Caroline County health department reports 85% drop in 911 calls among MIH enrollees; federal grant to expand service expected July 1

Holly Trace, director of nursing for the Caroline County Health Department, told commissioners on March 24 that a soft launch of the county's Mobile Integrated Health (MIH) program produced encouraging early results and that new federal funding will let the county expand the service.

Trace said the MIH partnership, which pairs health-department nursing staff with county emergency services, enrolled 10 new MIH patients and completed 17 MIH visits during the soft launch from December 2025 through February. "We did see 10 new MIH patients during that time period," Trace said, and reported that among enrolled clients the county measured "an 85 percent reduction in 9-1-1 calls after MIH enrollment." She added that the program has referred clients to internal social work, assessment services, food assistance, utility help and transportation supports.

KJ, a program staff member who presented cost figures, said the county's preliminary cost analysis points to savings from avoided emergency transports. "The average 9-1-1 call for the is right around $1,500 — between $800 and $1,500," KJ said, and the team estimated about $20,000 in avoided emergency-department costs when MIH visits replaced ED visits for the soft-launch cohort.

Program staff also described operational barriers. Trace said the MIH pilot ran one clinic day per week during the soft launch and that limited staffing, transportation gaps and a lack of in-home supplies (grab bars, smoke detectors, etc.) constrained the team's ability to serve all eligible residents. "Some of the barriers have been because we're only doing it one day a week currently — that doesn't always align with people's schedules," a staffer said. Fire department leaders in the room offered to install smoke detectors that the health team secures.

The immediate next step is a planned expansion. Trace told the board she had received word that Rural Health Transformation grant funding looks likely to support MIH expansion starting July 1, and county staff confirmed the Maryland Department of Health applied for federal funding for a MidShore region that will list Caroline County as the fiscal agent. "The Rural Health Transformation grant looks like we will be able to utilize that money to expand MIH services starting July 1," Trace said.

Commissioners and staff said they will return to the board with updated enrollment data and a June follow-up report prior to implementing a full schedule. The MIH team also said it will continue patient satisfaction surveys at enrollment and at 30, 60 and 90 days; Trace reported 100% satisfaction scores so far in the pilot group.

The program remains unreimbursed by insurance in its current form; staff said legislative and federal policy changes would be needed for ongoing billing, and commissioners suggested engaging their congressional delegation about funding and billing barriers.