On Jan. 28, 2025, the Lexington City Social Services and Public Safety Committee received an annual update on the city’s community paramedicine program from Chief Jason Wells and Lieutenant Alexander Young of the Division of Fire and Emergency Services.

The program, Lieutenant Alexander Young said, “is an innovative program that addresses the gaps in our healthcare and social services,” by expanding the traditional roles of paramedics and social workers to proactively serve people who are unhoused, elderly, high utilizers of emergency services, people with substance-use or mental-health disorders and residents with chronic illness.

City staff described a three-team model: mobile integrated health (MIH), a quick response team (QRT) for overdose follow-up, and a crisis response team. Each team is staffed with a mix of paramedics, social workers, peer specialists, an embedded police officer and crisis counseling staff. Chief Jason Wells and program members credited cross-agency partnerships — including an early practicum relationship with the University of Kentucky College of Social Work and an embedded Saint Joseph Hospital clinician who works with the program three days a week — for strengthening referral pathways.

The presenters gave account-level data and program results from 2024: the MIH team recorded interactions with 441 individuals; the quick response team followed up or attempted to follow up with roughly 1,400 nonfatal-overdose cases and logged 1,517 individual contacts; staff reported 42 treatments and said 218 Narcan kits (transcript: “Norcam”) were distributed during door-to-door or follow-up visits. Staff also described routine distribution of fentanyl test strips, resource packets and other harm-reduction supplies.

Program leaders traced the program’s origins to a 2017 Assistance to Firefighters grant (reported in the presentation at $272,000) and a 2018 pilot under the Kentucky Board of EMS. The presenters said the program has relied on multiple federal grants awarded by the Bureau of Justice Assistance (BJA) — the current BJA award is expected to run through 2026 — and also cited a 2024 award from the Kentucky Department for Medicaid Services that broadened outreach capacity.

Planned expansions discussed included adding three paramedics to multiple teams “in the next few weeks,” launching the crisis response team and piloting Suboxone administration in the field. The crisis response team, Lieutenant Young said, will pair an LFD paramedic with a licensed professional counselor (LPCA) who can self-dispatch or be requested when available; the team will monitor the radio during business hours and respond to certain behavioral-health calls with the goal of calming scenes and transporting people to appropriate care rather than defaulting to an emergency department. Young illustrated the target call type as “suicidal ideation with someone who has not yet done any harm and has no method to do that,” where a smaller, specialized response could be more appropriate.

On plans to give buprenorphine (Suboxone) after naloxone reversals, presenters said the drug could reduce the immediate risk of repeat overdose by providing a partial agonist that reduces withdrawal and the short-term chance of reuse. Patrick Branham, a firefighter-paramedic on the program, framed the approach as a way to “make contact while they’re still feeling good” after reversal and increase the chance of linking the person to recovery services.

Committee members voiced strong support. Council Member Morton said he “strongly support[s] the community paramedicine program” and urged growth of co‑response units. Vice Mayor Wu and other members encouraged ride-alongs to better understand field work; Wu said the experience felt like “neighbors visiting neighbors” and argued the program should be supported for both its human and fiscal benefits. Council Member Lynch pressed staff to clarify differences between the mobile integrated health team and the quick response team; staff described MIH as longer-term, social-work–paired case management and QRT as time-sensitive overdose follow-up within 24 to 48 hours of naloxone administration.

Program leaders also noted ongoing multi‑partner work: a newly convened “situation table” that gathers community partners to coordinate responses, a continuing partnership with the peer-support nonprofit Voices of Hope, and efforts to stand up a crisis-response unmarked vehicle staffed by a counselor and a paramedic. Leaders said some elements remain in development — for example, dispatch protocols for the crisis response team — and that the team will start “grassroots” and monitor demand and outcomes.

The committee did not take formal votes on program changes during the update but encouraged staff to return with operational details and continue collecting data to guide sustainable growth.

The program’s presenters asked council members to consider ride-alongs and additional staffing support; committee members repeatedly offered to help publicize and support partnerships that expand placements and referrals.

Looking ahead, staff said they expect to pursue additional grants and to present implementation details for the crisis-response pilot, Suboxone field administration and any required clinical protocols as those plans mature.