The Center for Public Safety Excellence and the IAFC’s Metro Chiefs section partnered to develop a series highlighting proven practices of Metro departments accredited by CPSE’s Commission on Fire Accreditation International. Developed by the CPSE Center for Innovation staff, each case study outlines the opportunity the agency faces, the actions they took, the outcomes of their efforts, and provides tips for replication.
Cobb County, Georgia, is a culturally diverse community that has experienced significant growth. In 1977, it had 265,790 residents; today, it has a population of approximately 772,000, a change of 190 percent. For comparison, the United States population grew by 51.7 percent, and Georgia’s population grew by 109.4 percent during that same period. The Cobb County Fire & Emergency Services (CCFES), created in 1971, provided traditional public education programs for grades kindergarten through five and code enforcement for areas protected by the department. The education program was school-based, with six dedicated department members visiting local schools, often three times yearly. With the continuing growth, then-Chief Hilton initiated a strategic change to a more comprehensive approach, moving to a community risk reduction model. In 1978, one facet of this was the creation of the Public Fire and Life Safety Education division.
The opportunity
Initially, this division had the same focus as the previous program; however, as the new division continued to develop and expand, it faced logistical and financial challenges. To overcome these hurdles and enhance the scope of safety education, the Safety Village concept was adopted in 1998, modeled after similar programs in Canada. This consolidated the various safety programs within a simulated environment, offering hands-on, role-playing scenarios that made learning more impactful and lasting. The students came to the education rather than the education traveling to the students. The day-long program provides time to cover several topics cohesively, supporting better retention of key learning objectives. In 2007, the Safety Village Foundation was founded to support and fund the further development and operation of the program. Local businesses participated by funding buildings in the “neighborhood” with their corporate names attached or with other program elements. This also demonstrated the effectiveness of involving the community in safety education, leading to a broader understanding that proactive educational approaches could mitigate risks and enhance community protection.
The action
The organizational culture of CCFES encouraged openness to change and innovation. As the community grew, the department and staff identified trends in service demands. What were the nature of the requests, where were they coming from in the community, and when were they made?From this data analysis, the staff recognized the need to address the specific needs of vulnerable populations, including the elderly and individuals facing behavioral, mental health and substance abuse issues. This realization led to the creation of the Cobb Fire CARES (CARES) and Cobb County Partnership for Assistance, Treatment & Health (PATH) programs. These initiatives represented a move towards community paramedicine, providing targeted care and reducing the burden of traditional emergency services. By employing a multidisciplinary team approach, these programs addressed the root causes of high emergency service utilization, offering more appropriate care and support for affected individuals.
Cobb Fire CARES was developed when the department discovered that many high-volume 911 utilizers were unaware of the number of social services available to them and, as a result, frequently used 911 instead. The CARES team is a specialized unit that seeks to offer people an alternative to relying on emergency services when more appropriate resources are frequently available. Areas addressed include mental health, substance abuse, fall prevention and education, and elderly assistance. Referrals for service come from the responding firefighters and paramedics who recognize these issues during initial patient contact and request the “CARE” unit. The CARES unit staff, monitoring the department radio communications, will also self-dispatch to an incident based on the information provided by the 911 Center. CARES uses a software platform, RiteSite, where on-scene responders using iPads can connect low-acuity patients with a telehealth physician who can direct the patient to the appropriate care provider. This can often direct the patient to a provider other than the local emergency room.
Cobb County Partnership for Assistance, Treatment, and Health (PATH) was initiated by the Cobb County Police Department in 2019 in collaboration with CCFES and the state of Georgia behavioral health system with the goal of addressing several critical aspects related to mental health:
- Reducing the mentally ill population in jails: The program aims to divert individuals experiencing mental health crises from incarceration and towards appropriate treatment and support services.
- De-escalating dangerous encounters with police: Officers on the PATH team are trained to handle mental health crises with an approach focused on minimizing conflict and ensuring the safety of the patient and responding officers.
- Decreasing additional mental health crises: The team seeks to prevent recurring mental health emergencies through effective response and follow-up care.
Each team comprises officers, community paramedics and licensed behavioral health clinicians. They respond to a variety of calls related to mental health, including psychotic episodes, disorderly conduct, and suicide attempts. They assess whether hospitalization or mental health services are necessary. The team’s approach extends beyond crisis intervention. Members follow up with individuals with the goal of preventing future crises. Currently, the program has two teams of three responders and funding is in place to add a third team in 2024. Each team is available from 0700 to 1600 hours, Monday through Friday.
Since its inception, the PATH team has been called to 648 incidents, resulting in only 27 arrests or 4.2 percent. Their primary focus is on connecting people with mental health support rather than sending them to jail.
The outcome
Historically, the department considered itself an early adopter of new initiatives in the fire service, frequently making decisions based on assumptions. The accreditation process demonstrated the importance of collecting and analyzing data relative to the community to verify anecdotal observations or change the organization’s focus. Today, it is data-informed, using that information, plus political and social environmental influences, to shape decisions and policies.
They also learned that partnerships with local law enforcement, health care systems, public health departments and community organizations were crucial in developing the community programs.
Tips for replication
- A data-driven approach and stakeholder engagement are critical to the success of such initiatives. Also crucial are continuous evaluation and willingness to adapt based on feedback and outcomes.
- Securing funding for new programs is a common challenge. It requires presenting a strong case for the investment, often backed by data and community support.
- Convincing internal stakeholders about the need for change within the department can be challenging. It involves demonstrating how the new practices will benefit the community and the department in the long-term.
- Begin by gathering baseline data on the issues you aim to address, such as fire incidents, mental health crisis interventions, and others. This will help you understand the scope of the problem and track progress over time.
- Identify and engage key stakeholders, including community members, local businesses, health care providers and educational institutions. Their input and support can be invaluable in shaping and supporting the initiative.
- Present collected data to elected officials and decision-makers to demonstrate the initiative’s need and potential impact. Well-documented evidence can be persuasive in securing support and funding.
Additional resources
- National Fire Protection Association (NFPA) “Community Risk Reduction (CRR) | NFPA”
- USA FACTS, Cobb County, GA population by year, race, & more | USAFacts
- RIGHT SITE HEALTH - Social Impact - RightSite Health
