A member of the Milton's C.A.R.E.S. team visits a patient in her home.
Georgia's cities are connecting the dots to create more comprehensive community health care. Through collaborative programming, the Milton and Valdosta fire departments are improving quality of life for residents while reducing the burden on public safety agencies.
Hospital emergency rooms have been called the safety nets of the American health care system, and they are overcrowded. It’s a problem, first cited in the 1980s, that has reached alarming levels since the COVID-19 pandemic, according to studies published by the Journal of the American Medical Association. The impact on Georgia’s cities can be felt most keenly by emergency services and law enforcement.
Milton C.A.R.E.S. Prevents Repeat ER Visits
Hoping to provide some relief to local emergency rooms and city personnel, Milton Fire Department started a medical response program that targeted high-risk individuals. Now in its third year, Milton Fire Community Advocates for Referral and Education Services (C.A.R.E.S.) provides community education and prevention in addition to response. The city reports that last year the paramedicine program achieved over 60-percent reduction in 9-1-1 use for non-life-threatening calls; fire engines were canceled 40 times; and the rescue unit was canceled 19 times. That means more valuable resources were available for life-saving emergencies.
C.A.R.E.S. has become a full-time job for Derek Hofmann, who is a firefighter, paramedic and registered nurse. Hofmann’s advanced life support equipped truck—Milton 410—can be seen in all areas of the city. The program has no eligibility criteria, except for city residency, and serves released ER patients, those recovering from surgery, or rehabilitation patients transitioning back home.
Hoffman said there are three primary ingredients for a successfully C.A.R.E.S. program: 1) an advocate who understands patient care, 2) strong relationships with local resources, and 3) current data about medical trends in the community, so that the program can proactively address issues.
Derek Hofmann explains how some of the tools the C.A.R.E.S. team uses work to local residents.
C.A.R.E.S. team members work closely with hospitals, medical practices, and other health practitioners to provide in-home visits to those in need of medical care. First responders also work closely with each other; Milton fire and police team up on a Co-Response Mental Health Unit, in which a C.A.R.E.S. member responds with a specially trained Milton Police officer on routine follow-ups for people who have suffered a mental health crisis.
Community partners have come on board to expand the C.A.R.E.S. network. Senior Services of North Fulton helps C.A.R.E.S. connect patients with transportation and Meals on Wheels. CPR and fall prevention classes are offered through the city parks and recreation department, hospitals and nursing homes.
New for 2024, a partnership with Northside Forsyth Hospital will create a closer connection between C.A.R.E.S. and recently discharged patients, assisting with transitional care.
“People get discharged and they might have a few more needs, such as transportation, meals, someone to check their vital signs and make sure there are no emergencies impending, go over medication, education, and diet restrictions,” Hofmann said.
A member of the C.A.R.E.S. team gives a shot to a patient.
In addition, an ongoing wellness program will provide monthly checkups, assist with home safety modifications or referrals, and hopefully prevent repeat visits to the hospital.
"I can stay with them and understand what's going on their social aspect, their environment, and see what I can really do to help," Hofmann said.
Learn more about Milton C.A.R.E.S. at miltonga.gov. Take a look at the City of Milton Fire-Rescue Department’s 2023 Annual Report here.
Valdosta HEART Helps Unhoused Residents
Valdosta Fire Department has a similar but different approach to the issue of overburdened emergency medical services. This South Georgia city is preventing medical emergencies by providing basic needs for unhoused residents through a new partnership with South Georgia Medical Center Health EMS. Known as HE❤️RT (Homeless Engagement Resource Team), the program offers essential items, such as water and non-perishable snacks, three mornings a week.
The initiative is supported by Lowndes County EMA, Greater Valdosta United Way, and Second Harvest of South Georgia.
"The impact on the healthcare system nationwide is that they're overtaxed,” Valdosta Fire Chief Brian Boutwell said. “So if there's something that we can do—say, a donated bottle of water and a pack of electrolytes that can prevent emergency medical dehydration—then the ambulance is available for that cardiac arrest or massive stroke. And that’s our goal."
The program is still in its infancy, with the first team hitting the street in July 2024 and making over 130 contacts in the first week. However, Boutwell is already picturing the long-term benefits of creating connections between first responders and a segment of the community that is in frequent need of emergency services.
"Maybe long-range, we can target that demographic and find out what the cause is. But the initial goal is that we provide these basic life needs and take that need for 9-1-1 out," Boutwell said. “It's not to keep them from calling 9-1-1, but basically to take away that need to call 9-1-1."
In his three decades of fire service, Boutwell said HE❤️RT is the most genuine connection he’s felt with people in the community. No one has a political agenda. No one is concerned about their pecking order. The people he meets are truly grateful to receive whatever he offers, whether it is as basic as a granola bar or the all-weather protection of a tarp.
“To see not one person say, “Nah, I’m good,” but to be grateful for a simple bottle of water. To me, that was a turning point that showed me this program is needed,” Boutwell said. “It's helping them, and it's also helping us and our EMS services, and it has an impact on all the other resources in town.”
Learn more about Valdosta HE❤️RT at valdostacity.com.