Firefighters union denounces removal of paramedics from mental health crisis program

CHICAGO — Police officers and paramedics have been removed from the city’s mental health crisis program — a change the firefighters’ union says violates their contract.

The Crisis Intervention and Engagement Program, known as CARE, provides teams of mental health professionals as well as specially trained police officers and paramedics to respond to 911 calls related to mental health. The program launched in 2021 with an initial investment of $3.5 million and has since expanded.

On Wednesday, Mayor Brandon Johnson announced that the CARE Team would now operate solely under the direction of the Chicago Department of Public Health and would not include police or fire personnel.

CARE teams will now consist of a crisis clinician and a paramedic, both employed by the health department.

When Chicago Firefighters Union Local 2 learned of the transition in April, the group filed a grievance against the city and the fire department as well as an unfair labor practice charge with the union’s local committee. Illinois Labor Relations Board.

Union President Patrick Cleary said CARE’s exclusion of fire personnel violates the union contract since non-union members would provide the city’s EMS services. Cleary also said proposed changes to union members’ hours, wages and conditions of employment must be brought to the bargaining table.

The Firefighters Union became aware of the changes to the CARE program through a job posting shared by the American Federation of State, County and Municipal Employees. The April job posting was for a paramedic and was listed under the Department of Health.

“We do this. These are our duties,” Cleary said. “You cannot offer our work to another entity.”

Cleary estimated that about 12 paramedics were involved in the CARE program.

Cleary said the city requested that the unfair labor charges be referred to arbitration. If the case is submitted to arbitration, it will be considered on November 19; otherwise, there will be a hearing before the Illinois Labor Relations Board on Jan. 30 and 31, Cleary said.

Over the past three years, some progressive aldermen have criticized the CARE program for its use of armed police officers.

Last fall, Ald. Rossana Rodriguez-Sanchez (33rd) and Johnson co-sponsored an order to establish the Mental Health System Expansion Task Force. The group released a report recommending the city expand, among other things, the non-police response to mental health crises.

Over the past year, CARE teams responded to just under 400 calls and conducted more than 700 follow-ups, according to the program’s website.

But Cleary said without paramedics, CARE teams would not be as effective. Paramedics have “three or four times as much training” as EMTs, said Anthony Snyder, director of emergency medical services for the Firefighters Union. Paramedics are also able to administer a wide range of medications and can operate manual cardiac defibrillators. Paramedics can only administer limited medications such as Narcan and epinephrine, Snyder said.

Although the CARE program was created to respond to mental health-related calls, that doesn’t mean there won’t sometimes be a need for physical medical care, Snyder said.

“My understanding is that the EMTs that they’re replacing our paramedics with are all relatively new,” Snyder said. “Paramedics are trained to detect real, life-threatening emergencies. It’s experience on the ground that teaches you that. These paramedics won’t have that, so it will be much easier for them to miss.

The Department of Health has hired 10 crisis clinicians and 10 paramedics for the CARE program, according to the mayor’s office. The city plans to hire two additional crisis clinicians, two additional EMTs, two supervisors and two case managers by the end of the year.

The city’s 2024 budget included $15.9 million for the CARE program.

“In more than 1,500 responses throughout the pilot period, our CARE teams made no arrests and reported the use of force in less than 0.1% of cases. This demonstrates that our CARE teams are adept at handling all mental and behavioral health crisis situations outside of those that include an acute public safety component,” the Mayor’s Office said in an email to Block Club.

CARE Teams will continue to be dispatched via 911 calls. Over the next month, CARE Teams will raise awareness of the program by visiting service providers, community groups, libraries, emergency rooms, districts police stations, fire stations and encampments, according to the mayor’s office.

The CARE program is active in Uptown, North Center, Lakeview, The Loop, Near South Side, Archer Heights, West Elsdon, Garfield Ridge, Clearing, West Lawn, Chicago Lawn, Englewood, Ashburn, Chatham and parts of Lincoln Square, Lincoln Park, the nearby West Side, Douglas, Brighton Park, Gage Park, Greater Grand Crossing, Roseland and Auburn Gresham, according to its website.

Over the next year, the CARE program will double its geographic reach, according to the mayor’s office.

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