Non-Emergent 911 Calls Offer Intervention Opportunity

  • Not every person who calls 911 needs to be transported to a hospital for emergency treatment. But people who make those phone calls do need some kind of health care; they just don’t know how to access the services they need.

    With that in mind, the health insurer CareOregon recently made a $2.5 million investment in a new Portland Fire & Rescue (PF&R) initiative to connect community members with the care they need. The Community Health Assess & Treat (CHAT) program will take a proactive approach to assessing and meeting the needs of members of Oregon Health Plan, the state’s Medicaid program.

    “CareOregon serves almost 400,000 people in the Oregon Health Plan in the Portland metro area…with the majority of those folks in Portland,” Eric Hunter, CareOregon president and CEO, said during a recent press conference. This new program will introduce a different way to handle 911 calls for non-emergency health issues coming from community members.

    PF&R initially approached Care­Oregon with the idea of this community health initiative after seeing their team speak about the social determinants of health at a local event. “This topic caught the attention of PF&R who had been working toward creating a new, more proactive approach to addressing community needs,” Becca Thomsen, a spokesperson for CareOregon, tells AIS Health.

    The CHAT program is launching in November with a proof-of-concept phase that will last for nine months. Initially, units and vehicles will be positioned in the downtown and southeastern areas of Portland, prepared to respond to low-acuity 911 calls.

    “Portland Fire, on average, responds to about 26,000 low-acuity calls per year,” Tim Matthews, PF&R deputy chief, said during the press conference. Low-acuity calls are those related to minor medical issues, like a stomachache or a minor fall, which do not require emergency treatment. When first responders arrive on scene for a call that falls into the CHAT program’s domain, they will not focus on transport as the first line of care. Rather, they will spend one-on-one time with the person, determining whether or not they have insurance and a primary care provider. “This gives us the opportunity to educate the individual about how to appropriately use 911 and how to access their individual health care and really make them take control of how they are navigating the health care system,” Matthews said during the press conference.

    The goals of the CHAT program are ambitious. Stakeholders are aiming to reduce the burden on emergency departments and to better serve the population, ultimately driving down health care costs while connecting people with the resources that they need.

    “From the CareOregon perspective, there have been several recent events — ranging from severe heat this summer to the impacts of COVID-related isolation — that have impacted member health,” Thomsen says.

    “We believe that having a partner like PF&R on the ground in the community will help address member needs in their moment of crisis and that we’ll be able to leverage additional data insights that will help us become more nimble and proactive in responding to anticipated member needs. “

    As the CHAT program moves through its proof of concept period, stakeholders will be carefully tracking its costs and its outcomes. “There is no initial cost to the city as we run through this…proof of concept, which is what makes it innovative,” Matthews explained during the press conference. The program’s leaders will track quarterly key performance indicators, working with CareOregon on the future of the program beyond this initial phase.  

    “PF&R will keep track of the reach of the program, including the number of people they responded to and if they were able to connect them to additional resources such as care coordination,” Thomsen tells AIS Health, a division of MMIT. “CareOregon will monitor emergency department utilization for non-emergent issues.”

    While it will take time for the program’s efforts to bear fruit, CHAT’s upstream, preventive model has the opportunity to reduce low-acuity 911 calls and improve health care resource utilization as more people are educated through the program. “The bulk of the people who fall into the 911 system where it is not an emergency, if we give them the right tools, we know we can change those health outcomes,” Sara Boone, PF&R fire chief, said during the press conference.

    Contact Becca Thomsen at thomsenb@careoregon.org.

    By Carrie Pallardy

    Click here for a pdf of the full issue

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