For several years, the Seattle Human Services Department (HSD) and Seattle Fire Department collaborated to design a service to respond efficiently and effectively to 911 calls that are not life-threatening, freeing up resources for true emergencies.
About 42 percent of 96,000 calls received by Seattle’s 911 dispatch center in 2018 were not life-threatening. These calls included behavioral health and addiction issues that firefighters and medics were not equipped to deal with, as well as calls from individuals with chronic conditions.
In mid-2019, Seattle Mayor Jenny Durkan and Fire Chief Harold Scoggins announced the birth of Health One—a mobile integrated health unit carrying two specially trained firefighters and a social worker with experience serving people with diverse needs, including chronic conditions experienced by older people and individuals with disabilities. The firefighters received training in mental health, motivational interviewing, and other skills. (Please note that all firefighters in King County are already dually trained as emergency medical technicians.) Two civilian case managers from HSD/Aging and Disability Services shared the initial assignment.
In her 2020 State of the City address on February 18, 2020, Seattle Mayor Jenny Durkan called this team out by name: “The Health One unit includes two firefighters—Roger Webber and Matt Jung—and two social workers—Ashley Clayton and Donna Andrews.…Every day this team answers calls and helps people in need.…They are literally doing life-saving work.”
Mayor Durkan shared a story from the first week that Health One operated: “One day last fall, Health One responded to a call. A woman was found shivering on the sidewalk and could not hear. The crew wrapped her in blankets, communicated with her in sign language, and Health One took her to a shelter and then connected her with a stabilization program.”
A moment later, Mayor Durkan said, “I am very pleased to announce today that this summer we will launch a second Health One, to expand service in the city of Seattle.”
“It was a joy to hear Mayor Durkan acknowledge our social workers and firefighters for their excellent work, and even better to see Health One succeed in serving the people of Seattle,” said HSD director Jason Johnson. “Adopting a human services approach, more people get connected with ongoing services and our case managers are able to check back later to see how things are going.”
Three additional firefighters—Doug Grey, Theresa MacMillan, and Chris Schatz—have helped staff the rig. Two additional Aging and Disability Services case managers—Kieran Skye and Riley De Hoog—recently joined the Health One team.
Health One operations started in early November 2019. In its first quarter, Health One made 220 runs—averaging five per shift. Triage, assessment, referrals, coordination, and transport took, on average, 42 minutes; however, each case generates an additional 30 minutes to several hours of backend coordination work.
Social needs, general weakness, behavioral or psychiatric crises, substance abuse, and intoxication are common issues. Approximately 52 percent of Health One cases have involved homeless individuals. The median client age is 52. Approximately two-thirds of clients are white and one-third are people of color.
Health One is an extension of Seattle Fire’s Mobile Integrated Healthcare Program, which includes support for vulnerable adults who need referrals to community-based health and human services—HSD/Aging and Disability Services’ first partnership with Seattle Fire, which started in 2011. Aging and Disability Services case manager Ashley Clayton has worked with these programs for four years. The other three case managers joined the team in 2019.
HSD/Aging and Disability Services also collaborates with Seattle Fire, Seattle Police, other first responders, Adult Protective Services, and the Office of the King County Prosecuting Attorney on elder abuse prevention. In 2019, Seattle Fire made 412 mandatory reports to Adult Protective Services and HSD/Aging and Disability Services.
For more information, see Seattle Channel video coverage of a Lunch & Learn: Coordinated Response to Abuse, Neglect & Exploitation in 2018. Aging and Disability Services Kathi Church, who appears in the video, was joined recently by a second elder abuse case manager, Alexis Espindola, who will co-locate in the Seattle Aging and Disability Services office and the King County Prosecuting Attorney’s office.
HSD collaborates with other fire departments as well. See Aging and Disability Services case manager Nancy Tillman’s article referencing the Redmond Fire Station 11 Mobile Integrated Health Team—A Sobering Journey (January 2020)—and her article that mentions Bellevue Fire Cares—From Homeless to Housed: Christmas Came Early for Santa (December 2018).
Contributor Irene Stewart manages communications for Aging and Disability Services and serves as editor of AgeWise King County. To access services, call Community Living Connections at 1-844-348-5464.