Emergency medicine professionals are trained to react. They analyze a scene and collect information. They must quickly discover whether there is a trauma, a medical event or both. They must understand why. They act — day after day, call after call, on repeat.

The services first responders provide are indispensable. On a day when a 911 call is placed, they become a lifeline during the worst of times. Responders react.

But what happens the next day? The day before? Is reacting to an emergency enough? Can emergency medicine professionals also operate proactively and provide comprehensive care that aids in emergency prevention?

In January 2023, in partnership with Believe in Recovery, East Jefferson Fire Rescue (EJFR) launched the Fire CARES program. CARES, which stands for Community Assistance Referral and Education Services, is designed to connect individuals to services and resources, improving their quality of life.

The proactive program receives referrals stemming from 911 calls. They try to determine why the call was made and whether it could have been prevented. They look for trends. They review vulnerabilities and service gaps, look for opportunities to assist, and make contact.

In its first year of operation, the CARES team made a total of 1,286 contacts, 249 of which were new referrals and 1037 follow-up visits. The team coordinates several services, including home visits, phone contacts, medical devices, transportation arrangements, family assistance, substance abuse counseling, health insurance sign up, case management and hospital diversion — oftentimes addressing many of these issues in a single contact.

The program is modeled after the successful CARES program through the Poulsbo Fire Department, among many others. To get the program off the ground, EJFR applied for and received an alternate response grant. The entire program is supported by grant dollars from the city, county and Olympic Community of Health.

As 2025 approaches, the program’s viability is in question. According to Black, there is a significant shortfall in the budget for CARES at the moment - in the amount of $123,000.

“We are getting help, but not as much as we have in the past… we only have two fixed revenue sources,” Black said. “That’s property levies, and then the ambulance billing that we get from insurance companies.”

Black added that they do not receive any taxes or user fees for CARES. At the moment, there are grant considerations; however, there is no guarantee that EJFR will receive funding.

“We’re struggling to argue to our state and local representatives. You have to help us find a way, whether it’s through Medicare, Medicaid, or DOH,” he said. “This can’t go away. Who will do this job if we cannot fund CARES? Nobody.”

The CARES team consists of just two people: Jeff Woods, a full-time firefighter/paramedic with EJFR, and Aaron Wasson, a community support specialist employed by Believe in Recovery.

EJFS Fire Chief Bret Black said the CARES team is exceptionally impactful because their skills and specialties complement each other seamlessly.

“They’re kind of the concierge of support services for the whole county. They take the time to investigate what’s causing somebody to fail to thrive, have an accident or an injury in a proactive manner,” Black said. “We encounter a fair amount here in our community; whether it’s mental health issues, substance abuse, housing instability or a number of other things, all piled together.”

Jefferson County’s median age is 59, so it is of little surprise that more than 60% of contacts are either senior support or home health services.

Wasson said that the process is investigative in nature and that he and Woods are “kind of detectives.”

“We’ll come into a situation, and then basically we’re like, how are you doing? Do you have any family? Do you live alone? What are you struggling with? How can we help you?” Wasson said.

One of the primary referrals the CARES team receives is when first responders discover that someone is at risk because of unmet medical needs, followed by general assistance and falls.

“You sit down, and you listen to all their woes, and then you look through the house. With their permission, we’re always just perusing and looking at rugs and looking at all the fall prevention stuff. And then we look in the fridge to see if they have any food,” he said. “And then we look in the bathrooms to see what they got in there.”

The team handles the smallest of tasks, from moving furniture to removing trip hazards to making sock recommendations that prevent slipping. They will also try to determine whether the individual has a support system and get a better idea of their housing and financial situations.

Additionally, they work as community advocates. An important aspect to the job is connecting people with services. Oftentimes, on scene, Woods and Watson will be in contact with support services, such as Adult Protective Services, Jefferson Healthcare and Olympic Area Agency on Agency to coordinate continued assistance to those who need it.

A key to the CARES team’s success is their relentless approach to following up. They are hard to ignore, even harder to fool. Their care is consistent and vigilant.

“We’re going to call you back,” Woods said. “We always follow through.”