Meeting Patients Where They Are: EMS-Based Navigators Go the Extra Mile
Emergency medical services (EMS) are often the first clinical touchpoint for someone after they’ve experienced an overdose. Arriving on the scene, EMS assesses, stabilizes, and transports patients with substance use disorder (SUD) to ongoing care. Ideally, in the ED, patients meet with a navigator, who guides them through treatment options, including medications for addiction treatment (MAT) – free of judgement.
But what if the navigator could reach a patient before or even if they never made it to the hospital?
EMS-based navigators are alerted to patients immediately after they experience overdose reversal or a substance use-related EMS encounter, while hospital-based navigators typically receive referrals from clinicians and nursing staff when a patient with SUD reaches the ED. Following up in the field, by phone, at homes, and within the community, EMS-based navigators go wherever the patient is – often connecting with individuals who rejected transport to the hospital.
In 2018, Bridge worked with Contra Costa Health to launch its EMS model, working with paramedics to identify and treat patients who would benefit from MAT. Through its Choosing Change program and with the foundation laid by Bridge, Contra Costa took that program one step further by embedding a navigator in its EMS system to ensure every field encounter had a pathway to follow-up care.
“Overdose rates in 2020 were still really high and we thought — what can we do to support people in real time with evidence-based treatment?” said Phoebe Blaschak Oliveira, RN, PHN, BSN, who leads Choosing Change. “We didn’t want breaks in the chain. If EMS responds to an overdose or withdrawal and the patient is eligible for a medication that can save their life, we want to administer it to them right then and there. And whether or not they go to the hospital, we want to make sure they can access continued treatment. That’s why navigation is housed under EMS — so those potential connections to care don’t get lost.”
When EMS encounters a patient with SUD in the field Contra Costa Health’s navigators Tambra Divine and Marilyn Tims receive an automatic notification to follow up.
For Divine, this notification isn’t a box to check — it’s a relationship to build.
“Linkage to care depends on the patient’s goals,” she said. “Sometimes it’s just holding space and listening to what a patient wants to do about treatment. We help them make appointments, explain what to expect, make sure they have their prescriptions, and show them how to follow up. We give them the opportunity, the education, and the navigation services so they know what’s available. We meet the patient where they are.”
Sometimes the difference between wanting care and accessing it comes down to something deceptively simple, like making a phone call. Patients with SUD often must call an access line to schedule their first treatment appointment. If they agree, Divine sits with them during that call, preparing them for screening questions and offering emotional support in real time. It’s a small act, but it’s also the moment many patients say yes instead of giving up.
Steven* was one of those patients.
He received buprenorphine in the field after EMS responded to his overdose; he had cycled in and out of treatment multiple times. Then, he met Tambra, who helped him understand his treatment options, and he sustained follow-up for the first time. Years later, he remains in recovery and has established primary care to manage his overall health. He also remembers how the paramedic treated him during his last call: with care, with education, and without judgement, which mattered to him immensely.
Trust makes that possible. Early in the program, Oliveira’s team shared outcome data and success stories with EMS teams, reinforcing that their work did not end at the scene. Paramedics could see the downstream impact — patients entering ongoing care, stabilizing, rebuilding. What once felt like isolated responses became a shared mission.
Redlands Fire Department, also a part of EMS Bridge’s network, which responds to more than 250 overdose incidents annually, is another California team that recently launched its own EMS-based navigation program built around the operational realities of fire and EMS response. Before implementing the navigator role, the department saw 100 percent loss to follow-up after emergency department admission. Now, navigators work closely with MAT providers and receiving facilities to identify residents in need of support and follow up on every referral.
Since October 2025, their navigator has conducted outreach to nearly 50 clients, maintaining weekly check-ins and guiding them through treatment and other services.
“EMS-based navigators are critical because they meet individuals at the point of crisis, often immediately after an overdose, when they may be most open to support,” said Carly Cripe, RN, MICN, EMS coordinator for Redlands Fire. “By embedding navigators within EMS and fire systems, departments can bridge the gap between emergency care and long-term treatment, reducing repeat 911 calls, emergency department utilization, and overdose recidivism.”
For fire departments, the benefits extend beyond individual patients. The EMS-based navigation model improves outcomes, reduces strain on emergency systems, strengthens community partnerships, and demonstrates leadership that focuses on prevention rather than reaction.
Join us
EMS-based navigation — and how other hospitals can integrate the model — is the focus of EMS Bridge’s regional virtual collaborative on March 24, 2026 at 12pm PST. If you are working in the EMS field and want to learn more about the EMS-based navigation model, register to join the upcoming conversation by signing up via the EMS Bridge contact form or by adding the invite directly to your calendar.
*Steven is a pseudonym.