Valley Regional Fire in Auburn CARES

Program helps patients with chronic health issues outside of a hospital setting.

By Kimberly Terhune

Valley Regional Fire Authority

The Valley Regional Fire Authority’s Community Assistance, Referral, and Education Services (CARES) program is celebrating a successful year under a new program model. CARES aims to assist patients with chronic health issues outside of a hospital setting, increasing the availability of emergency response units while decreasing the frequency of low-acuity 911 calls.

When developed in 2015 and 2016, the goals of the CARES program were two-fold: first, to increase the availability of our response units and, second, to decrease the frequency of repeat low acuity 911 calls by connecting community members in need with appropriate resources.

An analysis of nearly six years of data found that the most effective way to achieve both goals is to invest resources in the second goal: connecting people with resources and services that will reduce their reliance on the 911 system.

Thus VRFA developed a new “referral only” model, meaning engines, ladders, and aid units will respond to all low acuity calls and then refer the patient, as necessary, to VRFA social workers. This process occurs in the field via tablet computers and reporting software.

Social workers can “respond” during business hours to assist Firefighter/EMT’s, but most of their work is completed in a non-response context. When a referral is received from the field, social workers use various tools and techniques to connect the client with appropriate providers and services. In this way, social workers assist clients in moving away from the 911 system toward care that more appropriately addresses their needs.

In August 2022, the VRFA hired Carrie Talamaivao as the Lead Social Worker, and shortly after, Social Worker Stephanie Lopes joined her. In September 2022, the VRFA entered into a contract to provide CARES services for residents of Mountain View Fire & Rescue. Social Workers Talamaivao and Lopes assist community members in both jurisdictions after receiving referrals from response personnel. Most are referred because they can no longer care for themselves, while others have fall or mobility issues, healthcare needs, mental health challenges, substance abuse disorders, and/or unsafe living conditions.

Social workers use various tools and techniques to connect clients with appropriate providers and services, helping move them away from the 911 and emergency department systems toward care that appropriately addresses their needs. In the past year, the team has connected patients to resources such as Veteran’s Services, fall prevention, home health, hospice, transportation, caregiving, substance use, and mental health support.

Between August 1, 2022, and July 31, 2023, the CARES team received 444 referrals and worked with 274 patients. Ninety-eight percent of those patients were enrolled in the program, with only four not enrolled due to death, voluntary commitment to a psychiatric ward, or current connection to known resources. When we compare a patient’s 911 use before and after enrollment, we see 911 usage by that patient drop 9% on average in the first month. After four months post-enrollment, we see around a 35.3% decrease in 911 use.

Due to the increasing demand for this program in both service areas, the VRFA has entered into an agreement with the University of Washington to host two social work interns. The interns will work with CARES to develop clinical and practical social work skills over the next 9 to 12 months.