Public Health Heroes: Field Health Services Reflecting on Baltimore in the Post-Unrest Era

Baltimore City Health Department Field Health Services Michelle Haynes

Two years ago, Michelle Haynes, a phone operator with the Baltimore City Health Department’s Field Health Services Non-Emergency Medicaid Transportation (NEMT) program, was on the phone with a woman trying to arrange her normal non-emergency medical transport to a doctor’s appointment. At the time, Baltimore City was in the midst of unrest following Freddie Gray’s death. A number of pharmacies were closed and many residents were unable to access their necessary prescriptions.

Through labored breaths, the woman on the phone tried to tell Ms. Haynes that she had a shortage of her blood clot medication and could not take her normal dosage. Michelle recognized that the combination of her medication shortage and difficulty breathing could mean the woman was having a medical emergency.

“I am going to call emergency services to come assist you and I’ll stay on the phone until they arrive,” Ms. Haynes said to the woman. Within minutes, the ambulance arrived and the paramedics assisted the woman. As it turns out, the woman was having a pulmonary embolism, a blood clot in her lung, which could have been deadly.

Usually, Field Health Services (FHS) does not make emergency arrangements in the NEMT program; however, the circumstances of the situation and Michelle’s expertise allowed her to save the woman’s life.

 

Going Above and Beyond for Patients

The FHS staff of 18 operates BCHD’s NEMT call center. Monday through Saturday, from 7 a.m. to 11 p.m., the staff work to ensure that Baltimore’s most vulnerable residents with Medicaid are transported to their non-emergency medical appointments. On average, the staff coordinates 130,000 rides to 30,000 clients per year. The rides are operated by an external vendor.

Baltimore City Health Department Field Health Services Durina TaylorBaltimore City Health Department Field Health Services Yvonne

When you visit the FHS site located in Charles Village, you will find people like Ms. Haynes, who has worked at FHS for 20 years; Durina Taylor and Wanda Betts, who have worked at FHS for over 25 years; and Yvonne Crowell who brought her 14 years of EMT experience to BCHD. Rudy Godwin, who joined the FHS team three years ago after working in BCHD’s HIV outreach program, uses his prior experience to connect clients with other services at BCHD, such as treatment for HIV and sexually transmitted infections. 

Baltimore City Health Department Field Health ServicesBaltimore City Health Department Field Health Services Rudy

And there is Karen Harper, a former -police officer from Barbados, who has worked through intense shifts during extreme weather, such as 2016 Winter Storm Jonas. She recalled being on the phone at 2 a.m., helping to coordinate a list of dialysis patients with rides to ensure they were able to access their services.

During the same blizzard, Baltimore City government was closed; yet, the FHS staff was working around the clock to identify critical patients who most needed medical assistance. During the storm, they coordinated with the Maryland National Guard and Baltimore Fire Department to move patients on sleds to transport them to their medical appointments.

Baltimore City Health Department Field Health ServicesBaltimore City Health Department Field Health Services Karen

Three staff members deliver methadone two times per week to homebound patients who would otherwise be unable to access the necessary treatment. Wanda Betts shared a story about a delivery to a regular client did not answer the door when they arrived. Ms. Betts knew immediately that something was wrong because this client always expected them and answered the door quickly. The staff called 911 for assistance. When first responders entered the home, they found the client unconscious in his living room. Thankfully, EMS was able to ensure the client’s safety and once he recovered, and FHS continued delivering his treatment. 

 

Connecting Patients to Needed Care

FHS arranges transportation for individuals who have Medicaid and no other transportation available to go to medically necessary appointments (not emergencies). The arrangements must be scheduled in advance. The screening process includes a letter from a physician saying that the patient cannot take public transportation because of a medical condition.

In order to see if someone qualifies or to arrange FHS, they can call the main number, 410-396-7433. The operator screens the application using the patient’s Medicaid information through an electronic verification system. The person is automatically approved for 30 days and must receive a doctor’s certification within that 30 day period.

FHS is a Center for Medicaid and Medicare Services federally mandated program supported as part of the State Medicaid Program, which are implemented by BCHD. Over the past two years, BCHD has worked closely with the Maryland Department of Health and Mental Hygiene to ensure that FHS is meeting the requirements of the program.

Under the leadership of Director Shonda Deshields and Deputy Director Tamara Anderson BCHD has continuously improved the FHS’ infrastructure and customer service. For example, the team recently implemented a new phone system to improve the call center services in addition to upgrading to an electronic scheduling system that is connected to the transportation vendor. In the past, the staff coordinated on paper and spreadsheets to coordinate hundreds of thousands of rides. As a result of the change, the program is now able to quickly process and coordinate more calls and clients.

At BCHD, we are very lucky to have such a dedicated FHS team that works hard every day to serve the residents of Baltimore.  

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