The City of Austin Paramedic Practitioner Program (PPP) is expanding both their medical and mental health services and is now a two-person emergency services team for vulnerable populations and people experiencing homelessness.  Started by the City of Austin’s Office of the Chief Medical Officer and in partnership with Austin/Travis County EMS, this successful program is expected to continue hiring staff and expanding on current services during 2022.
 
“Austin/Travis County has a lot of gaps among the vulnerable populations,” said Travis Baker, Senior Paramedic Practitioner and Clinical Manager for the program. “This program delivers care that can help bridge the difference between critical care services and services that can be taken care of on-site such as stiches, IV fluids, burns, issues with asthma and other illnesses.” While Baker responds to medical issues, he also hands out information to people living on the streets on how they can access support services, housing information, and social services that will help mitigate future illnesses and assist the homeless in finding the resources they need.
 
The PPP Team currently treats between 100-200 patients a month, mainly on the streets, while traveling in an emergency response vehicle that is equipped with life-saving medical equipment.  By meeting and treating patients where they are, at the site of their emergencies, the team is able to deliver care rapidly and efficiently, while helping save those who do not require hospitalization from having to make unnecessary and costly trips to hospital emergency rooms. About a third of this team’s patients are people experiencing homelessness. 
 
“We have a large population living in Austin that knows of no other way to access medical care than to contact 911, said Chris Brown, EMS Physician Assistant for the Paramedic Practitioner Program.  “Often times, a Paramedic Practitioner is the only provider they have seen in a long period of time and we are fortunate enough to be able to take time to listen to their complaints and medical issues and assist in their care. “
 
Data has shown that 30-40% of all 911 calls are not life-threatening calls that may not require an ambulance transport to the hospital, and this is where the Paramedic Practitioner Program comes into action.  The most common calls the team responds to are for illnesses, chronic wounds, burns, abscesses, skin infections, worsening of existing conditions such as asthma and chronic heart conditions, and minor injuries such as cuts or sprains, all of which can be handled effectively on the streets.  While many of Baker’s patients have less serious needs, he says that some have required and received urgent, life-saving care. Patients who require immediate hospital care are still transported to an emergency room by ambulance.
 
This service helps to relieve ER congestion and takes some of the workload off EMS responders by freeing up ambulances and fire trucks to focus on critical care emergency calls that require transportation to the hospital.  It also helps manage growth and response times for both the first responders and for vulnerable Austin-Travis County residents. 
 
Benefits of the PPP includes saving time and money for the patients, taxpayers and the City and County by:

• Costing approximately 1/4th of the cost to operate than if an ambulance responded
• Being approximately 1/10th of the cost of a fire truck responding to calls for medical help
• Decreasing unnecessary ambulance transports and costly ER bills

 “The success of this program in the past 3 years has been instrumental in reaching our most vulnerable populations by giving people medical care and options for helping to ensure their health and wellbeing,” said Chief Medical Officer for the City of Austin, Dr. Mark Escott.  “We’re excited to be expanding this program and its services to our communities and continue to work on breaking down silos between the City of Austin, Travis County and other stakeholders by sharing communications and data.”

The PPP team receive requests from other ambulance crews and from community health paramedics.  The team also has access to the 911 dispatch system where they can respond where needed and self-assign calls to their unit.