Asheville – Following the holiday break, public comment at the Buncombe County Commissioners’ meeting was not so overwhelming. The main themes addressed by the mere “fifteen or so” callers Chair Brownie Newman announced were in the queue, were objections to awarding economic incentives to defense contractor Raytheon, removing Civil War monuments, lowering COVID occupancy allowances, and moving the Asheville Primary School to an as-yet-undisclosed location. After public comment, the commissioners went into closed session to discuss ongoing matters with former county leadership indicted for corruption.
During the “County Manager’s Report” segment of the meeting, County Attorney Mike Frue publicly announced the county would pay $167,500 plus $1,865 in mediation fees to settle a case in the US District Court. Frue was not at liberty to disclose much about the case, but he related that back in October of 2017, the sheriff’s department responded to a call from the McMahan family because their son, for whom there was an outstanding warrant, was, “having some issues.”
Upon arriving on the scene, an altercation erupted between Mr. McMahon and one or both of the deputies. Then, Mrs. McMahon got in the fray, and all three were arrested. The deputies were suspended two days without pay, and the charges were later dropped. Frue said all parties agreed to the terms of the settlement, law enforcement’s side of the story being deemed a “doubtful and disputed claim.”
To that, Commissioner Jasmine Beach-Ferrara stated, “A case like this deserves some pause and recognition on our part as electeds here. I would like personally, Mike, to ask you to make an apology to the family. When someone calls for assistance and there’s a mental health crisis happening, which it sounds like was the case here, they deserve to be treated with respect and compassion and get access to the services that they need.
“I’m heartened that our community is moving in that direction, at the level of conversations that are happening and at the level of programs that are happening, and that shortly we’ll hear about a paramedic model that seeks to do that. I think one way that we help change this is that when these cases do come to light, we do take time to talk about them.”
The program Beach-Ferrara referenced came up as a budget amendment. The Dogwood Trust had previously awarded the county $382,000 for one year of funding for community paramedics who would respond in “real-time” to opioid overdoses. Among other things, the teams would bring Naloxone to the scene, expedite the acceptance of victims into detox programs, and then conduct “follow-ups” for chronic disease management and prevention.
The amendment would increase the grant by $117,953 to fund a program manager position. Emergency Services Director Taylor Jones related the program had suffered delays due to COVID, and so it didn’t launch until November, but Dogwood was already impressed by its results. They were also receptive to the complaint his office lodged about having to pull an emergency responder off duty to attend meetings.
The manager would be charged with engaging partnerships for funding and program support, tracking metrics, assigning roles and responsibilities, and ensuring mission alignment. The program’s objectives were to divert persons with opioid addictions from emergency departments and into Medicated Assisted Treatment, which, as a hybrid of methadone clinics and wraparound services for chronic disease, is the current best practice in detox protocols. Doing so should reduce recidivism response volumes, make a dent in epidemics spread from needle sharing, and improve health outcomes for individuals.
Successes
Jones celebrated the early successes of the program, which included the forging of partnerships for fundraising and feeding, clothing, and sheltering the homeless. As is typical of government programs, this one was deemed successful by the growing number of persons utilizing its services. Jones then shared the program’s general vision for collaborating with a broader range of providers and eventually enrolling victims of overdose in MAT on-the-scene.
Wrapping up, Jones said this was a first step in reimagining public safety. Underprivileged people, he said, can’t afford primary caregivers and regular checkups; so their go-to for accessing medical services has traditionally been hospital emergency departments. Consequently, Buncombe County paramedics have already built relationships in underserved communities, and relationship-building, he said, was the main thing. As a client-centered program, community paramedic response teams would lift people up by connecting them to appropriate medical attention, instead of destroying their opportunities for a normal life by giving them a criminal record.
The services, Jones said, are needed now more than ever, with COVID lockdowns increasing depression, suicide ideation, and other forms of mental illness. He said he was already expecting the community paramedics to receive 12,000-16,000 calls this year. Changes will therefore be needed in the dispatch system and coordination with municipal law enforcement agencies within the county.
And that would tie back to the work session presentation a few hours earlier on municipal-county 911 consolidation. The effort to consolidate dispatch services for Asheville and the county has been underway since 2003. Whereas in former times consolidating communications centers was deemed a security risk, it is now considered a best practice nationwide, with 15 other counties in the state in some stage of consolidation. Advantages include those typical of any consolidation, as well as addressing the county’s desire to receive more per-seat 911 funding from the state and increasing capacity for dispatching revisioned responders, like community paramedics. Future actions include onboarding other Buncombe County municipalities into the consolidation.