Learn about MIH and Community EMS

Mobile Integrated Health Care (MIH) and Community EMS are new programs that utilize mobile resources to deliver care and services to patients in an out‐of‐hospital environment in coordination with healthcare facilities or other healthcare providers.

• Community EMS is a collaborative system that addressed illness or injury prevention through high value public health services in the community.
• MIH is a system of pre- and post-hospital services that utilizes mobile resources, including EMS Personnel, community paramedics, and other providers to deliver a coordinated continuum of care that supports patients’ needs in the community.
• MIH with ED Avoidance is an additional component of an approved MIH Program that allows for management of 9-1-1 patients, as appropriate and in accordance with the DPH ED Avoidance Protocol, in alternative settings including outpatient clinics, psychiatric facilities, and the patient’s home.

What to know

Three programs have been created to address gaps in illness prevention and health care service delivery.

	Community EMS (CEMS)	MIH	MIH with ED Avoidance
Program Description	A collaborative system that addresses illness or injury prevention through high value public health services in the community.	A system of pre- and post-hospital services that utilizes mobile resources, including EMS Personnel, community paramedics, and other providers to deliver a coordinated continuum of care that supports patients’ needs in the community.	An additional component of an approved MIH Program that allows for management of 9-1-1 patients in alternative settings, including outpatient clinics, psychiatric facilities, and the patient’s home.
Operations	CEMS programs are operated by a local public health authority in partnership with a primary ambulance service’s EMS Personnel.	MIH programs are operated by healthcare entities together with operational partners such as ambulance services, hospitals, health plans/insurers, or physician practices/medical homes.	MIH with ED Avoidance programs are operated by a DPH-approved MIH Program and utilize the primary ambulance service and paramedics with advanced training.
Services Provided	CEMS program applicants may apply to operate one or more evidence-based, illness and injury prevention services from the Defined List of Community EMS Services based on the needs of their community. Applicants may also petition to add a new service to the Defined List of Community EMS Services.	MIH program applicants may propose services that will address identified service delivery gaps in their community. The services should improve quality, access, and cost effectiveness; increase patient satisfaction; improve patients’ quality of life; and increase interventions that promote health equity.	MIH with ED Avoidance applicants propose services that are in line with the DPH ED Avoidance Protocol to address identified service delivery gaps in their community. ED Avoidance encounters follow a primary ambulance service response (9-1-1), patient assessment, and consultation with on-line medical direction. Oversight
Oversight	Designated primary ambulance service’s affiliated hospital medical director.	Medical director designated by the MIH Program.	Designated primary ambulance service’s affiliated hospital medical director.

Application information

The Department of Public Health is accepting applications for Community EMS, MIH, and MIH with ED Avoidance programs.  Visit the application pages for each program type to learn more about program requirements, download the application, and apply.

• Apply to operate a Community EMS Program page to learn more about program requirements, download the application, and apply.
• Apply to operate an MIH Program
• Apply to operate an MIH Program with ED Avoidance