View full size image of A CHAT emergency responder holds open an exit door in an apartment building.Kyle LaClair has responded to thousands of 911 calls in his career as a paramedic and saved many lives. Trauma, strokes, heart attacks, gunshot wounds, overdoses, he's been there. But one call that haunts him came from a man who had just been discharged from the emergency room at a local hospital. The caller had a prescription in hand, but didn't know where the nearest pharmacy was, had no way to get there, had no insurance and no money to pay for it. So he called 911 from the hospital parking lot.
Portland's 911 call center gets about 56,000 calls every month. Many of these are non-emergency medical calls, where the caller needs medical attention, but not necessarily the emergency room. Enter Community Health Assess and Treat (CHAT), a program run by Fire & Rescue Portland. CHAT was launched in 2021 to meet the soaring number of non-emergency calls as the COVID-19 pandemic pushed the public-safety system to its limits. CHAT responders can tackle people's urgent medical issues without taking them to the hospital. This frees up firefighters to respond to life-and-death situations. CHAT responders can spend more time with callers and treat them on the scene. Better yet, CHAT also maintains an aftercare team who follow up on 911 callers to provide ongoing support – like help getting into stable housing or even picking up prescriptions.
We rode along with LaClair and the CHAT aftercare team on a recent afternoon to learn more about their work to help people in the community above and beyond a trip to the ER.
How long have you been with CHAT?
About four years now. I'm a paramedic. I used to work on an ambulance crew. That is hard work, and I was getting burned out after the pandemic. Then this opportunity came up and I'm really excited about it.
Why? What's different?
When you're on the ambulance crew, you have moments where you know you saved someone's life. But generally, you spend 30 minutes with someone and then you hand them off to the hospital and that's it. But on CHAT, we circle back. We might work with someone over two or three months. We help people go from living in a tent to living in an apartment. We got a lady out of a hoarding situation and into assisted living. It's really gratifying to see the change you made in their lives.
How did you get into this field?
When I was a kid, my Boy Scout troop leader was a paramedic. He was a real mentor to me. Later I went to Roosevelt High School and he inspired me to get into a program for healthcare occupations.
When someone calls 911, should they always go to the ER?
No. Not at all. A lot of folks call 911 because they're desperate and they don't know who else to call. But they don't need an ambulance. A lot of times, they just need their meds! That's what's great about CHAT. We can respond to emergencies. But we can also follow up later and get them their meds. If they need to go to the hospital, we help them get there. But if it's something that we can handle and manage them, we want to treat them where they are.
How do you approach overdose calls?
Narcan is saving lives. No doubt about it. But we're still losing 50 people a month to fatal drug overdose. When we get a call, we make sure the person gets Narcan as soon as possible. Once the person has been resuscitated, Narcan puts them in withdrawal. They feel terrible. And they get the craving for the drug. So we offer them buprenorphine. That's a medication that gives them some relief. And we can get them a ride to the Blackburn Clinic or the Old Town Clinic to help them get off the drugs. And maybe get shelter, too.
Do you get to know the people you're helping?
Oh, absolutely. Our ability to go out and talk with someone can make a huge difference in their lives. We can come check in on them and say hey, what do you need? And that relationship goes a long way. A lot of people don't have a lot of trust, they've been robbed and lied to. So developing that relationship is absolutely essential. We have a client who uses a wheelchair. Her apartment was filled with clutter – it was a serious fire hazard and she couldn't get around. We helped her clean it out.
You've been doing this a while. How do you know when to lean in and help someone straighten things out and when to back off?
Everybody's needs are different from person to person. If they don't want it, or they're not ready, we'll just give them our card. When you're ready, give us a call and we'll be happy to help you. With addiction, sometimes there's a very narrow window when someone feels ready to go to detox. So when it's their moment, we're standing at the ready for when they reach out.