In a ground-breaking pilot collaboration, Partners has teamed up with the Los Angeles Fire Department (LAFD) to provide health coaching to 911 ‘super users,’ and other callers in need of community-based services. Starting in June, trained health coaches will help individuals referred by the fire department to manage their healthcare needs, including connecting that person to a regular doctor, helping connect them with transportation services, and setting up access to other key community programs.
LAFD’s Emergency Medical Service (EMS) deals with everything from gunshot wounds to stubbed toes, responding to more than 350,000 calls a year across the city. But with more than 85% of calls to the fire-department being medical, and many of those being non-emergency complaints, the most appropriate response is often not firefighters or fire trucks. As a result, a pilot program funded by LA Mayor Eric Garcetti’s Innovation Fund, has added a Nurse Practitioner Response Unit (NPRU) to LAFD’s EMS. This new resource enables simple medical problems to be dealt with at the scene, a measure that in its first three months has cut trips to the ER by 55% among patients seen by the NPRU. The pilot has also revealed that many of the people who use the 911 system have social and medical needs that are beyond the scope of emergency services.
Terrance Ito, the nurse practitioner working with EMS, explains the type of need that he and his paramedic field partner, Aaron Guggenheim, all too often encounter. “A lot of the calls we get are really about things like social isolation. It’s reassuring to have some big, bulky men come to your home and tell you that everything’s ok. People are so isolated that the fire department might be the only people they’ve spoken with in three weeks. You don’t see those things when you work in the emergency department. But now that I’m working with Aaron, I see the people who call 911 because they have no-one to take care of them, or they don’t understand health insurance or think they won’t be able to get it, or they have no transportation to get to a doctor.”
“And it’s not our area of expertise,” added Aaron. “We can try to identify certain things in their home – either their physical environment or social environment – like maybe around food, or they have stairs but they walk with a walker – things like that – try to figure out why they’re calling 911 so often. We can ask them, sometimes that helps, but it takes some detective work. If we can identify yes, this person has a need, then figuring out how to help them is better left to a professional agency like Partners in Care, that can dive into it and figure it out.”