By Carina Julig
The Santa Fe New Mexican
SANTA FE, N.M. — As temperatures dipped to dangerous lows and Santa Fe enacted a “Code Blue” in mid-January, Mayor Michael Garcia rode along with the city’s Alternative Response Unit as it offered support to people living on the streets.
Garcia wrote in a Jan. 10 Facebook post the experience gave him valuable insight “into how we can further strengthen the services and support provided by the Alternative Response Unit.”
| EARLIER: N.M. city’s crisis team sees decline in responses due to ‘growing pains’
Days later, the Santa Fe Fire Department pulled one of the people on Garcia’s ride-along off the unit.
Emergency Medical Services Capt. Faith Applewhite and other EMS captains were removed from the ARU team Jan. 20 . The decision would allow them more time to focus on other duties, including quality control for cardiac arrest calls and other high-acuity dispatches, the city said.
Interim Fire Chief Scott Ouderkirk said it didn’t make sense for the department’s four EMS captains, its most highly trained medical professionals, to be full-time members of the unit. Paramedics are still available to the ARU on an on-call basis, he noted. It was unclear why lower-level paramedics were not assigned to the unit instead of the captains.
Ouderkirk told the Public Safety Committee this week the shift was a “small change” and said the ARU is “still able to fulfill all their capacities without them on that truck the whole time.”
Fire Chief Brian Moya, who is serving as interim city manager in the new Garcia administration, did not respond to a request for comment Friday on the issue.
Public safety and health professionals in the community had mixed reactions to the change. But officials with two organizations that partner closely with the ARU both raised concerns, noting the lack of EMS captains has reduced the unit’s ability to be an effective partner.
“We have, as a partner agency, already seen differences in how we’re able to collaborate,” said Kate Field, the director of crisis services with New Mexico Solutions, a nonprofit contracted by the county to operate the La Sala Crisis Center.
She added, “We will continue, of course, to work closely with them and support them however we can. But we’re kind of shocked.”
Despite praise from city officials since the ARU launched in 2021 and calls from community members for an expansion, the unit’s call volume has decreased every year, and declined 45% between its first full year of operation in 2022 and 2025.
Garcia said in statement Friday the ARU’s services are “not going away or being reduced.”
Provider concerns
The Alternative Response Unit was established to respond to 911 calls regarding people who primarily needed social or behavioral health services, including many who are homeless, mentally ill or struggling with addiction. It joined the fire department’s Mobile Integrated Health Unit, better known as MIHO, which was created in 2016 to provide care to frequent 911 callers.
Both divisions have standing biweekly meetings with La Sala and the Christus St. Vincent High Utilizer Group Services program, better known as HUGS, for patients who tend to use the emergency room as their primary health care provider.
HUGS caseworker Sierra Logan said Monday the removal of paramedics from the ARU “hobbles their ability to collaborate effectively with us.”
Having paramedics on the unit made it possible for the ARU to medically evaluate people in the field and send them to the hospital, if necessary, she said, adding they also could give the HUGS team a heads up.
The removal of the EMS captains leaves the unit with only case managers, who Logan said also do important work but don’t have the same specialized training or authority to provide medical care.
The fire department offers all case managers the option to take an emergency medical technician certification course paid for by the department, according to Ouderkirk, and one of the unit’s case managers is a licensed EMT through that process.
The fire department has no plans to place other EMTs or paramedics on the unit, he added.
Field said her team at La Sala saw “an immediate difference” in mobile crisis scenes after the EMS captains were removed, noting there is “a very different philosophy” between people who have received specific training in mobile integrated health services and those who have not.
The thing that is “most unfortunate” about the decision, Logan said, “is that it has direct impacts on the most vulnerable people in our community.”
Community reactions
Ted Bolleter, a former city assistant fire chief who now sits on the Public Safety Committee, said it made “no sense” to have EMS captains on the ARU.
“It’s like putting a brain surgeon on a call where you could use just a regular medic,” he said in an interview Wednesday.
Case managers on the unit should also be certified as EMTs, he said, but he doesn’t think it’s a major concern if they aren’t: “Narcan can be pushed by anyone now,” he noted, referring to the opioid overdose reversal medication.
He believes the ARU would be better suited to a different department.
The city has a $7.9 million, four-year contract with San Francisco -based nonprofit Urban Alchemy to provide similar services — “street outreach” to the homeless. Urban Alchemy employees are not medically licensed but carry nalaxone, the generic form of Narcan.
Ginger Robertson, chief operating officer at La Familia Health, which occasionally works with the ARU in its Health Care for the Homeless program, also said she found the change reasonable after reviewing the Public Safety Committee’s discussion.
“As short as we are in New Mexico with every type of health care provider, both physical health, emergency and behavioral health, it makes sense,” said Robertson, a paramedic and licensed clinical social worker.
“I get where the city is coming from in not wanting to use a fairly high-ranking, high-paid individual for that role,” she added. “That does not seem like a good use of resources.”
But Cameron Crawford, a Santa Fe County firefighter and member of the city’s Public Safety Committee, said the ARU change was “very concerning” to him.
“Making sure that the ARUs are staffed adequately is important, and EMS captains obviously have a leadership role in the administration of medicine,” he said.
Crawford said he believes the ARU should be “the city’s largest public safety department,” noting most of the calls he responds to in his role with the county could be handled better by a social worker.
Declining response
Ouderkirk said the fire department and mayor are “firmly committed to the success of the ARU and the service they provide to our community.”
The unit received two new vehicles last year, purchased with grant money, he wrote in an email Friday. Though, he didn’t specify the source of the funding.
Still, the department’s support for the program hasn’t led to an expansion of its services. Rather, along with fewer staff, the unit’s call volume has declined, decreasing from more than 1,500 in 2022 to just 827 last year, even as the city’s homeless population and Santa Fe County’s drug overdose death rates continued to rise.
The New Mexican reported in November 2024 that 12 of 13 budgeted positions for the unit were staffed at that time. The ARU and MIHO now have nine budgeted positions, and six are filled, according to Ouderkirk. The fire department on Feb. 24 will begin accepting applications for three new case managers to fill the vacancies.
A Community Health and Safety Task Force convened by the city in 2020 to assess public safety initiatives recommended in a 2023 report the city expand the ARU to 24/7 operations.
Garcia said in a New Mexican questionnaire during the 2025 campaign expanding the ARU was one of his top budget priorities for the coming fiscal year.
It’s unclear whether that’s still on the table; a list of budget priorities the council and mayor developed collaboratively put increasing affordable housing, improving the efficiency of city systems, and measures “to reduce crime and increase public safety” as its top three goals.
Garcia said in his statement Friday changes to the ARU are aimed at “improving service delivery, protecting taxpayer investment, and ensuring that our fire and EMS professionals can continue providing exceptional care to our residents.”
He added, “I am proud of the Santa Fe Fire Department for embracing innovation while keeping community safety at the center of every decision.”
Field and Logan said they hope the fire department will be open to discussing the change with its community partners.
“We respect the decisions of other institutions and organizations and get that it’s difficult to manage limited resources,” Logan said. “And I think collectively, we really wish that the paramedics would be reinstated.”
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