City, County Restore Program To Assist Frequent 911 Callers

Speaker 1: 00:00 In San Diego, first responders are on the front lines of providing services for people suffering with a mental health crisis. An estimated 70% of people who frequently call nine one one have a mental health issue and that's putting a strain on the system to address this challenge. City and county officials announced this week that they are putting more money into a program that assists frequent nine one one callers. It's called rap, the resource access program. KPBS evening edition host Ebony Monet spoke about rap with an Jensen who was with the San Diego Fire and rescue department. Speaker 2: 00:37 What can you tell us about rap? Uh, the resource access program is, is what we call rap and it was, um, started as a pilot program in 2008 and expanded in 2010 and it addresses frequent nine one one colors of the system. And roughly 1% of the population in San Diego generates almost 20% of the call volume that EMS receives. And so we have a group of specially trained paramedics who monitor the system and find people who are frequent callers. They're always vulnerable and in some way either having a social or medical difficulty and are specially trained, paramedics intervene and provide resources and connect them to resources and they become their advocate to maintain longer term services and thin Diego has a homeless crisis. We've been hearing about the ramifications of that crisis for a few years now. Is this tied into the growing homeless population in any way? Speaker 2: 01:36 Well, with the, we have about 1400 people who would be considered frequent nine one one colors. And in that total group, about 55% of them are homeless. And, but when we moved to higher frequency of nine one one utilization, like if we look at people who call more than 20 times per year, that's about 90% home. People experiencing homelessness or, um, if we look at people who call more than 50 times per year, that's 100% of people who are experiencing homelessness. So how would frequent calls to nine one one put a strain on the emergency system? Can you, can you talk about just what that looks like? What, what's what's been happening? As I said before, 20% of our call volume is, or almost 20% is generated by frequent nine one one colors. And the, the EMS system is meant to handle that. So we can handle that. Speaker 2: 02:26 But when we look at individuals and their experience in the nine one one system, we realized that we may not be addressing their needs the way that they need help. And so if we can adjust our approach to providing care, then we can save money for it, the community and we can also help people more effectively. And so how does, um, wrap support our emergency system? You know, the mission of rap is to help vulnerable EMS patients and also to preserve safety net resources. And it's, uh, it's uh, something that you don't have to choose between, which is nice that, you know, we can tackle both of those at the same time. Tell us more about the announcement this week. Um, what additional resources or are being put towards the, the rap program? The county has given us to part clinicians, mental health clinicians, which about 70% of our higher, higher utilizers I, you know, are suffering some from some sort of mental illness. Speaker 2: 03:24 And so that's really helpful to us. So they, they've given us two per clinicians. And then Amr as well has also given us a two paramedics. And then we have our fire department paramedics working too. So it's a, it's a good partnership between the three entities. How does the outreach team determine who needs the help? Our paramedics are trained to find patterns in data and paramedics are required to document. There's a national database standard data dictionary that we document by and we take that database and we transform it and we, um, run analytics on it in real time and we find people who are either very vulnerable or very high in their nine oh one utilization. So the paramedics will look at this and we have, uh, a system that they run through and find people and they'll find our highest utilizers or our most vulnerable people and they'll proactively make contact with them once the, um, people in need are identified. Speaker 2: 04:21 What kind of resources can they be linked to? The paramedics in PR, clinicians will encounter that individual and they'll go through a five point intervention cycle. And that always begins with stabilization. And um, people we'll never attach and be successful in services unless you end the immediate social, medical or mental health crisis. And so the first stage is always to make sure that they're stable and that they can think properly and that they're not hungry and that they have the proper medications for their condition. So once they're stabilized, then our paramedics will look for the transitional and longterm services. And those are just services that are in the community. But it's, it's very, you know, our system of care is, is can be complex to navigate through. And so the paramedic helps that individual navigate through those different services. And ultimately, how will this, this help that the county? Speaker 2: 05:17 I think it helps the county, it helps the community and it helps our, um, personnel, you know, in the streets. If you want to make a first responder really stressed out, they deal with emergencies every day. But if you want to stress out a first responder, then you make them feel helpless. And so when our emergency responders encounter social situations, they don't always know what to do. And so, um, internally we hope to relieve the stress on our, our personnel. Um, and definitely we are providing better care to our patients and making sure that they're getting the right services. Speaker 1: 05:52 That was an Jensen with the San Diego Fire and rescue department speaking to KPBS evening edition Anchor Ebony Monet.