Growing medical needs stress fire departments in Twin Cities suburbs

Alarms blared in Bloomington Fire Station 1 one morning last week. Call for assistance to a home on 96th Street.

Fire Chief Ulie Seal squinted at the address on the oversize monitor on his office wall.

"Weren't we just there?"

Earlier, firefighters had helped an older woman get down her steps to get to an appointment, another firefighter told Seal. Now she was back from the appointment and needed help up the stairs — and had no one to call but 911.

A surge of medical calls, not all emergencies, is stressing fire departments that serve growing and aging suburban communities. Chiefs across the metro report that such calls now account for between 70 and 85% of their calls in a given year, with the proportion rising. At the same time, departments are facing staffing shortages that are forcing them to do more with less: 20 years ago, Bloomington had 155 part-time firefighters; today, the roster hovers at just over 100.

"We play whack-a-mole," Seal said. "I'd say we run around and put out fires, but we actually do that."

Across the metro, departments are trying to keep up by staffing up. Maplewood is seeking a federal grant to kick-start hiring. Bloomington and Golden Valley are shifting from part-time to full-time firefighters so they can attract enough people, and Bloomington is building a new fire station to accommodate firefighters on long shifts.

There are also efforts to prevent non-emergency calls before they happen. In St. Louis Park, firefighters are connecting residents with health care and other help to keep them independent and healthy — and cut down on 911 calls for non-emergencies — through a department partnership with a community health agency.

It started with people who needed help after a fall, Chief Steve Koering said. He estimated about a third of people who fell and called 911 didn't go to the hospital, so there might be no record of their fall, no medical care, no one installing grab bars in their homes. They would fall again. And again.

"How many times do we have to go there before somebody does something?" Koering said. "If you're picking them up off the floor and hoping somebody else is going to solve the problem, your call volume is going to keep going up."

A decade ago, Koering responded to a lot of calls like the one from the Bloomington woman who needed help navigating her stairs. He got calls from people who didn't understand all of their doctor's instructions after getting out of the hospital. Some just found calling 911 was the simplest way to get medical care.

Koering started working with staff at the city's Park Nicollet clinic to set up a program in which firefighters would visit patients after they got out of the hospital to make sure they understood what they needed to do to get well, that they had enough food and that their homes were safe. The people who got visits tended to call 911 less, Koering said.

"What made it work was the essential trust the community places in firefighters," he said.

In 2016, the fire department linked up with an Otsego nonprofit, Care Resource Connections, to form the Community Health Alliance and take the firefighter visit program further. After a hospital discharge or a medical 911 call, a firefighter visits a patient to check in and asks if they would be willing to be connected with resources. If they agree, firefighters pass along what they know to a Care Resource Connection social worker, who then loops in the person's doctor and arranges help — anything from regular rides to a food pantry to mental health care.

After six years, the approach seems to be working. People who used to call 911 every day or multiple times a day are calling rarely, Koering said. While neighboring cities are seeing 5 to 7% more 911 calls each year, he said calls in St. Louis Park have dipped by 1 to 1.5% over each of the last five years.

The model is starting to spread. West Fargo, N.D., worked with St. Louis Park and a North Dakota health agency to replicate the health alliance, Koering said. Hopkins is looking to join the St. Louis Park program, and Duluth and Fridley are considering similar partnerships.

Meanwhile, other Twin Cities metro communities are taking their own approaches. Brooklyn Park's fire inspector is meeting people in their homes to talk about safety and build trust. Maplewood is educating residents on preventing falls, and partners with community paramedics who can connect patients to ongoing care.

"There's a huge component of being proactive," Maplewood Chief Michael Mondor said.

Koering said St. Louis Park's approach isn't necessarily a cost-saver: "To connect them with resources takes resources," he said.

City funds pay staff and firefighters' time, though the program got a grant from Park Nicollet this year. And a wave of retirements means St. Louis Park will still need to hire firefighters.

The real benefit, Koering said, is that residents are able to stay healthy and independent — with their city's support.

"It's really a quality-of-life discussion."