By Nicholas Gilmore
The Santa Fe New Mexican
SANTA FE, N.M. — The Santa Fe Fire Department is proposing more changes to the city’s Alternative Response Unit, which has seen a shake-up in recent months amid disagreements over the best way to move the program forward.
A new organizational plan presented at a Tuesday meeting would see the unit staffed with emergency medical technicians and “ARU techs” — following the reassignment of paramedics out of the unit earlier this year — in addition to two case managers.
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The Alternative Response Unit was created in 2021 to provide a team to respond to behavioral health emergency calls to help steer people toward resources and to offload some calls from police. The unit, which is part of the fire department, has enjoyed popularity among city residents and many officials have expressed interest in expanding it, but it has responded to fewer and fewer calls in the years since it was launched and currently has less than half the staff it once did.
The proposed reorganization comes after former staff members and behavioral health providers have expressed concerns about the direction of the program following staffing changes by fire department officials and what a former supervisor who resigned recently called a lack of administrative support for the unit.
Medical transport
Fire Department Assistant Chief Mario Risso presented the proposed reorganization to the city Public Safety Committee, an advisory panel made up of community members and chaired by City Councilor Amanda Chavez, Tuesday evening.
Committee members expressed interest, although some questioned Risso about the department’s reassignment of EMS captains out of the ARU earlier this year. If the unit wishes to transport someone to the hospital, it must now call in medical transport separately, he acknowledged.
“Is it fair to say that if we haven’t backfilled the loss of the emergency medical personnel on that unit, doesn’t that kind of negate the whole purpose of ARU, which is to cut down on having to call out unnecessarily?” asked Cameron Crawford, a committee member and firefighter.
Risso said he felt putting a fire department paramedic captain in the unit in the first place negated its purpose.
“It’s not an alternative to the fire department when you’re staffing it with the fire department,” he said.
Matthew Martin, the unit’s case manager supervisor, said the ARU is not currently taking calls “that have a heavy medical feel or need psych evaluation.”
“For those calls, we’re a support service — we’re second going in, and we take the calls that we know we can be primary on, and we do what we know how to do,” Martin told the committee. “There are occasions where we have to call for medical support, but once this new model continues to play out, I think that will start to dissipate.”
New structure
The proposed organizational chart shows the fire department’s third assistant chief overseeing the unit, with a behavioral health manager supervising both an ARU supervisor and a case management supervisor. The former supervisor would oversee three “ARU techs” and three “ARU EMTs,” and the latter would oversee two case managers.
Risso said the tech positions would be “very similar” to the case managers employed on the unit now, adding the EMTs would be able to perform medical assessments.
Asked about the difference between an EMS captain and an “ARU EMT,” Fire Chief Scott Ouderkirk said in an interview the agency’s EMS captains hold paramedic licenses, the highest in EMT licensure. He said an “ARU EMT” would be able to perform medical transport.
“Things that fall within those different scopes are things such as intubation, certain kinds of medications they can give — which, our EMS captains have never had to use those kind of skills on the ARU — so there [are] a few things that paramedics can do that EMT basics cannot do, and it’s a higher level of training that takes another year in school to get a paramedic license,” Ouderkirk said. “The other EMTs can still do assessments, they can still give lifesaving aid, they can still give medical attention, and they can still do quite a bit of things.”
The unit is currently staffed with three case managers and two supervisors. The staff fell to just five people — down from about 13 at its peak — after the departure of Nicole Ault , the former behavioral health manager, last month.
“I know there’s been a lot of discussion about the movement of the EMS captains off that unit and affecting their operational capabilities,” Risso said Tuesday. “That unit has been running calls over the last four months. It does affect their assessment, because there’s not a paramedic on that unit to do that, but we’re looking at this as an alternative unit — an alternative to a fire department resource — so we feel that if we can bring behavioral health-specialized, ARU-focused, EMT-certified members onto that unit, that we can alleviate some of those issues with formal medical assessments, transporting to different facilities, transporting to hospitals.”
Call volume data provided by the city and the Regional Emergency Communications Center shows the unit has been sent to fewer and fewer calls since it launched in 2021. Over its first full year of operations in 2022, the unit went to 1,543 calls; in 2025, it handled 827 calls, a 46% decrease.
Martin noted case managers in the unit are handling fewer clients as well. Whereas they each had a caseload of 25 to 30 clients in the unit’s early days, each case manager is now handling around five clients.
‘It could be more’
During Tuesday’s meeting, Chavez expressed agreement with City Councilor Pilar Faulkner, who has said the Alternative Response Unit should be moved out of the fire department. Faulkner wants it moved into the city Community Services Department instead.
While Faulkner insisted the program has not seen any cuts and is “not under attack” by administrators, Chavez acknowledged concerns from community members related to the reassignment of EMS captains, noting there was a “shift in structure.”
“Although there might not be … a financial cut — because we’re still paying for paramedics or EMTs that can still serve this purpose — when we’re looking at the structure and visually how ARU looked, things were taken away … and I think we need to be fair to advocates and not act like we’re imagining that occurred, because we’re not,” Chavez said.
Chavez nodded to a working group planned to examine the unit and propose possible changes, acknowledging the program has not lived up to its potential. The process of changing the city’s alternative response, she argued, should include input from staff as well as behavioral health providers.
“If we’re changing the model, then let’s do it right, because I think part of the issue is we need ARU to exist where anyone could look it up and know exactly what kind of services they should be provided,” Chavez said. “That’s what needs to occur — where they know what ARU should consist of in regard to staff, what kind of services are attached to it, when they respond, what that could lead to in regard to support for an individual, and all of that in writing, and I think that that development, the development of that plan needs to have all of those individuals’ input.”
She said fire department officials are scheduled to give another presentation on the unit to the committee in June.
“We are in a place right now where we have something that’s broken — and not because the service that’s being provided is bad, or because it’s not making a difference — but because we know it could be more,” she said. “We know that we could create a structure that’s better defined, which would help with the service in general.”
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