going through some legal issues at the time, most people in this world probably would have looked at me and said, You're not Yeah, I'm not messing with that. I'm not touching that. They didn't do that here.

It was an in to the medical field that I've wanted since I was little, and to this day, if you met her right now, she would say “She was one of my best students!”

Now, my life is awesome. I'm married to an amazing man. I have three well rounded just incredibly intelligent children, and I get to help people every single day.

Kristen Carpenter

Sadly, Whitney was involved in an ambulance wreck a few years ago and can no longer lift her right arm. Her bosses created a position for her with QRT in 2021. Larresca had been on the team from the time it started in 2017 in each other, they found a trusted colleague who became a dear friend.

Larresca Barker

Like, like, I don't pray or anything like that. Like, I'm like, not religious. But sometimes when, when in a job like this, it can be very taxing, right? In more ways than one, and there were times when, like, I would cry myself to sleep, like, just hoping the next day would be better.

She, like, just appeared, and I'm like, “She's the bee's knees!” Life is wonderful now, like you know it is. I have a wonderful husband and two wonderful girls. I also have a stepdaughter who's wonderful. She's a nurse at Cabell.

Like, the thoughts of me feeling like, like, I think you said you mentioned, like, disappointment. I'm not gonna say those thoughts are gone, because I think, like, we strive to, like, not just stay stagnant like, we want to keep going so we don't know what the future holds. But I certainly don't feel the way I did before EMS and before QRT. It has, it's taught many lessons.

Listen, EMS. The first career that I ever lasted longer than six months at okay, learned a lot, okay? And there, there were days where it just, it has beaten me down, right? And do I think the EMS system, not just like in the state, but as a whole, could be better Absolutely. And then, of course, you're not. You don't know those things until you're in the thick of it. It is a good career. It's a lot of fun. You get to see a lot, get to do a lot. I would recommend it to anybody really.

Kristen Carpenter

Quick Response Teams are growing in West Virginia, in a state where communities often have limited resources, higher unemployment rates and increased rates of substance use disorders, an integrated approach to physical and behavioral health is required to truly support people. The social and health issues that people face are complex. Showing up every day to establish trust and more regular access to resources is crucial to overall community health outcomes. To put it simply, the QRT approach works.

Larresca Barker

It's just, it's a necessity, like, what is the alternative, right? Like not having these things available, I would hate to see those numbers. You know, in every aspect, you would have higher incidence of infections, whether that be, you know, HIV and syphilis, and we all know those two go hand in hand, probably higher rates of homelessness, because addiction isn't just it's not just the drug, right? It is all consuming of childcare and whether you're housed or not, like it has a complete control over your entire livelihood, not just, it's not just the drug seeking, right? It's, it's far more than that. So, like, if we tackle this, this one thing called addiction, we're really tackling, like the whole person. It's, it's what it is.

Whitney Maxey

Many people in West Virginia are on some type of public assistance SNAP or medical cards or whatever, and if you've ever stepped into a phone call or a building or online portal and tried to navigate that yourself as an educated tax paying citizen, it is difficult. Now imagine having nothing going for you in your life, and all you do is use drugs and live on the street and you've lost your kids. How do you navigate that? How do you navigate that without help? And that's what we do. We just we're the perfect middleman between we will go online, we will go to the DHHR, we will do whatever we need to do to get you signed up on all of those resources. And I think it's important for us to realize, and we do a great job of it, is that you can't get somebody sober and then turn them loose to the life that they were living. So they have to have, they have to have the opportunity to be housed and have a job and have skills and knowledge and even then, still helping them navigate systems that are not set up to be user friendly.

Kristen Carpenter

Larresca and Whitney are enrolled in an EMS Certificate Program at the University of Charleston. Continuing education is a requirement for EMS workers, but they're actually pretty into it.

Larresca Barker

EMS life is all about CEs, continuing education credits, like you say the word CE, like we start twitching. So in order to keep our certification as EMT and paramedic whatever, you have to take so many continuing education hours every year, right? And you have to turn those in. You can do the standard, just basic the CEs is required to keep your certification. But I think we go above and beyond with that. Like, why not, especially when they're free. Like, bring it.

Kristen Carpenter

The EMS Leadership Program that Larresca and Whitney both completed this summer was made available in 2025 to working adults in the EMS, EMT and paramedic professions to build leadership and management skills for enhanced career opportunities. The program was offered at no cost to participants by the West Virginia higher education policy commission through funding from the West Virginia governor's office and the legislature.

Whitney Maxey

As providers and then a community resource like you should never stop seeking knowledge. Ever, ever, ever, like when we discovered that we were gonna have to do like in depth IV drug user wound care, we took a class through Stanford for wound care. So we just wanna be like the best. We don't want you to ever have to ask a question and us not be able to at least know about it, or know where to get the information from. Yeah. So I do have goals for my future, though. I want to, I want to be a physician's assistant so and I have enough credits to get an RBA, but I just need to put the money together and do the things.

Larresca Barker

She is. It's, it's recorded.

Whitney Maxey

I'm manifesting that, so yeah!

Kristen Carpenter

Appalachian Care Chronicles is a production of the West Virginia Higher Education Policy Commission, Health Sciences Division, which is solely responsible for its content. Guest opinions are their own.

If you or someone you know is in need of support, help for West Virginia offers a 24/7 call chat and text line you can call or text HELP 4 West Virginia at 1844, help 4 WV or chat online.

Special thanks to Cabell County EMS.

I'm Kristen Carpenter, and you've been listening to Appalachian Care Chronicles. Next time, we'll be following Dr Judd Lindley, an obstetrics and gynecology doctor caring for patients in some of West Virginia's most medically underserved areas. From rural clinic visits to a solar powered family farm, Dr. Lindley shares what it means to show up with humility, honesty and a sense of humor. See you then!