Portland Fire & Rescue's CHAT program could be a starting point for developing a new model
Of the programs described in this special report , only one has indicated interest in taking on the task of becoming a street response team similar to Eugene’s CAHOOTS program: Portland Fire & Rescue’s CHAT (Community Health Assessment Team).
Firefighter Tremaine Clayton, CHAT’s manager and sole staff person, is familiar with CAHOOTS and the nonprofit health care provider that runs it, White Bird.
“White Bird is my inspiration for what CHAT is and what it can become,” he told Street Roots during a ride-along in February. He’s volunteered in White Bird medical tents at events, such as at the Oregon Country Fair, and said the experience has changed his approach, helping him to see the value in self-care and finding the human component in patient care.
As CHAT exists today, its primary function is to work with people who over-utilize 911 services to lower their reliance on first-responder services, but Clayton wants to expand CHAT and take on more issues affecting the homeless community.
“The city’s been looking at that CAHOOTS model,” Clayton said, “and I’m super stoked to see that conversation taking place. I very much want to do something like that.”
He’s been thinking about different models for CHAT. He said one model he’s been considering is “eerily similar” to the street response team that Street Roots envisioned . But Clayton is limited in what he can do currently, as Portland Fire & Rescue is facing budget cuts.
An expansion and reshaping of Clayton’s program would make the most sense if Portland officials were to decide that solving the problem within the next two years is a priority.
For one, it should be the city – not the county – that operates or contracts with a street response team for several reasons. The objective of the program is to remove the city-run police bureau resources from responses, and it will also give other city bureaus, such as parks, development services and the transportation bureau, a team to call in lieu of expending their own staff resources in addressing issues that arise from street homelessness. Ultimately, if Eugene’s program is any indication, it will save the city millions of dollars annually.
Among city bureaus, Portland Fire & Rescue is the obvious choice. It has established trust in the community and the infrastructure already in place to operate a citywide street response team.
Albeit with a few hurdles to overcome, Portland Fire Chief Ryan Gillespie said he could see his department operating such a program.
“The fire department – the way that we’re set up and our access – really puts us in an advantageous position to respond to all types of issues around the city,” Gillespie said. “We’ve historically been set up to respond to emergencies. That definition, of emergency, I think has broadened, and one person’s emergency is different than another person’s emergency. As our call volume continues to rise, we are finding ourselves going on increased, lower-acuity calls where, really, another type of resource would be more appropriate.”
Commissioner Jo Ann Hardesty has also expressed interest in creating a different kind of first-responder service. She’s the commissioner assigned to both the Bureau of Emergency Communications and Portland Fire & Rescue – the two bureaus needed to make a street response team operated through the fire department and dispatched through 911 possible.
“If we’re talking ‘in addition to,’ it’s almost a no-brainer,” said Gillespie, but his department is looking at 1 percent cut in the upcoming budget cycle and may be losing one of its Rapid Response Vehicle teams.
Gillespie made it clear that a street response team run through the fire bureau would require new money and a new training program. It doesn’t make sense to send firefighter-EMTs, who are highly trained on responding to an array of specific fire and rescue emergencies, on calls for unwanted persons. And, he said, some of the calls police answer, such as trespassing, are outside the scope of firefighters’ current skill sets.
“Anything can be resolved with training and changing what our work looks like,” he said, “but it’s not as simple as saying, OK firefighter-EMTs, you are now going to be responding on these calls, and we expect you to be able to deal with that. That’s not realistic to ask that.”
In addition to training and money, the Portland Firefighters Association will need to be on board. Getting approval from this union could be a challenge, especially if the street response team included a new lower-paid tier of employees working for the bureau, Gillespie said.
“I’d be remiss to say or commit to something without including them in the conversation,” he said.
But the fire chief is supportive of looking at models for a street response team, and he thinks that with union support and new sources of revenue, a street response team could be up and running through his department in as soon as 18 months.
In the early days of Portland’s street response team, volunteers could be utilized to get the program off the ground while cost savings are being proved. The local medical community’s response to 1-year-old Portland Street Medicine shows there’s great interest.
“We are definitely maxed out for volunteers,” said the program’s organizer, retired physician Bob Toepper. “Everybody wants to help, but we can’t fit 200 doctors and nurses in our program just yet.”
But however a Portland street response team might pan out, none of the interested parties has an interest in telling people to “move along” without having a place for them to relocate. And that includes Hardesty’s office and Portland Fire & Rescue.
If Multnomah County follows through on plans to open a peer-run addictions and mental health drop-in and resource center in downtown Portland, it could offer a welcoming and low-barrier location for people to be transported to for a connection to services, or even just a cup of coffee and a conversation with a peer who has similar lived experience as a first step.
The county has already approved a $5.8 million purchase agreement for a building on Southwest Park Avenue that would serve as the peer-run center if the sale goes through.
“If we could get something like this to work in the downtown area, I’d love to see it replicated in east county, in north county,” said Neal Rotman, the county’s community mental health program manager. He’s been advocating for a peer-run resource center for years, he said.
Investing in service providers that can accept drop-offs from the street response team would make sense for the county. The street response team would likely save it money, too. Fewer police responses would mean fewer bookings into the Multnomah County jail and fewer cases cycled through the Multnomah County Courthouse. If Harbor of Hope achieves its navigation center, that could serve as another drop-off location.
Additionally, if the Joint Office of Homeless Services were to follow through on its Safe Parking Program, responders would be able to tell people living in their vehicles where they could park without being hassled. This program is a partnership between the city and Catholic Charities. As planned, churches would offer their parking lots as havens for car and RV campers, but despite being rebooted, this program has yet to get off the ground.
Street Roots is not pretending the solutions are simple or that this imagined Portland Street Response team would be able to address all the complexities and conflicts arising from street homelessness. But, as demonstrated by our neighbors to the south, this sort of approach would achieve its goal of reducing police involvement, costs and trauma. A solution and pathway have presented themselves. Now all that’s needed is political will.
Email Senior Staff Reporter Emily Green at emily@streetroots.org . Follow her on Twitter @greenwrites .
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