Fire Mobile Crisis Team Policy Quiz

Fire Mobile Crisis Team (FMCT) Policy

• The FMCT was designed to respond to low-acuity mental health crises with a master's level clinician and a BCFR Paramedic.
• The FMCT is dispatched upon request from on-scene law enforcement or fire personnel.
• The FMCT is a joint effort between Bernalillo County Fire and Rescue (BCFR) and Mental Health Services.

FMCT Responsibilities

• Scene size-up:

  • FMCT Paramedic is responsible for recognizing hazards, ensuring scene safety, establishing a safe area for treatment, utilizing appropriate isolation precautions, protecting evidence, and activating EMS or Fire Dept. as needed.
  • Mental Health Clinician (MHC) is responsible for making contact with law enforcement, observing the client's position, and obtaining consent from the client for the Paramedic to conduct an assessment.

• Documentation:

  • The MHC will complete a mental health assessment on the Electronic Health Record (EHR).
  • All calls for service require an NFIRS report at minimum.
  • If the client's crisis is due to a medical condition, the Paramedic will complete an electronic patient care report (ePCR).
  • The MHC and Paramedic will evaluate the client's mental status, including baseline status, onset, progression, and preceding symptoms.
  • The MHC will be the first to make contact with the client to establish rapport.

• Treatment and Disposition:

  • If the Paramedic assessment is abnormal, the client will become a patient.
  • If the client voluntarily accepts transportation to an emergency department, the Paramedic will treat and request transport by Albuquerque Ambulance (AAS).
  • If the client requires advanced care, the Paramedic will request AAS and/or fire department to respond.
  • If the client needs medical care but refuses voluntary transportation, disposition is based on the mental health assessment and current EMS protocols.
  • If the client is determined to be gravely disabled or a danger to themselves or others, the disposition will be based on the Bernalillo County/Albuquerque EMS Guidelines and/or Consortium Physician Consultation and transportation decision will be based on patient choice or EMS Guidelines.
  • If a psychiatric emergency is suspected, the client will be offered voluntary care and transportation to a psychiatric facility or emergency department.
  • If the client requires psychiatric care but refuses voluntary transportation, a Certificate of Evaluation (C of E) will be generated, or transportation will be based on the Bernalillo County/Albuquerque EMS Guidelines and/or Consortium Physician Consultation. In this case, Law Enforcement must transport the client.
  • Clients may be transported to a psychiatric emergency service receiving facility, mental health provider office/clinic, shelter, or emergency housing in the FMCT vehicle.

• Referral and Priority of Referral:

  • If a client needs immediate intervention but does not meet criteria for mental health or medical transportation, the FMCT will attempt to refer the client to Mental Health Services.
  • Adult Protective Services (APS) may be contacted for immediate referral of a dependent or elderly adult if concerns regarding safety, abuse, or neglect arise.
  • For urgent or routine referrals, the EHR will include necessary documentation, including a direct referral contact and follow-up plan.
  • Routine referral information will be provided to the client and/or designated decision maker.

FMCT Documentation

• An EHR, including elements of the psychiatric assessment of the client, will be completed for all clients/patients by the clinician.
• If the patient is turned over to an ambulance for medical transportation, the transporting paramedic will complete an ePCR. The FMCT Paramedic will also complete a separate ePCR with details of assessment/findings up to the time of transfer of care, or while en route to the hospital.

FMCT Dispositions

• Clients assessed by the FMCT may be transported to a psychiatric emergency service receiving facility, mental health provider office/clinic, shelter, or emergency housing in the FMCT vehicle.
• Transportation to an office, clinic, shelter, or emergency housing must be pre-arranged by the FMCT Licensed Clinician.
• If a client is not transported, a FMCT program Non-Transport Form will be signed.

FMCT Precautions and Comments

• If abuse or neglect of an elder or dependent adult is suspected, the appropriate verbal and written reports will be filed, and appropriate authorities contacted.
• If a senior is identified in need of further care or services, the FMCT will refer the client to the Long-Term Care State Ombudsman and if there are concerns about safety, they will ensure this is also reported to APS.
• The FMCT will make all transportation and referral decisions in accordance with existing patient care protocols, as well as Bernalillo County/Albuquerque EMS Guidelines and/or Consortium Physician Consultation.