-Do you have the description of the vehicle,
like what color, make, and model?
-Public safety is in the spotlight in Seattle,
facing a record number of homicides
and an opioid epidemic all too visible on the city's streets.
-This is the worst drug crisis I've ever seen in my life.
-But reports show nearly four out of five 911 calls in Seattle
are for nonemergency incidents.
-Often we don't need a gun and badge.
We need people trained and skilled
at the kind of outreach and kind of treatment
that we want to see.
-Will a new dual-dispatch program
get help to those who need it,
and free up police to focus on more serious calls?
And what lessons can be learned
from a similar program from Seattle Fire?
-We can't just take everyone to the emergency room.
-Our panel weighs in.
-Our average response time right now is five minutes.
-We find ourselves policing a lot of social issues.
-How is Seattle's approach to public safety changing?
Some answers next on "City Inside/Out."
♪♪
And joining me to discuss these issues of public safety
and community well-being,
I have the chiefs of Seattle's three public safety departments,
including Amy Smith,
acting chief of the new CARE department.
That's Community Assisted Response and Engagement,
known as the third public safety department.
But your number one right here, Amy.
Thank you very much for being here.
-Yeah. Happy to be here.
-And also, we have with us
Chief Harold Scoggins of the Seattle Fire Department.
Chief Scoggins, good to see you too. -Good to see you.
-And also with us, we have Adrian Diaz,
the chief, of course, of the Seattle Police Department.
Chief Diaz, great to have you here.
-Glad to be here.
-All right, let's jump into it.
And I think a lot of Seattleites know these guys,
but they might not know you as well.
So I want to break this down with you, Chief Smith, if I could.
Can you describe what CARE is?
And I'd really like to focus on the dual-dispatch pilot program
that you launched at the end of October,
and how that's changing the way
the city responds to emergency calls.
-Yes, so CARE has been organized
as the third public safety department.
The genesis of the concept
is really just anchored in 911 data.
If you look at all the calls that come in to 911,
how many do not require or involve fire
or medical transport or police, some kind of enforcement.
And this is a national trend.
If you look at the calls,
about half don't necessarily require either team.
And I think as we've become culturally more sophisticated,
understanding behavioral health,
understanding mental-health crisis,
how to be really culturally sensitive
and responsive to groups,
you realize lots of different types of professionals
might be best suited to certain call types.
And so you really need to organize
not just a little pilot or another,
you know, sub team and a department,
but actually just set up a new department.
And so that's what Seattle has done.
This has happened in some other cities,
but what Seattle is doing I think is the most significant
because we also, in this department,
we house Seattle 911.
So that's kind of like the data hub. -Right.
-And then we'll have diversified response teams.
And that's what the first CARE crisis responder team is.
And then we will also house an Office of Violence Prevention
where we're really thinking about
early intervention and prevention strategies
that don't need to sit in the police department.
-Okay. Thank you for breaking that down.
And we'll get into the nuts and bolts of it in just a minute.
But, Chief Diaz, maybe I can go to this question next and expand
on what Chief Smith was saying,
just why the response to emergencies is changing.
Because the SPD asked the National Institute for Criminal Justice Reform
to study its 911 calls.
You found out last year nearly 80% of those calls
were for nonemergency incidents.
So I think the idea is,
if CARE is in place to work on these lower acuity calls --
like they're called, the person down --
that frees up officers, which I know are in short supply here,
to respond to more serious kind of criminal calls, right?
-Well, that's actually the significant trend.
You know, we know that many of our police departments
are actually getting smaller just because of people
leaving major cities
and other departments throughout the country.
So we've actually had to really be able to assess,
like, what are our calls for service,
what are we really focused on responding to?
And we find there's a lot of calls that are just not made for
or not designed for the police officer to respond to.
And so that is the reason why it's so crucial
to have other partners at the table
to be able to take on some of that workload.
You know, we've we've actually, you know,
prided ourselves over the last, you know,
27 years that I've been on the job,
but even before this, um, we've built up programs.
We've, you know, had community service officers,
you know, we've had mental-health responders
that respond with officers.
But really, you know, some of this work
is not really designed for policing.
You know, we find ourselves policing a lot of social issues.
And that's not where police should be.
You know, we want to focus on the crime.
And now, we know that there's impacts
from the social issues that do create,
you know, crime, but allowing us to just focus on the crime,
and I think what happens is over,
you know, over the course of my career,
a lot of police departments said,
"Well, no one's taken on that work, so we need to do it."
And honestly, I think now we're starting to realize
we just don't have the staffing to be able to do that.
And we honestly don't have the skill sets
to be able to do that, too.
I'd rather have mental-health professionals
work with people in crisis.
That doesn't mean that we can't be a component of it,
but I really wanted to actually say
let let the professionals that go through schools training
and all those other things for years on end do that work.
-Okay. Thank you very much.
And Chief Scoggins, I wanted to talk to you about this
because the Seattle Fire Department
has been doing very similar work to this with Health One.
SFD's Mobile Integrated Health response unit
launched in 2019.
Combination of firefighters and case managers
from the Seattle Human Services Department.
You help people get medical care, mental-health care,
maybe even shelter if they need it.
And I think it's a similar situation to SPD's
because in 2018, the fire department found
that 42% of its calls were low acuity.
So I just wanted to talk about this.
Why is Health One important for your department,
and how has it been working?
-Um, you know, Health One's been working great.
You know, we're four years into it last month.
um, like you said,
we started in 2019 and we saw a need.
Many of our responses were lower acuity medical responses.
So it didn't require that lights and siren,
fire-engine aid car,
medic unit going down the street,
but it did require some help.
And we had so many of those
that they have been overwhelming the system.
So what we have right now is two firefighters and a case manager,
and they do an amazing job, and they're able to spend
the amount of time that's needed on scene
to figure out exactly what the person needs.
And sometimes that takes 15 minutes
and sometimes that takes an hour and 15 minutes.
Sometimes that means that they're going to be
going to the shelter, or sometime that means
that they're setting up an appointment
for a medical appointment two days later.
They do all of those things. They have vouchers for LIFT.
They're able to reconnect folks to their case managers
or health care workers or families.
All of those things that you can imagine,
that's the gap that they stand in for the fire department,
which is very important because they leave our fire engines,
ladder trucks, medic units, aid cars available
to run those critical medical emergencies.
-Got it. Thank you.
Chief Smith, I want to make sure I break this down,
what it looks like when someone calls 911
and what resources get dispatched where.
So you run the show there.
When does a 911 call turn into a dual-dispatch situation
or a Health One situation?
What does that look like?
-Yeah, so, in 911, what we want to determine right away
is if there's a serious medical condition or threat,
and then it goes right to the Fire Alarm Center.
And then they take it from there
and they determine what response to send.
Is this fire, is this Health One,
Health 99, Nurse Navigation.
There's an array of resources on that side.
So that's the primary question.
If it's not going to the Fire Alarm Center --
again, the question is, "Is it an emergency?"
because we can divert to nonemergency.
We've got 988 online now too. -Right. Suicide prevention.
-Right. Exactly.
Um, but then the question is,
you know, is this a priority one,
which means a significant threat to life.
That's what priority one should be.
So we are cleaning up some of the call types
and driving stronger protocols to make sure that,
you know, from a space of fear and cynicism,
we're not calling everything priority one.
So an officer once said,
"Amy, if you make everything priority one,
nothing is priority one," you know,
and that was actually a very impactful thing for me
to hear early, that we need to be very thoughtful about that
in the space of a lot of crisis,
a lot of violence, that we don't mis-code, basically.
So is it priority one, is it priority two --
where, again, there is an urgency,
there's a higher acuity, a concern for public safety,
potential threat of violence.
But then as you go down,
priority three, we've ruled that out.
The call takers are very thoughtful.
There's rigid protocols, you know, answering questions
and trying to surface
what the caller is observing, usually.
You know, sometimes we're calling on our own behalf,
but often somebody's just seeing something and feels concern,
feels like they should call 911.
You know, often it just sounds
like a compassionate bystander to me.
And so people ask me what types of calls,
and when I'm sitting in 911
what you often hear is, you know, "I'm on this corner.
He's slumped over. He doesn't look like he's doing well."
And so then we're trying to surface, is this an overdose?
Is this a heart attack, a medical condition?
But often it's not.
Often somebody is crying or they're muttering,
they're in distress,
it seems like they're not safe.
Recently, there was a call where somebody wasn't clothed
and it was 28 degrees outside.
So we could see that there's no weapon here,
there's no violent behavior, but we must send someone.
And so, again, who would be required
in that situation, right?
And so I'm trying to create capacity
for both of these two teams who are highly skilled
and really need to be reserved for high-priority calls.
-Got it. And, Chief Scoggins,
maybe I can add you to the mix here,
because I wanted to figure out
how your Health One units get dispatched,
because people can't call Health One directly,
it has to come from 911, right?
I just wanted you to describe how this looks.
-Sure, once the call leaves Amy's shop
over at the 911 center,
if it's a fire or medical emergency,
generally these calls are in the medical category,
then we get it and we triage it.
So our dispatchers go through a series of protocols
and all the Q&A with the person
on the other end of the line,
and they'll determine if it requires
a full lights-and-sirens response
with medics, EMTs, and fire engines,
or can we deploy Health One
or can we send it to our Nurse Navigation line.
And so oftentimes Health One
is directly dispatched from our Fire Alarm Center.
So that's one way you can get them.
Or if they go, they treat you,
they build a relationship and they reconnect with you,
we actually do case management on Health One.
So there's follow-up that takes place the next day,
the day after, to make sure you got your meds filled,
to make sure you got your appointment.
If you're an older adult,
we have a vulnerable adults program,
so we go and check to make sure
they're getting what they need.
And the reason why that's important is,
if we do not do these things,
they will be a 911 emergency where you do need the medics
and all of the skills that we have.
-All right, thank you. Chief.
Chief Diaz, I wanted your take on this
because your officers go out
with these behavioral health specialists from CARE
on these dual-dispatch calls.
I'm just trying to figure out
what is the officer's role in those situations
and also when and how can an officer decide,
"Okay, health specialist, you got this.
I'm moving to another call." What does that look like?
-Yeah, it's just like any other call.
What the fire department does is it's triaging.
It's really assessing, is there harm?
And what is that harm and is --
And when I say "harm," I mean, is it a safety issue
and is it a safety issue for, for the care workers to,
to be able to proceed?
And a lot of these situations that we have,
dealing with people in crisis
or what we refer to as, sometimes, "people down" calls,
um, where somebody literally it's probably
because of an alcohol intoxication,
could be drug, you know, a drug issue.
It could be a variety of different things.
It could be just people sleeping on the sidewalk.
And officers are having to go to that,
and they're like, "What resources are we gonna provide?"
-Right. -And there's no safety issue.
So, you know, they're going to end up
making that assessment to say, "Well, CARE,
it's better in your department."
-I always get this question, though,
when I talk to people about dual dispatch.
It might seem like the situation is under control,
but what if it escalates in some way?
What happens then? What does that look like?
-Yeah, you can already start to --
officers are already assessing those situations
very much on the front end.
You can tell when a person's, you know,
can have triggers or agitation in the call very early on,
just by them showing up.
And sometimes the officers might actually sit back
and let the contact be the CARE department initial.
And if they start to see, okay,
this person is already aggravated
and then I'm going to end up stepping in,
it might end up being that the officers,
you know, are coming on scene,
and the person actually might be aggravated
by the officers and they might say, you know,
"It's best for us to just step back,
let the CARE people assess it,
and we're just going to stay away.
We're not going to leave the scene,
but we'll just let them handle it."
So again, everything is a case-by-case situation.
But, you know, officers have done this for a long time.
In fact, they've been doing it.
They've been handling those calls.
And they're like, at this point,
it's better for another department
to start taking leadership in it.
-Chief Smith, can you just talk to me
about this from a dispatcher kind of a situation?
This call comes in, at first classified as lower acuity,
but then something escalates.
How does that work in terms of how you're communicating?
-Yeah, well, there's two ways the CARE team
has been responding.
The first way is that police go to a call
and then they say, "Is the CARE team available?"
They just -- I hear it all day long,
I'm listening to the radio, and it made me smile
because I didn't know if the police would have trust
in that new resource right out of the gate.
But week one, I mean, I heard it all the time.
I'm hearing requests for the CARE team from officers
sometimes at 7:00 or 8:00 in the morning,
and we're not online yet.
You know, we're coming on at 11:00.
But I'm very happy to hear that. It's going well.
You know, the feedback loop is in place
with both of these departments
and then with other folks in the field
and Human Service Department.
So we're having these coordination meetings.
But so that's one way.
That would be a secondary response.
And again, police have been doing this for a long time.
They've had CSOs that they invoke.
They've worked with the King County Mobile Crisis Team.
And so it's not as confusing on the inside
as people assume that it would be.
It's exactly the same protocol.
It's just swifter. It's a swifter dispatch model.
So dual dispatch, if our dispatchers say,
"This is a good thing for the CARE team" --
sometimes it's a high utilizer.
-Someone who might call 911 a lot.
-All the time, is consistently in distress.
And we can see in our notes
that there's never been a threat of violence,
that there's a sort of a chronic issue
and we know how to respond.
And in that scenario,
police are given situational awareness,
they're on the channel, but they can say,
"CARE team, take it.
Let us know if you need anything."
So all folks on the front lines of human behavior
and crisis response were really well trained to know
when to take a step back, when to not proceed.
And this happens between these two departments already.
You know, often fire will be going in
and then they'll realize, "Nope, we need to be partnered
with our officers first."
-Yeah, I was gonna ask for your take on this, Chief Scoggins.
Have you been able to respond with Health One,
but then it's turning into a larger emergency?
Talk to me about those two pieces.
-Well, sure, I think this happens every day
between police and fire.
We go on so many calls together,
whether it's a scene of violence,
whether it's an overdose,
whether it's a really bad traffic accident.
We're always working together in the field
and we've been doing that forever.
And I think we do it really, really, really well.
We support each other.
We'll call for P.D. when we need some assistance,
or they'll call for fire when they need some assistance.
So it's been happening
and it will continue to happen with Amy's team
because there's a lot of people out there that need help.
And what you can see right here
is we're trying to figure out what help you need,
and that'll determine on who's sent.
-Thank you. Yeah.
And Chief Scoggins, I'll stick with you on this one.
I want to try to talk about some of the challenges involved with this work.
I think about this.
Your crew meets with a patient, takes the time
to deal with their needs, and then what next?
Because you know it and I know it --
Our region has a shortage of receiving facilities,
drug and alcohol treatment centers,
nursing facilities, shelters, et cetera.
How does that shortage impact the work of Health One?
-It's a significant impact.
Places to take people is our rate-limiting step
each and every day.
We can't just take everyone to the emergency room.
People need so many different things.
Someone may need a shelter bed, and the shelters may be full.
Someone may need a place to go
for their substance-use dependency
and we want to get them there,
and that's what our Health 99 team has been doing since June,
and that's the overdose response team.
But what they're seeing is there's just not places
to take people, even when we get them to,
"Yes, that I'm ready to change my life.
I want to get some help.
I want to get off of this," whatever this is.
Oftentimes our challenge is finding a place to take them.
And so that's our rate-limiting step.
I know a lot of work is being done on this space.
It just seems like a slow walk
when you're running the calls every single day
and you're running into the same barrier every day.
And is it a deal where it's like,
"Okay, we'll check up with you tomorrow.
We can't we don't have that space right now"?
Is that what it turns into?
-It turns into all of those things.
"We'll check in with you tomorrow.
We'll follow up with you.
Let's get your cellphone number,"
because if someone is unhoused and sometimes it's difficult
to try to find them the next day.
And so when they have a cellphone, we work hard,
but we carry a lot of things to build trusting relationships,
whether it's snacks and food and socks and water,
and on cold days blankets, and all of those things.
All these interactions help us build trust.
And our team has great relationships.
Each day we have two Health One unit teams on the street,
and we have Health 99, which was our third Health One unit.
But that unit is running overdose calls all day long.
And their number one goal is to try to figure out
how to get people to transition into a different lifestyle.
-Yeah, and maybe I can jump off of that
and go to you, Chief Diaz,
because I did want to talk about the fentanyl crisis
that our region is in right now.
And as you know, we had a big public debate in Seattle
over the past several months,
creating a gross misdemeanor statute
on public drug use and possession.
I just wanted to make sure I broke this down,
because you got some people out there saying,
"Lock them all up," and then you got other people saying,
"We don't want a return to the war on drugs."
I guess I'm just trying to figure out
how is the SPD approaching our drug crisis,
how are partners like CARE
and the fire department helping out?
-Yeah, you know, as I mentioned earlier,
we talk about us policing social issues.
Drug and alcohol addiction are much a social issue.
I mean, now, there are criminal activity
that occurs as people sell
and, you know, it creates a black market system
and you have a variety of crime activity
that's associated with that.
But the actual addiction is really something
that we find ourselves having to police.
And so, you know, really, as working with the mayor's office,
city council, and other community partners in this,
we all had a seat at the table
to create this new drug usage law.
And we really identify "harm" and "no harm."
And when there is no harm, somebody's in an encampment,
and they're, you know, smoking fentanyl,
we still want to get them into services,
but we're not going down the approach of an arrest.
But when there is harm, when we know that, you know,
we can look at Third and Pike or 12th and Jackson
or, you know, other areas in our city
that there are a lot of harm that --
you know, school environment of kids
going walking through these areas,
um, you know, shopping districts,
criminal activity that's associated with it.
And we know we can identify quickly that there is harm.
And so that is where the officer can come in
and make that, you know, contact.
We might refer to it as an arrest.
Um, but our sole goal is to get them into services.
But, you know, what we're finding is,
is that people have also have issues of warrants.
We've, you know, recovered a rape warrant,
we've recovered assault warrants.
And, you know, we've actually recovered guns.
And so there are other things
usually sometimes can be associated with that.
But at the end of the day,
if there is somebody that is willing
and wanting to get services, we are hoping them to connect
into a variety of different programs.
And that's where our officers' goals are.
-Right, you can't arrest your way out of this
is definitely what I'm hearing here.
Thank you for breaking that down.
Chief Smith, I wanted to talk about a challenge
that I'm seeing with CARE, and you touched on this earlier.
Just the size of it. You got three teams of two.
They've got certain hours that they're working every day.
Six employees out there working in this downtown core area.
I guess I just wanted to ask,
is that going to be enough to make a dent,
to make a tangible impact on public safety?
-No. It's a meaningful step forward
because the department is organized now.
This was legislated, right?
We have these new first responders in the city.
So it's incredibly significant, and I feel that.
But I'm always quick to say, with police co-response
with Health One, Health 99,
we are woefully inadequate to respond to the crisis.
You know, I think folks feel like,
"Oh, we've got a team now." No, it's six people.
And this is shift work.
And so I don't even have all my six people
in the field at the same time.
We would need to scale significantly,
but we also need to coordinate efforts.
We're all in conversations about what else could be dispatched.
We have great community service officers.
Could we dispatch them from 911?
That's happened in the past. Could we do that again?
So looking at the whole system,
what does the nonprofit sector have to respond,
you know, what does the public sector?
Are there other private entities, groups?
We've got We Deliver Care teams like that.
And I'm really having fun in the role because a lot of it,
it does feel like air-traffic control a little bit,
and also I like analysis.
-You have a different idea of fun than I do, but keep going.
-Yeah, I've been told that before.
No, I'm having a really good time
because I love figuring out how do you really audit
every asset you have in community,
get everyone in a room,
and then figure out who does what the best,
and then, where are the gaps?
And then you start to scale.
And so even right now I'm not recommending
that I scale this team.
I want to stitch together the continuum of crisis response.
And I may make the recommendation,
no, we need more co-response.
We are in a fentanyl crisis right now.
We have 1,200 overdoses, you know,
so even when we talk about record homicides,
that is so significant and so tragic, but 1,200.
You know, so back to your question about, you know,
criminalizing addiction and things like that.
Of course I don't want to do that,
but we have to intervene
in a way that people have a chance at life.
And fentanyl is not the same
as other substance-use disorders.
-Yeah. Very true. Thank you.
We need to start wrapping up here,
and you were going down a path that I'd like for you
to keep going, if you could, Chief Smith,
because I want to try to figure out
how to measure success in your work in public safety.
A few months from now will it be,
"Our teams have responded to X amount of calls
or gotten X amount of people into drug treatment"?
What does success look like for you?
-Yeah, in the short run,
what we're really looking for are outputs.
You know, we're not going to have outcomes yet
because, again, we don't have a system
set up to receive people
in a way that could provide a meaningful intervention
where your life is redirected.
We don't have that yet.
I'm looking for response time right now.
Can police and fire get to more
priority one and two calls more efficiently?
That's very easy to track.
I'm looking very carefully at the CARE metrics.
Our average response time right now is five minutes.
In part that's because
we're in a small geographic location.
Qualitative data. Did you feel safe?
Did you feel equipped to respond?
Were police needed?
Do police perceive that this is a useful step forward?
You know, on the community level,
I'm with a lot of neighborhoods and the business community,
and really what I'm trying to assess for myself is hope.
Do we have a sense
that things could be better than they are?
Because I feel like our communities
are disenfranchised, we're discouraged.
There's a lot of grief and loss and sadness
that hangs in the air when you walk around,
knowing that we've invested millions of dollars,
and why is it getting worse?
So it's again, a meaningful aspect to the work
to be in these conversations.
I recognize that even just our true collaboration
and respect for one another and coordination,
that is hopeful to people.
It's significant, apparently, you know,
that this mayor's office is insisting
that we really are collaborative
and that the mayor's office will collaborate with council.
-Yeah, it's important to hear that. Thank you very much.
Chief Scoggins, just some thoughts on measuring success.
You've had some success with Health One.
Where does that program need to go?
Your hopes for this team-up we're talking about right here?
-Yeah, some of the ways
we measure success is what Amy just mentioned is,
are we keeping our emergency response units available?
That's one. Another area is, are we helping people?
We're able to look and see,
how many vulnerable adults did we actually help?
How many times have we reconnected someone
with their case manager or their family?
How many people have we actually gotten off the street
and into a shelter bed?
These are just some of the ways we measure success,
and we can look back on that.
In 2022, we had over 1,100 direct dispatches,
but over 2,700 referrals that were made
by the firefighters in the field that we went
and did follow up on because people needed help.
All those are ways that we measure success.
-Thank you. Chief Diaz, I'll have you wrap up.
And I've talked with you about metrics of success
in a lot of different ways.
You're trying to reduce response times
for top-priority 911 calls.
You're trying to hire more officers.
You're trying to develop a culture
of more compassionate and equitable policing.
You've got a lot on your plate, I know.
Focusing on the work of this group at the table here,
how are you going to gauge the success
of what's happening here?
-Well, our boss immediately always says
the number one charter for the city is public safety.
And for us, it is literally making sure
that people feel safe in the city.
And, you know, I know I walk the areas,
I actually drive by some of these locations
every single morning as I come into work to get an assessment
of what it's going to look like for the day.
And so, you know, we look at there's really both sides.
There's the qualitative metrics --
How do people feel when they walk in the streets?
Do they feel like there's disorganization?
Do they feel safe?
And then there's the quantitative,
which is all the stats stuff.
And we're monitoring both.
I looked at my stats just for 2018
as a comparison, just five years ago.
We're actually on the same violent crime trend as 2018,
but I had 31 homicides in 2018, I have 71 right now.
And so, like, why is it --
when you're looking at almost 5,000 cases,
why is the difference between 40 homicides?
You know, when we look at overdoses at a record high,
almost four times what we had just a couple of years ago,
you know, we've got to figure out
what policies are in place that we're actually doing,
is there a contributing factor?
Are we working with the prosecutor's office?
Is our criminal justice system working?
Is our partnerships working with, you know,
getting people into the right services and connected?
So there's a variety of areas that we're still looking
and making sure that we're actually measuring
the right metrics.
But there's still more to measure.
-I was gonna say -- To be continued.
There's a lot more to this story.
Thank you all for your input.
And everyone watching, thanks for your input too.
What are people saying on social media
about public safety in Seattle?
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I'm Brian Callanan.
Thank you for joining us right here
on "City Inside/Out" on Seattle Channel.
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