NM Fire Department Tries New Approach to 'Down and Out' Cases

Moments after climbing into the driver’s seat of a city-owned Ford Expedition on a recent weekday afternoon, Jacob Francia took his first call.

Dispatchers sent him to East Central, where a 9-1-1 caller had reported what is frequently described as a “down and out” – someone in public view who appears to be unconscious.

Albuquerque Fire Rescue, which provides Albuquerque’s first tier of emergency medical response, fields about 17,000 such calls a year. It would typically send a fire engine staffed with a lieutenant, driver and two firefighters. The city’s ambulance contractor would likely head out, too.

But Francia is not a firefighter or a paramedic. He is an officer with the city’s Security Services Division, which is now handling some of those calls in a pilot program intended to make the Albuquerque public safety system more efficient.

Officials say a fire department response is unneeded more often than not; in about 10,000 of the approximately 17,000 down-and-out cases, the fire truck is canceled while en route or the crew arrives but the person who inspired the call is nowhere to be found.

And, they say, the calls require medical intervention less than 1% of the time.

“We were having big fire trucks driving all over looking for patients who weren’t there, and a lot of time they weren’t patients at all,” said Emily Jaramillo, AFR’s deputy chief for emergency services.

That challenge prompted discussion at the city’s public safety meetings. Jason Downing realized he might be able to help.

As deputy chief of the city’s Security Services Division, which falls under the Department of Municipal Development, he has a 100-person staff that already patrols bus stops and other city facilities.

His officers each go through 80 hours of training that includes first aid, CPR and communicating with people who have behavioral health issues.

They seemed like an obvious resource for the fire department, Downing said.

“We’re here, there’s a need, let’s help out,” he said.

The fire department provided Downing’s team with some additional training, older vehicles from its fleet and access to its radio channel. Security officers began taking calls for what the city has dubbed “wellness checks” in December.

Since the program uses existing staff and equipment, the city has implemented it at no cost. And it has potentially saved money; AFR estimates that a dispatched fire engine costs about $94 per half hour.

Though he has not calculated the equivalent expense for his department, Downing said “we can beat that rate.”

Downing’s staff is available to dispatch from about 3 p.m. to 11 p.m., Tuesdays through Saturdays, and is for now limited to areas along the Albuquerque Rapid Transit corridor and other ABQ Ride bus routes, keeping them in already-familiar territory.

Staffers are sent only to the “unknown” cases, meaning the dispatchers do not have information indicating that there is a drug or medical component.

In the first six weeks, the guards have responded to 76 calls that would otherwise have gone to AFR. On about one-third of them, the responding officer ultimately called AFR.

“If the person is too intoxicated (when they get there), if they’ve experienced a medical emergency, if they’ve overdosed, they have some baseline training all city employees have in terms of responding to that, and they call us out so we can still respond if it’s a medical situation,” AFR’s Jaramillo said.

Now that they are dialed into the same radio channel, Downing said, it is easier and faster to summon the fire department’s help.

But more than half the time – 43 of the 76 calls – the security officers arrived and could not locate anyone or the potential patient walked away and refused help.

Security officer Francia never made contact with anyone on the aforementioned call he took last week.

As he headed east on Central toward the address, dispatchers called him off. The subject of the original 911 call had apparently entered a vehicle and left the scene.

Lt. Tom Ruiz, an AFR spokesman, said the department had 14 other calls around the city at the same time, so Francia’s efforts meant more fire department resources were available for the other calls than would have been otherwise.

“If our trucks aren’t going on a wellness check call, they’re available for that cardiac arrest or that structure fire” that could be happening, Ruiz said.

After the cancellation, Francia continued patrolling Central Avenue waiting for his next call and doing what AFR classifies as “proactive self-dispatch” – stopping to perform welfare checks if they see someone who appears to be down and out along their route. In six weeks, security officers made 209 such contacts.

Shortly after 5 p.m., Francia spotted a man wearing a red coat and slumped on the sidewalk near a check cashing business. He pulled into a nearby parking lot and approached the man for a brief conversation.

Francia said the man explained that he was hungry, so he directed him to a meal site up the street. After extending his hand to help the man stand up, the man began walking in that direction.

Francia said he likes his new responsibilities.

“I actually enjoy it. It’s similar to what I was doing already,” he said. “As soon as the opportunity came up (to take welfare check calls), I volunteered.”

Jaramillo said firefighters in Southeast Albuquerque – crews “who sometimes run 40 calls in 48 hours” – have felt their load lighten a bit since the Security Services Division began helping and that she sees the potential to expand the partnership in the future.

“At the end of the day, we’re not going to reduce 911 calls so we have to look at how can we be the most efficient with what we have before we start asking for more (resources),” she said. “I really think we took what we already had with people who were already doing the job, and we just made everybody’s job easier.”

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