1
00:00:00,000 --> 00:00:09,000
This episode is sponsored by Transcend, a veteran owned and operated performance optimization company that I introduced recently as a sponsor on this show.

2
00:00:09,480 --> 00:00:14,080
Well, since then, I have actually been using my products and I've had incredible success.

3
00:00:14,440 --> 00:00:20,240
There was initial blood work that was extremely detailed, and based on that, they offered supplementation.

4
00:00:20,240 --> 00:00:31,120
So I began taking DHEA, BPC157 for inflammation based on the fact that I've been a stump man and martial artist and a firefighter my whole life, lots of aches and pains,

5
00:00:31,520 --> 00:00:37,120
dihexer to help cognition after multiple punches to the head and shift work and peptides.

6
00:00:37,400 --> 00:00:48,280
Four months later, they did a detailed blood work again, and I was actually able to taper off two of the peptides because my body had responded so well to just one of them that it was optimized at that point.

7
00:00:48,280 --> 00:01:01,680
So I cannot speak highly enough of the immense range of supplementation that they offer, whether it's male health, female health, peptides to boost your own testosterone, which I would argue is needed by a lot of the fire service,

8
00:01:02,000 --> 00:01:06,960
or whether it's exogenous testosterone needed, especially after TBIs or advanced age.

9
00:01:07,320 --> 00:01:13,560
Now, as I mentioned before, the other side of this company is an altruistic arm called the Transcend Foundation,

10
00:01:13,560 --> 00:01:19,120
which is putting veterans and first responders through some of their protocols free of charge.

11
00:01:19,600 --> 00:01:28,120
Now, Transcend are also offering you the audience 10% off their protocols, and you can find that on jamesgearing.com under the products tab.

12
00:01:28,600 --> 00:01:39,800
And if you want to hear more about Transcend and their story, listen to episode 808 with the founder Ernie Colling, or go to transcendcompany.com.

13
00:01:39,800 --> 00:01:46,240
Welcome to the Behind the Shield podcast. As always, my name is James Gearing, and this week it is my absolute honor to welcome on the show,

14
00:01:46,640 --> 00:01:54,360
Division Chief over EMS for Vancouver, Washington, and 34 year veteran of the fire service, Rob Milano.

15
00:01:55,080 --> 00:01:59,600
Now, as you will hear in this conversation, addiction fractured Rob's family.

16
00:01:59,960 --> 00:02:06,880
And it was that same perspective on the mental health crisis that pushed him to be part of the solution in his own department.

17
00:02:06,880 --> 00:02:12,760
So we discussed a host of topics from some of the progressive wellness solutions they have,

18
00:02:13,240 --> 00:02:24,520
the amazing telehealth embedded in their 911 system to reduce the non emergent calls they respond to, leadership, sleep deprivation, and so much more.

19
00:02:25,200 --> 00:02:30,040
Now, before we get to this incredible conversation, as I say every week, please just take a moment.

20
00:02:30,040 --> 00:02:36,320
Go to whichever app you listen to this on, subscribe to the show, leave feedback and leave a rating.

21
00:02:36,880 --> 00:02:43,160
Every single five star rating truly does elevate this podcast, therefore making it easier for others to find.

22
00:02:43,640 --> 00:02:48,360
And this is a free library of almost 1000 episodes now.

23
00:02:48,760 --> 00:02:54,520
So all I ask in return is that you help share these incredible men and women stories,

24
00:02:54,520 --> 00:02:59,800
so I can get them to every single person on planet earth who needs to hear them.

25
00:02:59,800 --> 00:03:24,360
So that being said, I introduce to you Rob Milano. Enjoy.

26
00:03:24,360 --> 00:03:33,240
Well, Rob, I want to start by saying truly thank you so much for reaching out as people are going to hear in this conversation.

27
00:03:33,240 --> 00:03:40,000
Your department has so many proactive solutions to some of the things that really do plague our profession.

28
00:03:40,480 --> 00:03:44,600
But I want to start by simply welcoming you onto the Behind the Shield podcast today.

29
00:03:46,040 --> 00:03:48,920
Yeah, thanks, James. I've been a longtime listener.

30
00:03:48,920 --> 00:03:58,360
I think that you've added an amazing thing to our profession and to law enforcement and our military troops.

31
00:03:59,560 --> 00:04:05,720
It's it's I there's been many of your guests that I've had huge takeaways from.

32
00:04:05,720 --> 00:04:12,440
So I'm happy to be here today and hopefully I can I can share some of the things that have worked well for us in our system.

33
00:04:12,840 --> 00:04:16,280
Absolutely. So where on planet earth are we finding you?

34
00:04:16,280 --> 00:04:18,760
My morning, excuse me, your morning, my afternoon.

35
00:04:19,800 --> 00:04:21,960
Yeah, of course. So I'm at home today.

36
00:04:21,960 --> 00:04:28,360
I live in a small suburb south of Portland, Oregon, by the name of Camby.

37
00:04:29,080 --> 00:04:30,760
I've been here for the last 20 years.

38
00:04:32,040 --> 00:04:34,040
We live on a small farm.

39
00:04:34,040 --> 00:04:39,960
We have some acreage and yeah, so we actually have a lot of sunshine today.

40
00:04:39,960 --> 00:04:41,800
So that's that's a good thing for us.

41
00:04:41,800 --> 00:04:42,840
Beautiful.

42
00:04:42,840 --> 00:04:48,280
Now, are you with the farmer, you actually grow in your own food and do you have livestock or poultry?

43
00:04:49,720 --> 00:04:54,440
We have some poultry and we do have a horse.

44
00:04:54,440 --> 00:04:56,840
We're down to one, thankfully.

45
00:04:57,560 --> 00:05:01,160
They eat and go to the bathroom a lot.

46
00:05:01,160 --> 00:05:06,840
And I swear that their waste is twenty dollar bills most of the time.

47
00:05:06,840 --> 00:05:09,400
So they're not a cheap animal to maintain.

48
00:05:09,400 --> 00:05:15,720
We do have a large garden and we do garden like a lot of our own vegetables and stuff.

49
00:05:15,720 --> 00:05:22,520
So, yeah, so that's pretty much, you know, the main use that we use our place for.

50
00:05:22,520 --> 00:05:28,040
But we have a very large family that we'll kind of get into and how we got there as well at some point.

51
00:05:28,040 --> 00:05:30,840
So we have a lot of kids that needed a lot of room to run.

52
00:05:31,480 --> 00:05:32,840
Beautiful. Well, we'll get to that.

53
00:05:32,840 --> 00:05:38,520
But just just with that one singular focus of being self-sufficient, how did that look?

54
00:05:38,520 --> 00:05:41,880
How did that serve you through the pandemic?

55
00:05:41,880 --> 00:05:46,600
And if you were king for a day, what would you advise people as far as

56
00:05:48,280 --> 00:05:53,080
leaning into that self-sufficiency for their own health and obviously,

57
00:05:53,080 --> 00:05:56,680
you know, the ability to grow your own food when the food supply is dwindling?

58
00:05:58,280 --> 00:05:59,720
Yeah, the king for the day thing.

59
00:06:00,760 --> 00:06:03,720
I think the biggest thing is cost, right?

60
00:06:03,720 --> 00:06:09,560
Processed food is cheap and especially a single income family like ourselves

61
00:06:10,600 --> 00:06:12,120
with a lot of mouths to feed.

62
00:06:13,080 --> 00:06:19,080
You know, we kind of get trapped sometimes in that in the processed food bank as well.

63
00:06:19,800 --> 00:06:26,680
But, you know, I think that if I was king for a day, I would hopefully be able to find a way

64
00:06:27,240 --> 00:06:30,600
to reduce the cost of whole foods.

65
00:06:30,600 --> 00:06:38,280
And, you know, and make that apparent, you know, both back in the school system,

66
00:06:38,280 --> 00:06:40,840
as well as like in our home life.

67
00:06:41,480 --> 00:06:48,520
So during like during the pandemic, you know, I was fortunate to work from home a lot.

68
00:06:49,400 --> 00:06:54,120
You know, so we were able and again, coming back to like a large family with a lot of kids,

69
00:06:54,120 --> 00:06:59,080
like our kids really weren't isolated because we had room for run and they all had people,

70
00:06:59,080 --> 00:07:01,160
you know, to be with, you know.

71
00:07:02,200 --> 00:07:07,720
And it was amazing during that time how our calendars just like went blank,

72
00:07:07,720 --> 00:07:12,200
which was probably like the most healthy thing for our family at that time.

73
00:07:12,760 --> 00:07:17,400
Because we were just running from sports field to sports field and theater to theater

74
00:07:17,400 --> 00:07:23,240
and concert to concert with all of our kids that it was just never a minute of downtime.

75
00:07:24,200 --> 00:07:26,680
So it was a really nice reset for our family.

76
00:07:26,680 --> 00:07:32,120
Unfortunately, that creep has kind of come back in post-COVID that we're pretty busy again.

77
00:07:32,120 --> 00:07:38,600
But I think like being able to be home, being able to, you know,

78
00:07:39,320 --> 00:07:45,160
live off our land a little bit better was definitely helpful, you know,

79
00:07:45,160 --> 00:07:47,640
for our families like mental health during that time.

80
00:07:48,280 --> 00:07:50,520
So let's jump ahead because I'm curious.

81
00:07:50,520 --> 00:07:51,480
I'm sure you're listening.

82
00:07:51,480 --> 00:07:55,480
So what's the backstory and the dynamic of this large family?

83
00:07:55,480 --> 00:07:56,760
That you have now?

84
00:07:57,400 --> 00:07:58,200
Yeah, of course.

85
00:07:58,200 --> 00:08:00,440
So we're a blended family.

86
00:08:01,080 --> 00:08:06,520
Both my wife and I came into our relationship 13 years ago, both with two kids each.

87
00:08:07,800 --> 00:08:16,120
And products of addiction was really the demise of both of our relationships.

88
00:08:16,760 --> 00:08:22,840
So that was a uniqueness that, you know, I think really tied my wife, Jessica and I together.

89
00:08:22,840 --> 00:08:24,600
Was that piece.

90
00:08:24,600 --> 00:08:27,160
And so, and our kids being affected by that.

91
00:08:27,160 --> 00:08:30,360
So we both had sole custody of our kids.

92
00:08:31,880 --> 00:08:36,600
And so we were able to blend our family pretty seamlessly, which was amazing.

93
00:08:36,600 --> 00:08:42,520
Like it was like from the first day our kids met each other, they were like just instant,

94
00:08:42,520 --> 00:08:47,000
you know, friends and engaged and continued to be.

95
00:08:47,560 --> 00:08:49,400
That is one problem we don't have in our house.

96
00:08:49,400 --> 00:08:51,160
Like we don't have a lot of friends.

97
00:08:51,160 --> 00:08:54,600
We don't have a lot of infighting.

98
00:08:54,600 --> 00:08:58,760
Our kids are kind of like their own little tribe and they really do stick together.

99
00:09:00,360 --> 00:09:05,160
So a few years after we'd been married and things were moving along,

100
00:09:06,360 --> 00:09:09,240
we got involved in the Oregon foster care system.

101
00:09:10,360 --> 00:09:18,360
And we were successful in fostering a seven-year-old boy that was the same age as our son.

102
00:09:18,360 --> 00:09:29,800
And he, after two years of some port battles and DHS integrations, we were able to adopt him.

103
00:09:30,840 --> 00:09:39,000
And so he's been with us for the last eight years and, you know, is just one of our tribe.

104
00:09:40,760 --> 00:09:45,160
And then, and he was again a product of addiction and mental health.

105
00:09:45,160 --> 00:09:51,160
His mom really struggled with that and ultimately, you know, lost custody of him.

106
00:09:53,560 --> 00:10:03,960
Then about three years ago now, my wife's first cousin went through some tough times

107
00:10:03,960 --> 00:10:05,960
and struggles with addiction.

108
00:10:06,840 --> 00:10:11,560
And DHS showed up at her doorstep and was going to take her kids.

109
00:10:11,560 --> 00:10:17,160
And so she called my wife and we still had our foster care licensing.

110
00:10:18,360 --> 00:10:23,960
So we were able to work out a deal that the kids came to us and not into the system.

111
00:10:25,560 --> 00:10:28,200
So they've been with us for the last three years.

112
00:10:29,800 --> 00:10:33,720
Pretty tough time over the last three years with that.

113
00:10:33,720 --> 00:10:41,960
Of both parents, there's three parents involved with those three kids and two separate dads.

114
00:10:42,760 --> 00:10:47,560
And one dad's completely out of the picture and one dad struggles heavily,

115
00:10:47,560 --> 00:10:49,560
and all of them struggle heavily with addiction.

116
00:10:51,000 --> 00:10:56,360
But one dad really wasn't able to take on the kids.

117
00:10:56,360 --> 00:11:03,160
So we entered in, as we tried to navigate everything, even like the simpleness of trying to get

118
00:11:03,720 --> 00:11:08,680
the kids healthcare insurance and to start trying to meet their needs,

119
00:11:09,480 --> 00:11:11,880
led down a pretty tough path for us.

120
00:11:12,840 --> 00:11:21,240
And since we didn't have custody and the state kind of backed out of any assessment,

121
00:11:21,240 --> 00:11:26,840
as far as the foster side of things go.

122
00:11:26,840 --> 00:11:30,440
So we were kind of just left on our own with it.

123
00:11:32,440 --> 00:11:35,160
So we started down the guardianship and custody route.

124
00:11:36,440 --> 00:11:41,880
And that took almost a solid year to get through, but we do have custody of them now.

125
00:11:43,160 --> 00:11:48,280
I am happy to say, and hopefully we'll kind of get into this a little bit more in the future,

126
00:11:48,280 --> 00:11:55,560
about some of the innovations that Vancouver Fire has done as far as the opiate issues in our area.

127
00:11:56,920 --> 00:11:58,920
Both parents are clean and sober.

128
00:11:59,880 --> 00:12:11,960
And mom is well engaged and back in their lives and participating right alongside of us as co-parenting.

129
00:12:11,960 --> 00:12:16,840
This month, they actually moved to some overnights with both parents.

130
00:12:18,280 --> 00:12:20,680
So there is success stories out there.

131
00:12:22,440 --> 00:12:24,440
Yeah, so that's kind of our tribe.

132
00:12:24,440 --> 00:12:26,440
That's how we kind of came to be.

133
00:12:26,920 --> 00:12:27,960
That's amazing.

134
00:12:27,960 --> 00:12:31,000
And this is the conversation I've had so many times on the show.

135
00:12:31,000 --> 00:12:36,200
And it's so beautiful, especially when law enforcement says, look, this war on drugs isn't

136
00:12:36,200 --> 00:12:41,960
working. Arresting people because of addictions is just simply creating more trauma in households.

137
00:12:41,960 --> 00:12:45,080
And you're obviously seeing the next generation of addiction.

138
00:12:45,080 --> 00:12:46,440
It can go one of two ways.

139
00:12:46,440 --> 00:12:51,720
The mother and or father find that the healing that they need, get back on their feet, and then

140
00:12:51,720 --> 00:12:54,120
are able to start rebuilding that family dynamic.

141
00:12:54,120 --> 00:12:58,440
And in the meantime, you and your family have stepped in and been that family for them.

142
00:12:59,160 --> 00:13:02,120
Or they get discarded and the kids end up in a different place.

143
00:13:02,120 --> 00:13:07,400
The parents are in prison or even worse, crippled addiction or overdose.

144
00:13:07,400 --> 00:13:14,840
And it's just the solution is so painfully simple, which is just putting compassion and kindness

145
00:13:14,840 --> 00:13:20,760
back into the addiction conversation and encircling those people in the therapies and the help that

146
00:13:20,760 --> 00:13:22,760
they need to get them back on their feet.

147
00:13:24,200 --> 00:13:27,000
Yeah, no, I couldn't agree more with you, Jim.

148
00:13:27,000 --> 00:13:34,680
You know, and Oregon's been pretty progressive with the decriminalization laws, as has Washington

149
00:13:34,680 --> 00:13:43,160
State. And the unfortunate piece of both of those programs was there was not the support system built

150
00:13:44,040 --> 00:13:47,960
to bring those people into care and to assist them.

151
00:13:48,840 --> 00:13:50,840
And that still is a problem.

152
00:13:50,840 --> 00:13:52,840
And I think that's a very important point.

153
00:13:52,840 --> 00:13:58,040
And we're getting ready to roll out medication-assisted treatment in our field.

154
00:13:58,040 --> 00:14:05,080
And one of the big hurdles that we're having right now is being able to build a network of social

155
00:14:05,080 --> 00:14:12,200
workers and clinicians that can help support these people as their brain fog kind of lifts from their

156
00:14:12,200 --> 00:14:19,080
addictions. And so it's, you know, so that's the problem.

157
00:14:19,080 --> 00:14:26,040
And so it's, you know, so that's been it's almost kind of backfired in our states.

158
00:14:26,040 --> 00:14:32,600
And I believe almost made the problems worse with the decriminalization, because again, just all

159
00:14:32,600 --> 00:14:34,040
those pieces weren't in place.

160
00:14:34,920 --> 00:14:36,840
It's kind of the cart before the horse approach.

161
00:14:37,480 --> 00:14:41,720
I was literally having the same conversation with someone the other day, you know, and what happens

162
00:14:41,720 --> 00:14:46,840
now is you get the, you know, the people who still are set in their ways because they don't have the

163
00:14:46,840 --> 00:14:49,480
capacity to think like a kind, compassionate human being.

164
00:14:49,480 --> 00:14:55,240
So they want to keep arresting addicts and they point to, you know, the Northwest and go, see,

165
00:14:55,240 --> 00:14:56,040
it didn't work there.

166
00:14:56,040 --> 00:14:57,880
But we didn't do it properly.

167
00:14:57,880 --> 00:15:01,080
It's like pointing to Obamacare and saying that national health doesn't work.

168
00:15:01,080 --> 00:15:02,600
That wasn't national health.

169
00:15:02,600 --> 00:15:04,120
Wasn't even close to it.

170
00:15:04,120 --> 00:15:08,520
If you look at the Portuguese model, they took that money from the war on drugs.

171
00:15:08,520 --> 00:15:13,480
And obviously then, let me just be very clear, they freed up a huge amount of money and resources

172
00:15:13,480 --> 00:15:17,160
for chasing the traffickers and chasing the dealers.

173
00:15:17,160 --> 00:15:19,400
That's those people are behind bars.

174
00:15:19,400 --> 00:15:23,800
But all the other money they referred and they opened addiction counseling, you know,

175
00:15:23,800 --> 00:15:26,440
mental health counseling, job creation, housing.

176
00:15:27,000 --> 00:15:29,320
So they had all those pieces in place.

177
00:15:29,320 --> 00:15:33,080
What we've done wrong in America is like you said, there's been decriminalization or, you know,

178
00:15:33,080 --> 00:15:38,920
safe injection sites, but we haven't proactively done, you know, put everything in place so that

179
00:15:38,920 --> 00:15:43,560
addict can go from that criminal route to that medical route that they actually need.

180
00:15:43,560 --> 00:15:48,120
And now you've got the opposition, you know, wringing their hands going, see, it didn't work.

181
00:15:48,120 --> 00:15:53,000
It's like, no, that was never ever a true trial of what it should look like.

182
00:15:53,640 --> 00:15:56,920
It was the same piecemeal attempt as Obamacare was.

183
00:15:56,920 --> 00:15:59,000
So if we're going to do it, we need to do it properly.

184
00:16:00,440 --> 00:16:01,000
Yeah.

185
00:16:01,000 --> 00:16:01,240
Yeah.

186
00:16:01,240 --> 00:16:04,520
And I think that that's, I mean, that's one of those things, right?

187
00:16:04,520 --> 00:16:14,440
That, you know, you get so much governance that comes into play in those arenas and those spaces

188
00:16:14,440 --> 00:16:19,480
in, you know, that it's a really good idea as it enters the ballot, right?

189
00:16:19,480 --> 00:16:20,840
And people vote on it.

190
00:16:20,840 --> 00:16:24,040
And obviously in Oregon and Washington, those things passed.

191
00:16:25,400 --> 00:16:28,520
But then now it's planning time, right?

192
00:16:28,520 --> 00:16:30,360
So government has to get involved.

193
00:16:31,320 --> 00:16:34,120
And I, you know, having been in government work for 30 years,

194
00:16:34,120 --> 00:16:38,520
I see that over and over again, that these really good ideas come to the forefront.

195
00:16:38,520 --> 00:16:43,400
But by time it goes through the machine of the politics, the labor groups, the,

196
00:16:44,920 --> 00:16:50,520
you know, management and it gets spit out the other end and it looks completely different.

197
00:16:50,520 --> 00:16:53,800
And, you know, I mean, you bring up the Affordable Care Act.

198
00:16:53,800 --> 00:16:57,480
I mean, that was identical to what happened there.

199
00:16:57,480 --> 00:17:03,080
You know, Obama, I think, had a great idea and it looked really good during the polls.

200
00:17:03,080 --> 00:17:05,720
And then when it got spit through the political machine,

201
00:17:06,360 --> 00:17:08,760
it was something completely different that actually, I believe,

202
00:17:08,760 --> 00:17:11,000
made healthcare worse in the United States.

203
00:17:11,800 --> 00:17:17,000
So, yeah, I think we need to have more purpose, like, in those conversations.

204
00:17:17,800 --> 00:17:18,120
100%.

205
00:17:19,080 --> 00:17:19,320
All right.

206
00:17:19,320 --> 00:17:23,320
Well, let's go to your timeline and then we'll obviously talk about some of the proactive things

207
00:17:23,320 --> 00:17:24,440
that you're doing in Vancouver.

208
00:17:25,160 --> 00:17:28,520
So tell me where you were born and tell me a little bit about your family dynamic,

209
00:17:28,520 --> 00:17:30,440
what your parents did, how many siblings?

210
00:17:30,440 --> 00:17:39,080
Yeah. So I was born in Whittier, California, down in Los Angeles County, and that's where my parents

211
00:17:39,080 --> 00:17:46,440
were raised. And they were kind of post high school sweethearts. And I grew up in Southern

212
00:17:46,440 --> 00:17:54,600
Orange County. My dad has always been in finance of some sort, whether financing cars or financing

213
00:17:54,600 --> 00:18:07,320
homes. And he did some real estate brokerage for a long time down there. And he was in army intelligence

214
00:18:08,200 --> 00:18:20,120
in Vietnam and spent some time over there. And so pretty great stuff there. He was also adopted

215
00:18:20,120 --> 00:18:30,360
through his church. Just another family had two boys about the same time and couldn't afford both

216
00:18:30,360 --> 00:18:39,080
of them. And my adoptive grandparents couldn't have kids. So they worked out a deal and all of

217
00:18:39,080 --> 00:18:46,680
a sudden my dad had new parents at a really young age. And it was just not really talked about.

218
00:18:46,680 --> 00:18:54,600
And I don't know if that's what kind of led me to having some passion towards adoption. But I think

219
00:18:55,320 --> 00:19:05,160
that his story definitely kind of tells true of later in life he was able to reconnect with his

220
00:19:05,160 --> 00:19:11,160
biological brother and then that he has an amazing relationship with. And probably one of the reasons

221
00:19:11,160 --> 00:19:18,520
that it pulled them from Southern California up to Oregon because my uncle is here in Oregon. So

222
00:19:18,520 --> 00:19:24,760
they've rekindled a pretty solid bond and relationship after 30 years of being separated.

223
00:19:26,120 --> 00:19:32,120
And he was able to reconnect with his biological father before he passed and his biological mother.

224
00:19:32,120 --> 00:19:42,200
So pretty good story there. My parents have been married I believe over 40 years now.

225
00:19:43,400 --> 00:19:53,080
And so I came from a really solid foundational home. My mom was a hairdresser for a long time

226
00:19:53,080 --> 00:20:02,040
and then she kind of entered the corporate world in like a safety industry. And so I think that

227
00:20:02,040 --> 00:20:09,000
you know in helping with like safety systems and did that for a really long time. She's also

228
00:20:09,000 --> 00:20:16,600
retired now. My parents live pretty close to us. They're about 15 minutes away so we see them quite

229
00:20:16,600 --> 00:20:22,200
frequently and a big part of our tribe and our family. And then I have an older sister that's

230
00:20:22,200 --> 00:20:27,000
still down in Southern California. She lives in Fountain Valley and her and her husband are both

231
00:20:27,000 --> 00:20:33,160
school teachers down there. And I have two nieces through that as well. So that's kind of my family

232
00:20:33,160 --> 00:20:40,200
dynamic. With you being a 30 year first responder yourself, have you had conversations with your

233
00:20:40,200 --> 00:20:46,520
father about the impact of his service in Vietnam? Because that generation especially with the home

234
00:20:46,520 --> 00:20:51,880
coming element had such a different experience than I mean the Korean War sadly a lot of people

235
00:20:51,880 --> 00:20:57,240
don't even discuss but obviously the World War II vets and then more recently the Gulf War vets.

236
00:20:57,240 --> 00:21:04,120
What was the ripple effect if any that you've discussed with him about the Vietnam experience?

237
00:21:05,880 --> 00:21:14,760
Yeah that has come more to light in the last few years with him more so than ever. It really

238
00:21:14,760 --> 00:21:24,600
wasn't discussed very much and he didn't really talk about it very often. But more and more

239
00:21:25,480 --> 00:21:32,920
over time he has become more open about it. Post retirement they downsized their house a little

240
00:21:32,920 --> 00:21:38,200
bit and moved more into kind of a planned community. And he made some new friends in

241
00:21:38,200 --> 00:21:45,560
the neighborhood and they started a poker club and they were all part of like a veteran group.

242
00:21:47,480 --> 00:21:58,120
And my dad just really didn't he never had the need to access military services or VA services.

243
00:21:59,400 --> 00:22:05,320
So he just never did. And so in that group one night they're all playing poker and they start

244
00:22:05,320 --> 00:22:09,400
saying like he was complaining about his hearing aids or his eyeglasses are like well why don't

245
00:22:09,400 --> 00:22:13,880
you go up to the VA and get some stuff and he's like oh no I don't need to do that and they're

246
00:22:13,880 --> 00:22:20,520
like oh you should sign up it's great you know. So now my dad's all in like he kind of got a taste

247
00:22:20,520 --> 00:22:26,920
of that and he is all in and utilizing those services. My dad's a three-time cancer survivor

248
00:22:26,920 --> 00:22:34,760
and also was just recently diagnosed with Parkinson's and is in that early onset and all

249
00:22:34,760 --> 00:22:41,880
of those things tied back to the chemicals that they were using in Vietnam. So now he actually

250
00:22:42,840 --> 00:22:50,360
has a disability through the VA as utilizing those services and I think a lot of that has opened up

251
00:22:50,360 --> 00:23:01,960
more pride in his service and his ability to talk more freely about his time. He was fortunate.

252
00:23:03,000 --> 00:23:08,680
He was able to like stay in the United States for the majority of his service time and only had to

253
00:23:08,680 --> 00:23:13,960
spend a little bit of time over in Vietnam and most of that time was spent like in an office

254
00:23:13,960 --> 00:23:20,200
building because he was doing Army intelligence and kind of like a little bit of a little bit

255
00:23:20,200 --> 00:23:27,720
kind of directing the crews on the ground. So thankfully he wasn't necessarily out in the

256
00:23:27,720 --> 00:23:36,040
front lines of that but I do know that he did spend some time out in the field and saw the

257
00:23:36,760 --> 00:23:41,960
the effects of war and so yeah we've talked through some of those things.

258
00:23:43,160 --> 00:23:47,480
My father-in-law had the same thing he was exposed to Agent Orange when he was in the Navy in Vietnam

259
00:23:47,480 --> 00:23:53,080
and these multiple cancers and all kinds of things. So this is the thing about taking care

260
00:23:53,080 --> 00:23:57,240
of our veterans specifically. I mean our first responders too but our veterans whether it's the

261
00:23:57,240 --> 00:24:02,600
burn pits of modern day or whether it was the Agent Orange back then. I mean if they were

262
00:24:02,600 --> 00:24:06,920
inadvertently poisoned when they were supposed to just be worrying about the enemy then

263
00:24:06,920 --> 00:24:13,320
it's up to this country to take care of them. Yeah I fully agree. All right well then what about

264
00:24:13,320 --> 00:24:17,560
athletics? What were you playing and doing as far as sports when you were in the school age?

265
00:24:18,920 --> 00:24:24,680
Yeah so you know growing up in Southern California I know you spent some time down there. I mean it

266
00:24:24,680 --> 00:24:33,880
was that you were an hour from the beach, an hour from the mountains. So I've always been a big

267
00:24:33,880 --> 00:24:41,320
board sports guy so whether it was skateboarding or surfboarding or wakeboarding or up in the

268
00:24:41,320 --> 00:24:47,960
mountains you know snowboarding that has been a big passion of mine my entire life and still is today.

269
00:24:50,440 --> 00:24:58,120
So and then like as far as like high school sports I was a runner so I ran track and cross country.

270
00:24:58,920 --> 00:25:02,520
I grew up playing soccer and but when I got to the high school level I just

271
00:25:03,320 --> 00:25:09,320
it was way too competitive in Southern California for that you know that's kind of the people ship

272
00:25:09,320 --> 00:25:16,920
their kids there to play soccer. So yeah so I toyed around a little bit with that but you

273
00:25:16,920 --> 00:25:23,000
know my big thing was you know running more long distance you know so long distance stuff in track

274
00:25:23,000 --> 00:25:27,640
and then cross country. And what about career aspirations? What were you dreaming of becoming

275
00:25:27,640 --> 00:25:36,040
when you were in the school age? Yeah so fire service was a big thing for me. I like at a really

276
00:25:36,040 --> 00:25:43,640
young age. I grew up on a small cul-de-sac with five houses. On one side was a Newport Beach captain,

277
00:25:43,640 --> 00:25:51,160
on the other side was a battalion chief with Wayna Park. And so you know so I was just immersed

278
00:25:51,160 --> 00:25:57,080
in that and in California like conflagrations happened all the time and we lived in Southern

279
00:25:57,080 --> 00:26:04,600
Orange County and so they would come I remember distinctly both of them coming into the cul-de-sac

280
00:26:04,600 --> 00:26:09,960
with their task force you know to like grab some food because their wives had made food and all

281
00:26:09,960 --> 00:26:15,960
the kids in the neighborhood come up you know run out and you know participate you know with

282
00:26:15,960 --> 00:26:22,680
with that fire apparatus in the cul-de-sac. And so that was kind of that start of it all.

283
00:26:23,640 --> 00:26:31,560
I also like really thought about being a teacher and so when I hit college you know I was actually

284
00:26:31,560 --> 00:26:38,680
taking some early childhood education classes and the fire program at the same time because I was

285
00:26:38,680 --> 00:26:45,240
kind of trying to weigh which way I really wanted to go. But yeah the fire service just really stuck

286
00:26:45,240 --> 00:26:51,960
with me. In high school we had Orange County Fire Authority come in with their Explorer program into

287
00:26:51,960 --> 00:26:59,640
the high school and the guy that was running the program, the coordinator of the program, was a big

288
00:26:59,640 --> 00:27:05,160
skateboarder as well and had a big half pipe in his backyard and he lured us all over there.

289
00:27:07,720 --> 00:27:13,720
And then before I knew it I was signing up and being a part of Orange County Fire Authority and

290
00:27:14,520 --> 00:27:19,080
doing that for all through high school and then my first year of college as a pay call.

291
00:27:20,600 --> 00:27:24,760
What was the environment that you were trying to get hired in? Because we

292
00:27:24,760 --> 00:27:28,920
modern day and we'll get to this of course you know we have this horrendous recruitment crisis

293
00:27:28,920 --> 00:27:35,400
now and I think that what people don't realize is how far we are from the 90s and early 2000s

294
00:27:35,400 --> 00:27:41,880
when thousands of people were testing for a handful of jobs. Oh yeah I mean it was it was amazing James.

295
00:27:41,880 --> 00:27:49,400
I remember sleeping on street corners just for an application. It was like a homeless

296
00:27:49,400 --> 00:27:55,960
encampment around City Hall of just a bunch of firemen that are trying to get a job.

297
00:27:55,960 --> 00:28:01,080
And I remember you know you'd make relationships with people in the line so you could go use the

298
00:28:01,080 --> 00:28:07,560
bathroom or go grab food or do something. So and that was just to get an application.

299
00:28:08,760 --> 00:28:18,760
You know and I remember testing at LA County and having to go to the old Lakers arena with like

300
00:28:18,760 --> 00:28:23,400
20,000 people and it was just this constant noise and they gave you like a little piece of plywood

301
00:28:23,400 --> 00:28:29,080
and your your test and you're sitting there in the bleachers you know trying to take a test.

302
00:28:30,040 --> 00:28:38,680
You know so that environment has just completely shifted and very hard you know to get into the

303
00:28:38,680 --> 00:28:45,160
program. You know thankfully through Rancho Santiago College which is now Santa Ana College down

304
00:28:45,160 --> 00:28:53,480
there my affiliation with Orange County Fire as an explorer and as a pay call like assisted in

305
00:28:53,480 --> 00:29:02,200
getting into that program and the mentors that I had through that. But then you took all the

306
00:29:02,200 --> 00:29:09,320
classes and then you just waited for your name to be drawn to go into the academy. And so it you

307
00:29:09,320 --> 00:29:17,640
know it was very prolonged. And then paramedic school was the same thing. They literally used to

308
00:29:17,640 --> 00:29:24,360
have this it was like the old lottery ball like bingo like old folks home bingo thing with all

309
00:29:24,360 --> 00:29:30,440
the balls in the cage and they'd roll it around and they'd pull names out of who the next paramedic

310
00:29:30,440 --> 00:29:38,120
class was going to be. So I sat through that for a few times and wasn't one of my balls wasn't

311
00:29:38,120 --> 00:29:45,320
picked. So I headed up to Oregon to go to paramedic school there. Yeah it was such a different you

312
00:29:45,320 --> 00:29:52,760
know environment and I wasn't there. I went to school in let me see 03 04 I got hired in 04.

313
00:29:52,760 --> 00:29:59,160
But the environment I went it was still very very challenging. It just happened that Hialeah at the

314
00:29:59,160 --> 00:30:04,600
time was so poorly paid that not as many people were applying because Miami-Dade was actually

315
00:30:04,600 --> 00:30:09,880
making double. So when I put it in and there was so many Cuban people there like I was a minority

316
00:30:09,880 --> 00:30:16,520
you know a random English person in a very very Cuban city was I was almost the affirmative action

317
00:30:16,520 --> 00:30:21,960
hire I think. But I mean but that was a real thing as well you know and this is the thing people are

318
00:30:21,960 --> 00:30:27,560
scared to talk about diversity and affirmative action. But you were part of the explorer program

319
00:30:27,560 --> 00:30:32,840
and I think that is the how you truly forge diversity these mentorship programs especially if

320
00:30:32,840 --> 00:30:38,200
you go into underserved communities that aren't being represented and that has to be you know

321
00:30:38,200 --> 00:30:43,480
rectified. But you find the best candidates within you don't just scoop a bunch of people that fill

322
00:30:43,480 --> 00:30:48,840
that criteria and say you know you're all welcome because you haven't you know selected the ones

323
00:30:48,840 --> 00:30:54,760
that are actually worthy to do the job. So talk to me about that as a white male in the 90s.

324
00:30:54,760 --> 00:30:59,560
What was the resistance to getting hired because I mean it is a conversation needs to be had because

325
00:30:59,560 --> 00:31:09,960
I don't think it was done in the correct way back then. Yeah so it was tough and most of the hires

326
00:31:10,840 --> 00:31:19,080
were and even down to the college level into programs there was very much high levels of

327
00:31:19,080 --> 00:31:28,360
incentive for minorities to come in and women as well. Because again the fire service was poorly

328
00:31:28,360 --> 00:31:37,800
represented with those with those groups. So I understand why they needed to do what they needed

329
00:31:37,800 --> 00:31:49,240
to do there. But like as a white male that made it more difficult. Like it forced me to figure out

330
00:31:49,240 --> 00:31:57,720
my individuality of being a different candidate and how to express that in interviews and what

331
00:31:57,720 --> 00:32:03,720
I could bring to that table. Which took time you know I tested a lot of fire departments. I sat

332
00:32:03,720 --> 00:32:09,800
through a lot of interviews. I went through a lot of you know captain so and so's interview for

333
00:32:09,800 --> 00:32:17,160
success classes you know over the years. And I think the biggest takeaway was just trying to

334
00:32:17,160 --> 00:32:23,160
divide myself from the cookie cutter other candidates and bring something else to that table.

335
00:32:23,160 --> 00:32:28,440
So talk to me about the move to Oregon. You're trying in Southern California it's just not

336
00:32:28,440 --> 00:32:32,040
happening there. You know what was the the difference when you got to that state?

337
00:32:33,800 --> 00:32:41,480
Yeah so my right after high school we my family my parents we did a short stint

338
00:32:42,280 --> 00:32:48,600
of a move from Southern California up to Eugene Oregon when I was about five years old.

339
00:32:48,600 --> 00:32:56,120
And we were there for five years and my parents loved it and my sister and I loved it. But my

340
00:32:56,120 --> 00:33:00,760
grandparents who were still back in Southern California you know their health was deteriorating.

341
00:33:01,480 --> 00:33:06,360
And so we moved back. And then it was always talked about we're moving back to Oregon we're

342
00:33:06,360 --> 00:33:12,040
moving back to Oregon. And then my sister got into high school and then I got into high school and

343
00:33:12,040 --> 00:33:17,400
so my parents just didn't want to uproot us during that time. But the minute I graduated high school

344
00:33:17,400 --> 00:33:20,440
my parents were there was a for sale sign in front of the house and they were gone.

345
00:33:21,800 --> 00:33:29,000
So they moved back to Oregon. Yeah so I forged ahead on my own down there like at that point

346
00:33:29,000 --> 00:33:35,320
you know being an 18 year old kid that was surfing every morning and very much involved in the

347
00:33:35,320 --> 00:33:42,520
Southern California lifestyle. Like I wasn't going to Oregon. I'm not are you kidding. I'm not doing

348
00:33:42,520 --> 00:33:51,080
it. So but after after the first year stand down there it was apparent that I was not going to get

349
00:33:51,080 --> 00:33:57,320
into medical school down there at that time. And that was kind of that next thing that was going

350
00:33:57,320 --> 00:34:02,200
to separate me. And that was what my mentors were telling me. You got to get your paramedic. That's

351
00:34:02,200 --> 00:34:06,600
you know you're going to go from testing against thousands to testing against hundreds if you can

352
00:34:06,600 --> 00:34:13,560
get that medic done. So you know my parents actually like moved into a rural community

353
00:34:13,560 --> 00:34:18,520
just outside of Eugene. And there was a small volunteer fire department right across the street.

354
00:34:19,480 --> 00:34:23,720
So my dad calls me one day and was like hey I walked across the street the other day and talked

355
00:34:23,720 --> 00:34:28,680
to the chief and they need volunteers so bad like they'll put you on a fire truck tomorrow.

356
00:34:28,680 --> 00:34:34,600
You know come on up here. You know and so I went and visited over Christmas and

357
00:34:34,600 --> 00:34:42,360
ended up like going back home packing up and moving to Oregon. There was nearly zero competition.

358
00:34:42,360 --> 00:34:49,640
They were almost begging for people to come into the paramedic program. And they I was fortunate

359
00:34:49,640 --> 00:34:57,560
enough to meet some great people that brought me in as a resident volunteer within a fire station.

360
00:34:57,560 --> 00:35:02,840
I was awarded a scholarship that I drove their fire based ambulance form and they paid for all

361
00:35:02,840 --> 00:35:10,840
of my medics school gave me a place to live. Introduced me to my lifelong friends that I still

362
00:35:10,840 --> 00:35:19,720
have to this day. And so I lived there for two years. Finished off my paramedic degree there.

363
00:35:19,720 --> 00:35:29,400
And got a ton of experience. You know a great small rural fire department that ran ambulance

364
00:35:30,200 --> 00:35:35,080
and kind of like you know did the rig shuffle. If it was a fire you got on the fire truck.

365
00:35:35,080 --> 00:35:41,160
If it's a medical call you got on the medic unit. So did that for three years and I think it really

366
00:35:41,160 --> 00:35:48,280
qualified me and made me ready for you know the next year. And so I was able to get a

367
00:35:48,280 --> 00:35:53,640
degree for you know my next step you know when I got my first career job.

368
00:35:54,440 --> 00:36:02,360
So where did you find yourself then? Yeah so was testing like crazy right. And I even had a point

369
00:36:02,360 --> 00:36:07,080
in paramedic school that was like I don't want to do this. Like I just want to be a firefighter.

370
00:36:07,960 --> 00:36:17,000
And you know really wanted to drop out. But pushed forward. I had a chief officer kind of get a hold

371
00:36:17,000 --> 00:36:24,440
of me one day. And back when it was a little bit more aggressive in the fire stations. You know he

372
00:36:24,440 --> 00:36:32,280
grabbed me by the shirt and pushed me up against the wall. And told me that it will never be easier

373
00:36:32,280 --> 00:36:39,720
in your life than now to get that done. And he was a gentleman that had gone he'd gone back to get his

374
00:36:39,720 --> 00:36:45,400
paramedic about 10 years into his career as a firefighter. And he's like I was married. I had

375
00:36:45,400 --> 00:36:53,240
kids. And here I'm back in medic school. You know and he's like so don't do that. You know you're

376
00:36:53,240 --> 00:37:00,360
almost there. Finish it out. And it will make things better for you. And I'm glad that I took

377
00:37:00,360 --> 00:37:07,000
that advice. I'm glad he got my attention. You know. And so finished up medic school and had a

378
00:37:07,000 --> 00:37:14,680
bunch of job offers. Right as I was finishing up medic school. So I went to work in southern Oregon

379
00:37:14,680 --> 00:37:21,560
for the city of Grants Pass. And I was Grants Pass was kind of a training ground department

380
00:37:21,560 --> 00:37:28,920
for a larger department south of there Medford. And Medford had just hired like eight

381
00:37:29,640 --> 00:37:37,400
Grants Pass firefighters. So they had to do a big grab. And so I came in and they had actually

382
00:37:37,400 --> 00:37:44,760
I was I was far enough down on the list that I didn't get the first grouping offers. So the first

383
00:37:44,760 --> 00:37:51,080
group of candidates were just finishing up their academy. And I came in right as they were finishing

384
00:37:51,080 --> 00:37:56,360
and they said well there's only two weeks to the academy left. But if you can catch up with them

385
00:37:56,360 --> 00:38:03,000
you can take the final and then we'll put you on the line. So I was successful with that. So within

386
00:38:03,000 --> 00:38:11,480
so within two weeks I'm in a station and working on a rig. So so that happened you know pretty fast

387
00:38:11,480 --> 00:38:16,440
and at the time they were running two person engine companies. You know so you were just

388
00:38:17,000 --> 00:38:26,280
you were right in the middle of it. And that was like the first real hit you know because that was

389
00:38:26,280 --> 00:38:38,120
in 98 and black tar heroin was a big thing. And down in southern Oregon they the county there

390
00:38:39,400 --> 00:38:44,760
they would vote out the police department quite frequently. And then they had a privatized fire

391
00:38:44,760 --> 00:38:52,200
department a few of them that covered the county areas. So the city was really the only like

392
00:38:52,200 --> 00:38:59,320
professional fire department in the county. And so we you know it was weird. You would go out into

393
00:38:59,320 --> 00:39:05,560
the county on a fire and if they didn't have a contract with the private provider you would wait

394
00:39:05,560 --> 00:39:10,920
for the Oregon Department of Forestry and they'd come in and make sure that like the forest lands

395
00:39:10,920 --> 00:39:18,840
didn't burn down and they let the house burn to the ground. And so just an interesting environment

396
00:39:18,840 --> 00:39:28,280
down there and then a huge at the time before legalization a huge marijuana grow operations.

397
00:39:28,280 --> 00:39:34,200
I mean thousands and thousands of acres just west of there kind of in the mountain range

398
00:39:34,200 --> 00:39:42,680
towards the coast. And just like no man's land and cartels were in there. And just so a ton of drugs

399
00:39:42,680 --> 00:39:51,160
were running through that community. And so seeing that firsthand was a big eye opener.

400
00:39:52,200 --> 00:39:58,360
Really seeing like my first real like pandemic that you know that we're giving Narcan all the time and

401
00:39:59,000 --> 00:40:07,000
getting people back breathing and having them walk out of the hospital. And so yeah so that

402
00:40:07,000 --> 00:40:15,240
that was my first adventure. I met my first wife there. We got married and she was from there and

403
00:40:15,240 --> 00:40:22,680
wanted to move away because she'd been there her whole life. And so we so I started taking

404
00:40:22,680 --> 00:40:29,560
fire department tests up in the Portland area. And then made that transition moved up the I-5 corridor

405
00:40:29,560 --> 00:40:36,360
to the town that I actually live in now. And went to work for that fire department. And

406
00:40:37,400 --> 00:40:45,560
was there for 16 years and promoted through the ranks. Left there as the division chief of EMS

407
00:40:45,560 --> 00:40:53,080
and training. I mean fire and EMS training and safety. And I was also the volunteer coordinator.

408
00:40:53,080 --> 00:41:03,400
So a lot of hats. And really I guess I approached the grass is greener approach. I think I had a

409
00:41:03,400 --> 00:41:14,040
really good gig at that department. And a really good group of people to work with. And a neighboring

410
00:41:14,040 --> 00:41:20,520
department that was a little bit larger was going to the outside for shift battalion chiefs. And

411
00:41:20,520 --> 00:41:29,720
saw an opportunity to go back to shift. And so I took that job. And great department.

412
00:41:31,000 --> 00:41:37,880
Really different demographic of Canby. Canby is kind of a country club. We have you know

413
00:41:40,520 --> 00:41:47,400
good schools, good economic backgrounds, large farming community, right on a gorgeous river,

414
00:41:47,400 --> 00:41:55,000
a lot of things going for it. And a lot of care homes. So run a lot of car wrecks. A lot of

415
00:41:55,000 --> 00:42:04,520
rural roads. Really low fire response. So you're just kind of running fall patients and chest pain.

416
00:42:04,520 --> 00:42:12,520
And just kind of not really having a really more rugged

417
00:42:12,520 --> 00:42:22,440
response. But moving down to Marion County, larger department, four staff stations,

418
00:42:23,400 --> 00:42:32,760
three additional volunteer stations. So Marion County is where Salem is, which is the state

419
00:42:32,760 --> 00:42:43,240
capital. So just tons of penitentiaries, being a state capital seat. Just the demographic was

420
00:42:43,240 --> 00:42:50,680
different. And all of a sudden I'm running stabbings and shootings and a fire every shift.

421
00:42:51,720 --> 00:42:58,920
They worked the 4896. But we did all in class overtime. And so we had to do a lot of

422
00:42:58,920 --> 00:43:07,160
work. So you're pretty much on a 72 as a BC and then a 72 off just constantly.

423
00:43:08,520 --> 00:43:15,880
And really busy system. Fire base transport as well. And you were just going and those crews

424
00:43:15,880 --> 00:43:25,560
were just getting wrecked and dealing with mandatories and budget constraints constantly.

425
00:43:25,560 --> 00:43:31,880
So it was just here I'd come from this, again, this country club of a fire department for the

426
00:43:31,880 --> 00:43:40,760
majority of my career. And then I'm just in the thick of it now. And then not being, not promoting

427
00:43:40,760 --> 00:43:47,800
up through the ranks there was an interesting gap of just trying to integrate with the shift and

428
00:43:47,800 --> 00:43:56,360
just kind of get the buy-in of the crews. And I feel I was successful with that. But there was

429
00:43:56,360 --> 00:44:04,760
some strain there. And it was interesting, the fire chief at the time said, I'm hiring you

430
00:44:04,760 --> 00:44:14,760
to be our change agent. We got to do something different here. And so I was just trying to

431
00:44:14,760 --> 00:44:23,000
get that change there. And that was a tough feat to get that change there.

432
00:44:25,640 --> 00:44:34,200
And so I mentioned budget cuts. So the budget cuts were coming. Oregon has some weird tax laws,

433
00:44:35,640 --> 00:44:41,640
not weird, but some tax limiting tax laws that don't allow government agencies to keep up with

434
00:44:41,640 --> 00:44:48,600
inflation. So what that causes is that the majority of public agencies within the state of Oregon have

435
00:44:48,600 --> 00:44:55,000
levies and bonds. And those are three to five year terms that you have to revote in every time.

436
00:44:56,280 --> 00:45:08,360
And so very quickly, a levy was probably not going to pass. And the idea was to just get rid of the

437
00:45:08,360 --> 00:45:14,920
battalion chief program. And since I didn't promote through that system, I didn't have any

438
00:45:14,920 --> 00:45:19,560
bump back rights to go back on the fire engine. So I started looking for a job really quick.

439
00:45:20,280 --> 00:45:28,520
Because I saw that I probably wasn't going to have a job pretty soon. So the city of Vancouver,

440
00:45:29,240 --> 00:45:38,040
just across the river here in Oregon, was hiring. And so I put in my name. And it was a really long

441
00:45:38,040 --> 00:45:43,560
process. It took a year. So it was from the time I interviewed to the time I started my job was

442
00:45:44,360 --> 00:45:54,120
11 months later. And they actually had had a deputy chief resign in the middle of the

443
00:45:54,120 --> 00:46:00,840
division chief hirings. So they had to kind of pause the division chiefs and get a deputy

444
00:46:00,840 --> 00:46:09,080
hired first. So it just kind of prolonged things. But in 2017, I moved to Vancouver fire

445
00:46:10,120 --> 00:46:17,240
and as the EMS chief. And it's been great. I mean, I can't say enough about the department

446
00:46:18,040 --> 00:46:23,480
and about the humans that work there. It's been amazing.

447
00:46:23,480 --> 00:46:30,840
When you talked about the Black Tar heroin, I had Sam Quinones on the show who wrote Dreamland. And

448
00:46:30,840 --> 00:46:37,480
from what we've seen, and obviously, Dope Sick is another great story on the prescription side that

449
00:46:37,480 --> 00:46:45,000
led to Black Tar. Was the Oregon crisis created by the prescription by the Ocicontin, that kind

450
00:46:45,000 --> 00:46:53,320
of thing that so many other parts of the country saw? Assumably. I don't know the statistics on it.

451
00:46:53,320 --> 00:47:04,680
Assumably. And just from my own personal story, my ex-wife transitioned from prescription

452
00:47:04,680 --> 00:47:12,440
painkillers to more illicit street drugs. And that was because the doctors were finally cutting her

453
00:47:12,440 --> 00:47:19,960
off. And it just led down a darker and darker road. And unfortunately, I don't think she's found

454
00:47:19,960 --> 00:47:24,920
that sobriety fully yet. We don't really have any contact with her anymore.

455
00:47:26,040 --> 00:47:36,120
But and just seeing that firsthand, I think sometimes we want to sensationalize that the

456
00:47:36,120 --> 00:47:43,880
opiate crisis, whether it was in the 90s with the Black Tar all the way up through the Oxycodones

457
00:47:43,880 --> 00:47:53,320
and Norcos up to Fentanyl and Parafentanil now, it's not just on the street. It's in the million

458
00:47:53,320 --> 00:48:02,600
dollar home. It's the businessman. We actually in Clark County, our Sheriff's Office just had one

459
00:48:02,600 --> 00:48:11,560
of their commanders found at his desk overdosed and died. And there was Fentanyl crushed up on

460
00:48:11,560 --> 00:48:22,440
his desk. So he was snorting Fentanyl from his desk. So I don't think that it's just on the street.

461
00:48:22,440 --> 00:48:28,920
And sometimes it gets sensationalized that way. I think it's in our neighborhoods. It's in these

462
00:48:28,920 --> 00:48:34,760
houses. It's in our schools. I think it's much bigger than just the streets.

463
00:48:35,400 --> 00:48:40,760
Yeah. Yeah. I know Johann Hari did a great job of showing. And this is just a sad truth.

464
00:48:40,760 --> 00:48:47,880
When it was the crack epidemic in LA and New York and some of these other places were real hot spots,

465
00:48:48,520 --> 00:48:53,960
it was obviously viewed as a poor person's disease and arguably even certain races.

466
00:48:53,960 --> 00:49:00,360
But when the Oxycontin crisis, when the opioid crisis came in, all of a sudden it wasn't rich

467
00:49:00,360 --> 00:49:05,000
or poor. It wasn't poor. Excuse me. It was rich and middle class and it was black and white and gay

468
00:49:05,000 --> 00:49:09,720
and straight and Christian and Muslim. It was everyone, which is the reality of addiction.

469
00:49:09,720 --> 00:49:14,680
But up until that point, I think people have been allowed to be duped into the fact that

470
00:49:14,680 --> 00:49:19,800
addiction is a poor person's issue. But it's not. And there's as many wealthy

471
00:49:20,760 --> 00:49:24,920
alcoholics as there are poor alcoholics. Addiction is a mental health crisis that

472
00:49:25,480 --> 00:49:32,520
goes beyond any sort of borders whatsoever. Of course. And our family is a living testament

473
00:49:32,520 --> 00:49:45,480
to that. Every all 10 of us in our household are a product of addiction. And so it is truly everywhere.

474
00:49:46,760 --> 00:49:51,880
Well, let's start with that topic then as far as Vancouver. So you've had such a story career up

475
00:49:51,880 --> 00:49:59,160
to this point from volunteer, paid on call, the EMS side, the fire side. Now you're in Vancouver.

476
00:49:59,160 --> 00:50:03,720
What are some of the proactive things that you're putting into place when it comes to the addiction

477
00:50:03,720 --> 00:50:16,520
side? Yeah. So the addiction side, we have a high rate of opiate problem. Again, not just on the

478
00:50:16,520 --> 00:50:27,160
streets. And we're responding to two or three overdoses a day in our system. We're 11 stations.

479
00:50:27,160 --> 00:50:39,320
We have 19 companies in those 11 stations. We have about 220 humans. And we run about 40,000

480
00:50:39,320 --> 00:50:48,120
calls a year. So we're a busy system. We're fire-based. And so everything's ALS from our

481
00:50:48,120 --> 00:50:55,320
squads to our truck companies. And so we have a minimum staff of at least one medic on all those

482
00:50:55,320 --> 00:51:01,880
rigs. And then we have a public-private partnership that we own the contract for the ambulance

483
00:51:01,880 --> 00:51:07,640
transport and our current provider is American Medical Response, who I believe we have an amazing

484
00:51:07,640 --> 00:51:15,400
relationship with. And comparatively to what you see throughout the nation, some of the street wars

485
00:51:15,400 --> 00:51:25,480
that will happen between private and public. So as far as the opiate response, again, two to three

486
00:51:25,480 --> 00:51:34,360
times a day, our crews are responding to that. And there's just, I think, there's a lack of

487
00:51:34,360 --> 00:51:41,080
coordination between all the resources. So the crisis teams aren't talking to the homeless

488
00:51:41,080 --> 00:51:45,000
response teams that aren't talking to the police department, that aren't talking to the fire

489
00:51:45,000 --> 00:51:50,200
department that aren't talking to the ambulance. So there's zero coordination. And then the

490
00:51:50,200 --> 00:51:56,920
hospitals are doing their own thing. So the big piece was really bringing together

491
00:51:58,440 --> 00:52:05,480
all those players into one space. So we implemented, about 10 years ago, we implemented

492
00:52:05,480 --> 00:52:11,000
a crisis response team coordination meeting that brings together all of those players.

493
00:52:11,000 --> 00:52:19,960
Because we're all going on the same people, but how do we coordinate better to provide them,

494
00:52:20,520 --> 00:52:31,720
the patient, the best access? Or when somebody new hits the streets. Everybody has a loyal customer

495
00:52:31,720 --> 00:52:41,080
or a frequent flyer that they go on consistently. And so it's just a matter of time before we all

496
00:52:41,080 --> 00:52:47,240
start seeing that same person. So that has been a great group. That was kind of a starting point,

497
00:52:47,240 --> 00:52:56,200
was having some of that crisis integration. And then the next piece that we implemented

498
00:52:56,200 --> 00:53:02,360
at the beginning of the year was a leave at home Narcan program. So anytime our crews

499
00:53:03,560 --> 00:53:11,640
deliver Narcan in the field and get a response back from the patient, they're offered a leave

500
00:53:11,640 --> 00:53:21,080
at home Narcan nasal spray kit that's left with them. The hope there is that they have that

501
00:53:21,080 --> 00:53:28,280
available to them in the case of overdosing again. Because again, the addict, especially with opiates,

502
00:53:29,400 --> 00:53:34,680
has a total brain fog. Their receptors are completely different rewired when they're

503
00:53:34,680 --> 00:53:41,960
addicted to the opiate. So when we give them Narcan in the field, we send them into withdrawal.

504
00:53:42,680 --> 00:53:48,600
So they're dope sick. They're hating life. So the only thing they're thinking about at that point

505
00:53:48,600 --> 00:53:53,960
is getting high again. So a lot of times we'll revive somebody and before we can even get a

506
00:53:53,960 --> 00:53:59,320
refusal, they're walking off down the street and they're going to find their next high because they

507
00:53:59,800 --> 00:54:12,360
feel like crap. So we wanted to provide that piece. It wasn't as well accepted by the field

508
00:54:12,360 --> 00:54:18,280
as initially thought. Some of our crews actually had some pretty strong political views on it that

509
00:54:18,280 --> 00:54:26,280
were just enabling the addict. So we're in a partnership with the Oregon Department of Health,

510
00:54:28,280 --> 00:54:33,960
I apologize, the Washington Department of Health, and they're providing through grant funding,

511
00:54:33,960 --> 00:54:39,800
they're providing the Narcan kits and we had to apply to get into that program. And during that

512
00:54:39,800 --> 00:54:47,000
interview, you had to do an intake interview, and the gentleman on the other side of the screen,

513
00:54:47,000 --> 00:54:57,720
you could tell probably had a harder life. And so I asked him, hey, obviously there's other programs

514
00:54:57,720 --> 00:55:03,400
like this throughout the state of Washington. What are some hurdles that you're hearing from

515
00:55:03,400 --> 00:55:09,400
the agencies that are utilizing it? And he said exactly what we faced. He said, yeah,

516
00:55:09,400 --> 00:55:14,600
some people have some political stance on it that we're just enabling the addicts. And he goes,

517
00:55:14,600 --> 00:55:19,640
but I'm a walking testament. He goes, it was the fifth time that I had had Narcan that I finally

518
00:55:19,640 --> 00:55:27,000
got clean. I've been clean for 10 years. So utilizing that story is just so powerful,

519
00:55:27,000 --> 00:55:34,040
I think, with the crews. And ultimately at the end of the day, our crews signed up for a job

520
00:55:35,080 --> 00:55:41,720
to protect lives. And sometimes I think we can forget that. And I think there's a lot of different

521
00:55:41,720 --> 00:55:46,360
reasons why, but at the end of the day, we're there to protect lives, whether it's pulling them out of

522
00:55:46,360 --> 00:55:51,800
a house, whether it's Narcanning them for the 15th time, maybe that's the time that it happens for

523
00:55:51,800 --> 00:55:58,600
them. I'll pretty much guarantee you that even if we pulled the same person out of a burning house

524
00:55:58,600 --> 00:56:05,320
five different times, nobody'd have a problem doing that, especially with our crews. But

525
00:56:06,040 --> 00:56:13,080
for some reason, these other kinds of things, I think they struggle a little bit more with.

526
00:56:14,040 --> 00:56:18,760
So our next phase of that, like we talked about, we recognize that that would drive

527
00:56:18,760 --> 00:56:27,320
symptom is a real problem. And so our next phase is here this next month, our county cares team,

528
00:56:27,320 --> 00:56:38,600
so our community paramedics will be rolling out buprenorphine, which is medication assisted treatment.

529
00:56:38,600 --> 00:56:45,560
So what that is, is it's a withdrawal medication that will stay in their system and help kind of

530
00:56:45,560 --> 00:56:54,120
clear that brain fog. And we're still establishing currently like our social work system and our

531
00:56:54,120 --> 00:57:01,080
care, like our crisis center systems and our drug rehabilitation system so we can reconnect with

532
00:57:01,080 --> 00:57:07,640
those individuals post-treatment. And there have been a lot of different systems throughout the

533
00:57:07,640 --> 00:57:13,640
United States that have done this program. San Francisco was kind of the forefront of that.

534
00:57:13,640 --> 00:57:19,240
And Contra Costa County area of California, they kind of started that through their public health

535
00:57:19,240 --> 00:57:28,040
system years ago. But it has stayed in the hands of those community paramedics. What we're going

536
00:57:28,040 --> 00:57:34,680
to attempt to do in Clark County is put it on every fire apparatus so every paramedic in the county

537
00:57:35,400 --> 00:57:41,640
can give that treatment. So we're going to do that quick trial with our community paramedics.

538
00:57:41,640 --> 00:57:49,720
First and then we'll be rolling it out the first of the year countywide, which is different.

539
00:57:51,720 --> 00:57:56,600
Hopefully we have a better response from that, that we can get people

540
00:57:58,120 --> 00:58:04,440
clear enough to be able to accept the help. Their addictions at that point are so harsh

541
00:58:04,440 --> 00:58:11,400
that they're not thinking clearly. And obviously for somebody to get help, they need to have a

542
00:58:11,400 --> 00:58:17,480
clear mind to be able to want that help and accept that help and have a higher level of success

543
00:58:18,360 --> 00:58:23,960
of receiving the help. So that's what we're doing as far as the opiate crisis in our community.

544
00:58:25,080 --> 00:58:28,600
When you talk about the resistance, this is one thing I struggle with. And I know we talked about

545
00:58:28,600 --> 00:58:35,720
this before. Firstly, it's a waste of Narcan. I literally had someone I used to coach with in

546
00:58:35,720 --> 00:58:40,840
a gym say this about one of her family members. And you hear these stories, like you said,

547
00:58:40,840 --> 00:58:45,080
the person you spoke to, Christina Dent, who I had on recently talking about addiction,

548
00:58:45,080 --> 00:58:51,960
it was amazing because she's a conservative Christian, brought up through that kind of

549
00:58:51,960 --> 00:58:57,240
philosophy doctrine. And she had very opposing views. And it was actually a foster situation

550
00:58:57,240 --> 00:59:02,680
for her too, where she saw how much this mother who was struggling with addiction truly loved her

551
00:59:02,680 --> 00:59:08,280
child. And she ended up overcoming that. But if you just said, oh, she's a waste of Narcan,

552
00:59:08,280 --> 00:59:14,120
that mother never would have survived and that baby would have been motherless. So you have the

553
00:59:14,120 --> 00:59:18,200
compassion fatigue element. And obviously our crews are burnt out. And we're not going to be

554
00:59:18,200 --> 00:59:22,120
talking about that in a minute, how we can mitigate that through work weeks and proactive

555
00:59:23,160 --> 00:59:28,520
telehealth solutions. But the other side, I think, is cultural. And this is what I struggle with.

556
00:59:28,520 --> 00:59:34,920
And I talked about this a lot. I have a faith, a kind of multi spiritual faith, if you like.

557
00:59:35,960 --> 00:59:39,640
And the tenets of what I believe in are kindness and compassion and community and

558
00:59:39,640 --> 00:59:46,520
gratitude and forgiveness that most of them share. What I believe in is that we can all

559
00:59:46,520 --> 00:59:52,280
share. What I don't understand as a nation is how you can leave a synagogue or a church

560
00:59:53,000 --> 00:59:57,720
after listening to the teachings of, for example, Jesus, who was out there amongst the people,

561
00:59:57,720 --> 01:00:04,040
giving everyone as many chances as they needed. And then you can say, we're wasting Narcan on

562
01:00:04,040 --> 01:00:10,200
addicts. So culturally, within the fire service and then within the nation, I think a lot of us

563
01:00:10,200 --> 01:00:14,200
need to take a step back, look in the mirror and ask this question. If it was your family member,

564
01:00:14,200 --> 01:00:17,960
would you give up after five Narcans? If it was one of your brother or sister firefighters,

565
01:00:17,960 --> 01:00:23,240
would you say five is enough? Of course you wouldn't. So why won't you have that same mentality

566
01:00:23,240 --> 01:00:30,200
to the people that you're actually paid to respond to? Yeah. And I think compassion fatigue is there,

567
01:00:30,200 --> 01:00:38,040
right? And I think that that when that is hitting those crews, I think that that is definitely on

568
01:00:38,040 --> 01:00:45,560
that forefront of the reasoning of why they were feeling those ways. But yeah, I can't agree with

569
01:00:45,560 --> 01:00:57,720
you more as far as like, I have a strong faith myself, James, and Jesus was not out there helping

570
01:00:57,720 --> 01:01:05,400
the rich, right? Like he was in the trenches helping the murderers and the rapists and the

571
01:01:05,400 --> 01:01:14,760
adulterous and the prostitutes, right? And if we're going to really make a dent from a faith base,

572
01:01:15,560 --> 01:01:29,400
I really believe that that's where our approach needs to really be. So yeah, I think moving

573
01:01:29,400 --> 01:01:35,640
forward with like our opiate problems, I think like sharing this information with our crews,

574
01:01:36,440 --> 01:01:42,520
sharing like some of these stories of the people getting help, like as this program develops more,

575
01:01:42,520 --> 01:01:47,720
especially the medication assisted side of it, like that, oh, wow, like this person really did

576
01:01:47,720 --> 01:01:56,040
get the care that they needed and they're a thriving member of society now. I really think

577
01:01:56,040 --> 01:02:03,000
that those are going to be part of that storyline to really, I guess, change that narrative.

578
01:02:04,840 --> 01:02:07,640
Well, I love that idea of is it buprenorphine? Have I got that right?

579
01:02:08,920 --> 01:02:13,000
Yeah, because I hadn't heard of that. That wasn't in the discussion when I was working. I actually

580
01:02:13,000 --> 01:02:19,640
just saw today is my six-year anniversary of transitioning out of a paid fire department. But

581
01:02:19,640 --> 01:02:25,320
I, you know, the number of overdoses I used Narcan on, I mean, I'd say that in the fire service,

582
01:02:25,320 --> 01:02:31,080
you truly save lives when you use Narcan. I mean, I'm okay. And at Dunkin Donuts once having to

583
01:02:31,080 --> 01:02:37,960
any do an EJ is before the, you know, the mad device. And, you know, the woman was so pissed off

584
01:02:37,960 --> 01:02:41,960
because I'd ruined her high. She had like two breaths per minute. You know, she was literally

585
01:02:41,960 --> 01:02:48,760
moments from death, but, and another one that filled my rescue with everything from every orifice

586
01:02:48,760 --> 01:02:55,080
possible after she came around, you know, so it's, it is a violent snatch back to reality. So then to

587
01:02:55,080 --> 01:03:00,200
be able to temper that with a transition drug. I mean, that's, that's genius.

588
01:03:01,240 --> 01:03:08,840
Yeah. Yeah. And it's not new, right? Like, you know, Suboxone is, is, you know, the trade name.

589
01:03:08,840 --> 01:03:13,480
It has been around forever, you know, you know, for a really long time and they've used that,

590
01:03:13,480 --> 01:03:19,640
but it's been more in a clinical setting, you know, and now we can take it to the field. So,

591
01:03:20,440 --> 01:03:24,360
and getting like medical oversight, you know, through like our medical program directors.

592
01:03:24,360 --> 01:03:30,280
So, you know, that, that, I think that's where the difference is, because as I said, you know,

593
01:03:30,840 --> 01:03:35,400
probably even back when you were, you know, out in the field, most of the time when you Narcan

594
01:03:35,400 --> 01:03:42,200
these people, you would take them to the hospital, right? And right now, a very small majority

595
01:03:42,200 --> 01:03:49,320
go to the hospital post Narcan. So, so like the hospital doesn't have the opportunity to get them

596
01:03:49,320 --> 01:03:55,320
connected with social work and get them started on those treatment plans, right? Whereas us in the

597
01:03:55,320 --> 01:04:00,200
field, we can do that. Like we can be out there and we can provide that. And can we make the

598
01:04:00,200 --> 01:04:07,000
difference? Again, I'm worried that we don't have enough support for them. You know, there's not

599
01:04:07,000 --> 01:04:15,800
enough facilities to take them to. There's not enough social workers to help them and navigate

600
01:04:15,800 --> 01:04:22,760
those convoluted systems, depending on if they're on Medicaid or Medicare or, you know, a state

601
01:04:22,760 --> 01:04:29,800
funded healthcare system or, or private insurance. You know, there's just some barriers there that I

602
01:04:29,800 --> 01:04:37,000
think we need to find approaches to help break down those barriers and make it as easy as possible

603
01:04:37,000 --> 01:04:43,240
for that person in crisis for that glimpse that that medication can provide of clarity, you know,

604
01:04:43,240 --> 01:04:53,240
because that's our target time. We've got to get in there with the appropriate services to hopefully

605
01:04:53,240 --> 01:05:00,200
help that person get that help. It's amazing how many issues that we struggle with, you know,

606
01:05:00,200 --> 01:05:06,520
globally really stem from a philosophy as false economy. And, you know, some people are making a

607
01:05:06,520 --> 01:05:12,920
lot of money and I always talk about the obesity epidemic that we have. That's extended to England

608
01:05:12,920 --> 01:05:19,080
or to the UK. And to me, the NHS is the most beautiful altruistic healthcare system on the

609
01:05:19,080 --> 01:05:24,760
planet, but at its core, it's relying on the fact that there's a push to make the nation as healthy

610
01:05:24,760 --> 01:05:29,560
as possible. So you don't dip into the taxpayers money until you absolutely need it, you know,

611
01:05:29,560 --> 01:05:34,120
expectant mothers and taking care of the elderly and God forbid, you know, car crash or cancers.

612
01:05:34,680 --> 01:05:40,840
But the general population, you want to keep healthy. That's where the money is by not using

613
01:05:40,840 --> 01:05:47,400
a system. There is the money. But if you, as the UK is seeing now, allow your, you know, your

614
01:05:47,400 --> 01:05:53,640
nation to get fat and sick, now you become an absolute drain. And so what we've seen in,

615
01:05:53,640 --> 01:05:59,160
you know, in the addiction world is the prison systems that are making a huge amount of money.

616
01:05:59,160 --> 01:06:03,640
You know, you see the war on drugs, there's a shitload of money in the war of drugs itself.

617
01:06:03,640 --> 01:06:08,040
These are all reactive. They are not solving the problem. So when people say, oh, we're going to,

618
01:06:08,040 --> 01:06:13,000
you know, we're gonna need more taxpayers money like, no, we just need to take you from downstream

619
01:06:13,000 --> 01:06:17,560
where it's not working and you know, it's not working and move it upstream. And it's the same

620
01:06:17,560 --> 01:06:22,360
conversation with the firefighter work week, you're destroying your firefighters. We need to take that

621
01:06:22,360 --> 01:06:29,400
money from downstream and give my opinion, an extra shift to 24 72. And there's going to be money

622
01:06:29,400 --> 01:06:33,480
left over. And you talked about, you know, brand out stations and those kinds of things. All those

623
01:06:33,480 --> 01:06:37,880
stations will be open. All those rigs will have three or four people on at that point. But if we

624
01:06:37,880 --> 01:06:43,720
continue to allow, you know, something that is just clearly not working and the war on drugs,

625
01:06:43,720 --> 01:06:48,760
I mean, the thirties is when it started. So we're talking, you know, 80 90 years by this point

626
01:06:48,760 --> 01:06:55,000
of a longitudinal study by proactively. And that means courageously taking that money and putting

627
01:06:55,000 --> 01:07:00,840
it at the front, investing in your fire department, in your nation. That is how you fix it. You don't

628
01:07:00,840 --> 01:07:03,960
need more money. You just need to use your resources wisely.

629
01:07:03,960 --> 01:07:13,880
Yeah, I agree. I agree. Yeah. And I, you said a lot of things there. So the, yeah,

630
01:07:16,120 --> 01:07:23,080
obviously the funding, as we kind of talked about earlier, you know, as that money gets shuffled

631
01:07:23,960 --> 01:07:28,040
through a system, right through whatever machine that money is getting shuffled through, right,

632
01:07:28,040 --> 01:07:33,880
there's just everything that's going to be shuffled through. And so, you know,

633
01:07:33,880 --> 01:07:42,040
every hand in the world, you know, grabbing ahold of it, you know, and, and then sometimes that

634
01:07:42,040 --> 01:07:48,040
money, especially in a government level, gets so watered down, trying to appease as many people

635
01:07:48,040 --> 01:07:56,040
as possible that there's not enough to get it right. You know, and again, like that coordination

636
01:07:56,040 --> 01:08:02,440
of looking at that big picture, right? Like if we can do all of these things, we would have the

637
01:08:02,440 --> 01:08:11,880
funding for whatever passion project was there to make things better, right? And sometimes we can

638
01:08:11,880 --> 01:08:19,960
even be our own worst enemies, you know, with, you know, I fully support and agree with work week

639
01:08:19,960 --> 01:08:27,880
reductions, both at the, you know, at the chief officer levels and in the 40 hour environments

640
01:08:27,880 --> 01:08:35,240
and at the shift level environments. And, but sometimes, like, again, we can be our worst

641
01:08:35,240 --> 01:08:43,000
enemies with that, but maybe, maybe we don't want to negotiate down our work week because we want

642
01:08:43,000 --> 01:08:51,320
more pay. Or we, this time we want to go after work week reductions, but we don't want to go after pay,

643
01:08:51,320 --> 01:08:59,800
you know, so it's all this big negotiated, you know, ship or not limiting our work hours, right?

644
01:09:00,680 --> 01:09:07,960
You know, I, across my desk yesterday, an email came about we, our firefighters are allowed to work

645
01:09:07,960 --> 01:09:18,680
96 hours in a row with a 12 hour break. And this individual had worked 218 overtime hours in a two

646
01:09:18,680 --> 01:09:25,880
week period. He's choosing to do that, right? Like, we're not, he's not being mandatory. None of those

647
01:09:25,880 --> 01:09:37,080
were mandatory shifts. But here is an individual, he is a paramedic, he is a driver that is literally

648
01:09:37,080 --> 01:09:46,520
has had like three 12 hour breaks, you know, in a 14 day cycle, you know, which is just asinine to me.

649
01:09:46,520 --> 01:09:53,640
And, you know, so at like, at what point do we help save each other from ourselves, you know, with

650
01:09:53,640 --> 01:10:00,040
that, I'm sure he will have a very nice paycheck and his retirement will be boosted and all of

651
01:10:00,040 --> 01:10:06,680
those things. And by him voluntarily taking those shifts, it didn't mandatory somebody into those

652
01:10:06,680 --> 01:10:16,520
shifts. But I think that there are things that we can do to save us from ourselves.

653
01:10:17,720 --> 01:10:22,360
I mean, this is that this is why I think this has been a sticking point is this conversation goes

654
01:10:22,360 --> 01:10:28,520
from the new hire all the way through to the city and county managers and everyone in between chiefs

655
01:10:28,520 --> 01:10:33,480
and you know, everyone below that, because the answer is yes, every single one of us needs to do

656
01:10:33,480 --> 01:10:37,640
our part. And I've talked about this a lot. Firefighters need to stop going around telling

657
01:10:37,640 --> 01:10:43,720
the world that we have the best shift schedule ever, because we don't. It's awful. Absolutely awful.

658
01:10:43,720 --> 01:10:49,160
You know, the when it comes to the shifts, you know, the chiefs have got to stop saying, well,

659
01:10:49,160 --> 01:10:53,320
if we give them more time off, they'll just work more. If there's all that overtime available,

660
01:10:53,320 --> 01:10:58,440
that means that there's, you know, a huge issue when it comes to staffing that they have so much

661
01:10:58,440 --> 01:11:01,800
overtime available in the first place, you know, those should be filled. If there's a need, an

662
01:11:01,800 --> 01:11:07,320
ongoing need that should be with a paid person in that position. And I think the overtime absolutely

663
01:11:07,320 --> 01:11:12,280
comes around when you have the wildfires and the hurricanes and the earthquakes and all the things

664
01:11:12,280 --> 01:11:16,280
where we have to kiss our families goodbye and say, I need to be there. I need to do the extra

665
01:11:16,280 --> 01:11:22,920
stuff today. But this is the problem is, you know, when when it comes to my rank, the firefighter,

666
01:11:23,560 --> 01:11:28,600
if you're pushing against wellness and wellness initiatives, because you're living above your

667
01:11:28,600 --> 01:11:33,640
means, you need that money, then you need to figure out another way of getting that money.

668
01:11:33,640 --> 01:11:38,840
Because if you give if we fight for this rest and recovery that we need, that gives you a

669
01:11:38,840 --> 01:11:43,640
beautiful opportunity to become an entrepreneur and do something else that you love on the side

670
01:11:43,640 --> 01:11:47,960
that puts you in your home with your children and your wife or your husband or your partner,

671
01:11:48,520 --> 01:11:54,200
getting a good night's sleep to get up the next day and go hang drywall sculpt logs with a chainsaw,

672
01:11:54,200 --> 01:12:00,360
whatever your thing is, that, you know, you're not is not going to be detrimental to you.

673
01:12:00,360 --> 01:12:05,320
So when people complain about the overtime, this is my thing. It's like that was never supposed to

674
01:12:05,320 --> 01:12:11,240
be when you when you signed up, it said salary is this. And you've allowed yourself to devolve and

675
01:12:11,240 --> 01:12:16,360
become part of the problem when it comes to the staffing. What we need to do is create an

676
01:12:16,360 --> 01:12:21,240
environment that really draws people back to the profession, just like when you were testing when I

677
01:12:21,240 --> 01:12:26,360
was testing so that they you know, we are fully staffed and occasional overtime, which is great

678
01:12:26,360 --> 01:12:32,440
once in a while. Perfect. And then not only will that second entrepreneurial project, if you need

679
01:12:32,440 --> 01:12:37,640
it, allow you to make money on the side, but it also gives you a new tribe. So when you transition

680
01:12:37,640 --> 01:12:42,520
from the job, whether you're fired, whether you retire, whatever it is, you have that next thing

681
01:12:42,520 --> 01:12:49,960
to go to, but to go all in, in the fire service at the detriment of you never being home. As a

682
01:12:49,960 --> 01:12:54,360
firefighter, we have to look ourselves in the mirror and go, I can't do that anymore because

683
01:12:54,360 --> 01:13:00,040
I'm screwing every single other man and woman in this department by my self-serving attitude.

684
01:13:02,520 --> 01:13:08,840
Yeah, no, that's that's true. That is definitely true. And again, I think that comes back to being

685
01:13:08,840 --> 01:13:21,320
purposeful with your system. Right. And it kind of like root causes back to recruitment. So we were

686
01:13:21,320 --> 01:13:29,240
fortunate two years ago to float a ballot measure that added a third truck and added three paramedic

687
01:13:29,240 --> 01:13:34,440
squads. And at the same time, some general fund money came in that we were able to add an 11th

688
01:13:34,440 --> 01:13:41,880
engine. So that added all those positions. We're a four platoon system, you know, with like a 46 and

689
01:13:41,880 --> 01:13:49,240
a half hour work week, you know, that keeps getting negotiated down. Obviously, hopefully the goal is

690
01:13:49,240 --> 01:13:54,920
at some point to get to the 42 hour work week that that they wouldn't have any debit days that they

691
01:13:54,920 --> 01:14:01,800
needed to pay back. So so we've been transitioning through that that four platoon system since 2017.

692
01:14:01,800 --> 01:14:11,880
Or 2018, January 2018. So it's, you know, but when we hired all these positions, obviously, we also

693
01:14:11,880 --> 01:14:17,640
were dealing with our attrition at the same time of retirements. So we were down all of these

694
01:14:17,640 --> 01:14:24,040
positions, we had made promises to get those rigs into service as quickly as possible. So back in

695
01:14:24,040 --> 01:14:31,560
January of this year, we actually staffed our third truck and our third squad. And we were able to

696
01:14:31,560 --> 01:14:40,280
get it into service. And then we had to move on to the fourth squad without the people. So those

697
01:14:40,280 --> 01:14:50,120
those two rigs across all, you know, four shifts are staffed with overtime. And so on top of we can

698
01:14:50,120 --> 01:14:55,880
have 12 people off per shift and all of the other things that happen within the labor contract. So

699
01:14:55,880 --> 01:15:03,800
we had to move on to the fourth squad. And because before the firefighters all rotated through the

700
01:15:03,800 --> 01:15:12,600
driver position. So, so that, and at the same time, we went for class for class overtime. So now the

701
01:15:12,600 --> 01:15:20,200
pool got smaller of people that could be available for those shifts. And because of promotions and

702
01:15:20,200 --> 01:15:29,000
rank, not having all those positions is probably the one that has hit the hardest every day with

703
01:15:29,000 --> 01:15:37,400
mandatories. So coming back to recruitment, so we recruit all these individuals, we get them into

704
01:15:37,400 --> 01:15:42,600
our academy, one of the things that we've seen over multiple academies now are pre existing injuries

705
01:15:42,600 --> 01:15:50,040
that come to the forefront. We have a very aggressive 18 week academy. We really hold a high

706
01:15:50,040 --> 01:15:59,080
bar, our training cadre does an amazing job. And we are, people are breaking. And it's not because

707
01:16:01,080 --> 01:16:05,880
it's not because we're doing something wrong, like on the training ground, or that we're not being

708
01:16:05,880 --> 01:16:12,280
purposeful with warmups and stretching and functional fitness and all of those things.

709
01:16:12,280 --> 01:16:18,680
It's that literally these people are broken coming in. And so we've worked with like our medical

710
01:16:18,680 --> 01:16:26,280
provider that does our physicals and put more focus on looking at pre existing conditions.

711
01:16:27,800 --> 01:16:32,280
But if the candidate doesn't advise of that during their medical physical,

712
01:16:32,280 --> 01:16:37,320
then we don't know about it. And then they come in and all of a sudden we get a recruit that says,

713
01:16:38,600 --> 01:16:45,320
I can't do burpees. I have like a torn rotator cuff. I can't do a burpee.

714
01:16:47,320 --> 01:16:52,760
So like all, well, did you disclose that in your medical physical that you had a torn rotator cuff?

715
01:16:53,400 --> 01:16:59,400
No, he never asked. So we've actually had these 30 person academies,

716
01:16:59,400 --> 01:17:08,680
that like we were only graduating 20 to 25. And so that's been a real struggle. So then we're just

717
01:17:08,680 --> 01:17:14,360
each academy, we think we're going to gain some ground, but then we're still down five and we're

718
01:17:14,360 --> 01:17:21,240
still down five from the last one. And we're trying to catch up with that. And until that happens,

719
01:17:21,240 --> 01:17:27,320
that we can get enough quality candidates in there, that we're going to be able to get

720
01:17:27,320 --> 01:17:33,080
the right candidates. That we're going to continue to have the mandatories. We're going to continue

721
01:17:33,080 --> 01:17:39,240
to have the reduction of that staff that aren't able to fill those positions. And I agree with

722
01:17:39,240 --> 01:17:45,800
you, James. My worry is like looking upstream that we're just going to have compounding issues

723
01:17:46,680 --> 01:17:54,280
with our mental health of our people, our burnout, our people just quitting and going

724
01:17:54,280 --> 01:18:04,840
back to the profession. And I hate to see that, the investment that both the candidate and the

725
01:18:05,640 --> 01:18:13,800
city put into these people to get them through their first year, is huge. And for them not to

726
01:18:13,800 --> 01:18:22,040
make it, is hard. And we have no qualms our organization is aggressive. We have no qualms

727
01:18:22,040 --> 01:18:30,320
not making it. We have a very thorough performance appraisal system during the academy and they

728
01:18:30,320 --> 01:18:35,380
get put on a performance improvement plan pretty quick and if they don't remediate to

729
01:18:35,380 --> 01:18:47,000
that plan, then we cut our ties. So we do our effort to try to help them, but at the

730
01:18:47,000 --> 01:18:57,000
end of the day we can't help, then they're let go.

731
01:18:57,000 --> 01:19:02,480
What is your physical entrance test? Is it the CPAT or?

732
01:19:02,480 --> 01:19:09,080
It is. It is. And so we're concerned about it and we're bouncing everything off. Our

733
01:19:09,080 --> 01:19:16,040
current fire chief came from CAL FIRE and so he's a big BIDL test guy. So we have been

734
01:19:16,040 --> 01:19:21,360
evaluating the BIDL, we've been evaluating the CPAT and then we've also been evaluating

735
01:19:21,360 --> 01:19:30,280
going back to our own in-house physical agility test. Or a mixture of all of them. It's like

736
01:19:30,280 --> 01:19:36,520
the first pass, like a CPAT, that they come in with their CPAT and then as we get close

737
01:19:36,520 --> 01:19:43,040
to job offer, we bring them back and we do an in-house physical. Like kind of maybe a

738
01:19:43,040 --> 01:19:50,920
work hardening or work performance type test and just really kind of see where their functional

739
01:19:50,920 --> 01:19:59,200
fitness is. Just to try to eliminate some of those that should have never hit the line

740
01:19:59,200 --> 01:20:03,960
and should never have hit the academy. Because that just endangers everybody else out there

741
01:20:03,960 --> 01:20:08,360
on that drill ground if they're not whole coming in.

742
01:20:08,360 --> 01:20:12,960
Well, I'm assuming as well there's probably some that could be. They're just not and they

743
01:20:12,960 --> 01:20:16,360
need the time or the direction. So I don't know if you've, have you heard of the functional

744
01:20:16,360 --> 01:20:17,960
movement screen FMS?

745
01:20:17,960 --> 01:20:18,960
Yes.

746
01:20:18,960 --> 01:20:23,520
Yeah. So I mean, maybe even some of those somewhere along the way, because I mean, I, it's funny,

747
01:20:23,520 --> 01:20:29,520
I just came across it a couple of days ago. I did the CPAT thinking I'm going to have

748
01:20:29,520 --> 01:20:33,200
to go back to the fire service because I'm not going to have any pension money left after

749
01:20:33,200 --> 01:20:40,520
I left because I cashed it out to do this. And so I went and did it. And at 45 years

750
01:20:40,520 --> 01:20:45,480
old, I was, the time was 720. And this is again, this is not, every time I sound like

751
01:20:45,480 --> 01:20:51,680
I'm bragging, it's not, it's just the 1020 should not be like everyone high-fiving yourself.

752
01:20:51,680 --> 01:20:58,320
Like that's a very substandard performance in the CPAT. So the way that you really get

753
01:20:58,320 --> 01:21:01,520
that time down to where it should be is that you have the strength, you have the fitness,

754
01:21:01,520 --> 01:21:05,200
you have the mobility that allows you to breeze through that test. Because the CPAT is not

755
01:21:05,200 --> 01:21:10,000
a hard test. So, you know, if you're getting people that are getting through the CPAT that

756
01:21:10,000 --> 01:21:15,280
clearly are still deconditioned or hiding injuries, then it sounds like, yeah, another

757
01:21:15,280 --> 01:21:20,120
layer of kind of a, rather than just a medical, you know, where someone's just, you know,

758
01:21:20,120 --> 01:21:24,760
it's getting you to bend over and cough like an actual athletic trainer evaluating these

759
01:21:24,760 --> 01:21:29,160
people to make sure they do have it. And if they don't, you know, just rolling them back

760
01:21:29,160 --> 01:21:32,520
in and saying, well, you're not disqualified, but we need to get you to where, you know,

761
01:21:32,520 --> 01:21:36,600
you overcome that injury. You'd be a good candidate, but you can't go through with these

762
01:21:36,600 --> 01:21:41,920
deficits because yeah, as you said, then you're going to break in 18 weeks of throwing 24s

763
01:21:41,920 --> 01:21:42,920
and dragging hoes.

764
01:21:42,920 --> 01:21:49,640
Yeah, correct. Yep. So that's, I mean, that's where we're at right now. We're evaluating

765
01:21:49,640 --> 01:21:55,360
those pieces and we're learning each academy. Our academies historically were like 10 or

766
01:21:55,360 --> 01:21:59,520
12 people. And, you know, for the last two years, our training division has been pumping

767
01:21:59,520 --> 01:22:05,040
out 30 person academies. So it's just, it's been just an adjustment logistically of like,

768
01:22:05,040 --> 01:22:12,320
how do you get that many people through and get them solid skill sets? And I mean, even

769
01:22:12,320 --> 01:22:18,960
down to the EMS level, as I said before, we minimum staff at one medic per rig. And so

770
01:22:18,960 --> 01:22:26,000
a lot of these candidates that are coming in are medics. And in our county, we require

771
01:22:26,000 --> 01:22:31,240
them to be like a lead medic, like within like their third, like pretty much the first

772
01:22:31,240 --> 01:22:35,200
three months that they're on the line, they're working through a paramedic taskbook with

773
01:22:35,200 --> 01:22:41,320
an FTO. And so that's a lot of pressure for especially a brand new medic fresh out of

774
01:22:41,320 --> 01:22:47,920
school to get them to the point that they're a lead medic in our county is tough. We have

775
01:22:47,920 --> 01:22:53,400
aggressive protocols, we have zero call ins, you know, our medical director allows us to

776
01:22:53,400 --> 01:23:02,120
do a lot, you know, and so we do expect a ton from our paramedics, you know, so giving

777
01:23:02,120 --> 01:23:09,020
them the tools, one of the EMS captains that works with me, that is her only job when they

778
01:23:09,020 --> 01:23:17,240
come out of the academy is she is like 100% assigned to each one of those FTOs of anything

779
01:23:17,240 --> 01:23:23,600
that they need of getting those people up to speed and getting them ready to go.

780
01:23:23,600 --> 01:23:27,880
Speaking of the work week for a second, you're working towards the 42, you're kind of close

781
01:23:27,880 --> 01:23:33,240
already. How does that compare to the agencies around you? Are they still 56?

782
01:23:33,240 --> 01:23:41,280
No, no, our county, our state really, Washington State has been really on the forefront of

783
01:23:41,280 --> 01:23:50,600
work week reductions, you know, and four platoon has been in the, like up in the Seattle area,

784
01:23:50,600 --> 01:23:57,720
have been like 20 years they've been in a four platoon system, you know, so and I think

785
01:23:57,720 --> 01:24:02,440
that that's been a big negotiating tool for the Washington State Firefighters Council

786
01:24:02,440 --> 01:24:09,560
is work week reductions. So I believe there's only currently there's two departments that

787
01:24:09,560 --> 01:24:15,400
are on a four platoon in our county, all working about the same amount of work week, and then

788
01:24:15,400 --> 01:24:21,400
two that are getting ready to transition there, like through their negotiations. And I believe

789
01:24:21,400 --> 01:24:26,800
one other one has it in their labor agreement that they will discuss it next time. But they

790
01:24:26,800 --> 01:24:32,560
do have their Kelly days, right? So, you know, that's been that's been in our system for

791
01:24:32,560 --> 01:24:38,760
20 plus years, were the Kelly days. So, so they were we're getting work reductions, it

792
01:24:38,760 --> 01:24:47,320
just wasn't the four platoon. And the majority of our state is not doing the 2472s, the majority

793
01:24:47,320 --> 01:24:56,240
of our state is doing 24 on 48 off 24 on 96 off. So that's just kind of a schedule that

794
01:24:56,240 --> 01:25:03,760
they have chosen. And I don't I don't know any of the data that went into those decisions,

795
01:25:03,760 --> 01:25:10,400
you know, at the time, but but yeah, so it and I think a lot of it was in regards to

796
01:25:10,400 --> 01:25:17,600
we do have, we have individuals that live in California, Oregon, and Idaho, and Montana.

797
01:25:17,600 --> 01:25:22,360
So I think that they were looking for those longer breaks of time for like travel back

798
01:25:22,360 --> 01:25:24,280
to wherever their home is.

799
01:25:24,280 --> 01:25:28,920
Brilliant. All right, well, then, so that was the work week side, obviously, we're trying

800
01:25:28,920 --> 01:25:34,520
to reduce the amount of time that we literally have to be in the station. The other side

801
01:25:34,520 --> 01:25:40,840
of the conversation is, as you mentioned, you know, 11 stations, 40,000 calls, the immense

802
01:25:40,840 --> 01:25:46,520
workload that we're putting on our first responders. And, you know, the term bullshit call is there

803
01:25:46,520 --> 01:25:50,020
for good reason, because we are called for a lot of things that we should never ever

804
01:25:50,020 --> 01:25:53,680
be called to in the first place doesn't mean that we're not going to respond with compassion

805
01:25:53,680 --> 01:25:58,600
and kindness. But the reality is, it did not need a fire engine with three or four people

806
01:25:58,600 --> 01:26:04,440
to mitigate it, it might have needed an urgent care clinic, or a simple prescription, or,

807
01:26:04,440 --> 01:26:12,200
you know, a talk with a counselor. So talk to me about how you guys have addressed the

808
01:26:12,200 --> 01:26:17,920
less acute calls with the with AMR, because I think this is a solution that is, in my

809
01:26:17,920 --> 01:26:20,040
opinion, should be nationwide.

810
01:26:20,040 --> 01:26:27,880
Yeah, so our first our first jump at it was eliminating low acuity, like priority five

811
01:26:27,880 --> 01:26:34,120
calls for fire response. So we entered into an agreement as part of our contract with

812
01:26:34,120 --> 01:26:40,440
AMR that they would handle those priority five calls by themselves. And we would only

813
01:26:40,440 --> 01:26:45,760
engage if they needed us. So if they got on scene and the acuity was higher, they would

814
01:26:45,760 --> 01:26:51,480
dispatch one of our rigs and we would respond. So that was kind of our first jump. And that

815
01:26:51,480 --> 01:26:58,120
was that was multiple 1000s of calls a year that just dropped off. And it is kind of a

816
01:26:58,120 --> 01:27:07,880
balancing act. Because you constantly have to be tweaking the system, like looking at

817
01:27:07,880 --> 01:27:12,640
your your dispatch protocols and how they're how they're dispatching the call and how they're

818
01:27:12,640 --> 01:27:19,480
intaking the call, you know, and really watching from like a medical direction standpoint of

819
01:27:19,480 --> 01:27:25,120
are we meeting the mark or how many of these call types are ending up getting back, like

820
01:27:25,120 --> 01:27:32,440
getting upgraded or are are like code three returns to the hospital. So just constant

821
01:27:32,440 --> 01:27:38,480
vision on that and like with a with a really strict lens. And, you know, all the way down

822
01:27:38,480 --> 01:27:43,080
to you know, it was it was interesting, the fire chief at the time that like really pushed

823
01:27:43,080 --> 01:27:48,640
for the reduction of priority five calls. Our city hall, like right across the street

824
01:27:48,640 --> 01:27:54,120
from our city hall is a big community park. And on the other side is like some buildings

825
01:27:54,120 --> 01:27:59,200
that have some coffee shops. So he was he was actually himself like that was the big

826
01:27:59,200 --> 01:28:05,560
forefront of the priority five reduction program. He's walking across that park one day and

827
01:28:05,560 --> 01:28:12,340
a guy and he's a past paramedic and and a citizen drops and starts seizing. And he picks

828
01:28:12,340 --> 01:28:17,760
up a cell phone, he calls 911. And and we actually have a fire station at that time,

829
01:28:17,760 --> 01:28:22,920
we had a fire station like a couple of blocks from there. And and he's on the phone with

830
01:28:22,920 --> 01:28:28,000
a 911 dispatcher and and the guy was, you know, coming out of the seizure and talking

831
01:28:28,000 --> 01:28:34,080
to him now. So it gets coded as a priority five call. So no fire response. So he the

832
01:28:34,080 --> 01:28:39,800
chief is even asking like, is is engine one or truck one and station? And they're like,

833
01:28:39,800 --> 01:28:44,480
yeah, they're both available, chief. And and he's like, where are they? And it's a priority

834
01:28:44,480 --> 01:28:50,680
five call chief. You're getting a MR and they're coming from across town. Right. So so even

835
01:28:50,680 --> 01:28:54,080
like, you know, so that just kind of says like, sometimes it's just like it does miss

836
01:28:54,080 --> 01:29:02,200
the mark in that sense. But negative outcomes, we have showed no negative outcomes from that.

837
01:29:02,200 --> 01:29:06,920
So that's been a positive program. The next program that we instilled, we call our red

838
01:29:06,920 --> 01:29:16,120
dot facilities. So and they are like health care facilities, urgent cares, care homes

839
01:29:16,120 --> 01:29:23,200
that have 24 hour like nursing or physician care. We don't respond to those calls. So

840
01:29:23,200 --> 01:29:28,980
we keep a track of those buildings and those structures. You know, we have I think just

841
01:29:28,980 --> 01:29:35,840
over 25 of those buildings and it's just constantly growing and that we just don't even respond

842
01:29:35,840 --> 01:29:40,360
to calls in those. It would be an AMR only like just an ambulance response only to those

843
01:29:40,360 --> 01:29:47,640
facilities because they already have medical care on site. There's no need for first response.

844
01:29:47,640 --> 01:29:54,040
So that that was kind of the second tier of that. The next phase is we rolled out a BLS

845
01:29:54,040 --> 01:29:59,760
pilot with AMR. And that was and all of those attempts were to keep the ALS ambulances available

846
01:29:59,760 --> 01:30:06,600
for the critical calls. So we partnered again with AMR on that and they rolled out three

847
01:30:06,600 --> 01:30:15,800
cars in our system. And then we worked through it in the sense that if the BLS ambulance

848
01:30:15,800 --> 01:30:21,440
is on scene and it ends up being an ALS call, our paramedic would get on that rig and ride

849
01:30:21,440 --> 01:30:27,760
in with them. And that's countywide. And each of those BLS ambulances, part of that negotiation

850
01:30:27,760 --> 01:30:34,000
was them being completely outfitted ALS. So they're outfitted ALS and our crews have access

851
01:30:34,000 --> 01:30:41,320
to all of that equipment. So that's been a favorable program and that has shoveled off

852
01:30:41,320 --> 01:30:47,500
a ton of we call it level zero when there's not an available ambulance for more than three

853
01:30:47,500 --> 01:30:55,120
minutes in our system. Our system goes into level zero. And so that allows like the AMR

854
01:30:55,120 --> 01:30:59,800
to start freeing up ambulances or up staffing their ambulances with like their support staff

855
01:30:59,800 --> 01:31:08,060
or however they're going to manage like the surge that the system could hit. So that took

856
01:31:08,060 --> 01:31:13,880
a ton of that stress level off the system and helped integrate the system better. And

857
01:31:13,880 --> 01:31:21,080
then the third phase of that was a product that AMR provides called nurse navigation.

858
01:31:21,080 --> 01:31:30,760
So that actually occurs at our 911 center. So as they're going through our pro QA dispatching

859
01:31:30,760 --> 01:31:36,440
system, our medical director has allowed certain call types to just be automatically funneled

860
01:31:36,440 --> 01:31:44,760
to the nurse navigation center. And so that links you up with at a minimum a registered

861
01:31:44,760 --> 01:31:52,600
nurse in the state of Washington and all the way up to a PA or a physician at some times

862
01:31:52,600 --> 01:31:57,360
that would then so you would get transferred as that caller over to the nurse navigation

863
01:31:57,360 --> 01:32:02,520
center and there are a couple of different things can happen there. Either the nurse

864
01:32:02,520 --> 01:32:06,800
navigator kind of talks you through it gives you some self care tips and you hang up and

865
01:32:06,800 --> 01:32:14,160
everybody's good to the nurse navigator recognizing oh there's a higher acuity here and they kick

866
01:32:14,160 --> 01:32:20,640
it back to the 911 system and we would do a higher priority response to oh it sounds

867
01:32:20,640 --> 01:32:25,020
like you probably need to go to an urgent care. So they've developed contracts with

868
01:32:25,020 --> 01:32:31,280
all the urgent cares and immediate carriers in our community and they can do scheduling

869
01:32:31,280 --> 01:32:37,520
right through their system. So they could say hey Mr. Gearing looks like you've got

870
01:32:37,520 --> 01:32:42,280
a zoom care right down the street from your house. We can get you in at three thirty.

871
01:32:42,280 --> 01:32:48,760
Does that work for you. And you accept or deny. And then and then we would ask do you

872
01:32:48,760 --> 01:32:53,880
have a ride. And so there's a contract with Lyft so they can come pick you up and take

873
01:32:53,880 --> 01:32:59,400
you directly to your appointment bring you home. And then nurse navigation navigates

874
01:32:59,400 --> 01:33:05,560
that with whatever health insurance or uninsured. They have to that was part of our contract

875
01:33:05,560 --> 01:33:13,080
with them. They have to accept uninsured. So they provide all of that and then all the

876
01:33:13,080 --> 01:33:19,960
way to well you know as you talked about earlier with an obesity crisis you know I'm four hundred

877
01:33:19,960 --> 01:33:26,200
fifty pounds and I can't get in an Uber. Then Amar would send a BLS ambulance to pick them

878
01:33:26,200 --> 01:33:34,080
up take them and bring them back. They also have the ability there to to transition to

879
01:33:34,080 --> 01:33:42,200
a telehealth doctor. So so then they would just enter integrate right into that. So that's

880
01:33:42,200 --> 01:33:47,760
been a really successful program for us. We're still just tinkering with those call types

881
01:33:47,760 --> 01:33:52,760
because some of the call types that we brought in initially almost all of them were getting

882
01:33:52,760 --> 01:33:58,080
pushed back into the 9 1 1 system. And then there was some call types that weren't in

883
01:33:58,080 --> 01:34:03,920
the nurse navigation like criteria that we've just recently put in that had a really low

884
01:34:03,920 --> 01:34:09,360
transport rating that we weren't transporting those patients. So it's just kind of tweaking

885
01:34:09,360 --> 01:34:14,960
those dials all the time to try to find that fine tuning. That product is also available

886
01:34:14,960 --> 01:34:21,560
to our field crews. So our paramedics on the fire trucks or on the ambulances can directly

887
01:34:21,560 --> 01:34:27,680
call into that line on behalf of a patient maybe that they're on that maybe got triaged

888
01:34:27,680 --> 01:34:32,200
really high acuity wise. But when they got there they they do an assessment and they're

889
01:34:32,200 --> 01:34:37,600
like oh hey do you just want to go to an urgent care. And then they put them in touch with

890
01:34:37,600 --> 01:34:43,820
nurse navigation. And so they have a direct line right into that. And so our crews can

891
01:34:43,820 --> 01:34:50,840
access that very easily. So that's how we've been utilizing nurse navigation. It's been

892
01:34:50,840 --> 01:34:58,520
a great product. Right south of us is like the Portland metro area and all of those counties

893
01:34:58,520 --> 01:35:04,800
are also moving to nurse navigation. We were kind of the first ones in our geographical

894
01:35:04,800 --> 01:35:12,680
area to do it. And so it's been a successful program for us so far of reducing again reducing

895
01:35:12,680 --> 01:35:17,760
those calls. I've had a couple of guests on in the past that have talked about a similar

896
01:35:17,760 --> 01:35:22,840
concept but not like I said at a national level there were small kind of startups. But

897
01:35:22,840 --> 01:35:30,040
when I think about what I did for 14 years the number of calls where the medical director

898
01:35:30,040 --> 01:35:33,840
was some places were very aggressive like if they called you just take them to hospital

899
01:35:33,840 --> 01:35:37,960
you know DFO kind of thing. And you think about it now you've got let's say a five

900
01:35:37,960 --> 01:35:45,320
year old with a fever and now that child is going to an ER where the lights are on all

901
01:35:45,320 --> 01:35:50,520
night you might have a drunk and a psych patient either side or whatever it is. The parents

902
01:35:50,520 --> 01:35:55,120
are now getting a huge medical bill for that ER visit and that little girl or little boy

903
01:35:55,120 --> 01:36:02,160
is now taking up a bed that might be needed for a stroke or some true emergency. So there

904
01:36:02,160 --> 01:36:08,480
is no downside. The family gets to stay in their own home assuming again it's appropriate

905
01:36:08,480 --> 01:36:12,360
for that call. They're not getting a massive medical bill they're getting a far smaller

906
01:36:12,360 --> 01:36:18,640
bill. The crew is not being woken up for that call and the ER retains another bed for a

907
01:36:18,640 --> 01:36:23,840
true emergency. So every way you look at this model it makes perfect sense as long as as

908
01:36:23,840 --> 01:36:27,680
you said you're looking at it and adjusting it you know and giving it the attention that

909
01:36:27,680 --> 01:36:32,320
it needs so you're not missing things that are glaring.

910
01:36:32,320 --> 01:36:40,400
Yeah yeah and the other piece of nurse navigation that GMR which is the parent company of AMR

911
01:36:40,400 --> 01:36:49,600
has done really well with it is they do a hundred percent reconnect with that nurse

912
01:36:49,600 --> 01:36:54,640
navigation patient. So they you know a couple days later they have a team that calls and

913
01:36:54,640 --> 01:37:01,960
checks in and sees like you know does quality assurance and their ratings are super high

914
01:37:01,960 --> 01:37:08,800
that the citizen is very much willing and able for that. I mean I think if we look back

915
01:37:08,800 --> 01:37:14,200
historically right like as fires declined you know we had we needed a purpose in the

916
01:37:14,200 --> 01:37:18,680
fire service right. So let's hey let's start running EMS calls you know and that's kind

917
01:37:18,680 --> 01:37:22,360
of been this double edged sword that we were trying to increase our call volume but now

918
01:37:22,360 --> 01:37:26,280
we've just come to this threshold that we're overwhelmed so that now we're looking at okay

919
01:37:26,280 --> 01:37:31,080
how do we reduce our call volume you know and how do we reduce out of some of these

920
01:37:31,080 --> 01:37:35,960
calls. But like you think about it you call your chiropractor you call your your therapist

921
01:37:35,960 --> 01:37:39,360
you call your medical doctor if you get a voicemail that says if this is a life threatening

922
01:37:39,360 --> 01:37:47,280
emergency call 911 like we have to change that narrative and helping people to understand

923
01:37:47,280 --> 01:37:51,680
to make the right call right and providing them the resources of who that right call

924
01:37:51,680 --> 01:37:56,920
could be whether it's a nurse navigation pretty much every private insurance now has

925
01:37:56,920 --> 01:38:01,320
some sort of incentive to use telehealth you know helping people navigate their own health

926
01:38:01,320 --> 01:38:10,400
care system you know. So I think all of those options to help re market you know like like

927
01:38:10,400 --> 01:38:16,040
I look at like fire prevention efforts have been so successful historically you know where

928
01:38:16,040 --> 01:38:21,360
are EMS prevention you know and where are we doing what are we doing to help people

929
01:38:21,360 --> 01:38:26,800
to make that right call know when to call 911 and 911 is not the quick answer because

930
01:38:26,800 --> 01:38:31,640
you can't get into your doctor for two weeks you know that you call 911 because you got

931
01:38:31,640 --> 01:38:39,080
to go back to work right. So trying to eliminate some of that and I think that that therefore

932
01:38:39,080 --> 01:38:45,360
reduces those stressors on our crews because they're not going on that stuff over and over

933
01:38:45,360 --> 01:38:52,680
again and that they really are available for that more critical call.

934
01:38:52,680 --> 01:38:56,960
Absolutely now what about the cost to the fire department some of the models that I've

935
01:38:56,960 --> 01:39:01,840
heard there was no cost it was completely integrated and the billing was taken care

936
01:39:01,840 --> 01:39:08,240
for that particular service was taken care of by that company what is the kind of overall

937
01:39:08,240 --> 01:39:11,680
cost to the fire department in the ones that you're using.

938
01:39:11,680 --> 01:39:18,200
Yeah so with our partnership with AMR we are receiving zero cost to that product so AMR

939
01:39:18,200 --> 01:39:26,560
is absorbing that somewhere and I don't know where I have heard in systems to the south

940
01:39:26,560 --> 01:39:33,760
of us getting quotes in the 10 to 20 thousand dollar range per year for that service you

941
01:39:33,760 --> 01:39:40,080
know because nurse navigation like through DMR will actually even provide that service

942
01:39:40,080 --> 01:39:47,520
if AMR ambulance is not in that geographical area so even if you had your own fire based

943
01:39:47,520 --> 01:39:52,560
transport they would still provide that service to your dispatch center and to your medical

944
01:39:52,560 --> 01:39:59,440
director so I think it all kind of depends on what your system is right. Obviously AMR

945
01:39:59,440 --> 01:40:05,880
is a for-profit company you know so they're making money somewhere on it but for us at

946
01:40:05,880 --> 01:40:12,400
the local level in Clark County we are paying zero for through any of the fire departments.

947
01:40:12,400 --> 01:40:16,480
Yeah now from what I heard again from this other organization that you know that of course

948
01:40:16,480 --> 01:40:21,600
is going to be billing but it's going to be a fraction of the cost for you know ALS transport

949
01:40:21,600 --> 01:40:25,760
from a fire department so you got that bill now you walk through the front doors of ER

950
01:40:25,760 --> 01:40:29,440
so you're talking about thousands for that you know and then god forbid you stay overnight

951
01:40:29,440 --> 01:40:36,600
and get two Tylenol now it's another ten thousand dollars so avoiding you know that hyper inflated

952
01:40:36,600 --> 01:40:40,720
healthcare system that we're all fully aware of which is absolutely pertinent when they're

953
01:40:40,720 --> 01:40:44,920
trying to save your life but not for something that could be addressed in a centric care

954
01:40:44,920 --> 01:40:51,480
or you know some sort of erosion setting. Yeah it's broken James I mean it really it's

955
01:40:51,480 --> 01:40:59,120
broken you know we my wife and I really enjoy to get away to Baja California and so we go

956
01:40:59,120 --> 01:41:03,120
down there a ton you know a couple times a year and we were unfortunately down there

957
01:41:03,120 --> 01:41:10,360
one time and my wife had a kidney stone episode and so we end up in the urgent care in Toto

958
01:41:10,360 --> 01:41:16,560
Santos and you know like the southern tip of Baja and I'm just curious like the whole

959
01:41:16,560 --> 01:41:22,400
time like as she has a private room and a private nurse and they're taking her blood

960
01:41:22,400 --> 01:41:26,680
and doing imaging and they're doing all this stuff right and I'm thinking at the end I'm

961
01:41:26,680 --> 01:41:30,640
like oh man what's this and we had actually it was it was it was kind of a joke between

962
01:41:30,640 --> 01:41:36,480
her and I as she's like in pain with a kidney stone but we're joking because we were supposed

963
01:41:36,480 --> 01:41:40,200
to go to this nice dinner that night and I'm like hey do you think this ER bill is going

964
01:41:40,200 --> 01:41:47,240
to be more or less than our dinner was going to be you know and after all of that imaging

965
01:41:47,240 --> 01:41:57,640
medications and IV an assessment by a physician blood tests it was like $200 US you know so

966
01:41:57,640 --> 01:42:02,640
as you say you know the $10,000 for two Tylenol in our health care system I mean that really

967
01:42:02,640 --> 01:42:11,400
does shine a light on our system is broken and I wish I had an answer of how to get that

968
01:42:11,400 --> 01:42:15,720
fixed but it really is completely broken.

969
01:42:15,720 --> 01:42:20,760
Yeah well again I mean this is the the opposition to create in a healthy society when those

970
01:42:20,760 --> 01:42:24,600
are the prices there's a lot of companies making a lot of money from insurance companies

971
01:42:24,600 --> 01:42:28,680
to you know the hospitals themselves you know I mean all these different you know the prescription

972
01:42:28,680 --> 01:42:34,480
drugs I mean so much money is going in the pockets at the detriment of the American people

973
01:42:34,480 --> 01:42:41,040
so we owe it to you know not only ourselves but our children and grandchildren to turn

974
01:42:41,040 --> 01:42:45,920
the ship to turn it around back to good health where you know your health care will be inexpensive

975
01:42:45,920 --> 01:42:51,720
if it wasn't hyperinflated because there are so many consumers when 70% of the country

976
01:42:51,720 --> 01:43:01,000
is overweight or obese you know then do you just have this endless customer so it's supply

977
01:43:01,000 --> 01:43:06,400
and demand there's so much demand they basically can get away with charging what they want.

978
01:43:06,400 --> 01:43:09,880
Yeah yeah no I fully agree.

979
01:43:09,880 --> 01:43:14,640
So before we go to some closing questions are there any other proactive elements that

980
01:43:14,640 --> 01:43:18,720
you've got going on aside from the ones we've discussed?

981
01:43:18,720 --> 01:43:28,680
Yeah so I try to approach my division that I manage we have two amazing EMS captains

982
01:43:28,680 --> 01:43:34,960
our captains come off the line for up to two years and they can renew if they want if the

983
01:43:34,960 --> 01:43:41,120
daytime shift time stuff works for them and I am also blessed with a great EMS analyst

984
01:43:41,120 --> 01:43:46,880
that kind of helps us compile the data and helps us manage our ambulance contract and

985
01:43:46,880 --> 01:43:55,160
through that team our focus is what can we do to reduce the stress on the street.

986
01:43:55,160 --> 01:44:00,920
So utilizing the captains is kind of the face of the EMS division like out in the field

987
01:44:00,920 --> 01:44:06,560
they're responding on calls with the crews they're doing ride outs with new paramedics

988
01:44:06,560 --> 01:44:12,920
they're you know they're sitting at the kitchen table the sacred place in the fire station

989
01:44:12,920 --> 01:44:20,880
just filtering for information right and how can we make the job easier and less.

990
01:44:20,880 --> 01:44:29,440
So some of the things that have come from that are we've instituted hand tevy you know

991
01:44:29,440 --> 01:44:36,400
for pediatric protocols that's taken the 3 a.m. guesswork out of a pediatric dose we made

992
01:44:36,400 --> 01:44:42,640
sure that any integrations that we bring in integrate with our RMS system so we can lose

993
01:44:42,640 --> 01:44:50,280
all of the redundancy so our reporting system that we use is ESO which has been good and

994
01:44:50,280 --> 01:44:55,600
hand tevy integrates right in there so as the captain is doing all the work through

995
01:44:55,600 --> 01:45:02,360
the hand tevy app it just syncs right up with ESO so that paramedic doesn't have to write

996
01:45:02,360 --> 01:45:09,420
it down twice so we're just taking those steps out you know so we want to be really purposeful

997
01:45:09,420 --> 01:45:13,920
with any of that we don't want these one-off programs that you know somebody has to log

998
01:45:13,920 --> 01:45:19,600
into some other thing and do a bunch of other stuff our whole county like it's been a passion

999
01:45:19,600 --> 01:45:24,840
project of mine since I got there seven years ago to integrate the whole county to ESO so

1000
01:45:24,840 --> 01:45:28,800
we're all on one platform because we were all actually using something different so

1001
01:45:28,800 --> 01:45:36,720
as of today we all have ESO we can sync our tablets together completely reducing all of

1002
01:45:36,720 --> 01:45:44,480
that redundancy we bring together a team about every year of field providers and we bring

1003
01:45:44,480 --> 01:45:49,600
them in and we get in the backside of ESO and we try to figure out how can we reduce

1004
01:45:49,600 --> 01:45:56,040
clicks how can we orchestrate the drop-down menus for the most popular things to be at

1005
01:45:56,040 --> 01:46:03,620
the top so we can expedite that person completing that chart as quickly as possible and doing

1006
01:46:03,620 --> 01:46:08,440
it with the fewest amount of clicks some of our crews are running 15 to 20 calls in a

1007
01:46:08,440 --> 01:46:13,440
24-hour period and those three or four saved clicks you know that's just a false multiplier

1008
01:46:13,440 --> 01:46:19,040
that just adds up over time right so can we take that stress one of my EMS captains he

1009
01:46:19,040 --> 01:46:24,200
was on one of the busiest engines before he came in and he was a paramedic captain so

1010
01:46:24,200 --> 01:46:29,220
he here he was the captain of the rig and he was having to write 15 to 20 charts every

1011
01:46:29,220 --> 01:46:36,520
shift and so you know he's been a great like sounding board of like how can we make his

1012
01:46:36,520 --> 01:46:45,760
job easier when he was out there in the field we've we've also like instituted like Washington

1013
01:46:45,760 --> 01:46:53,600
State has a pretty strenuous EMT research program that's actually directed like through

1014
01:46:53,600 --> 01:46:59,800
our county medical director and like that gets approved by this at the state level that

1015
01:46:59,800 --> 01:47:05,480
is a good recertification program it's called our paramedic continuing education program

1016
01:47:05,480 --> 01:47:10,480
and and so that we have to have a hundred percent compliance on that and so as you know

1017
01:47:10,480 --> 01:47:16,880
like with work reductions guys aren't always there to take the training so we have to go

1018
01:47:16,880 --> 01:47:22,520
out and get that training for them and so we want to be really purposeful that like

1019
01:47:22,520 --> 01:47:28,680
if we have to get them off duty that we're not creating a mandatory hire behind that

1020
01:47:28,680 --> 01:47:33,920
right so we're doing our little part in the organization of like hey that training can

1021
01:47:33,920 --> 01:47:39,360
wait we don't need to mandatory somebody back to come cover for that person you know to

1022
01:47:39,360 --> 01:47:45,080
get that that training done so we really want to be purposeful with that the other piece

1023
01:47:45,080 --> 01:47:49,440
that we've done is we've integrated with the hospitals to have access to their epic like

1024
01:47:49,440 --> 01:47:57,680
their hospital data system so we can actually get instant hospital feedback on patient outcomes

1025
01:47:57,680 --> 01:48:05,200
and that has proved time and time again especially in the peer support space that you know being

1026
01:48:05,200 --> 01:48:10,560
being a you know first response ALS fire agency we don't go to the hospital very often right

1027
01:48:10,560 --> 01:48:14,320
so so our crews just kind of shut the back doors of the ambulance and then they're left

1028
01:48:14,320 --> 01:48:20,320
guessing like hey did that kid make it or you know did that mom live or whatever it

1029
01:48:20,320 --> 01:48:26,080
might be right so we can have our peer support members like reach out to our EMS team and

1030
01:48:26,080 --> 01:48:29,980
we can like get that information immediately right because the old days of us being able

1031
01:48:29,980 --> 01:48:36,520
to call call the charge nurse in the ER and say hey how's so-and-so doing on that transport

1032
01:48:36,520 --> 01:48:40,080
you know most the time we get blocked by the HIPAA talk right like oh we can't give you

1033
01:48:40,080 --> 01:48:45,800
that information you know who is this again right so so that was kind of a hurdle that

1034
01:48:45,800 --> 01:48:51,320
we overcame by like working with our legal departments to actually get access into those

1035
01:48:51,320 --> 01:48:57,720
systems and there's actually some federal stuff coming along about information share

1036
01:48:57,720 --> 01:49:03,080
as far as health care equity so so that would be really good to see too because I think

1037
01:49:03,080 --> 01:49:08,480
that will reduce those barriers even more to be able to get that feedback from the hospital

1038
01:49:08,480 --> 01:49:17,120
and that outcome so but from a peer support level just allowing again that instant feedback

1039
01:49:17,120 --> 01:49:22,400
to maybe that provider that was struggling with that call like hey they lived or hey

1040
01:49:22,400 --> 01:49:28,160
they didn't make it but the it's even right here in the ER physicians notes that EMS did

1041
01:49:28,160 --> 01:49:35,320
everything they could and like perfectly and that you know the aorta was completely torn

1042
01:49:35,320 --> 01:49:39,240
away from the heart and there was no way that person was going to live anyways right so

1043
01:49:39,240 --> 01:49:47,000
I think it helps bring that closure or that like that breath of fresh air to the to the

1044
01:49:47,000 --> 01:49:58,880
provider so so we've been really purposeful with with that and then let's see what else

1045
01:49:58,880 --> 01:50:04,960
have we done so obviously being two separate agencies from our fire department and AMR

1046
01:50:04,960 --> 01:50:08,920
obviously there can be crew conflicts right we have crew conflicts between our engine

1047
01:50:08,920 --> 01:50:16,560
companies sometimes right so but we wanted to establish a group so we we piloted and

1048
01:50:16,560 --> 01:50:22,400
and now we're doing a liaison group so we have a AMR supervisor and a field paramedic

1049
01:50:22,400 --> 01:50:31,040
and then we have a captain and a field paramedic from fire they have access to each other and

1050
01:50:31,040 --> 01:50:37,160
they can take in input like low-hanging fruit like certain ambulances don't bring in their

1051
01:50:37,160 --> 01:50:42,400
kits or fire I saw fire drive around the block again so they didn't have to come in and write

1052
01:50:42,400 --> 01:50:49,120
the chart or you know any of these little like petty low-hanging fruit items that group

1053
01:50:49,120 --> 01:50:53,760
gets funneled those things and they handle the outside of management like that this isn't

1054
01:50:53,760 --> 01:51:00,000
a discipline thing this isn't a you know we're going to try to do the I gotcha type thing

1055
01:51:00,000 --> 01:51:06,960
but it has proven to be a really good product like within our system of just having an avenue

1056
01:51:06,960 --> 01:51:13,520
to like funnel those like little concerns and so they don't get too big and then and

1057
01:51:13,520 --> 01:51:21,280
then we were a big hot wash so we do like a post-incident review right after all fires

1058
01:51:21,280 --> 01:51:26,600
and after all critical medical calls like that it's it's not to talk about what went

1059
01:51:26,600 --> 01:51:32,520
wrong it's just a real quick give a down and dirty of what happened anything that we can

1060
01:51:32,520 --> 01:51:39,640
improve upon next time those are all non-disciplinary and that has worked really really well in our

1061
01:51:39,640 --> 01:51:47,120
system that we can get kind of that more instant feedback and then doing joint training and

1062
01:51:47,120 --> 01:51:55,720
being a county that it's county driven EMS training really does allow us to have a better

1063
01:51:55,720 --> 01:52:04,800
interaction you know all the time with our mutual aid partners and our ambulance transport

1064
01:52:04,800 --> 01:52:12,640
agency that we're all on the same page and treating the patients the same way so that

1065
01:52:12,640 --> 01:52:19,520
that has been really helpful and kind of reduces that stress level I believe of our crews so

1066
01:52:19,520 --> 01:52:24,120
we just continue to look for those innovations of how do we take that stress out of those

1067
01:52:24,120 --> 01:52:33,120
calls we have I believe we have an amazing peer support team within in-house it's been

1068
01:52:33,120 --> 01:52:41,120
very purposeful it's policy driven it has a budget our members do an amazing job and

1069
01:52:41,120 --> 01:52:47,400
we call it bumps that like anybody can like call one of the peer support members and say

1070
01:52:47,400 --> 01:52:52,280
hey seem like James had a really hard time on that call can you give him a bump so then

1071
01:52:52,280 --> 01:52:58,160
somebody will reach out to him and do that and then and we have some decompression breaks

1072
01:52:58,160 --> 01:53:05,560
like so if a crew has a tough call they can they can call the battalion chief and they

1073
01:53:05,560 --> 01:53:11,400
can go out of service and we can do a defusing or a debriefing or if they just need to go

1074
01:53:11,400 --> 01:53:16,840
work out for 30 40 minutes they can do that so the the BCs just kind of handle that and

1075
01:53:16,840 --> 01:53:22,520
manage that so that's been like a helpful tool and I actually heard an awesome story

1076
01:53:22,520 --> 01:53:29,080
the other day one of our captains getting mandatory is a new thing for us because it

1077
01:53:29,080 --> 01:53:34,400
used to be when we didn't have position for position over time that the captain has just

1078
01:53:34,400 --> 01:53:38,240
never got touched right because it always had a firefighter before it ever get to a

1079
01:53:38,240 --> 01:53:46,760
captain so now our captains are getting mandatory and a crew recognized that the captain is

1080
01:53:46,760 --> 01:53:52,720
getting mandatory had just ran a pretty bad pediatric call and was kind of a ghost and

1081
01:53:52,720 --> 01:53:57,800
he was actually he was going to be mandatory into a 72 hour shift and the crew took it

1082
01:53:57,800 --> 01:54:03,640
upon themselves to find cover for him so he didn't get mandatory and called and negotiated

1083
01:54:03,640 --> 01:54:09,480
with another captain to take it right so I think that we really are watching out for

1084
01:54:09,480 --> 01:54:16,740
each other and I think that story is a testament to our guys buying in on our peer support

1085
01:54:16,740 --> 01:54:20,960
and taking care of each other and so I just hope that continues.

1086
01:54:20,960 --> 01:54:24,040
That's so good to hear I got a couple things I want to pull from you firstly when it comes

1087
01:54:24,040 --> 01:54:30,080
to patient outcomes I think the group that we forget about that really need to hear that

1088
01:54:30,080 --> 01:54:34,400
are our dispatchers are you able to get that information to them?

1089
01:54:34,400 --> 01:54:43,120
Yeah so it's great we have a great relationship with our county dispatch system our liaison

1090
01:54:43,120 --> 01:54:53,360
is actually a fire wife and she gets it and she was actually the wife of my first EMS

1091
01:54:53,360 --> 01:54:59,640
captain when I came to Vancouver it's his wife and she's so passionate about everything

1092
01:54:59,640 --> 01:55:09,080
so we have a county medical directors teams page that we do all of our QAQI through and

1093
01:55:09,080 --> 01:55:16,040
she is a member of that page so she sees all those outcomes she can even bring forward

1094
01:55:16,040 --> 01:55:21,480
like if they catch something on their QAQI internally like hey we want a patient outcome

1095
01:55:21,480 --> 01:55:28,400
because we just we think our dispatcher was off or our dispatcher coded it wrong so we

1096
01:55:28,400 --> 01:55:33,520
really want to know what the outcome is so she is a part of that and she's infusing that

1097
01:55:33,520 --> 01:55:40,280
information right back into our dispatch center and then our peer support team is engaged

1098
01:55:40,280 --> 01:55:48,920
with theirs and we invite them in whether it's virtually or in person for all of our

1099
01:55:48,920 --> 01:55:51,720
debriefings or diffusings as well.

1100
01:55:51,720 --> 01:55:56,280
Brilliant and the other thing when it came to the peer support what about access to counseling

1101
01:55:56,280 --> 01:56:02,080
itself that sounds like the best model that I've heard so far is either having a contract

1102
01:56:02,080 --> 01:56:06,520
with local counselors or even hiring one for your department.

1103
01:56:06,520 --> 01:56:12,560
Yeah so just a few months ago we finally brought on an in-house clinician we share that with

1104
01:56:12,560 --> 01:56:18,960
the police department he's still kind of getting his feet wet and figuring out our system you

1105
01:56:18,960 --> 01:56:25,760
know but he's already integrated heavily with both fire and police's peer support teams

1106
01:56:25,760 --> 01:56:30,680
our healthcare insurance is actually managed by our union so we have a healthcare trust

1107
01:56:30,680 --> 01:56:37,640
so that puts us in the driver's seat to provide services that are unique to firefighters and

1108
01:56:37,640 --> 01:56:46,040
not just to like a normal city employee so like stem cell replacement counseling with

1109
01:56:46,040 --> 01:56:54,520
culturally competent clinicians you know a naturopath you know 20 visits to a naturopath

1110
01:56:54,520 --> 01:57:00,920
or massage or chiropractic you know we really have a Cadillac program and our healthcare

1111
01:57:00,920 --> 01:57:09,160
trust is built of firefighters and retirees that are managing that system so it's I believe

1112
01:57:09,160 --> 01:57:14,400
it's next to none it's probably one of the reasons I have not promoted out of the union

1113
01:57:14,400 --> 01:57:20,280
because our healthcare is really good so hats off to our healthcare trust but one of the

1114
01:57:20,280 --> 01:57:26,800
things that we noticed was sometimes you know obviously clinicians are really having a hard

1115
01:57:26,800 --> 01:57:37,600
time like you know having available time so what do we do in the stop gap so our healthcare

1116
01:57:37,600 --> 01:57:44,280
trust recognized the city's employee assistant program was not meeting our mark so we established

1117
01:57:44,280 --> 01:57:52,440
our own EAP within our healthcare trust and that that is it actually links you to the

1118
01:57:52,440 --> 01:58:00,200
product better help which is a national system of virtual counselors that are licensed in

1119
01:58:00,200 --> 01:58:05,680
your area and their guarantee is that they will see you within 24 hours that they will

1120
01:58:05,680 --> 01:58:11,000
match you with a counselor so it's almost like a dating app that you kind of go through

1121
01:58:11,000 --> 01:58:16,140
and build your profile and then it matches you with a clinician that's going to meet

1122
01:58:16,140 --> 01:58:21,720
your need and we utilize that as a stop gap right like so hey we can't get you into an

1123
01:58:21,720 --> 01:58:26,880
in-person clinician for like a week or like four or five days but hey we can get you in

1124
01:58:26,880 --> 01:58:31,840
for better help to at least kind of stop the bleed we can get you in like within 24 hours

1125
01:58:31,840 --> 01:58:39,320
let's get that going so that's been really innovative I think it's been super helpful

1126
01:58:39,320 --> 01:58:42,920
and and been pretty progressive for our crews.

1127
01:58:42,920 --> 01:58:43,920
Brilliant.

1128
01:58:43,920 --> 01:58:47,560
All right well I'm going to shift to some closing questions so I can be mindful of your

1129
01:58:47,560 --> 01:58:53,080
time the first one I love to ask is there a book or other books that you love to recommend

1130
01:58:53,080 --> 01:58:57,800
it can be related to our discussion today or completely unrelated?

1131
01:58:57,800 --> 01:59:03,520
Yeah I have to say Tribe you know and I know you've had Sebastian on a few times and I've

1132
01:59:03,520 --> 01:59:15,000
I've listened to those that was so insightful to me just that the the move from an engine

1133
01:59:15,000 --> 01:59:25,360
as a captain to that chief car was like probably the most one of the most like depressing times

1134
01:59:25,360 --> 01:59:30,280
like in my career right because like now I'm just out there by myself and it didn't matter

1135
01:59:30,280 --> 01:59:35,400
that you'd worked with these guys for 20-30 years all of a sudden now you're you know

1136
01:59:35,400 --> 01:59:39,440
you've got a gold badge and you're not one of them anymore right so you're kind of this

1137
01:59:39,440 --> 01:59:47,260
Tribe of one now you know just kind of floating out there and you know and and so Tribe really

1138
01:59:47,260 --> 01:59:54,260
like brought it to my forefront of like how much community means and how I needed to be

1139
01:59:54,260 --> 02:00:01,680
purposeful like as a battalion chief to like engage with crews and and find those opportunities

1140
02:00:01,680 --> 02:00:08,520
to be a part of that Tribe still and how important that was so so I actually still give that

1141
02:00:08,520 --> 02:00:16,760
book to newly promoted battalion chiefs and and I think that I just yeah I think a lot

1142
02:00:16,760 --> 02:00:23,560
about that book the the other one right now that I'm just finishing up is Anxious Generation

1143
02:00:23,560 --> 02:00:33,280
by Jonathan Haidt and it is all about the effects that smartphones have had on us and

1144
02:00:33,280 --> 02:00:42,580
on our youth and raising you know two adult children and four teenagers and and two little

1145
02:00:42,580 --> 02:00:49,720
ones coming up it is amazing like just even though in our own house like seeing the effects

1146
02:00:49,720 --> 02:00:57,960
that screens have on their levels of anxiety and their levels of depression and and how

1147
02:00:57,960 --> 02:01:05,520
taking that away and getting back to playing and doing stuff is so important and it's funny

1148
02:01:05,520 --> 02:01:10,480
like you know I look at our acreage and we have a little motorcycle track and we've got

1149
02:01:10,480 --> 02:01:14,240
motorcycles and we've got a pool and we've got a trampoline and we've got all this stuff

1150
02:01:14,240 --> 02:01:19,920
that like and a horse and you know like I would have just been like and like it would

1151
02:01:19,920 --> 02:01:25,280
be like I was at camp every day but there's been times that our kids like we can't even

1152
02:01:25,280 --> 02:01:29,760
get them out there to do any of that stuff like they would rather sit and snapchat their

1153
02:01:29,760 --> 02:01:37,000
friend so so really being you know that book really like really shines a light on that

1154
02:01:37,000 --> 02:01:42,240
and so so that's that's been pretty insightful like for us and for our family.

1155
02:01:42,240 --> 02:01:47,840
What about movies and documentaries any of those that you love?

1156
02:01:47,840 --> 02:02:01,920
Oh man I do I do like documentaries I just finished the the Netflix one on Epstein and

1157
02:02:01,920 --> 02:02:07,920
trafficking and and how like big money how that gets hidden and it's not you know it's

1158
02:02:07,920 --> 02:02:11,920
kind of like what we were talking about earlier with opiates right it's not just it's not

1159
02:02:11,920 --> 02:02:16,800
just on the streets trafficking's not just on the streets you know it's in the million

1160
02:02:16,800 --> 02:02:23,640
dollar homes so so that was that was probably the latest one I watched and had a ton of

1161
02:02:23,640 --> 02:02:26,240
takeaways from that one.

1162
02:02:26,240 --> 02:02:30,400
Brilliant all right well then the next question is there a person that you recommend to come

1163
02:02:30,400 --> 02:02:35,840
on this podcast as a guest to speak to the first responders military and associated professions

1164
02:02:35,840 --> 02:02:38,240
of the world?

1165
02:02:38,240 --> 02:02:48,120
Yeah I'd really like to connect you with a woman Erin Johnson and she is a firefighter

1166
02:02:48,120 --> 02:02:54,720
up in the central part of our state and she's a clinician turned firefighter and she's also

1167
02:02:54,720 --> 02:03:00,280
the union president of that organization and she is the chair of our state council behavioral

1168
02:03:00,280 --> 02:03:07,560
health committee and I've gotten to know her through that and I think that she provides

1169
02:03:07,560 --> 02:03:15,680
an aspect of all of those worlds coming together right and I think that she has navigated that

1170
02:03:15,680 --> 02:03:21,080
well in her community and so yeah I would love to connect you with her.

1171
02:03:21,080 --> 02:03:24,600
Okay I'd love to as well thank you the name sounds familiar so I don't know if we're connected

1172
02:03:24,600 --> 02:03:28,920
on LinkedIn or somewhere I recognize the name but um but yeah that would be phenomenal thank

1173
02:03:28,920 --> 02:03:32,920
you all right well in the very last question before we make sure everyone knows where to

1174
02:03:32,920 --> 02:03:37,480
find you what do you do to decompress?

1175
02:03:37,480 --> 02:03:43,520
Yeah so um camping we do we try to get away and camp um we're fortunate our in-laws have

1176
02:03:43,520 --> 02:03:50,240
a really nice beach house up on the Washington coast we try to sneak away there um ride a

1177
02:03:50,240 --> 02:03:54,920
lot of motorcycles and still doing a lot of water sports and as I kind of mentioned earlier

1178
02:03:54,920 --> 02:04:01,440
like my wife and I love to get away to Baja as much as we possibly can and kind of spend

1179
02:04:01,440 --> 02:04:04,720
a little bit of time on the sea of Cortez side each trip and a little bit of time on

1180
02:04:04,720 --> 02:04:11,200
the Pacific coast side every time we go it's an awesome opportunity for us to connect.

1181
02:04:11,200 --> 02:04:15,280
Right well then the very last question I'm sure people have been blown away by so many

1182
02:04:15,280 --> 02:04:19,520
the you know progressive elements that we've discussed today where are the best places

1183
02:04:19,520 --> 02:04:25,120
to find you on on the internet and or social media?

1184
02:04:25,120 --> 02:04:32,680
Yeah LinkedIn's probably um a good good spot for that um and then um you know I I can share

1185
02:04:32,680 --> 02:04:38,400
you know emails with you um you know feel free to share that um uh with them I think

1186
02:04:38,400 --> 02:04:40,600
those are probably the best ways.

1187
02:04:40,600 --> 02:04:45,040
Thank you and then as far as the AMR I'll put the website on the uh web page for this

1188
02:04:45,040 --> 02:04:48,520
episode as well so people can access that.

1189
02:04:48,520 --> 02:04:52,320
Well Rob I want to thank you so much I mean like I said we've gone all over the place

1190
02:04:52,320 --> 02:04:57,320
from you know the powerful kind of addiction slash foster adoption story that you have

1191
02:04:57,320 --> 02:05:01,680
this beautiful large family now through to the progressive elements that have been infused

1192
02:05:01,680 --> 02:05:05,960
into your fire department but it's been a phenomenal conversation so I want to thank

1193
02:05:05,960 --> 02:05:09,920
you so so much for being so generous with your time and coming on the Behind the Shield

1194
02:05:09,920 --> 02:05:12,080
podcast today.

1195
02:05:12,080 --> 02:05:32,280
Yeah thanks James for the opportunity.