At the most recent HCA of MA Board of Directors meeting, Scott Cluett, Director of the DPH Office of Emergency Medical Services provided an update on the role out of Mobile Integrated Health and Community EMS in MA. Both programs were created by a 2015 act of the MA legislature, following a trend in many states to use EMS personnel to deliver care outside of the emergency transport role. Applications for MIH programs were released in December 2018, with a few coming online mid 2019. MIH programs must, in their applications: “identify and validate one or more gaps in service delivery using data and a corresponding community health needs assessment. Each application must also describe how the proposed MIH program will address identified gaps in service delivery and provide improvements in quality, access, and cost effectiveness, an increase in patient satisfaction, improvement in patients’ quality of life, and an increase in interventions that promote health equity, including cultural and linguistic competencies…”Coordination of care is explicitly required with MIH applicants either having named health care partners or a plan for primary care coordination.
Community EMS programs must be founded in partnership with a local municipality and focus on prevention if illness or injury. So far 11 cities and towns have launched programs with the most common services offered being fire burn prevention and education, home safety evaluations, sharps awareness (and at least in one community sharps disposal) and naloxone training.
The change in state law that allows EMS personnel to treat in lieu of transfer is just beginning to be understood. How it may be incorporated into home care and hospice patient care management remains to be seen. Cluett’s short presentation, along with the pertinent regulations, can be found here.
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