By Fire Chief Sean McGarry and Battalion Chief Nick Howcraft
The Ridge Road Fire District in Greece, N.Y., has always taken a targeted approach to serving our community. Over time, we have refined that approach to focus more directly on at-risk populations, using data to drive decisions and measure outcomes.
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Identifying the problem
In 2021, we took a closer look at our EMS call data and found that a significant portion of our responses were related to falls. At the same time, we were aware our district has a large and growing geriatric population, placing many of our residents at increased risk for injury and loss of independence, especially as the result of a fall.
This is not unique to our agency. Fire and EMS organizations across the country are experiencing increased demand driven by aging populations, especially within senior and assisted living environments. In many cases, residents are living in settings that do not fully meet their care needs, or necessary services cannot be put in place quickly enough. As a result, fire and EMS agencies often fill that gap through repeated service calls.
We also recognized that while falls are sometimes viewed as minor incidents, their impact can be significant. For many older adults, a fall is a life-altering event, and not all patients return to their prior level of independence or quality of life.
Recognizing both the frequency and severity of these incidents, we began looking for ways to move beyond a reactive model and focus on prevention.
Early efforts
Our initial efforts focused on education. Four members of our department were trained in the CDC’s Stopping Elderly Accidents, Deaths & Injuries (STEADI) fall prevention program, which allowed us to provide education at senior housing facilities.
While this was effective for group settings, it became clear that it did not reach many of the individuals most at risk, particularly those living independently. We needed a more individualized approach.
Developing a partnership
In late 2021, we began exploring partnerships with organizations that could help extend services into private homes. Through our medical director, we connected with Lifespan, a nonprofit organization serving older adults in Monroe County.
Lifespan provides a wide range of services, including care management, transportation, home safety evaluations, and assistance with accessing support services. Their ability to address broader needs — not just fall prevention — made them a strong partner.
With support from our medical director and fire district leadership, we established a referral partnership and began integrating it into our EMS operations.
Program implementation
The program was introduced to our members as a way to provide additional support to patients experiencing repeat falls or requiring frequent lift assists.
Our EMS officer began identifying patients with multiple fall-related contacts within a short period of time. Once these patients were identified, the officer would contact these patients directly to better understand their needs and identify potential contributing factors. During these conversations, referrals to Lifespan were offered when appropriate.
These discussions often revealed needs beyond fall prevention, including home care assistance, transportation and help navigating available services. Over time, personnel began identifying potential needs earlier, even before patients became repeat callers.
Program outcomes
2022 (first full year):
- 45 patient contacts involving repeat fall patients
- 27 referrals to Lifespan
- Average encounters per patient decreased from 3.8 pre-referral to 2.1 post-referral
2023:
- 42 patient contacts; 13 referrals
- Increased early identification by personnel
- Average one-year pre- and one-year post-referral encounters decreased from 4.1 to 2.6
- Even without referral, patient education helped reduce repeat calls
2024:
- 41 patient contacts; 20 referrals
- Average one-year pre- and one-year post-referral encounters decreased from 3.4 to 2.4
2025:
- 41 patient contacts; 16 referrals
- Six-month pre-referral average: 3.7 encounters
- Six-month post-referral average: 2.0 encounters
- Program presented at the National Association of EMS Physicians conference
Across all years, the most common needs identified were home care services, fall prevention modifications and transportation.
Key takeaways
Several consistent themes have emerged:
- Data can effectively identify where intervention is needed;
- Many repeat calls are tied to unmet support needs, not isolated incidents;
- Early engagement can prevent repeated service requests;
- Partnerships are critical to addressing needs beyond the scope of EMS; and
- Education alone can have a measurable impact.
Looking ahead
Five years ago, following up with patients to assess their broader needs would have seemed outside the traditional role of the fire service. Today, it has become an important part of how we approach community risk reduction.
This program has highlighted a larger issue that many agencies are facing. As the population continues to age, more individuals are living in environments that do not fully meet their care needs, or they experience delays in accessing services. In many cases, fire and EMS agencies become the default resource to fill that gap.
By building partnerships and focusing on early intervention, we have been able to better connect residents with appropriate services before an emergency occurs. This not only reduces repeat calls, but also helps prevent incidents that can significantly impact a person’s independence and quality of life.
Each contact and referral represents an opportunity to make a meaningful difference. Programs like this demonstrate that by addressing underlying needs — not just immediate emergencies — fire and EMS agencies can play an important role in improving outcomes for the communities they serve.
ABOUT RIDGE ROAD FIRE
The Ridge Road Fire District is one of only 334 agencies worldwide accredited by the Commission on Fire Accreditation International (CFAI). We were the first non-military fire district in New York State to achieve International Accreditation status. Since receiving our initial accreditation in 2005, we have successfully maintained reaccreditation every five years, continuing to uphold the highest standards of excellence in the fire service.
Our agency is staffed 24 hours a day, 7 days a week, by a minimum of 12 firefighters, three lieutenants, one captain and one battalion chief. In 2025, we responded to more than 6,100 calls for service, completed over 52,000 hours of training, provided fire safety education to nearly 4,900 children, and delivered fire and fall prevention education to almost 400 senior residents.
We offer competitive wages, comprehensive benefits, enrollment in the New York State Retirement System, and participation in the New York State Deferred Compensation Plan.
ABOUT THE AUTHORS
Sean McGarry serves as fire chief of the Ridge Road Fire District. He began his fire service career in 2001 as a volunteer firefighter and was hired as a career firefighter in 2006. He holds associate degrees in Fire Protection Technology and Paramedicine from Monroe Community College, as well as a bachelor’s degree in Communications from St. Bonaventure University.
Battalion Chief Nick Howcraft has been involved in the fire service since 2006 and became a paramedic in 2010. Over the past two decades, Howcraft has served in both volunteer and career roles. Since joining the Ridge Road Fire District in 2011, Howcraft has advanced through the ranks to his current position as battalion chief. He is a fire instructor and oversees the district’s EMS program, community outreach initiatives and grant efforts.
