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.
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