The Firehouse Clinic is the brainchild of the Director of the Alameda County Health Care Services Agency, who leads the design and development of health services countywide. The idea was spawned by something he noticed in 2009 in the aftermath of a controversial police shooting. During the protest that ensued, the crowd moved to the side of the road and cheered as a fire truck sped by. Another incident occurred later during the outbreak of the H1N1 epidemic. Firefighters were among those who delivered vaccinations to low-income residents who stood in long lines to receive vaccinations from the first responders, preferring to wait instead of going elsewhere for the vaccine. What these incidences suggested to Briscoe was the high level of trust that Hayward firefighters apparently enjoyed in low-income areas of the community. Noting that first responders also had specific knowledge about many patients, having responded to emergency health calls in the past, he reasoned that there might be merit in capitalizing on that trust and knowledge to improve access to primary care and preventative care.
The 2,400 square-foot Firehouse Clinic officially opened in early January of 2016 and operates from 8:00 a.m. to 8:00 p.m. weekdays, with eventual weekend hours. A full service primary and preventive care clinic, common medical visits to the Firehouse Clinic include:
An on-site lab runs basic tests, such as for blood sugar and pregnancy. In addition to medical services and follow-up from emergency room visits, the Firehouse Clinic staff provides health navigation services to connect patients to the best insurance program available to them and to a medical home for chronic care, if necessary. Medical staff also provides referrals to specialty care as well as acute care discharge follow-up to ensure that patients are taking medicines and following medical advice.
Over a period of years, the concept was discussed and explored until a collaboration of public agencies, health care providers, the California Healthcare Foundation, local architects, the fire department, labor groups, and the faith-based community mounted a grassroots effort to site the clinic at a new fire station.
Among the groups spearheading the effort was The Organizing and Leadership Academy. Formed in 2010, the group has taken on a mission of training the next generation of grassroots organizers and leaders. The group’s organizers and volunteers spent two months going door to door, visiting more than 11,000 households to inform residents about the firehouse clinic concept. The group gathered more than 1,900 letters of support from residents and more than 122 from businesses, congregations, and community organizations. The letters were presented to the Hayward City Council to garner support.
The firehouse clinic idea creates a nexus between the emergency first responders and the healthcare system by increasing communication, sharing data, and coordinating services to better connect patients to provide the best level of care and continuity. The staff uses tablets instead of computers to cut down on patient waiting time and ensure that records are easily accessible. In addition, exam rooms are equipped with wheeled carts loaded with supplies. The idea is to provide more effective, patient centered health care that improves patient outcomes and reduces costly emergency room visits, taking advantage of the trust and expertise of the first responders.
Hayward Fire Chief Garrett Contreras notes that firefighters are trained as first responders in an emergency. “We do trauma and emergency medicine really well, but when we have a patient that doesn’t have those significant issues, we treat them the same way—we send them to the emergency room,” he says. “There’s a better way to do it. There’s a better, more cost-effective way to help make this a healthier and more vibrant community.” By combining and co-locating these services thousands of unnecessary ambulance trips may be avoided, and patients can gain access to medical care beyond the emergency room.
The Firehouse Clinic is expected to treat 9,450 patient visits in the next two years, providing health services to about 2,400 new clients this year and 3,500 new clients next year. With Medi-Cal and Medicare billing and public funding, the operational model should be scalable and sustainable in this and other communities. It is expected to pay for itself the third year of operation in Hayward.
Timeline of Project: Since 2016
Initiator: Alameda County Health Care Services Agency
Cost of Project: The center was built on city land, but the county paid $1.2 million in construction costs, with Hayward covering another $840,000 in infrastructure and technology costs. The Tiburcio Vasquez Health Center operates the clinic and the county is subsidizing operating costs for the first two years.
Firehouse Clinic Fact Sheet
Firehouse Clinic Website
Tiburcio Vasquez Health Center, Inc.
Lori A. Baptista
Director of Policy