CARE unit 6-month update
 

In FY2020-2021, the City of Flagstaff determined the number of 911 non-emergent type calls was outpacing the resources of the Flagstaff Fire Department, Flagstaff Police Department, and local private ambulance company.  These types of calls were predominately based around substance use and mental health issues. With numerous other resources in the city, it was also determined that taking these clients to the hospital was not always the best option.  The City of Flagstaff, community members, and a special committee partnered together to approve and fund the CARE unit.  Through an RFP process, Terros was awarded a 3-year contract as a partner with the ability to extend for two more years.  The unit is staffed by a behavioral health professional and a Firefighter/Emergency Medical Technician (EMT) from Flagstaff Fire Department. It took months of planning, inter-agency and inter-divisional collaboration and finally hiring and training to support the new unit becoming operational.

On March 28, 2022, the unit went operational on a 10-hr workday from 9:00 a.m. to 7:00 p.m.  The unit was mobile in the community conducting public outreach and when not engaged with a client would respond to calls for service that came through 911 Dispatch. Over the last three years, the role of this unit is becoming clearer and the impact it has on the city, partners, Flagstaff Police Department, and the Flagstaff Fire Department.  The unit is based out of Fire Station 6 on Lake Mary Road, utilizing the community room for its headquarters.

In June 2024, Terros staff took over EMT services that were previously provided by the Flagstaff Fire Department to provide the most appropriate response level.   Per council direction, an update was requested to ensure the CARE unit was still meeting the mission and objectives of the program.

The CARE contract is currently in the 5th and final year and we will begin solicitation for services to continue the program.

The CARE unit continues the excellent work being done by the Terros team following the July 2025 transition to Terros staffing with EMTs and Behavioral Health Technicians. The CARE team has increased the public outreach, which could potentially be leading to reduced use of the 911 emergency system.  The unit has evolved from primarily distributing basic supplies to delivering higher-level medical and behavioral health support, including wound care education, on-scene health checks, and distribution of first aid kits that have been widely welcomed. Clients continue to recognize and trust the CARE van, are more willing to have wounds assessed, and are increasingly open to hospital transport when medically necessary. This trust is reflected in thoughtful medical upgrades, which increased slightly post-transition because of better clinical assessment, not over-escalation.  The transition has also led to increased Firefighter moral by allowing those individuals being available to respond to emergency calls.

The data is showing that a significant portion of CARE-related demand occurs during daytime hours, when the CARE team is actively deployed, and that this alignment is producing meaningful results. Flagstaff Fire Department data from October 2024 through September 2025 indicate that alcohol-related calls are more than twice as common during CARE hours (0900–1900), with 792 calls during the day compared to 380 overnight. Behavioral health calls show an even stronger daytime concentration, with 222 calls during CARE hours versus just 78 at night. This pattern reinforces that CARE is operating when community need is highest but is showing that Flagstaff Fire emergency units are still responding to many low acuity alcohol/behavioral health calls despite the CARE van being in service.

At the same time, the Flagstaff Police Department data illustrates the broader context CARE is working within. While public assist rides are more frequent at night, behavioral health and alcohol-related calls remain consistently high across both day and night shifts. CARE’s daytime presence helps absorb a substantial share of these complex calls, reducing pressure on the Police and Fire emergency responses and keeping them available for those true emergencies. 

Equally important, CARE continues to demonstrate strong de-escalation and client-centered practices. There have been no Police upgrades for violent clients during the time period presented, showing that CARE staff are effectively managing challenging situations while respecting client autonomy and maintaining safety. Overall, with the data and narrative together, the CARE is a strong success. However, we are seeing the CARE unit workload increasing, as is Police and Fire’s responses when the CARE unit is not in service or committed to another call. We will continue to monitor this data and work towards identifying the best contract proposal moving forward.