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LA Fire Dept proposes program for alcoholics who overuse 911 system

Firefighter paramedic Fred Gonzalez of Los Angeles County Fire restocks medical supplies after dropping off a patient at UCLA Medical Center and Orthopedic Hospital in Santa Monica on Monday morning, August 31, 2015. A UCLA-run pilot program starting Sept. 1 in Glendale and Santa Monica aims to reduce overcrowding, while also freeing up paramedics who get stuck waiting to pass off ER patients.
File: Firefighter paramedic Fred Gonzalez of Los Angeles County Fire restocks medical supplies after dropping off a patient at UCLA Medical Center and Orthopedic Hospital in Santa Monica on Monday morning, August 31, 2015. A UCLA-run pilot program starting Sept. 1 in Glendale and Santa Monica aims to reduce overcrowding, while also freeing up paramedics who get stuck waiting to pass off ER patients.
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The Los Angeles Fire Department keeps a list of “frequent flyers” of emergency medical services.

They’re called “superusers,” and in 2015 alone, the top 40 superusers in Los Angeles accounted for about 2,000 emergency responses.

“When ambulances are responding to these individuals — sometimes the same individual two times a day, taking the same patient to an ER twice in one day — that ambulance is not available to respond to the rest of the community,” said Los Angeles Fire Department Medical Director and physician Marc Eckstein.

According to Eckstein, 60 percent of those top 40 superusers last year identified as alcoholics.

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“These people aren’t getting the help that they need because they typically get work up in the emergency department, they sober up, and then they leave,” Eckstein explained. “They’re not getting into detox. They’re not getting housed, and our paramedics are getting tied up, and the ERs are already overcrowded.”

Spokespeople for the Long Beach and Pasadena Fire Departments also said alcohol plays a large role in the number of calls their departments receive.

The Los Angeles Fire Department has proposed a pilot program called the SOBER Unit. It’s a partnership between the Los Angeles Fire Department and the Los Angeles County Department of Health Services.

Instead of sending emergency services like ambulances to superusers who might be alcoholics, LAFD hopes to send a van staffed by an emergency responder -- like a firefighter or a paramedic -- and a community outreach worker from the Los Angeles Homeless Services Authority.

The emergency responder would have a checklist to ensure the individual is not in immediate medical danger. According to Eckstein, that checklist would include checking vital signs, mental status, and for evidence of head injury or seizure activity.

If the firefighter or paramedic determines that the person does not need to go to the hospital, then the community outreach worker would assist in bringing the individual to a new Los Angeles County Department of Health Services Sobering Center in Skid Row, scheduled to open this year.

There, the individual could detox safely under the care of nurse practitioners and have access to social services like housing.

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“It’s a win-win for everybody: for the patient, for the community,” Eckstein said. “It frees up emergency resources, decompresses the emergency department, saves taxpayers a lot of money.”

The Los Angeles City Council’s Innovation, Grants, Technology, Commerce and Trade Committee is scheduled to discuss the proposal and its nearly $170,000 request for Innovation Fund funding on Tuesday.

Eckstein said the fire department hopes to start a one-year pilot of the program this fall.

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