2017 Semifinalist
County of Clayton, GA
January 1, 2017

Clayton County Fire and Emergency Services is charged with providing health care on an emergency basis to more than 267,542 citizens through 12 Advanced Life Support Transport Units, one Community Paramedicine Unit, and three new Community Treatment Units. Federally designated by the Department of Health and Human Services as a Medically Underserved Area in 2013 and a Healthcare Professional Shortage Area in 2012, Clayton County was experiencing higher than average gaps in the continuity and availability of medical care for its citizens. The Board of Commissioners, through its Fire and Emergency Services Department, sought to remedy some of the access issues by providing non-acute medical care to its citizens through the use of nine nurse practitioners functioning as an integral part of its Mobile Integrated Healthcare Program. In January of 2013, a presentation was given to the commissioners outlining the state of emergency medical services (EMS) in Clayton County and, more specifically, the state of health care and the challenges that lay ahead. During this retreat, several options to address gaps within the local health-care model were presented to the commissioners based on an analysis funded by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR). The study indicated that approximately 15 percent of Medicare patients transported to the emergency department by ambulance can be safely cared for in other settings if available in a community. National models suggest that if these patients were transported to a physician's office, Medicare could save $559 million per year, and if they were treated at home, the expected savings would be significantly higher. Given the low-acuity nature of many patients being transported, one may anticipate a better patient care experience when patients are either treated at the scene by EMS or taken to a clinic-based provider with shorter wait times than in the emergency department. After just over two years of data gathering, the Board of Commissioners unanimously approved the $1.9 million budget and the hiring of the nurse practitioners commenced immediately. To date, all nine have been hired and paired with their paramedic partners.