An academic journal praised the City of Alameda’s Community Assessment Response & Engagement (CARE) Team for its reduction in EMS transports to emergency departments.

The Journal for Emergency Medical Services published a report titled, “City of Alameda (CA) Behavioral Paramedic Program Dramatically Reduces EMS Transports,” on Aug. 18. Author Tim Hong, MD, compared data from two parallel months in two consecutive years before and after the CARE Team program was implemented (data was provided by Alameda Fire Department). There were 56 EMS transports from Dec. 15, 2020, to Feb. 16, 2021, and 92 transports from Dec. 15, 2021, to Feb. 16 of this year. After the CARE Team program implementation, the number of transports to an emergency department dropped to less than one-fourth of pre-program levels, and transports to psychiatric facilities dropped by more than half.

“Although early on in implementation, the initial outcomes appear promising for alternative response and navigation options for people experiencing behavioral health emergencies that would be safer than an emergency department or jail,” wrote Hong. “Additionally, local emergency departments experiencing a lower burden of transported behavioral health patients can free up precious resources to meet other departmental demands.”

Most EMS responses (of which ACT comprises a large part) became non-transports, and drop-offs to alternative destinations increased. There were no major adverse patient outcomes identified during this period, according to Hong.

The CARE Team operates 24 hours per day, seven days per week. Each response unit consists of an EMT and behavioral paramedic.

The Alameda Fire Department (AFD) gave a six-month CARE Team update to the City Council on July 22. The CARE Team began on Dec. 16, 2021. In the time period ending on June 16, the CARE Team received 529 calls for service and the team responded to 376 of those calls. Of those 376 responses, the CARE team engaged with clients on 290 occasions. Of the 290 engagements, the client was referred to case workers from Alameda Family Services 204 times.

In the presentation, AFD provided details on future plans for the CARE Team. AFD wants to train additional AFD members, track state funding requests, evaluate dispatch protocols/methods and monitor the 988 hotline’s influence on the program, monitor and address the mental health of AFD responders and more.

At its April 19 meeting, the Alameda City Council approved a plan to extend the CARE Team pilot program to June 23, 2023 (“CARE Team Pilot Program Extended by City Council,” April 27; https://alamedasun.com/news/care-team-pilot-program-extended-city-council). The program offers an alternative to police intervention when emergency dispatchers receive calls regarding people dealing with mental health issues. Instead, the CARE Team, which consists of AFD personnel and case workers from Alameda Family Services (AFS), interacts with the person in need.

In response to the death of George Floyd and the Alameda police interaction with Mali Watkins (“Arrest Raises Questions for APD,” June 7, 2020; https://alamedasun.com/news/arrest-raises-questions-apd), former City Manager Eric Levitt established a community-led Steering Committee on Police Reform and Racial Equity to provide recommendations designed to restructure the delivery of law enforcement services. Among the committee’s recommendations was restructuring the methods for responding to mental health emergencies. Levitt directed AFD to proceed with CARE Team pilot program. The city reached an agreement with AFS to join the pilot program on Dec. 8, 2021.