Chicago’s newly-appointed fire commissioner is fleshing out her plan to reduce response times to medical emergencies that now make up two-thirds of all calls for fire service.
Instead of increasing the Chicago Fire Department’s existing fleet of 80 advanced-life-support ambulances, Annette Nance-Holt plans to purchase smaller vehicles, each staffed by two paramedics, to respond to less serious medical calls that do not require transport to a hospital.
The new level of care that Nance-Holt calls “mobile integrated health” would not only reduce the avalanche of calls to Chicago’s 911 emergency system, but also take the pressure off hospital emergency rooms and free up those 80 ambulances — backed by advanced life-support (ALS) engines and trucks — for more serious emergencies.
“I have been a captain on an ALS engine. I have worked on many ALS companies as a lieutenant. What you find out is, sometimes people just want somebody to come [and] take your blood sugar. Take your blood pressure. Give you an asthma treatment. Whatever it is. They don’t want to go to the hospital,” Nance-Holt told the Sun-Times on Thursday.
“It’s gonna keep the emergency rooms less clogged. And not tie up the transport of an ALS ambulance that actually needs to get to a person. Maybe a gunshot [victim]. Maybe a stabbing [victim]. Or maybe somebody having a heart attack, which is more critical at this point.”
The new medical model sounds a lot like the two-tiered system of ambulance service — for advanced life support and basic life support — that Chicago abandoned years ago.
It was tested during the pandemic, when paramedics visited the homes of Chicagoans who had contracted the coronavirus, but did not require hospitalization or had been released from the hospital.
It was also used to do well-being checks “when we had a lot of police and fire on lay-up due to COVID, because COVID hit us as well,” Nance-Holt said.
Most of the patients will be referred by their doctors or clinics.
“Someone who may be a diabetic. Somebody with congestive heart failure who just needs to be checked to see if they have fluid. Things like that. But anything that’s life threatening, 911 will be that number that you call to get transported,” the commissioner said.
“We have an aging population … During COVID, we could see more than ever that people didn’t want to leave their homes. They couldn’t get to the hospitals … This will take the strain off of insurance companies, emergency rooms, health care systems and divert our ambulances to more critical people.”
The alternative response will start with five vehicles and 10 paramedics.
“This is gonna expand to something else — like mental health components and, probably, the opioid crisis,” the commissioner said.
“Right now, we’re gonna tell you five [vehicles]. But I’m anticipating it’s gonna be greater than that.”
Nance-Holt is the first woman to serve as fire commissioner in the 162-year history of the department.
She has vowed to diversify a department with a long, documented history of discrimination through “vigorous recruitment in communities of color,” outreach to high school students in “under-represented communities” and by scheduling Chicago’s first firefighters entrance exam since 2014 by the end of this year or the first quarter of next year.
On Thursday, she took the first step toward that goal.
She promoted Mary Sheridan, the head of EMS, to be her first deputy and rounded out her leadership team with five men: two black, two white and one Hispanic.
They are Marc Ferman to serve as deputy fire commissioner for operations; Juan Hernandez as assistant deputy fire commissioner, EMS operations; Greg Stinnett to be district chief of EMS operations; Scott Ronstadt, assistant deputy chief paramedic of EMS logistics; and Mark Kiley as deputy district chief of the mobile reporting unit.
At the same time, Nance-Holt acknowledged the department has a long way to go when it comes to being a welcoming place for women.
When she first arrived at the predominantly white and male Bridgeport firehouse 30 years ago, she was unceremoniously welcomed by a male co-worker who put dog food in the Coca-Cola she was drinking.
“I was like, `OK.’ I put it back. I put it in somebody else’s Coke. Good. That’s the way I reacted to it,” Nance-Holt said.
“We can’t be part of the game. We’ve got to stand up and be different from that. I didn’t tolerate it [then]. I’m not gonna tolerate it now.”