Three Things To Read This Week
This week’s edition is focused on cities that are building public safety teams into their fire departments—specifically, we focus on how the renowned CAHOOTS team in Eugene, Oregon shifted its home from the police department to the fire department; the launch of new fire department-based behavioral response teams; and the launch of overdose response teams housed within fire departments.
1. “After 33 years, Eugene moves CAHOOTS from police to fire department.”
Eugene, Oregon’s mobile crisis response program, CAHOOTS—or Crisis Assistance Helping Out On The Streets—has served as the chief demonstration project for lawmakers trying to wrap their heads around how a clinician-led mobile crisis response team would look and operate. Yet, unlike many of the programs that CAHOOTS inspired, for three decades CAHOOTS itself was housed within the Eugene Police Department. Now, Tatiana Parafiniuk-Talesnick reports for the Register-Guard, CAHOOTS is moving to the city’s fire department: “The switch wasn’t motivated by one particular reason, Eugene Springfield Fire Chief Mike Caven said, but ‘a whole whirlwind of things’ including “recommendations from a recent outside evaluation of the city’s alternative response practices, and the fire department’s intent to shift toward an integrated health care model.”
2. Behavioral Response Teams
In Philadelphia. The Fire Department—in partnership with the city's Department of Behavioral Health and Intellectual Disability Services—launched a new behavioral health response team called AR-3 that is “dedicated to serving people with complex physical and behavioral health needs when they are in crisis,” the city announced this month. The unit, dispatched through the 911 system, arrives at crisis situations in a clearly marked SUV staffed with “paramedics, EMTs, and behavioral health specialists” who are trained in crisis intervention “with the goal of immediately connecting individuals to appropriate resources and/or treatment programs.”
In Salt Lake City. The Community Health Access Team, a first responder unit composed of “social workers housed within the fire department, helps people across the city in times of crisis,” Sofia Jeremias reports for The Salt Lake Tribune:
“The CHAT team is made up of three social workers… [who] accompany firefighters on mental health crisis, substance use disorder, and medical calls … [as well as] help the city’s unsheltered population connect to services…. Rather than sending someone with a mental health issue to a hospital emergency room, the social workers can help de-escalate a situation … [and] get their prescriptions refilled, connect to therapists or find substance use treatment programs. [Kyle Lavender, fire department division chief told the newspaper:] ‘When you need me there to deliver a baby, you’re going to be glad I’m there to deliver a baby. But when you’re having a psychiatric problem or a true crisis at that moment, you’re going to be really glad there’s a social worker, not just a paramedic.’”
Ana Valdemoros, a Salt Lake City Councilmember who supports the program explained to the newspaper that sending first responders who are—by training and profession—mental health experts is key: “A lot of times ‘it is not a matter of police intervention…it’s the mental health crisis that we’re seeing and we’re saying it’s serious. It’s something that we need to address.”
In Tulsa, the Fire Department partnered with clinicians working with city’s Family and Children’s Services’ Community Outreach Psychiatric Emergency Services Department to form the Alternative Response Team, a “new de-escalation team to try to reduce the number of people who experience a mental health crisis and end up in jail [or] a hospital emergency room… [and] functions without a police officer in the mix,” Andrea Eger reports for Tulsa World. The unit, dispatched through the city’s 911 system, is composed of paramedics “with at least 15 years’ experience and the same crisis intervention training that police officers receive alongside an experienced licensed clinician.” Capt. Justin Lemery, the Tulsa Fire Department’s director of emergency medical services explained to the newspaper the importance of this kind of behavioral health team for overall public safety:
“Their goal is to de-escalate crisis situations, stabilize in place 60% of these folks who might otherwise have been picked up and taken to jail… or if they need to go somewhere, to determine the most appropriate destination. This helps utilize our city’s resources more efficiently because these [behavioral health] teams … have the time to spend, where police or a fire truck need to go back in service so they can be available for other calls.”
3. Overdose Response Teams
In Seattle. The city’s Fire Department’s “new overdose response unit [is] seeing early success,” as Joel Moreno reports for KOMO News, ABC’s local affiliate. Moreno explained that the “one-of-a-kind overdose response unit just went operational” and is …
“staffed by a specially-trained crew focused on treatment… made up of two firefighters and a social worker. They go out to the initial medical emergency, but instead of rushing off to the next 911 call once it is resolved, they stay with the patient. They also follow up in the days to come…Firefighters still show up with Narcan and other life-saving equipment to deal with the immediate emergency, then the overdose response unit steps in to try and connect the patient to detox centers and other services.” [Seattle Fire Chief Harold Scoggins told the news station]: “Our early reports are saying that it's proven to be positive…. They spend the time on scene working with the person… it's not a call we go on and leave [instead] we go on, we work with you…[and] we follow up the next day because our intention is to get them into treatment.”
In Milwaukee. “Inside Milwaukee Fire Station 31 on the 2400 block of South 8th Street, you won’t find fire trucks. Yet, that does not mean help is not ready to respond,” Anthony Dubruzzi Writes for Spectrum One News. That’s because the building is home to the Fire Department’s Milwaukee Overdose Response Initiative—or “MORI”—, which is composed of “two teams that work seven hours a day during the week [going] through EMS and dispatch data to find all the fatal and non-fatal overdoses in the county. After doing so, a team of community paramedics from the fire department, along with certified peer support specialists, is sent out to follow up, ideally 24 to 48 hours later, with the individual and loved ones.” Fire Department Captain Dave Polachowski told Spectrum One that the fire department based model is a good one because: “Our badge gets us in the door, and then the peer support takes over … Our members will offer a HOPE kit, which has Narcan and fentanyl test strips and information inside of there, leave that with them, [and] advise them that we are going to follow up with them.”
In Dallas. The city’s Fire-Rescue Department partnered with non-profit Recovery Resource Council to launch a “new overdose response team saving lives one person at a time… [offering] patients face-to-face resources [and] support, ” Alanna Quillen reports for NBC5. Here’s how the team works:
“The Recovery Resource Council pairs one of the peer specialists with a Dallas Fire Rescue Paramedic. The team pulls data from every overdose 911 call and physically goes back to the address to track down the person who overdosed. If they can meet the person face-to-face, the team offers free boxes of the nasal spray Narcan, resources, phone numbers and life-changing connections to recovery programs….‘We can’t rehabilitate somebody who’s dead. Somebody who dies from an overdose doesn’t have an opportunity to learn from their mistake,’ said Becky Tinney, special projects director for Recovery Resource Council, ‘We have to start thinking of different ways to address this epidemic.’”
