Hennepin EMS tells county board its paramedic‑led buprenorphine protocol and 'bridge' outreach are keeping patients connected to care

At a May 19 Hennepin County Board meeting, Dr. Tim Coomer, assistant medical director of Hennepin EMS, told commissioners the agency is using a paramedic‑driven protocol to give buprenorphine to patients in withdrawal and operates an EMS "bridge" team that calls and connects patients to care after nonfatal overdoses.

"We go on about 6 calls a day where naloxone ... is administered," Coomer said, and added that by volume "the vast majority of nonfatal opioid overdoses that involve EMS happen here in Hennepin County and Ramsey County." He told the board Hennepin EMS handles about a third of the state's nonfatal EMS‑involved opioid overdoses.

Coomer described the program as among the first in the country to allow paramedics, under a paramedic‑driven protocol, to administer buprenorphine in the field when patients meet clinical criteria. "We were the first program in the country to have a paramedic‑driven protocol," he said, adding that other U.S. programs required a physician to be on scene.

Board members pressed Coomer on follow‑up and outcomes. He said the county tracked the initiative closely and found that "the overwhelming majority of patients got better," with "about a quarter to a third of these patients" still in some form of treatment at one month compared with near‑zero previously. Coomer cautioned that privacy and the mobility of the population make follow‑up beyond about 30 days difficult: "It's really hard ... most of that is actually 30 days within our own partners who are just reporting back to us, without patient specific data."

Coomer also described the EMS bridge team—paramedics who received extra training and who call every patient who received naloxone or buprenorphine to offer support and resources. Where permitted, bridge team members can "drive out, meet the patient, and give buprenorphine under my license," he said, which Coomer called a critical part of linking people to ongoing care.

The program has produced additional materials for other jurisdictions. Coomer said the county developed minbridge.org as a resource for medical directors, ambulance providers and paramedics wanting to set up similar programs, and that the Minnesota Regional Poison Center provides an urgent call line to help manage withdrawal in the field.

Commissioners praised the program and the EMS staff in the room. Several commissioners called the work "nation‑leading," and noted they have seen regional declines in overdose calls that may reflect both state distribution of naloxone and local treatment efforts.

Coomer warned that sustainability is a challenge: the bridge team is grant‑funded and has "one year left of that grant funding," and the county is seeking additional grants and partnerships to continue the work. He also said the county is exploring long‑acting injectable medications that could protect patients for weeks or months but cautioned those options are expensive and often face prior‑authorization hurdles.

The presentation was informational; no board action was required. The chair and several commissioners thanked Coomer and the EMS employees present for the program and its early results.