Transcript OPERATION CARE - National Fire Protection Association

OPERATION CARE
Baltimore HealthCare Access, Inc.
Baltimore City Fire Department
Background
 EMS has become
overwhelmed with frequent
calls to 911 for nonemergency related issues.
 This is problematic in that it
diverts the EMS away from
handling true emergencies,
which can in turn
compromise response times.
 Non-emergent calls are
costly. For example, it can
lead to higher taxes for City
residences.
Issue
 Many calls come from
individuals who have
non-emergent health
needs of a re-occurring
nature.
 They do not know how
to gain access to the
care, treatment, or
services they need.
Proposed Solution
In May 2008, BHCA,
BCHD, and the BCFD
began a pilot project called
Operation Care to provide
case management services
to frequent 911 callers.
The goals of the project
were to:
 Ensure that patients were
adequately linked to
healthcare and other
community services.
 Decrease the number of
non-emergent calls to 911.
Intervention
 BCHA assigned dedicated case
managers to work with the top
25 patients during the pilot
period from May 12, 2008 –
August 1, 2008 (3 months). 10
patients participated in the pilot.
25 Initial Patients Referred
Deceased, 5,
20%
Participated in
the Pilot, 10,
40%
Incarcerated, 2,
8%
County
Residents, 2,
8%
Hospitalized, 2,
8%
Unable to
Locate, 4, 16%
Deceased
Incarcerated
County Residents
Unable to Locate
Hospitalized
 The majority of participants
received 8 to11 weeks of
intervention.
Participated in the Pilot
 The case manager conducted
an assessment of needs, and
coordinated care/services to
address those needs.
Data: May 12, 2007 – May 12, 2008
Patient
Patient
1
3
7
Total
Non-Transport Responses
103
Transport Responses
1
6
2
54
3
63
4
55
5
7
6
11
7
23
8
30
9
130
10
33
TOTAL
412
5
0
108
Age, Insurance Status, and
Diagnosis of Patients
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






1
2
3
4
5
6
7
8
9
10
Age
65
65
61
88
39
89
52
53
47
52
Insurance
Private
Medicare
Medicaid
Medicare
Uninsured
Medicare
Medicare
Medicare
Medicaid
Medicaid/ PAC
Diagnosis
Diabetes, depression
Cardiac, depression
Hypertension, osteoporosis
Diabetes, asthma, dementia
Drug/alcohol, psychiatric
Cardiac, depression
Cancer, paralysis
Congestive heart failure
Drug/alcohol abuse
Drug/alcohol, seizure disorder
Interventions Provided
 Health Insurance Enrollment
 Medical Coordination to:






Community Health
Clinics
Primary Care Providers
Specialty Providers
Disease Management
Programs
Mental Health Providers
Substance Abuse
Programs
 Social coordination to:
 Food Pantries
 Adult Daycare
Services
 Transportation
 Assistance with
Activities of daily living
 Housing Resources
 Homeless Shelters
 Employment
Resources
Referrals Made for the Pilot
Participants
Patient
Programs and services to which patient was referred
1
Psychiatric evaluation, nutritional consultation, diabetes management, adult protective services, domestic
violence program
2
Adult evaluation services, specialty care (ophthalmology), adult day services, Food Stamps
3
CARE (Adult Day Care), Meals on Wheels, durable medical equipment (wheelchair)
4
Adult and geriatric services, specialty care (ophthalmology), medicine compliance
5
Health insurance, drug treatment
6
Baltimore City Health Department’s Personal Care Program, specialty services (ophthalmology/podiatry),
energy assistance
7
Substance abuse treatment, assistance with photo ID/birth certificate
8
Kidney disease program, transportation, Adult Protective Services, Meals on Wheels, assisted living
9
Long-term drug treatment, psychiatric evaluation
10
Food Stamps, Medicaid
Outcome
 Call Reduction
7 out of 10 participants
showed at least an 80%
decline in calls.
 Financial savings were
substantial.
The predicted cost of
services would have been
$37,186.61. The actual
cost was $5,525.14 over
the pilot period.
A savings of $31,661.47.
Benefits
 This was a triumph for all parties involved.
 The EMS was able to answer more true
emergencies.
 BHCA was able to continue its mission to
provide care coordination services to the
most difficult populations in Baltimore City.
 Most importantly, the participants were able
to get the help they truly needed, and their
overall quality of life was improved.
September 1, 2008 – September 31,
2010
 63 clients came through the program.
 39 client files were closed out at some point
during the above timeframe.
 820 home visits occurred. 410 of the 820
home visits were successful.
Staffing
 Operation Care has
been expanded.
 There is a case
manager and an RN
case manager working
full-time to connect
clients to services.
FY2011 2nd Quarter Data
Status of Operation Care Clients
Number of open cases for Operation Care
clients.
37
40
37
35
Number of new clients referred to Operation
Care.
28
30
17
25
Number of Operation Care clients successfully
receiving on-going case management.
28
20
15
Number of clients in a "holding pattern" due to
previous high levels of activity but low
levels of call volumes in the last 5 months.
9
10
Clients Determined to be Deceased
2
5
Clients Housed in a Nursing Facility.
1
Number of Operation Care clients closed out.
4
Number of home visits performed made to
Operation Care clients.
97
0
Number of open cases for Operation
Care clients.
Number of Operation Care clients
successfully receiving on-going case
management.
Currently
 28 slots are filled
 17 slots are vacant
 6 additional slots likely to become vacant in
the next 30 days
 24 people are in a “holding pattern”
Questions?
Contact Information
 Kibibi Matthews, Director of Homeless Services &
Operation Care
(443) 814-5780
[email protected]
 Tracee Janey, RN Case Manager
(443) 602-1352
[email protected]
 Krystle Martin, Case Manager
(443) 248-3338
[email protected]