MIH is thriving after first four years

Las Cruces Fire Department (LCFD) Mobile Integrated Healthcare (MIH) Coordinator Paul Ford told the Las Cruces City Council the program boasted 554 responses last year and 1,080 interventions providing referrals, visitations and treatment services to frequent users of the 911 emergency system.

Speaking at the council’s Nov. 23 work session, Ford said MIH was created in the fall of 2016 to deal with LCFD’s high volume of emergency-services calls from a small number of city residents who often did not have access to or know about other resources they needed, including transportation, assistance getting out of bed and back and forth to the bathroom – what Ford called “the activities of daily living.”

Ford said participants enrolled in MIH are seniors living in their own homes with care gaps (87 percent), mobility is a primary issue (70 percent), transportation issues (66 percent) and untimely discharge from care (36 percent).

Many frequent 911 callers are seniors with mobility issues who have Medicare coverage but are struggling to maintain their independence in their own homes, Ford said.

“The seniors need someone there all the time, but can’t afford it,” he said.

“This is really exciting, City Councilor Gabe Vasquez said. “Aging in place is a big deal for a lot of folks.”

Other frequent callers are disabled, low-income Medicaid recipients, who often have mobility issues and substance-abuse and/or behavioral health issues, Ford said. Medicaid will pay for personal caregivers, but their hours are capped at 40 per week.

That group is “very resistant to change,” Ford said, and often the “most vulnerable to health issues and untimely death.”

MIH greatly increased the services it provides because of COVID-19, he said, helping meet “a huge need for food and prescription delivery” and welfare checks, either in person or on the phone.

During the first months of the pandemic, Ford said MIH “upstaffed to help provide case management for 43 high-risk seniors,” whose needs included deliveries, welfare checks, comprehensive needs assessments, infection control assistance and transportation.

Ford said MIH has begun a memorandum of understanding (MOU) with New Mexico State University’s school of social work, deploying masters-degree students with MIH providers as part of the students’ internships. MIH also has an MOU with Memorial Medical Center’s Family Physicians residency programs, as resident physicians are deployed with MIH staff and work directly with those served by the program.

MIH has acquired a transport van that is handicapped accessible so MIH enrollees “can safely accesses services they need in the community at the time they need it,” Ford said.

Ford said MIH is at work on a pilot project that combines a number of healthcare and crisis-intervention professionals to create a mobile crisis intervention team to respond to behavioral-health 911 calls in the city.

The team includes an MIH paramedic, a plain-clothes officer of the Las Cruces Police Department who is trained in handling calls involving the mentally ill and a licensed clinical social worker.

The team can respond to crises, make referrals to appropriate services and determine “meaningful and appropriate pathways to care,” Ford said. A successful team will reduce the number of crisis intervention calls the city receives and also will reduce the number of arrests and use-of-force incidents, he said.

LCFD Fire Marshal Cody Haver said an request for proposals for the team has been approved.

Ford said a $500,000 grant will allow MIH to create an opioid overdose response team “to follow up on every confirmed overdose with a team-based outreach model to navigate the patient and family to supportive services.”

Going forward, Ford said more caregiver services will be needed, including connections to city Dial-a-Ride services, Meals on Wheels and case management, he said, and even helping deal with referrals for seniors living in squalor whose houses need to be cleaned up.

MIH results July-December 2019 show that more than 93 percent (28 of 30) of MIH “graduates” had a reduction in acute care utilization, Ford said, adding that 29 of the 30 had found a primary-care provider and 100 percent had access to transportation to alternate care services.

 “We will continue to thrive and work at this,” said Fire Chief Eric Enriquez.