2.
City Council Work Session
- Meeting Date:
- 06/15/2026
- TITLE
- Nurse Navigation
- PRESENTED BY:
- Sara Naylor
- Department:
- Fire
Presentation:
Yes
Legal Review:
No
Project Number:
N/A
RECOMMENDATION
Authorize city staff to begin the formal process of integrating the GMR (Global Medial Response) Nurse Navigator system into the (EMD) Emergency Medical Dispatch system at the Billings City/County 911 Communication Center. This system will allow low acuity Omega and Alpha emergency calls to be handled over the phone by a nurse versus sending emergency resources.
EXECUTIVE SUMMARY
The Billings Fire Department is requesting authorization for City staff to begin the formal process of integrating the Global Medical Response (GMR) Nurse Navigation Program into the Emergency Medical Dispatch system at the Billings City/County 911 Communication Center.
A significant portion of 911 calls are medically appropriate but do not require an immediate emergency response from fire or EMS resources. These lower acuity calls often involve patients who need medical guidance, access to a clinic, telehealth support, transportation to an appropriate care setting, or assistance navigating the healthcare system. Historically, the primary option for these callers has been to dispatch emergency resources and, in many cases, transport the patient to an emergency department, even when the patient’s condition may not require that level of care.
The GMR Nurse Navigation Program provides an alternative pathway for selected low-acuity 911 calls, specifically Omega and Alpha-level calls identified through the Emergency Medical Dispatch process. Instead of automatically dispatching emergency resources, eligible callers may be transferred to a licensed nurse navigator who uses established clinical protocols to assess the caller’s condition and connect the patient with the most appropriate care option. This may include self-care instructions, referral to urgent care, coordination with a Federally Qualified Health Center, telehealth evaluation, or other non-emergency healthcare resources. If the nurse navigator determines the patient does require an emergency response, fire and EMS resources can still be dispatched.
Implementation of this program is intended to improve system efficiency, preserve emergency response resources for higher-acuity incidents, reduce unnecessary emergency department utilization, and provide patients with care options better matched to their actual medical need. The program also directly supports Recommendation #20 from the 2021 CPSE Report, which states that BFD should work with the 911 Dispatch Center to implement response protocols that alter the BFD response mode when calls are determined to be minor or non-emergency.
Representatives from GMR will provide City Council with an overview of the Nurse Navigation Program, anticipated integration with the existing Computer Aided Dispatch system, implementation steps, clinical safeguards, and the estimated number of annual calls that may be eligible for nurse navigation.
A significant portion of 911 calls are medically appropriate but do not require an immediate emergency response from fire or EMS resources. These lower acuity calls often involve patients who need medical guidance, access to a clinic, telehealth support, transportation to an appropriate care setting, or assistance navigating the healthcare system. Historically, the primary option for these callers has been to dispatch emergency resources and, in many cases, transport the patient to an emergency department, even when the patient’s condition may not require that level of care.
The GMR Nurse Navigation Program provides an alternative pathway for selected low-acuity 911 calls, specifically Omega and Alpha-level calls identified through the Emergency Medical Dispatch process. Instead of automatically dispatching emergency resources, eligible callers may be transferred to a licensed nurse navigator who uses established clinical protocols to assess the caller’s condition and connect the patient with the most appropriate care option. This may include self-care instructions, referral to urgent care, coordination with a Federally Qualified Health Center, telehealth evaluation, or other non-emergency healthcare resources. If the nurse navigator determines the patient does require an emergency response, fire and EMS resources can still be dispatched.
Implementation of this program is intended to improve system efficiency, preserve emergency response resources for higher-acuity incidents, reduce unnecessary emergency department utilization, and provide patients with care options better matched to their actual medical need. The program also directly supports Recommendation #20 from the 2021 CPSE Report, which states that BFD should work with the 911 Dispatch Center to implement response protocols that alter the BFD response mode when calls are determined to be minor or non-emergency.
Representatives from GMR will provide City Council with an overview of the Nurse Navigation Program, anticipated integration with the existing Computer Aided Dispatch system, implementation steps, clinical safeguards, and the estimated number of annual calls that may be eligible for nurse navigation.
BACKGROUND (Consistency with Adopted Plans and Policies, if applicable)
Representatives from GMR will present to the council their proposal to integrate their nurse navigation system into the existing CAD (Computer Aided Dispatch system) utilized by the Billings City/County 911 Communication Center. GMR will provide a background and overview of the system, how the will integrate with the current system, implementation steps, and the number of calls annually we anticipate being moving to this system. This system will also meet the CPSE 2021 Report Recommendation #20 stating "BFD should work with the 911 Dispatch Center to implement response protocols that alter the BFD response mode when calls are determined to be minor or non-emergency."
FISCAL EFFECTS
There is no cost to the city to integrate this service. GMR currently serves the City of Billings and BUFSA with their ambulance transport company, American Medical Response (AMR).
STAKEHOLDERS
ALTERNATIVES
Council May:
-Directing staff to begin the formal process of integrating the Nurse Navigation system into the Billings City/County 911 Communication Center
-Not direct staff to begin the formal process of integrating the Nurse Navigation system into the Billings City/County 911 Communication Center
-Directing staff to begin the formal process of integrating the Nurse Navigation system into the Billings City/County 911 Communication Center
-Not direct staff to begin the formal process of integrating the Nurse Navigation system into the Billings City/County 911 Communication Center