Olympia Fire Department proposes adding ambulance and clinical services

With the addition of new laws on public safety, the Olympia Fire Department (OFD) proposed several major changes to their emergency-response services.

OFD presented two proposals to the city council’s Ad Hoc Public Safety Committee meeting last Thu., Aug. 12. These proposals include expanding the OFD CARES Pilot Program and equipping an Emergency Basic Life Support Transport System. CARES stands for “Community Assistance Referral Education Services.”

OFD CARES Pilot Program

 Generally, CARES serves as a hospital diversion program and provides support for patients who are in crisis. The program usually handles low acuity patients or those who are struggling with psychiatric or behavioral issues or have social support needs.

Currently, the fire department’s CARES program only has one social worker. To expand their crisis response, Olympia Firefighter Erin Johnson presented a proposal for an expanded CARES Pilot program.

Under a pilot staffing model, the OFD will create a separate behavioral health unit which will be composed of a program director, two licensed social workers, and a behavioral specialist.

Aside from launching their CARES Unit, the program would also include a system for Medicaid reimbursements. Johnson shared that under this proposal, the fire department has two options.

One of the options is a treat-and-refer program. The firefighter explained that once they were able to determine that a call does not warrant an emergency room visit, they may refer the patient to the following experts or programs:

• Licensed healthcare provider
• Crisis Response Unit (CRU)
• Behavioral Health Resources
• Chemical dependency
• Urgent care
• CARES team

By simply making a referral call, Johnson told the committee that the fire department can bill Medicaid for $115.34. Based on last year’s Medicaid referrals, Johnson shared that the fire department could generate an estimated $134,000.

Emergency BLS Transport System

 Aside from the need to expand their crisis response, Olympia Fire Chief Mark John also shared that the department saw an increase in the number of medical calls. “The problem has only gotten worse,” John said.  

These medical calls may be divided into:

• ALS (advanced life support): this caters to patients who need a higher level of medical care. ALS calls are usually handled by one of Thurston County’s seven paramedic units.
• BLS (basic life support): this refers to non-life-threatening medical cases or patients who require non-emergency medical transportation. These are currently handled by the fire department, sometimes assisted by a private ambulance.

Based on the fire department’s 2020 data, the number showed that only 691 medical calls were classified as ALS while 3,402 of these calls were classified as BLS. In addition, BLS-related calls make up 81 percent of all transports.

As a result of the increasing number of BLS calls, the fire chief admitted that “at times it is very difficult for us to manage.” He noted that these issues affect the fire department’s response time, as well as the quality of their services.

New Basic Life Support transportation system

With this, the OFD proposed to launch a BLS emergency transport system. The system would be composed of three ambulances, 18 qualified firefighters, and an OFD CARES vehicle. Overall, the proposal would have an initial capital cost of an estimated $3 million for its first year. Chief John stated that he believes the fire department can recoup this investment within three years.

John claimed that having a BLS transport system would increase their capacity to respond to calls and allow the department to meet national standards. Once approved, John shared that it would improve their rating and help Olympia to become the first fire department to obtain a Class 1 rating in the state of Washington.

“We are very excited about the possibilities and we really have a sincere desire to innovate...and talk about the future of public safety,” the fire chief said.

For now, these proposals are at the advisory stage. There are many details that the OFD needs to clarify before the city council could vote on them