Mobile Community Healthcare Program

FIRE & RESCUE

Mobile Community Healthcare Program

Frederick County’s Mobile Community Healthcare Program [MCH] has given its paramedic Matthew Burgan “a whole new appreciation for the way we do healthcare.” “Providing preventative measures not only minimizes crisis situations for patients, but also makes sense in terms of dollars and cents,” he said. Reducing the public’s use of ambulances and emergency rooms is a “much more effective and affordable way to deliver services.”

Launched in 2018, MCH is a partnership between the county’s Division of Fire and Rescue Services, Health Department, and Frederick Health Hospital. It was designed to connect patients with the medical care they need, thereby reducing the stress on emergency medical services. The program has decreased both the number of calls to 911 for non-emergencies and hospital emergency room visits for regular health care, Burgan said.

MCH does not replace a patient’s need for primary health care or the roles of clinicians, he emphasized. Instead, it works with the patient’s healthcare team to implement and maintain existing care, and supports clinicians with enhanced assessments and individualized home patient care.

Prior to launching MCH, planners evaluated data to determine what populations to serve, and the best ways to help them. The initial task was to identify residents who had made “disproportionately high numbers of calls for service,” Burgan said. Since its inception, the program grew to include specialized responses related to the COVID pandemic and people who use drugs.

MCH has three main components: the high utilizer program, an in-home Covid vaccine clinic, and the Community Outreach and Support Team [COAST], Burgan said. The “neat thing about the three programs is that there is a lot of overlap between them.” 301-600-0624

“The Covid pandemic had a tremendous role in shaping our operation,” Burgan observed. “Early on, like everyone else, we were faced with the challenges of not understanding the disease. It took time to assess by monitoring the data and instituting public health measures not paid attention to in the past.”

With the pandemic raging, the MCH program proceeded to give COVID-19 tests and vaccines. In 2021, 2,300 doses of vaccine were administered to people in their homes, many of whom were either homebound or residing in senior living facilities. “We think of it as 2,300 people who didn’t have to go to the hospital for care,” Burgan said.

Among the most pressing problems the team identified was “an increase in calls from the substance use population,” Burgan recalled. COAST was developed to respond to the situation. Operating two days a week with a focus on prevention; along with partners like the Frederick County Health Department’s addiction specialists, it provides this population with appropriate resources. The work includes responding to overdoses, linking patients to treatment and other resources, and supporting family members.

While anyone can refer a patient by contacting MCH, the “lion’s share of referrals come from Emergency Medical Service clinicians,” professionals who work in the field, responding to 9-1-1 calls and interacting directly with patients, Burgan said. “They have an uncanny sixth sense for identifying problems and can make a referral by simply checking a box on their report,” he noted. “When the information comes to us, we intervene by offering the patients resources before the situation becomes a crisis. We tackle every case at the earliest convenience.” At the start of 2023, Burgan said, “We will double our presence in the field by adding a second uniformed EMS clinician.” In only four years, all three MCH programs – high-utilizer, vaccine clinic, and community outreach -- have proven their value to the community.