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Caroline County launches mobile integrated health pilot to cut 911 calls
Summary
Caroline County will launch a mobile integrated health pilot Dec. 1 to deliver nurse-paramedic home visits to adult residents who called 911 five or more times in six months, aiming to reduce emergency transports and connect frequent users to primary and social services.
The Caroline County Commissioners on Nov. 25 heard details of a new Mobile Integrated Health (MIH) pilot that county health and emergency services staff said is designed to reduce emergency department visits by high-frequency 911 callers.
Holly Trice, who introduced the effort at the meeting, described the program as a collaboration between the Caroline County Health Department and the Department of Emergency Services. Staff said MIH will target adult county residents who have placed five or more 911 calls in the prior six months. The program will begin a soft launch Dec. 1, with the team seeing one client per week during December and expanding to broader implementation in January.
Presenters said a nurse and a paramedic will perform in-home physical, psychosocial and environmental assessments, conduct medication reconciliation (with support from a University of Maryland PharmD partner), arrange telehealth connections with primary care when needed and link clients to community resources aimed at reducing future 911 use. Staff estimated about 73 residents currently meet the "high utilizer" threshold.
Officials described initial staffing as six providers rotating on a midweek schedule to avoid overtime; organizers plan to prioritize clients by need and require client consent for enrollment. Metrics the team will track include post-enrollment 911 utilization rates, patient surveys on health literacy and connection to primary care, counts of medication reconciliations and PharmD consultations, and timely follow-up contacts to assess whether interventions reduced calls.
County staff and meeting attendees praised the approach as a way to keep paramedics available for high-acuity calls and to provide targeted support for people whose repeated emergency calls reflect unmet health or social needs. Presenters said the project has seed support from the Caroline Foundation and county core funding; they reported a recent $50,000 grant from the foundation to help cover early implementation costs and said they are pursuing additional grants and reimbursement pathways at the state and federal level.
The presenters asked the board to consider supporting legislative or advocacy efforts to enable reimbursement for MIH services; current Medicare/Medicaid reimbursement for this type of mobile integrated care remains limited, they said. Staff committed to sharing quarterly implementation data with the commissioners and to returning with updates after the December soft launch.
Next steps: soft launch begins Dec. 1; broader service delivery is expected in January, with quarterly reports to the board on utilization and outcomes.
