Jul. 24—A different kind of health care is coming to the south end of the valley.
Thanks to a $75,000 grant from Ashland Community Hospital Foundation, Ashland Fire and Rescue is partnering with Mercy Flights to offer what's known as "mobile integrated health" services to Ashland, Talent and Phoenix.
Mobile integrated health is a combination of an old-fashioned house call with social work and community service. Those who need medical care urgently, but are not in mortal danger, can call MIH instead of 911.
The MIH program has functioned in the Medford area for the past six years, largely off referrals from paramedics. First responders refer frequent callers or vulnerable patients to the MIH program with a "warm hand off" as often as possible.
The patients who benefit most from the program often are elderly or disabled, and some who struggle with their mental health can be slow to trust, emergency workers say.
The program functions best, said Ashland Deputy Fire and Rescue Deputy Chief Marshall Rasor, when MIH staff can be present in the moment of referral and be introduced to the patient by paramedics they already know — what's known as a "warm hand off."
Until now, the Mercy Flights program didn't have enough staff to make that critical transference of trust possible in the Ashland area. Rasor said when his department tried to lean on the program, it would sometimes be a day or so before MIH staff could reach the person.
Ashland Community Hospital Foundation's $75,000 grant will pay for a sixth full-time staff member for Mercy Flights' existing mobile integrated health program, shrinking response time and increasing effectiveness for Ashland, Talent and Phoenix.
In addition to helping vulnerable people avoid an expensive ride to an hourslong wait in a hospital emergency room, the program keeps paramedics and emergency rooms free for life-and-death calls.
'It was kind of personal for me'
Todd Beck, fire captain and paramedic at Ashland Fire and Rescue, is grateful for the relief.
"We're on track to hit 5,000 calls for this year," Beck said.
Since Beck started at Ashland Fire and Rescue in 1999, the volume of calls has increased 400%, while the number of staff has gone up only 25%.
"We call 'em frequent flyers," Beck said of the homeless, transient, elderly and other vulnerable people who frequently call for help with services he described as caregiving.
"We're there to provide emergency services, and a lot of times we're getting called for things that aren't even remotely an emergency," he said.
Beck described one frequent flyer, an elderly marine, a Vietnam veteran who is terminally ill with cancer. The disabled amputee was repeatedly calling 911 for help cleaning himself or getting back into his wheelchair.
"It was kind of personal for me," said Beck. "My son is in the same branch; he's a Marine. I could not stand to see that man in that condition. But he was proud, you know?"
Beck said Ashland Fire and Rescue turned to Sabrina Ballew, the MIH coordinator for Mercy Flights.
Beck credits Ballew and the program with finding the disabled veteran the hospice care he needed.
"We address the social determiners of health," Ballew said.
Adapting to community need
The Mercy Flights program is part of a national trend to connect people with health care.
"What's unique about an MIH is it can be adapted to a community's needs," Ballew said.
A typical call could look like emergency room or urgent-care service at home. It could include services such as blood tests, prescription refills, de-escalating panic attacks and COVID-19 vaccinations.
Sometimes the care could be helping someone who has fallen and can't get up, are disoriented or suffering from nutrition deficiencies.
Staff are cross-trained in skills normally left to social workers, such as crisis de-escalation, mental health evaluation and substance-abuse treatment.
The program includes community health workers trained to help patients navigate the complicated labyrinths of social programs, as well as overcoming food or housing insecurity.
Staff help through referrals, or sometimes directly. Ballew said during the height of pandemic lockdowns following the Almeda Fire, Mercy Flights' MIH staff delivered food boxes to people.
Staff can attend doctor appointments with people who don't feel they can advocate for their own care. They can work with people discharged from hospital treatment who are struggling with surgery aftercare or a difficult diagnosis.
The Ashland Community Hospital Foundation grant covers the expansion of the program and its software — digital database Unite Us.
The software, Rasor explained, helps prevent overlaps in patient care.
Patients were sometimes stuck on a pendulum swinging between long-term care plans created by primary care doctors or specialists and quick emergency-response medicine administered by paramedics who couldn't know the history or long-term care of a patient.
People with disabilities, mental health problems, substance-abuse disorders or who are in a state of duress are frequently unable to articulate their full medical situation to 911 dispatch or paramedics.
Unite Us helps fill the gap by keeping medical records such as treatment plans and diagnoses accessible to MIH staff and paramedics.
Rasor said his firefighters and paramedics began their training in referrals and the Unite Us software July 14. He estimates the program will be ready for referrals in a couple of weeks.
'A humongous burden off our backs'
Medford and Jackson County have been able to call on the program since 2016. The program was started because paramedics felt a need was going unfulfilled, Ballew said.
"Sometimes fire or emergency personnel get into a home and see the patient may not have stable housing, food, access to care or an understanding of their medical diagnosis," Ballew said.
Paramedics and firefighters wanted to respond to more than the immediate need behind the 911 call. Mercy Flights worked with Providence Medford Medical Center and Jackson Care Connect to establish support for the program in Jackson County.
Now, six years later, Ballew said, the program can point to its 2021 data as evidence of success.
The program has seen an 85% increase in patients returning to or finding a new primary care provider after working with the program; it has documented a 71% reduction in readmission for hospital stays and a 48% reduction in emergency room visits.
Rasor said the grant pays for only one year for the extra staff needed to cover the south end of the valley, but he hopes the program can collect enough data to prove its worth and keep Ashland, Talent and Phoenix covered.
"In my experience, it's taken a humongous burden off our backs," Beck said.
Those who can think of a neighbor or a loved one who could benefit from the Mercy Flights MIH program can call Sabrina Ballew at 541-858-2684.
Fire District 3, serving the other side of the valley from Central Point to Sams Valley, has had its own program since 2019, and it functions differently than the Mercy Flights MIH.
While the District 3 Community Care Team evolved from the same paramedic observations of unmet needs, the team itself has more flexible applications.
District 3's 911 dispatchers use a system of questions built into a computer system to differentiate between different kinds of calls, from life-threatening emergencies to an urgent but not lethal call for help.
"If you're our 911 center, and a call comes in, they ask the questions and the code comes out. It's for the community care crew — Crew 22, that's their call sign — then they go out," District 3 Chief Bob Horton said.
This system ensures the response matches the need of the caller, Horton explained.
Like the MIH program, District 3's team has a paramedic and an EMT with additional training that enables them to meet a broad range of medical and social needs. But District 3's Community Care vehicle also responds to emergency calls, if it's the closest unit available.
The Community Care Crew also has partnerships with local nonprofits, Horton said, who can perform acts of preventative care, like installing grab bars in the homes of seniors to prevent them from becoming frequent flyers.
Horton said he looks at the program through his own experience working as a paramedic in the Las Vegas area for 17 years.
"The 911 system and how we respond to calls, it goes back to World War II. We knew the tools we brought were not the right tools to solve the issues we were seeing," Horton said.
"This is the response-systems adaptation to care for the needs of our community."
Reach Mail Tribune reporter Morgan Rothborne at firstname.lastname@example.org or 541-776-4487. Follow her on Twitter @MRothborne.