Fire dept.'s MIH program aims to reduce 911 calls
The pilot project will help residents solve the larger, underlying problems in their lives — such as substance abuse or home hazards
By Diana Alba Soular
Las Cruces Sun-News
LAS CRUCES, N.M. — In Las Cruces, some residents call 911 a lot.
More specifically, 30 residents called for emergency help from the Las Cruces Fire Department more than 10 times apiece in 2016, according to city numbers. And, while emergency personnel don't discourage people from calling 911 when it's necessary, they say the high rate of 911 use by a small percentage of the city's population is a symptom of bigger problems: gaps in the health care system and gaps in residents' knowledge about how to access care or related resources, such as transportation.
"They're calling 911 to receive a ride to the hospital, by ambulance, so they can see a doctor," said Las Cruces firefighter and paramedic Paul Ford. "And they use this method as their primary way to access the health care system. And that's not how this is supposed to work."
A pilot project launched in September of last year by the Las Cruces Fire Department aims to reduce 911 calls to the city by helping residents solve the larger, underlying problems in their lives — such as mental illness, substance abuse or home hazards that cause frequent falls — that are behind their calls to emergency responders. Dubbed "mobile integrated health care," the model is a growing trend among fire departments across the country, LCFD officials said. The hope is that the project will reduce the number of 911 calls — and the related expense — to the city.
The pilot project in Las Cruces consists of one staff member — Ford — who's assigned to follow up with people who are possible clients in need of help.
"We ID people calling 911 frequently," Ford said. "We go to their location to investigate and offer services. We identify gaps in their health care and assist in directing them to resources. We perform home safety checks, where applicable, which is very important, especially for the disabled. And we follow up to ensure they have received the resources that they need."
The Las Cruces Fire Department is calling its pilot program the Community Assessment and Navigation, or CAN, project.
SAVING A LIFE
The fire department highlighted to city councilors one of its biggest successes since launching the pilot program. A senior identified by LCFD only as "Mr. R" called 911 a total of 20 times between September and October of last year because he'd fallen and needed help getting off the ground.
Ford said fire personnel were concerned about the man's overall health, Ford said. The CAN unit followed up with him and connected him to Dial-a-Ride, the city's transit service for people with a disability. Within three days, he saw his primary care doctor. And several days after that, he was admitted into the hospital. There, he was diagnosed with a broken neck from an earlier fall that had caused near-paralysis.
"He couldn't get around because of what we found out later was a broken neck," said LCFD Deputy Chief Steve Mims. "He hadn't been to his doctor because he couldn't move around. He had a broken neck, and nobody knew about it."
The man was moved to El Paso, where he had family. Family members didn't realize the man had been having such severe health problems because he hadn't told them, LCFD officials said.
"The family calls and thanks the Las Cruces Fire Department for the help, because they feel that we saved his life," Ford recounted to city councilors last week.
HIGH-VOLUME 911 CALLERS
The bulk of calls for help to the Las Cruces Fire Department are not for fires, but rather people in need of medical and physical aid. In 2016, the department received 16,302 calls for help, and about 65 percent of them were EMS calls, according to city numbers.
Among the EMS calls, 30 people generated 462 calls for help in 2016. A total of 236 people called 911 four or more times.
Both groups — less than 1 percent of the city's population — generated about 1,600 calls altogether, amounting to roughly 15 percent of the EMS incidents to which LCFD was dispatched, according to LCFD.
If the number of calls by frequent 911 callers could be reduced, "that's a lot of savings for the organization, the city and the community," Mims said.
MENTAL HEALTH STRIDES
Residents with a mental health condition are also likely to benefit from LCDF's pilot program, fire officials said. A model for mobile integrated health care in Colorado Springs concluded that three out of four clients had a mental illness, Ford said.
Ford said he didn't have data specifically on clients in Las Cruces' pilot program, but he estimated about half the people he's visited have had a mental health condition.
Officials said LCDF doesn't respond to behavioral incidents — something left to the police and ambulance service — but a mental health condition can be an underlying factor in other types of 911 calls.
Micah Pearson, vice president of the National Alliance on Mental Illness-Doña Ana County, said he learned about the fire department's new pilot program recently. He's optimistic it will fit hand-in-hand with another new effort, called Assisted Outpatient Treatment, aimed at helping residents who have serious mental illness. That project, which will start ramping up at the end of March, allows a judge to mandate outpatient mental health treatment for people who have frequent encounters with involuntary hospitalization or the criminal justice system because of their conditions.
"These are exactly the situations our potential client base would be a part of," he said of the fire department's EMS responses. "Why are they calling 911 a lot? Is it because they're having an issue with their mental health condition, and they have no other access to services?"
Pearson said other communities carrying out assisted outpatient treatment rely heavily on law enforcement to make referrals to their programs. And it makes sense the fire department and its new program would be another source of referrals, he said.
"We are going to reach out and work on this because I see an opportunity here to develop relationships," he said. "They're identifying people who need services. We have a pool of services."
A PILOT PROJECT FOR NOW
The LCFD program is a pilot project for now. Ford said the department would like to hire a social worker.
Mims said it would take authorization by City Manager Stuart Ed to become a permanent program. And any budget increases needed to go along with program expansions would have be authorized by the Las Cruces City Council.
"Obviously, we'd like to make it a full-time program," Mims said.
Fire officials said the program stands to benefit medical providers, such as hospitals, if residents are healthier overall. In some other communities, those entities have helped to fund a city's mobile integrated health unit.
Several Las Cruces city councilors expressed support for the project.
"This is another example of you all being proactive, and I appreciate it," Mayor Pro Tem Greg Smith told firefighters.
Copyright 2017 the Las Cruces Sun-News