Portland’s CHAT mobile teams expand MOUD, report ED and ambulance diversions

Portland Fire & Rescue officials told the Community and Public Safety Committee on Aug. 12 that the city’s Community Health Assess and Treat program, known as CHAT, has diverted hundreds of low-acuity 911 calls from emergency departments and is expanding onsite medication for opioid use disorder as part of a pilot.

CHAT leaders presented 18-month pilot outcomes for prehospital medication for opioid use disorder (MOUD), described partnerships with health-care coordinated care organizations and detailed barriers to longer-term sustainability, including limited-term staffing and challenges in obtaining Medicaid billing authorization.

The program, created in November 2021, dispatches specialized teams to low-acuity 911 medical and overdose calls to “send the right responder to the right call,” Deputy Chief Cory Wilson of Portland Fire and Rescue said. CHAT operates two service lines — response and aftercare — with overdose response teams and aftercare units that follow up with clients within 24 hours.

“Does every 911 call really need a transport to an emergency department?” nurse program manager Michelle Lavinia asked the committee during her presentation, spelling out CHAT’s goal to treat in the field when clinically appropriate and to reduce unnecessary ED admissions.

CHAT’s MOUD pilot uses buprenorphine (referred to in the presentation as “Bup” or “BUPE”)…