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About Street roots. (Portland, OR) 1998-current | View Entire Issue (Feb. 28, 2014)
street roots 5 Feb. 28, 2014 The chief o f P ortland Fire & Rescue talks about the changing role the bureau is p la yin g in the city’s well-being BY JAKE THOMAS STAFF w r it e r he word “firefighter” often conjures up images of burly men clad in heat- resistant suits and iconie firefighter bats, wielding axes and pulling people from , burning houses and kittens from trees. But in recentjdecades, fire departments, | particularly in urban areas, have taken on additional duties. Now/ responders at Portland Fire & Rescue (PF&R) have taken on some responsibilities resembling those of medical professionals and social workers. Responders are the first to show up when people are having the worst daysof their lives, and are routinely confronted with a : stark picture of poverty as they aid people' who’ve fallen through the social safety net. Recently, PF&R launched a program that sends an SUV out to lower-level calls that probably don’t require a hulking fire truck or fire engine (there is a difference). A recent study has found that the program eould help the PF&R budget-wise, requiring less have, a paramedic on every fire engine. maintenance and has while freeing up crews and larger vehicles for bigger calls. J.T.: What sort o f emergencies do first Street Roots sat down with Fire Chief B E r in J a n s se n s to ta lk a b o u t th e ch a n g in g role of PF&R a s jt increasingly becomes a primary health Fare provider to the streets. responders have to deal with? .. • PH O T O B Y C A R Y N B R O O K S /P O R T L A N D FIRE & RESC U E tragic event and it’s the worst day of , somebody’s life, and we’re showing up because they are in a bad way and they need they’re transported by an ambulance — the most expensive way to be transported to the -hospital, and the emergencyroom is the I t h a t an d th a t’s a g r e a t h o n o r fo r all of o u r try in g to lo o k a t is h o w to r e d u c e h e a lth our resources. We take great satisfactign,. in ,.. . moat expensive tvge ot ^carc,- members, knowing that people trust you EJ.: Any type of fire call. All firefighters enough to call 911. want to help people; that’s the big driver inside them. So when you go on a fire call, Jake Thomas: A new study cam eout on j.T.: Wfezf are responders’ role in the health they take a lot of pride in using a lot of the bureau’s use o fS U V sto respond to lower- - care o f people living on the street. W hat kind.of specialized skill and performing difficult jr- level non-emergency callSi I was hoping you services can they tasks, but it’s also could comment on that. proride to someone who very sad. You see a lot is having a medical of really difficult ; Erin Janssens: The rapid response emergency and is things as a firefighter, vehicles are staffed by two people, .'¡'hey are health Is the most homeless? . and I think people an SUV that responds to lower-acuity calls. prim ary thing we need to equate that with It could be checking on someone’s smoke E.J.: We havea police officers. All of help people attain because I: alarm. huge role in that, and these calls that police What a lot of people don’t understand is yon io n ?t bate foo d health, we really are the first are going on, that 30 years ago, fife departments aohleYliig anything else Is responders when nationwide worked to create efficiencies to I firefighters are going someone needs help. I f o |n f to fee really on because we’re the the taxpayers by responding to medical calls think sometimes medical help. in addition to being a fire and rescue people forget that we Firefighters see resource. We’re already responding to motor are and have been a people lose their vehicle accidents and any kind of traumatic big part of that safety homes and special injury. We already have medical training, so net for people who are homeless. ! hope to mementos they have, like a family photo the role of the fire and rescue emergency Continue providing as much support as we album. services really expanded into medical calls. possibly can. So when 911 is activated, we You also see people lose their .lives from About 70 percent of our calls are medical are dispatched. We will do a triage and a fires. You see people die from careless calls. patient assessment to see what kind of smoking or being under the influence of needs they'have. If there seems to be a something. Some that seem really fragic. , J.T.: You’re a veteran o f the bureau. When iriental health Crisis or something, we’ll get They’re all tragic. One woman’s house did the “rescue” p a rt o f Portland Fire & police to help with that because with the caught on fire and she got out of the house Rescue become so integral, because most people new behavioral health resources and and realized that the ashes of her sister ’ ju s t think about the fireside? connections, we have we’ll try to get them were in an nrn, and she went back in to get hooked up with those services. the urn and never got out E J.: When I came in to Portland Fire & | But if someone is Calling repeatedly, we . We go on all type of medical calls. When Rescue, going on 26 years now, we were can identify if there is a problem and how (the influenza strain) h ln l was going called Portland Fire Bureau. Our name was we can help with the root causes. Do they . around, we ended up going fin those calls changed to Portland Fire Rescue and have mental health issues? Do they not have and making assessments. We go on rescue Emergency Services. That changed in the . a heath provider? This is changing calls, like the woman who was stuck early to mid-90s. After that we kind of between the walls. We end up pulling quite a dramatic^lly. In the past, 25 percent of the re-branded ourselves. A lot of people people we responded to generally were few people out of the river, and I think continue to call us “Portland Fire Bureau.” uninsured. Hopefully, people will sign up people forget that that requires resources Fire is a big part of what we do, we are the and get some kind pf Coverage: arid specialized response in order to protect provider of fire prevention and suppression We’re working on this pilot for the Rapid people. Hopefully, they’re recreating,Jbut services, but we are also doing a lot. Response Vehicle program where we will try other people jump off bridges. We see | In 1985, Portland Fire then extended to do an alternate destination and an - shootings, stabbings; you name it, we go on from giving the firefighters training in- first alternate transportation pilot. People Who it. People struck by cars or bicycle, aid to EMT basic certification and EMT don’t have any health care, they wait and; accidents. paramedics. We. had, and we still strive to wait arid wait until it becomes a crisis arid Generally, whenever we show up, it’s a wUat care costs by connecting with the clinic to see if the patient is willing to participate and be transported to the clinic with their provider. | If they don’t have a provider, let’s get them signed up with some sort of health care coverage arid get- them into a system, where they can get routine care arid a complete diagnosis, instead of a Band-Aid approach where it is so intermittent that it just becomes a cycle. Maybe they need wound care but they don’t go back because , they can’t afford a doctor, and then they get an infection and they get really sick and they call 911 and are sent back. So we’re now frying to resolve matters in a more proactive and less costly way, and! think the RRVs • will help with that. But system-wide, we can look at. the solutiom And we work closely , with Multnomah County Emergency - Medical Services; They actually have a social worker. So when someone has been in the system more frequently, we can work with, the social worker. Good health is the most primary thing we. need to help people attain because if you don’t have good health, achieving anything else is going, to be really * difficult. 3.T.Z Do you have regulars? E J.: Occasionally we do, and we really fry to work with the social workers to find good people to help with iriental health issues- Hopefully, at least we can get people into Shelters or off the street. J.T.: Under the Affordable Care Act, we’ve seen.a big expansion o f Medicaid. I t seems like (that could really help get people some stable care. Have you seen any changes to far? . EJ.: Not yet. It’s really early. Tin excited to see the improvements of having more people covered. That’ll be a good thing. Missed an issue? Catch up on all the great conversations at news.streetroots.org