911 calls from the chronically ill drop after Milwaukee launches community paramedic initiative

Frequent 911 calls from chronically ill city residents have dropped significantly since the launch of an effort by the Milwaukee Fire Department to help those residents better manage their health conditions.

The Community Paramedic Mobile Integrated Healthcare Program began as a pilot project in the fall of 2015 after an analysis by the department revealed that 7% of the 62,763 calls for emergency medical services the year before — 4,288 responses — came from the same 100 people.

Once the program was initiated, from October to December 2015, calls from such patients who participated fell 26%.

In 2016 those calls fell by 56%, and fell by 62% in 2017, fire department officials said.

"I see it first-hand. People are getting better," said Capt. Michael Wright, mobile integrated health care coordinator for the department, who spearheaded the project.

Wright was among about 100 people who gathered Friday at the fire department's downtown Station 2 to herald the accomplishments of the program.

Since its launch, about 300 patients have participated in mobile integrated health care in rotating groups of 30 during 30-day periods, Wright said.

The program involves home visits by paramedics who receive 200 hours of managed care training from the University of Wisconsin-Milwaukee College of Nursing, in collaboration with the Medical College of Wisconsin.

That comes on top of the 2,000 hours of paramedic training they have already received, according to Milwaukee Fire Department Chief Mark Rohlfing.

The paramedics assess the health of patients with conditions such as asthma, congestive heart failure or diabetes, with the goal of preventing chronic health issues from escalating to expensive trips to emergency rooms.

The paramedics help connect those patients with medical services and identify and address other social obstacles to medical care, such as transportation to a doctor's office.

"The goal is better health and better care at a lower cost," Rohlfing said.

The paramedics also check smoke alarms and carbon monoxide detectors, promote firearms safety and look for other hazards, such as "slip and fall" areas in the home.

There are 34 community paramedics trained in managed care working with patients participating in the program at no cost.

"We had no blueprint to follow," the chief said.

"The best practices hadn't been developed. The program we've built is one of a kind," he said.

In 2017 state legislation was passed granting the paramedics legal authorization to function in non-emergency environments, and the project received legal authorization to operate as a full-fledged program, fire department officials said.

"We're serving the most at-risk citizens in a proactive way," Rohlfing said.