The Squad 1 crew makes their way to their truck at a downtown Greeley fire station. They're walking, not running, and once their truck is on the road, there are no flashing lights.
"We hardly ever use the siren," says driver Darren Conradson.
This is the Greeley Fire Department's solution to a vexing problem: 911 calls that simply aren't emergencies.
Instead of sending a big engine with several firefighters -- and possibly police officers and paramedics -- Squad 1 may take the call instead. None of the crew members are firefighters. Conradson is a community paramedic. The other crew members include a crisis intervention counselor and experts at helping people navigate the complex world of social services.
Their truck is red, but it's an ambulance. It comes to a stop at Paul Villa's small house. He's 89 and used to work in the fields and then at the local meat plant.
His goal is to keep living in his home, but he's had to resort to 911 several times for help -- but not always for what the fire department would consider an emergency.
Proactive steps, like this simple check-in, aim to prevent those non-emergency calls, Conradson said.
"So are you still good on your test strips?" Conradson asked Villa.
"Yeah," Villa replied. "I'm OK."
"And glucometer?" Conradson asked.
"M-hmm," Villa said. "Good."
Five people, 200 calls to 911
This proactive approach, mixed with Squad 1's triaging of 911 calls as they come in, represents a major shift in culture and thought for the fire department.
"We're very traditional," Chief Dale Lyman said with a laugh. "We like to send lots of people and big trucks to things."
The department is set up to respond to fires, life-or-death medical emergencies, hazardous materials situations and rescues. Yet too many 911 calls, Lyman said, are more along the lines of personal emergencies, like people who couldn't get to a doctor's appointment or can't find a way to pick up their prescription.
"So they get to a point where, 'Well, I'll call 911 and maybe somebody can help me,'" Lyman said.
"There is a segment of our population in our community that doesn't -- I'll just say it -- they don't have access to health care like you or I would."
For years, firefighters have exchanged anecdotes about such calls. That inspired Lyman to dive into the department's 911 data to learn more.
First, the obvious: 911 calls to the Greeley Fire Department are up significantly. Since 2001, they have risen by more than 160 percent thanks, in large part, to the city's growing population.
Yet Lyman uncovered another driver of the calls: social ills.
"The data, once we started looking at it, proved it," Lyman said. "There is a segment of our population in our community that doesn't -- I'll just say it -- they don't have access to health care like you or I would."
He also identified what he calls "super utilizers," people who call the department often, posing a big challenge for the increasingly-stretched department. In 2016, just five people generated more than 200 of the department's 911 calls.
One of them was a homeless person and chronic alcohol abuser who called 86 times, prompting 86 trips to the emergency room.
Another one, with mental health problems, made 26 of the calls and took 20 trips to the ER.
"It was insanity," Lyman said. "We're sending this highly-trained expensive crew -- fire apparatus, equipment -- for legitimate big-scale problems just over and over again to these things that don't need that. (…) It was a vicious cycle that needed to be stopped."
When Squad 1 hit the streets in a pilot last year using one of the station's old Chevy Suburbans, the frequent callers didn't just stop. But once the crew started securing long-term services and/or substance abuse help for the group, the number of 911 calls they made dropped significantly.
Squad 1 in action
After saying goodbye to Paul Villa at his house, Squad 1's crew gauge what they can do for him. Team member Meredith Munoz is also a coordinator with the nonprofit North Colorado Health Alliance and the Community Action Collaborative.
"He's afraid if he goes and gets care because they're going to say you need to go to a nursing home or something," she said. "His wish is to die in this house so he's very reluctant to even leaving."
That concerns Jayme Clapp, a mental health therapist with the nonprofit North Range Behavioral Health.
"I'm assessing his loneliness and if he's had contact because that can lead to a lot of physical problems," she said. "We want to make sure he doesn't lose contact with somebody who is checking to see."
Lyman said Squad 1 has the potential to make a positive dent on the homeless community. He told the story of one man who was linked to counseling and services through the crew and has since found a job.
"That's huge," Lyman said. "That's one less person that might be out on the streets or sleeping in the park because of substance abuse or whatever the case may be."
Greeley isn't alone in trying the concept. Departments in Colorado Springs and at least two other states -- New Mexico and Arizona -- have similar units and other departments around the country are studying the idea.
A growing need
So far this year, more than 12,700 calls have been made to 911. Squad 1 began operating in Feb. 1, and since then has run more than 350 of those calls.
"That's one less person that might be out on the streets or sleeping in the park because of substance abuse or whatever the case may be."
Yet the number of calls the squad is potentially needed for is much higher -- two, maybe even three, times as high. The squad only has funds to run 40 hours a week, not round-the-clock, meaning firefighters are still responding to non-emergency 911 calls.
But before Squad 1 existed, Lyman said, firefighters weren't always able to help people facing a personal crisis. That led to frustrations, he said, because firefighters want to be helpful. Now, firefighters can refer cases to the squad's crew for follow-up.
He said he's seeking additional streams of funding to cover more hours for the unit.
The existing funding is from the nonprofits that participate and, on the department's side, carved out of a savings the squad helped create. Because of Squad 1, the department hasn't had to send out his big engines to respond to as many 911 calls.
"Less miles," Lyman said. "Less wear and tear. Less fuel."
