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Portland To Create First-Responder Program For Low-Level Medical Calls

The Community Health, Assess and Treat Program, or CHAT, is expected to start mid-November with two pilot teams.
October 14, 2021

Headaches. Back spasms. Stomach pains. Cuts. A case of itchy toes.

Portland Fire & Rescue estimates they respond to roughly 28,000 of these low-level medical calls each year. Though many callers could be treated for their ailments at home, they will nevertheless be transported to a nearby hospital.

Officials with the Portland Fire Bureau say the current system is wildly inefficient, clogging up emergency rooms, straining the 911-system and driving up health care costs.

On Wednesday, fire bureau officials announced they’re trying to change the status quo with a new type of first-responder program.

The initiative, called the Community Health, Assess and Treat Program, will change how the fire bureau responds to nonurgent medical calls. Instead of focusing on taking patients to the hospital, first responders dispatched to these calls will treat people at home and help connect them with a primary care doctor.

The Community Health, Assess and Treat Program, or CHAT, is expected to start mid-November with pilot teams in downtown and southeast Portland.

Each team will be equipped with two firefighters who are licensed to respond to medical emergencies. In addition to treatment, officials said there will be an educational component that focuses on teaching callers where else they can access health care.

At a Wednesday press conference announcing the program, Fire Chief Sara Boone said many Portlanders don’t realize they have options outside of the emergency room.

“Our agency has seen a dramatic increase in calls to 911 over the last five years because a portion of our community members are unsure how to access health care services and making 911 their only option,” said Boone.

CareOregon, a nonprofit that provides health care services to low-income Oregonians, gave the city a $2.5 million grant to kickstart the program. Eric Hunter, the president of CareOregon, said Wednesday that nearly a quarter of their members who use the emergency room could have gone elsewhere.

“We’re excited about the opportunity to really change the dynamic of how people see the health care system and realize that the emergency room is not the first resort,” said Hunter.

City officials emphasized that the CHAT program will be different from Portland Street Response, another alternative first-responder program housed within the fire bureau. Portland Street Response, which is also in its pilot phase, dispatches a team — composed of a paramedic, two health workers, and a therapist specializing in mental health crises — to calls related to people experiencing homelessness or in the midst of a mental health crisis. The program aims to reduce the need for police on these types of calls.

While it’s possible the teams will work together, Lisa Reslock, Deputy Community Health Administrator for the CHAT program, said the two programs have a distinct focus. Portland Street Response will respond to people in crisis. CHAT will focus on people with physical chronic health issues.

“These chat teams are specifically to address the health needs of our population — the diabetes, the COPD [Chronic obstructive pulmonary disease] — any kind of health-related issues,” said Reslock.

But the two programs face a similar problem. While each is intended to lessen the call load for the city’s overburdened public safety bureaus, callers can only access them by calling 911. The head of the city’s 911 system recently told the City Council that call times have nearly tripled in the last eight months due, in part, to the fact that people were calling with non-emergencies.

Reslock said that over time, the fire bureau hopes to show callers the alternatives to 911 will be better-suited to their needs, eliminating the need for long hospital waits and time spent away from their family.

“For a while, people will call 911 until people realize that ‘Oh my goodness, it’s more beneficial for me to go see my doctor, and I don’t have to sit in an emergency room for four hours,” she said. “Ultimately, we believe that’s going to drive down their desire to even call 911.”

The pilot program is expected to last for nine months before the city decides whether to expand. The teams will work from noon to 2 a.m.