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Serving the vulnerable with proactive, rather than reactive care

Crawfordsville IN’s nationally-recognized MIH program expands the traditional scope of emergency care to encompass mental and physical wellness, education and community resources


Project Swaddle is a home-visiting program that provides a community paramedic as a physician-extender to deliver wrap-around care for pregnant women and recent mothers who face any number of health, social, and environmental challenges as part of the Crawfordsville (IN) MIH program.


By Samantha Swearingen

The City of Crawfordsville’s nationally-recognized Mobile Integrated Health (MIH) Department was launched as a pilot in January 2017 through a grant from the Indiana State Department of Health and a partnership with Franciscan Health Hospital of Crawfordsville, as an extension of the Crawfordsville Fire Department (CFD). In January 2024, MIH became its own city department but still works closely with CFD for services requiring medical oversight. The MIH Department is supported by Franciscan Health, United HealthCare, NACCHO and Indiana Department of Health; and collaborates with Crawfordsville Fire and Police Departments, Montgomery County Sheriff’s Department, InWell Integrative Wellness, as well as other stakeholders through partnerships of varying capacity.

The department staff of 11 is composed of two administrators, four paramedics, three nurses and two social workers, working under the medical direction of local physicians, and is focused on four programs. Crawfordsville’s community paramedics receive extensive training and certification before integration into the program, including a minimum of 5 years of experience, 40 hours of classroom training and over 200 hours of clinical rotations.

Together, the department serves the vulnerable members of the local population, helping them overcome barriers to care and meeting them where they need help the most.

Expectant and new mothers

The Maternal and Infant Program – including Project Swaddle & Project Bundle - is carried out by two MIH nurses, one paramedic and one social worker, and a collaboration with Franciscan Health. It is a home-visiting program in which MIH staff provide care to pregnant women, recent mothers and their babies, with an emphasis on those families who are facing health, social/emotional, economic and environmental challenges.

The program strives to improve maternal and infant health outcomes and reduce health disparities by improving access to prenatal, postpartum, and infant healthcare and support services, expanding care to include mental and physical wellness, education and resources, encouraging safe home environments, and reducing hospital re-admissions, emergency department visits and overall healthcare costs.

Chronic disease

Two MIH paramedics, one nurse and one social worker, in collaboration with Franciscan Health, comprise the Chronic Disease Program staff. This program aims to support existing health services, provide integrated partnerships with other health professionals, and extend access to health services – such as primary care, public health, disease management, prevention and wellness, and mental health – particularly to the underserved populations of the community who are affected by chronic disease, such as congestive heart failure, diabetes, chronic urinary conditions and chronic obstructive pulmonary disease.

Patients are encouraged to improve physical activity, nutrition, and medical compliance to help the patient maintain a wholly healthier lifestyle, allow longer aging in place, encourage safe home environments, and reduce falls, hospital re-admissions, emergency department visits and overall healthcare costs.

Substance abuse and behavioral health

The QRT Program is comprised of a multifaceted team of a MIH social worker and paramedic, in collaboration with Crawfordsville Police Department, Montgomery County Sheriff’s Department, and InWell Integrative Wellness. The Program personnel respond 24/7 for both emergent and non-emergent needs to address issues related to substance use and behavioral health by delivering individualized, in-home, patient-centered care that includes treatment, coordination of long-term treatment, counseling and additional wrap-around services.

QRT provides care, coordination and navigation from the scene of an incident through active recovery, via connection and education of harm reduction processes, identification of treatment and behavioral health options, community outreach and education. This program’s goals include prevention of problematic substance use and reduction of harmful outcomes through emergent response.


The newest program of the Mobile Integrated Health Department is the Immunization Program, which utilizes a MIH nurse to provide immunization services in homes, schools and other non-traditional settings to improve overall community vaccination rates and reduce barriers to vaccination access.

Preventing rather than reacting to care deficiencies

Crawfordsville’s MIH program expands the traditional scope of emergency care to encompass mental and physical wellness, education, and communal resource connectedness, reducing adverse maternal and infant health outcomes and disparities.

About the author

Samantha Swearingen is director for mobile integrated health for the City of Crawfordsville, Indiana’s Mobile Integrated Health (MIH) Department

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