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Earlier this year, local leaders in Lexington, Kentucky, launched the Community Paramedicine team, which responds to mental health and other behavioral health calls for service through a set of discreet, highly trained, and specialized teams that are housed under a single department.
Those teams include a quick response team (handling overdose-related calls), a mobile integrated health team (provides in-home visits to individuals with chronic medical conditions and frequent emergency service patients), and a mobile crisis response team (for immediate response to mental health-related calls for service). The various divisions that compose the Lexington Community Paramedicine team have been operational since 2018, but just this year, the team expanded and opened its own headquarters in the city.
Lexington is building what other cities around the country—like Albuquerque, Cambridge, Portland and more—are calling a “third branch of public safety” co-equal with the police department and fire department, often called a Community Safety Department, which houses a city’s civilian responder teams.
Safer Cities recently spoke with Alexander Jann, a lieutenant with the Lexington Fire Department who oversees the Community Paramedicine team, to better understand how the team is working. Here are three takeaways from our interview with the Lexington Community Paramedicine Team.
1. The Community Paramedicine Model And How It Functions.
The Right Experts, Shared Training: “Our team brings together firefighters, paramedics, social workers, and peer support specialists, each with a unique skill set. Clear roles and cross-training have been key, everyone completes Crisis Intervention Training and Mental Health First Aid, so we all share a common language and understanding when we arrive on scene.”
Collaborating Is Vital: “Even though the different teams within Community Paramedicine have separate day-to-day operations, we collaborate constantly because many of our clients face overlapping challenges with mental health, substance use, and social needs. Each discipline brings its own expertise: paramedics navigate hospitals and healthcare networks, social workers connect clients to community resources, and police officers are skilled in the judicial system. Together, this allows us to provide holistic support.”
Forging Partnerships With Existing Services: “Now that we’ve expanded into our new facility, our focus is on growth and strengthening relationships with community partners. One of our most exciting developments is our new partnership with the Veterans Center. This collaboration allows us to connect with veterans who have fallen through the gaps of the VA system, including those who may not qualify for benefits due to a discharge other than honorable. The Veterans Center gives us a pathway to provide outreach, connect them with support, and in some cases even help them work toward a discharge upgrade so they can access the resources they deserve.”
2. The Team’s “Impact On Residents Of Lexington And Fayette County Has Been Significant.”
Lt. Jann emphasized that the team has many success stories — “we see lives changed every week,” he said — while also underscoring the importance of protecting people’s privacy and medical information when describing how his team has helped people across the city and county.
To illustrate, Jann shared an anecdote that protects the identity of a patient while also highlighting the vital, collaborative work his team does every day — work that has delivered a “significant impact on residents of Lexington and Fayette County,” Jann noted:
“One example involves our partnership with corrections. A couple of months ago, we received a call letting us know about an individual being released who had a history of substance use disorder. We were able to make contact right away and quickly learned this person was still struggling with addiction and had no place to go.
Without support, there was a high risk of going back to old environments and using [substances] again. Instead, we were able to place them in a recovery house out of county, away from the people and places tied to their addiction. As of today, that individual is still in recovery and getting stronger every day.”
3. What Other Cities Need To Know About Launching A Team Like This.
Success Starts With Support From The Top: “We’re able to do what we do because we have complete support from the mayor, commissioner, city council, and fire administration. That backing gives us the space to innovate and the resources to make the program effective.”
Start Small, Deliver Results—And Message Your Success: “For cities trying to build a similar program, start small….Community Paramedicine cannot solve every challenge a client faces on its own, we act as the bridge between the individual and the resources they need. Our job is to understand the client’s needs, identify the right support systems, and connect them with the appropriate services, whether that’s healthcare, social services, or behavioral health programs. By recognizing that we are the middleman rather than the solution, the program can have a far greater and more sustainable impact in the community… Build a core team, focus on strong community partnerships, and show city leadership the program’s benefits.”
Don’t Work In A Silo: “...one of the biggest lessons we’ve learned is that collaboration is everything. You can’t do this work in a silo. Success comes from building genuine partnerships across healthcare, social services, and community organizations, and staying flexible as needs change. Patience is another lesson; it takes time to earn trust and establish credibility both within your department and with the public. If you invest in your people and keep your mission centered on serving residents, the impact can be transformative.”
Think Outside The Box: “I’d also encourage other cities to think outside the box. Community paramedicine has been around for some time, but in Lexington we’ve chosen to do it differently. Typically, QRT programs are run by health departments, Crisis Response Teams by police, and Mobile Integrated Healthcare by EMS agencies. Instead of separating those services, we’ve brought them all under the umbrella of the Lexington Fire Department’s Community Paramedicine program. That approach allows us to deliver more coordinated, consistent care and meet people where they are.”
Related: To gauge public support for Community Safety Departments as part of a city’s public safety infrastructure, Safer Cities recently conducted a national survey of registered voters and found overwhelming support—82% of Americans say they support their city creating a community safety department that functions as a “separate and coequal department alongside police and fire departments” and 83% say that community safety departments “allow police departments to focus on solving serious crimes.”
