In November, amid some of winter’s first snowflakes, community paramedic Christopher Williams rang the doorbell to a small, one-story home on a quiet residential street. No one answered. Days earlier, the man living there had overdosed, setting in motion the West Allis Fire Department’s Mobile Integrated Healthcare program (MIH), which sent a representative to talk with him in the emergency room and set up an appointment after his discharge to discuss treatment for his opiate addiction. But for that initial visit – and this second try – he never came to the door.
At Williams’ side stood Cassidy Nehs, a recovering addict of some 12 years and a peer support specialist with an opioid treatment program. MIH sends trained responders to home visits and even the scenes of overdoses to talk with friends and family. The department rang the hard-to-reach man three times before listing his case as inactive. “We’re persistent,” says Williams.
In all, the department reached 86% of West Allis overdose patients in 2021. Of those contacted, about half chose to enter treatment.
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In 2018, West Allis recorded 26 deaths from opioid overdoses, the highest per capita in Milwaukee County. Since then, city leaders believe an emphasis on overdoses by the MIH program has helped keep its numbers under relative control while COVID-19 has pushed them to record highs elsewhere.
The program has roots in 2014, when the city first set out to prevent calls for service instead of just respond to them. “The fire department is a very reactive organization,” says deputy chief Armando Suarez Del Real, the former leader of MIH. “And that model is beginning to reach the end of its usefulness.” MIH responds to and follows up on all kinds of health problems – falls by the elderly, mental health crises, obstetric and early childhood issues, malnutrition and cultural barriers to medical care.
But the opiate crisis has become front and center. Williams and Nehs recounted a recent overdose call – a woman with pinpoint pupils recently awoken with Narcan after her second overdose of October. When Nehs kneeled next to her, saying she’d been there herself and everything was going to be OK, the woman opened up. She wasn’t interested in treatment right away, but MIH later met with her for an hour and remains in contact. “Whether it’s the first time or the 100th,” Williams says, “we’ll be ready when the person is ready to accept treatment.”
