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Douglas County hears proposal to expand mobile integrated health team to reduce repeat EMS use
Summary
Lawrence Douglas County Fire Medical officials asked commissioners to fund a team lead, a third MIH paramedic and equipment to create two MIH teams for a pilot alternative-response program intended to reduce repeated EMS use and gather data on diversion from ambulance transports.
Lawrence Douglas County Fire Medical (LDC FM) told Douglas County commissioners July 8 that a modest expansion of its mobile integrated health (MIH) program would let the agency field two MIH teams to pilot alternative responses and better serve frequent EMS users.
John Darling, division chief of EMS at LDC FM, said the department is seeking three supplemental items in the county budget: an MIH team lead (an IBSC-certified community paramedic who would provide frontline supervision), a third MIH paramedic to allow two concurrent teams, and an EMS administrative specialist to improve billing and revenue recovery. “If we got both of those positions, you would have four community paramedics that would be able to provide these services,” Darling said.
Darling explained that IBSC-certified community paramedics complete roughly six months of additional coursework and field training to deliver wound care, chronic-condition management and medication reconciliation — services that differ from time-limited emergency transport care. He said two operational MIH teams would enable the county to dispatch the MIH team as a primary responder to certain low-acuity call determinant codes and collect data on ambulance diversions before considering any 24/7 expansion. “This would be a pilot program that would be available when we had staff. It wouldn't be something we stood up 24/7,” Darling said.
Commissioners probed cost allocation and partnerships. One commissioner asked why the request was framed as fully county-funded rather than split with the City of Lawrence; Darling said the funding source was carried forward as previously submitted and that an updated shared-expense EMS agreement is under negotiation. He also said MIH already coordinates with community partners, including a ‘familiar faces’ group convened with Lawrence Memorial Hospital to triage high-utilizer patients.
Darling and staff emphasized limits: MIH is intended as a short-term intervention and referral route, not a long-term case-management solution. Staff said MIH documents longitudinal patient histories and refers individuals to partner agencies for ongoing needs. Commissioners asked for data to support expansion and whether the city or hospital might contribute to pilot costs; Darling said those conversations are ongoing.
Next steps: commissioners recessed for deliberations; staff said the MIH supplementals are before the commission for budget consideration and that governance and cost-sharing discussions with the City of Lawrence will continue after budget season.
