FD's Social Workers Keep Pace with WA Patients amid COVID

Calling 9-1-1 is a rare occurrence for most people. But for some, it's the only number they know to call, even when there might be someone better out there to help.

The Spokane Fire Department Community Assistance Response Team works to connect frequent 9-1-1 callers to much-needed resources that can help improve their lives and address the root cause of their calls for emergency services.

Sarah Foley, a social worker who manages the program for the fire department, oversees a team of students working to connect often-isolated individuals to the resources they need to live healthier lives.

"I really do believe that people want to be healthy," Foley said. "Sometimes it's because there are so many barriers in their way that they don't see the avenue for making change in their life."

With COVID-19 limiting the accessibility of resources — often to online only, a challenge for elderly populations — Foley and her team are working to retain the progress they've made.

CARES started in 2006, when current Fire Chief Brian Schaeffer was finishing up a long shift.

A four-person paramedic company was dispatched to a call where an older man had fallen out of bed. Schaeffer saw how ragged and tired the crew was when they received the call, right before shift change, and one paramedic mentioned they had been to that address at least three times during their 48-hour shift.

So, Schaeffer went to the call by himself.

The man had fallen out of bed a handful of times recently and his wife was too frail to help him back into bed, Schaeffer recounted. The couple only had basic supplies in the house.

"What I found was, spending time with them, is that their biggest fear was having somebody ... take them out of their home or split them up and putting them in separate nursing homes," Schaeffer said.

He decided to help by calling around to the resources the fire department used at the time, but at every turn he was met with "voicemail and a huge amount of frustration."

The couple had a business card for a caseworker sitting by their phone, Schaeffer noticed. When he asked the wife why she hadn't called the caseworker, the woman said the text on the card was too small for her to read.

"The only number that she knew to call was 9-1-1. They were very proud, and they didn't want to ask for help," Schaeffer said. "This situation or similar was a daily occurrence in our city."

After being repeatedly called to the same residences, supervisors were getting frustrated and coming to Schaeffer to file EMS abuse complaints, he said.

"In reality, it wasn't that. It was people slipping through the cracks that needed a different level of service than what we were able to provide," Schaeffer said.

The afternoon he spent with the elderly couple pushed Schaeffer to begin working with the Eastern Washington University Master of Social Work program to create an internship that would allow social workers to respond to these calls and help individuals get the services they need to live safely in their homes.

More than a decade later, Foley has taken on running the CARES program.

She oversees a cohort of social work students each year who make visits to clients referred to the CARES program by firefighters. A firefighter might respond to a call for a fall and see that the person doesn't have handrails in their home or other equipment to help prevent falls. They refer the individual to CARES.

A social work student would then call the client and set up a visit to assess their needs, often discovering other issues such as a lack of consistent access to healthy food or transportation to medical appointments.

CARES team members help people navigate the often complex social services world, quickly identifying services and helping make the phone calls to sign people up.

During the COVID-19 pandemic, more and more people are isolated, needing help to connect to resources when stuck at home, said Mike Lopez, integrated medical service manager for the fire department.

"We've noticed an increase in the number of clients that fall into the CARES team realm," Lopez said. "The resources that were there prior to COVID, things like Meals on Wheels and home cleaning and things that would allow the individual to remain at home in a stable environment, aren't as readily available."

If someone is told to call around to numerous service providers, they get frustrated and can often give up, Foley said. The CARES team streamlines that process.

"The CARES team has always worked with people that are fairly isolated; now, that's harder," Foley said. "Some of the people we work with also have anxiety about COVID, so they don't want people coming into the home for caregiving. With that isolation, there's not always a simple answer."

CARES team members now connect with clients via phone to reduce visits to their home, but trusting someone with personal information over the phone is difficult, Foley said. Clients may require more contacts to build trust and rapport, Foley said.

The median age for CARES clients is about 70, Lopez said. Being at high risk for significant complications if they were to contract COVID-19, some people are skipping their visits with their primary care physician, which can cause chronic conditions to worsen.

"We need to make sure that people know that COVID shouldn't interfere with their ongoing health care, whether that's for chronic disease management or that's acute Illness," Lopez said.

While the last year has been challenging for the CARES team, adapting to their client's new challenges has been a valuable lesson for the students she oversees, Foley said.

"I think it provides them a solid platform for the students," she said. "When we talk about the impact of COVID, especially from a social service perspective, it's going to be something that the clients are impacted by for several years."

While the CARES team is doing everything it can to support clients, Foley reminded people to be aware of the vulnerable people in their lives.

"Spend time making those calls and insuring that they have those needs met," Foley said. "I think that can go just such a long way."

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