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This week's roundup tracks community paramedicine's push to catch patients before they hit the ER, North Collier Fire Rescue putting its new MH-45 mobile healthcare unit into service, Lakewood, Ohio seeking grants to expand a Neighborhood Paramedic Program running at 110% capacity, Dr. Michael Fine spotlighting Rhode Island's lagging adoption despite 30%+ ER-visit reductions elsewhere, and Saskatchewan's decade-old program, profiled through paramedic Dallas Schwartz, connecting unhoused and at-risk residents to detox, counseling, and long-term care.
Table of Contents:
North Collier Fire Rescue Launches New Mobile Healthcare Unit for Non-Emergency Calls
Lakewood Looks to Expand Overburdened Neighborhood Paramedic Program
Dr. Michael Fine: Why Rhode Island Is Missing Out on Community Paramedicine
Region of the Week: Saskatchewan, Canada
Read Time: 5 minutes
New Program
North Collier Fire Control and Rescue District put a new mobile integrated healthcare unit, MH-45, into service on July 20, aiming to handle non-emergent medical needs while freeing up traditional units for critical emergencies.
The "We Care" program was developed jointly by North Collier Fire Rescue, the Collier County Sheriff's Office, Collier County, and program medical directors, who established patient-selection criteria and treatment protocols.
Residents don't need to request the unit specifically — 911 dispatchers determine the appropriate response using established protocols, and the nearest available emergency resource is sent if MH-45 isn't available.
Though primarily meant for low-acuity cases, the vehicle is equipped and licensed for both basic and advanced life support transportation.
The district currently operates one such unit and plans to evaluate whether additional vehicles are needed.
Lakewood, Ohio officials are seeking grants and partnerships to expand their Neighborhood Paramedic Program, which has cut repeat EMS calls and helped residents with chronic illness and behavioral health needs, but is now running at roughly 110% capacity with just one dedicated paramedic.
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Thought Piece
Dr. Michael Fine argues that community paramedicine, where paramedics treat minor problems in the field or transport patients to urgent care instead of the ER, cuts unnecessary emergency room use by over 30% and is already working in 40+ states plus Canada, Australia, and the UK.
Rhode Island has barely adopted the practice, with only a handful of towns (West Warwick, South Kingstown, Charlestown, Providence, Pawtucket) trying it, often inconsistently.
Major roadblocks include insurers, Medicaid, and Medicare only reimbursing EMS for ER transport, forcing towns to self-fund the programs even though savings flow to insurers and government health programs, not local budgets.
A shortage of paramedics, doctors, and community health center staff, plus some EMS union resistance over fears of job loss, further stalls expansion.
Fine concludes the state lacks the leadership needed to coordinate funding and stakeholders, calling the current gap "crazy" given the potential savings.
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Region of the Week: Saskatchewan, Canada
Dallas Schwartz, a community paramedic with Medavie Health Services West, switched from traditional ambulance work to community paramedicine, a program running in Saskatchewan since 2011 that aims to get ahead of health issues before they become emergencies.
Rather than transporting patients to the ER, Schwartz assesses people where they are, including for withdrawal symptoms, unhoused individuals, or those staying temporarily with friends, and connects them with services like home detox, counseling, or nurse practitioners.
Unlike regular ambulance work, the role allows him to build ongoing relationships and follow up with patients, seeing them recover, get sober, or move into long-term care.
He notes Saskatchewan's health system faces rising strain from population growth, limited resources, and burnout among health workers, making programs like his increasingly important.
Becoming a community paramedic requires a roughly two-year endorsement process covering palliative care, withdrawal management, and phlebotomy, and Schwartz says the work, which he compares to a "Kinder Surprise" for its variety, still isn't widely known since patients are typically referred rather than self-selecting into it.