15 Sep 2014
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Health Clinic at Your San Leandro Firehouse?

Alameda County would fund the clinic as part of a pilot program to open five health "portals" at fire stations across the county. If San Leandro is chosen as one of the locations, the city would pay to construct the facility.

Health Clinic at Your San Leandro Firehouse?

Next summer Alameda County residents could have the option of heading to their local fire station for health care.

The county is currently developing plans to pilot health care clinics in five fire stations across the county, where residents — whether insured or not — would be able to receive basic health services at low or no cost. (Patients with insurance may be required to make a co-payment.)

The project is the first of its kind in the nation and is generating interest both across the county and nationwide, according to Chief Sheldon Gilbert.

"It's pretty exciting. People all over the nation and state want me to come and talk about it, [and] we haven't even done it yet," Gilbert said.

Each clinic would be staffed by a nurse practitioner, a paramedic and an administrative coordinator. These medical teams would also conduct follow-up care with patients via telephone or home visits, and would respond to non-life-threatening calls that come through 911. 

The idea, says Alex Briscoe, director of the county's health care services agency, is to get primary and preventive care to those who need it most, and to cut down on expensive emergency room visits. 

"We have to do something to reinvent the health care system," Briscoe said. "We believe we have the answer."

Preliminary locations for the clinics include one each in Hayward, San Leandro and Union City, and two in Oakland, although no final decisions have been made.

If all goes according to plan, Briscoe said the sites could open to the public by next summer. 

Lack of Insurance and Emergency Rooms

According to the U.S. Census Bureau, 13 percent of Alameda County residents were uninsured in 2009 — 187,438 people. Nearly one in 10 uninsured residents is a child. 

California also suffers from a below-average ratio of emergency rooms per population, leading to long wait times and overtaxed staff.

The American College of Emergency Physicians ranked California the worst in the nation in terms of access to emergency care. The physicians' group recommended ensuring access to primary care as one solution to the problem.

Briscoe says poor and uninsured county residents often have no choice but to rely on emergency rooms for basic health care.

"We wag our finger at them for waiting until health issues turn into emergencies," Briscoe said, "but where are you supposed to go again?"

In Fire Departments We Trust

Briscoe and his staff first thought up the idea of fire station clinics about a year ago, and plans have moved swiftly ever since.

Fire departments have become critical players in providing emergency medical services, Briscoe said. The county utilizes a public-private partnership to contract with all fire departments in its jurisdiction to provide first response to emergency calls.

Plus, the public generally trusts and respects its local fire department, Briscoe said.

To illustrate the point, he recalled observing a protest last year in downtown Oakland against the killing of Oscar Grant by a BART cop. The young demonstrators had been yelling at the police detailed to the protest when they heard the sirens of an approaching ambulance. They stopped their yelling and let the fire truck drive through, Briscoe said. 

That's when a lightbulb went off for Briscoe and staff.

"Our immediate response was 'wait a second,' could fire departments help us with the problem we have of access to primary care services?" Briscoe said.

It's not the first time the county's emergency medical workers would delve into preventive care. In 2009, Alameda County became the only county in the state where paramedics were given permission to immunize residents against the H1N1 flu virus.

Plus, the county already operates 19 health clinics in schools and community colleges, Briscoe said, so it has models for the proposed fire station clinics.

County Provides Operational Funds; Cities to Pay For Construction

In April, the county board of supervisors allocated $750,000 for the fire station project out of revenue from , a voter-approved half-cent sales tax increase dedicated to health services. The funding would cover the project for three years, said Fire Chief Gilbert.

Third-party reimbursements from programs such as  Medi-Cal would also help fund the venture, Briscoe said.

Local governments will have to shoulder the cost of constructing the clinics at each station. This one-time cost, according to Briscoe and Gilbert, could range from $350,000 to $600,000 per clinic.

Cities across the county have showed great interest in the program, Briscoe and Gilbert said. But they'll have to come up with the cash at a time of shrinking budgets.

The finance committee of San Leandro City Council unanimously agreed last week to recommend funding the project to the full city council, according to Mayor Stephen Cassidy, who chairs the committee.

"I'm confident that once the full council hears of this proposal, we will move forward and identify the funds necessary for the construction expenses," Cassidy said in an email.

He said the city could start by looking for grant money to fund the project.  

San Leandro Vice Mayor Michael Gregory called the idea "brilliant" at a June 16 meeting of the Alameda County Fire Advisory Commission, where Briscoe presented the plan.

"I just don't have enough good things to say about it," Gregory said.

Jill Replogle contributed to this story. 

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