In the last few years, Portland has tried a number of different tactics to make responding to 911 calls more efficient and faster. Not all of them have worked. In 2021, the Fire Bureau added the Community Health Division to shift its response, so that not every 911 call gets a full engine and ambulance. Though the Community Health Division and its Community Connect program have since been eliminated, a new audit of the program reveals much about how the bureau can best support programs like Portland Street Response and Community Health Assess & Treat (CHAT). KC Jones, audit services director, joins us to talk about the report.
This transcript was created by a computer and edited by a volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. In the last few years, Portland has tried various ways to improve its emergency response. In the Fire Bureau, Portland Street Response and Community Health Assess and Treat, or CHAT, were created to make it more likely that the appropriate people are being called in to help out for different kinds of emergencies. In 2021, the Fire Bureau put these new programs under its new Community Health Division. That division was a subject of a city audit that was released today. The auditors found that the bureau did not have clear goals for the division or a plan to meet those goals. KC Jones is the audit services director for the city and he joins us to talk about all this. Welcome to the show.
KC Jones: Hi, Dave.
Miller: I want to start with a weird wrinkle of this audit, which is that the division you investigated, the Community Health Division, was disbanded over the summer of 2023, after the audit period. Did that undercut the relevance of this audit?
Jones: We tried to focus our audit on the types of calls that these programs were designed to address. And our message is really, however the city is trying to address these low acuity calls, our recommendations around setting goals and measuring performance should be relevant to whoever and however the folks in the emergency response system are doing that.
Miller: Now I should say that even though the division was disbanded, the two most prominent programs that had been a part of it still exist. I mentioned them briefly in my intro, Portland Street Response and CHAT. Can you just briefly remind us what they are?
Jones: Sure. So Portland Street Response was established in February 2021 as a pilot. It was intended to provide a trauma-informed response to community members in mental health or behavioral health crisis, especially people experiencing homelessness. Community Health Assess and Treat, CHAT, was designed to respond to low acuity medical calls. So in those cases, two community health medical responders, maybe folks who have EMT certification, respond. So the main difference is behavioral health and mental health on PSR, and medical response on CHAT.
Miller: There’s a striking sentence in the audit, you say that “Portland Street Response and CHAT were caught in a no win situation.” What do you mean?
Jones: These are new programs. I think the consultant report that we highlighted in our report kind of highlighted this is a new area for fire bureaus across the country. These were national experts who were looking at this. These two programs were trying to do something new and different in the Fire Bureau. They were coming with different funding streams, different ideas around how they were started and given to the Fire Bureau to manage. So that’s where we kind of focused our objective on how well the Fire Bureau was integrating these new ideas into its existing portfolio.
Miller: You also basically write that there was, at best, skepticism, and perhaps just outright hostility towards these programs in some ways from the bureau, which hampered their ability to function. Is that a fair way to put it?
Jones: Sure. From the beginning, the bureau approached this kind of as a proof of concept. They were looking to see how it worked. For Portland Street Response, there was an ongoing study from PSU that was giving feedback. And they didn’t have a clear goal around how this would be ramped up, how it would expand. And then our main focus was how these programs fit together with each other to have overall goals to reduce low acuity calls, and with the rest of the Fire Bureau’s portfolio as articulated in their strategic plan.
Miller: Usually agency responses to audits say things like “we agree with most of your recommendations and we’ve already started implementing them” or “we actually disagree with this particular reading of what happened.” “We quibble with this,” in a sense. But Fire Chief Ryan Gillespie called into question, as I read it, the very premise of your audit. He said that the programs in the Community Health Division “were not intended to reduce firefighter workload,” something that you say that you’re going to see how well they’re doing to do this. What’s your response?
Jones: In a few places in the report, we really try to use specific language around how that workload is supposed to be alleviated. So in some cases, it’s the dual response that sometimes happens with a fire truck and one of these units. That allows the truck to get back and be on call again. Some of the things that the consultant highlighted were morale improvements, not having to respond to maybe mental health calls or different different types of calls throughout the day. In general, the Fire Bureau is protective of its traditional services.
Miller: But Chief Gillespie points out that almost 99% of Portland Street Responses calls are ones that otherwise would have been responded to by the police, not by firefighters. Doesn’t that, to some extent, undercut the idea that this is a program intended to reduce the number of calls that firefighters are going on?
Jones: I think with the transition to the new form of government, where we’re seeing a lot more interest in folks in the community and our office in particular on seeing this as a public safety service area, where they should be contributing to alleviating this need that the community sees as a problem needing to be solved, not as much which bureau should be doing what.
Miller: It’s very possible to read this audit as an indictment in the broadest sense of the current system that we have, of the weak mayor, distributed bureau leadership system that is on the way out. How much of the situation do you think will be improved simply by virtue of the charter changes that will be implemented in 2025?
Jones: That’s not totally clear. Our first recommendation is to develop a plan for the future of these programs. I think as bureaus are talking more kind within their service areas about where the best place for things are and which program should live where and how these overall goals for a service area should be set. That’s an opportunity here.
Miller: Do you think that these two programs should be staffed up more and should have increased services? They’re both limited by days and by hours, unlike full emergency response.
Jones: Sure. We leave those policy decisions up to the policymakers, but in our case, the things that we found are the sorts of things that would allow the bureau to make the case for those things. Goals that are articulated across the programs that can be rolled up into overall performance, a plan for adjusting programs based on those goals are all things that help a bureau make a case for expanding something or getting more funding, gives you a clearer sense of your capacity, and needs and then an ability to adjust based on changes.
Miller: What are the other key recommendations, other ways that you would like to see these programs or the leadership of them evolve?
Jones: So as I mentioned, our first recommendation is for a plan for the future of the programs, and then kind of cascading off of that. Setting clear goals for community health response, and then down from that, measuring progress and adjusting annually and reporting annually on how that’s going.
Miller: KC Jones, thanks very much.
Jones: Thank you, Dave.
Miller: KC Jones is the audit services director for the city of Portland. He joined us to talk about the audit that was released today of the Fire Bureau’s Community Health Division. It’s now disbanded, but the two main programs from the division still exist. They are CHAT and Portland Street Response.
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