Imagine a world where emergency services aren’t constantly overwhelmed, and vulnerable individuals receive the care they truly need—right in their own homes. This is the reality Anchorage is striving for with its innovative mobile health programs, and it’s already making waves. But here’s where it gets controversial: could this approach be the key to fixing a broken healthcare system, or is it just a band-aid on a much larger issue? Let’s dive in.
Jennifer Pierce, a mental health clinician with the Anchorage Fire Department, knocked on the door of a mobile home. The night before, the resident had called 911 for his brother, suspected of having a stroke. Now, Pierce was back to check on the family left behind. Inside, a woman in her 90s sat in a rocking chair, a blanket draped over her lap. Pierce knelt down, asking gentle yet crucial questions: Who was preparing meals? Had she seen a doctor recently? Was her breathing machine being cleaned regularly? These aren’t just casual inquiries—they’re part of a larger mission.
Pierce leads a groundbreaking pilot project called Community, Outreach, Referral, and Education (CORE), a two-person team comprising a licensed mental health provider and a paramedic. Their goal? To reduce repeat 911 calls and connect vulnerable residents with essential healthcare and substance use treatment services. But this is the part most people miss: it’s not just about reducing calls—it’s about addressing the root causes of why people call 911 in the first place.
‘They’re getting stuck in the system,’ Pierce explains. ‘They end up in the emergency room because something’s being overlooked.’ The CORE team takes a proactive approach, meeting community members in their homes rather than waiting for crises to escalate. In just the first two weeks, Pierce received over 20 referrals, proving the program’s immediate impact. By March, the initiative is set to expand, but the question remains: can it scale fast enough to meet the growing demand?
The CORE team’s daily schedule is driven by referrals from emergency medical services (EMS) crews, who often encounter the same callers—some dialing 911 as frequently as three times a month. These individuals typically have complex needs that aren’t met by a hospital bed. Instead, they require assistance with scheduling medical appointments, accessing higher levels of care like assisted living, or managing mental health challenges. Here’s the bold truth: many call 911 as a last resort because they simply don’t know where else to turn.
Joshua Browning, Pierce’s paramedic partner, illustrates this point perfectly. On one Wednesday morning, he spent four hours in a primary care office with a resident who had been in and out of emergency rooms and needed hernia surgery. By 2 p.m., they were on their third home visit, this time to an older adult suffering from chronic chest pains. It’s a grueling but necessary job, and it raises a critical question: Why aren’t these needs being addressed before they become emergencies?
The CORE program isn’t new—it was first launched in 2018 to address gaps in the healthcare system. However, it dissolved in 2021 due to lack of funding, only to be relaunched this month with a $175,000 state grant. Its absence was felt deeply, as non-emergency or ‘low acuity’ calls continued to strain emergency rooms and fire departments. Between 2014 and 2024, ‘basic life support’ calls rose by nearly 40%, a trend mirrored across the country. This is where it gets contentious: Are these calls a symptom of a failing healthcare system, or are they the result of individuals not knowing how to navigate available resources?
Michael Riley, one of CORE’s original founders, points out that paramedics and firefighters often felt ill-equipped to handle these calls. The program’s revival aims to bridge this gap, but it’s just one piece of a larger puzzle. The Mobile Crisis Team, launched in 2021, addresses mental health crises, but even it can’t solve everything. As Pierce notes, the needs of the community are evolving, and so must the solutions.
CORE is part of Alaska’s growing network of mobile integrated health (MIH) programs, which also operate in communities like Juneau and Ketchikan. These programs fill the gaps between emergencies and follow-up care, a lapse that has always existed but has widened due to factors like healthcare costs, insurance barriers, and mental health challenges. ‘The pathway just doesn’t work for many people,’ says Josh Jubb, Juneau’s MIH Program Director. But is this approach enough, or do we need systemic change?
The Anchorage pilot has shed light on a fragmented healthcare system that’s difficult to navigate, regardless of age or health status. Pierce spends her days in a gray Ford Explorer, laptop in hand, visiting residents in their living rooms and kitchens. She looks for clues—like scattered medications or unaddressed health issues—that could prevent the next 911 call. For example, in 2020, she helped a woman struggling with diabetes and mental health by identifying barriers to her care and advocating for her needs. This is the power of personalized, proactive care—but can it be replicated on a larger scale?
In March, CORE will expand to include opioid response referrals. When EMS responds to an overdose, naloxone (Narcan) is typically administered, but it often leads to withdrawal. The CORE team will now have the option to provide buprenorphine, a medication that eases withdrawal symptoms and increases the likelihood of individuals seeking help. ‘The window of opportunity with someone struggling with substance use is very small,’ says Josh Engle of True North Recovery. ‘This program could make that window a little bigger.’ But is it enough to combat the opioid crisis?
Here’s the ultimate question: Are mobile health programs like CORE a revolutionary solution, or are they merely treating symptoms of a much deeper problem? As Anchorage continues to pioneer this approach, the rest of the country is watching. What do you think? Is this the future of healthcare, or does the system itself need an overhaul? Let’s start the conversation in the comments below.
