Knoxville’s Mission District model takes EMS beyond the 911 call

In this episode of EMS One-Stop, Rob Lawrence speaks with Wesley Brookshear, critical care paramedic and FTO program supervisor with AMR in Knoxville, Tennessee, about a community-led effort that is changing how EMS responds to the city’s Mission District. What began as an attempt to understand unusually high 911 utilization has evolved into a multidisciplinary outreach program bringing EMS, public health, addiction services, shelter providers, clinicians and other community organizations directly to Knoxville’s unhoused population. By concentrating on relationships, consistency and basic human needs, the initiative has produced a reported 32% reduction in traditional EMS call volume while dramatically expanding access to wound care, food, addiction treatment, mental health support, nurse navigation and other services. Wesley explains why the program’s success is less about creating another specialized EMS unit and more about connecting people to the resources that already exist. The team initially arrived without uniforms, handed out fruit, listened and built trust before attempting to provide care. Two years later, the program has recorded thousands of encounters, helped more than 140 people enter treatment or sober living and generated remarkably few ambulance transports from its outreach activity. The conversation explores how other EMS systems can identify high-utilization areas, develop community partnerships, protect the mental health of outreach staff and start small—even with a single motivated employee. Above all, Wesley argues that EMS has an opportunity to move beyond simply transporting patients and instead become the connector that gets people to the care and resources they actually need. Additional resources: Global Medical Response - AMR Mission District Medical Team Program Sees 32 Percent Decline in 911 Calls eBook: How to fund community paramedicine Very high EMS utilizers: 7 strategies for local action From sirens to solutions: Guiding paramedics to a patient-centered mindset Public health at the front door: An MIH model to emulate Key quotes “We did go down without our EMS uniforms on. We went in black t-shirts, blue jeans and started making connections.” — Wesley Brookshear “We have noticed a 32% reduction in our normal call volume down at the mission since we started this program 2 years ago.” — Wesley Brookshear “MIH, mobile integrated healthcare, isn't a title; it's actually a list. It's mobile, it's integrated and it's healthcare.” — Rob Lawrence “This is not Wesley Brookshear, this is not AMR, this is an entire community of Knox County citizens that are coming together to support.” — Wesley Brookshear “We talk about the homeless or the unhoused, and I do use both terms, but the unhoused, and we act like it's those individuals; it's never those individuals, those are humans within your community.” — Wesley Brookshear “My mission wasn't admission avoidance, it was arrival avoidance.” — Rob Lawrence “Our folks are wrapping their own wounds now. We are providing supplies. We are giving education.” — Wesley Brookshear “Do not go down with the idea that you're going to cure this idea that homelessness is going to go away.” — Wesley Brookshear Episode timeline 00:49 –