Spokane Fire Department expands CARES and BRU: Suboxone on scene, more outreach hours and new behavioral‑health paramedics
May 04, 2026 | Spokane, Spokane County, Washington
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Chief Williams introduced CARES and the Behavioral Response Unit (BRU) updates to the committee on May 4. Sarah Foley, CARES team manager, said CARES is a social‑work response that follows up after 911 calls and referrals, connecting people to services and providing wraparound support.
Foley reported that in 2025 CARES recorded 769 referrals, completed approximately 1,520 home visits and worked with roughly 422 individuals (figures shown on the presentation slides). She said CARES provided volunteer service hours and has distributed Narcan widely, reporting more than 1,000 boxes placed in the community and at least 80 homes receiving Narcan once.
Anne Raven, medical services battalion chief and BRU lead, described BRU’s co‑response model with engines and ladders. The BRU has expanded from 40 to 72 weekly hours since March 17 and now carries on‑scene Suboxone to initiate treatment for withdrawal, which Raven said can reduce mortality in the short term.
"Suboxone itself is a life saving medication. Even 1 dose of Suboxone can decrease mortality by half for 1 to up to 2 days," Raven said, explaining the BRU uses Suboxone to stabilize patients and offer immediate treatment options, counseling and direct pathways to care.
Raven said the team has performed 224 behavioral‑health assessments and recorded 144 diversions from emergency departments during the period referenced, and that the department has made two conditional job offers for new behavioral‑health paramedic positions dedicated to BRU work. BRU staff said they are exploring an expanded on‑scene formulary that could include orally administered antipsychotics.
Council members asked about bed capacity and warm handoffs; Raven and Foley said they are coordinating with regional facilities and CARES will follow up after inpatient transitions to improve continuity of care. Staff acknowledged gaps in involuntary treatment locations and adolescent beds.
The committee did not take formal action; members suggested tracking cost savings from ER diversions as a future metric.
Foley reported that in 2025 CARES recorded 769 referrals, completed approximately 1,520 home visits and worked with roughly 422 individuals (figures shown on the presentation slides). She said CARES provided volunteer service hours and has distributed Narcan widely, reporting more than 1,000 boxes placed in the community and at least 80 homes receiving Narcan once.
Anne Raven, medical services battalion chief and BRU lead, described BRU’s co‑response model with engines and ladders. The BRU has expanded from 40 to 72 weekly hours since March 17 and now carries on‑scene Suboxone to initiate treatment for withdrawal, which Raven said can reduce mortality in the short term.
"Suboxone itself is a life saving medication. Even 1 dose of Suboxone can decrease mortality by half for 1 to up to 2 days," Raven said, explaining the BRU uses Suboxone to stabilize patients and offer immediate treatment options, counseling and direct pathways to care.
Raven said the team has performed 224 behavioral‑health assessments and recorded 144 diversions from emergency departments during the period referenced, and that the department has made two conditional job offers for new behavioral‑health paramedic positions dedicated to BRU work. BRU staff said they are exploring an expanded on‑scene formulary that could include orally administered antipsychotics.
Council members asked about bed capacity and warm handoffs; Raven and Foley said they are coordinating with regional facilities and CARES will follow up after inpatient transitions to improve continuity of care. Staff acknowledged gaps in involuntary treatment locations and adolescent beds.
The committee did not take formal action; members suggested tracking cost savings from ER diversions as a future metric.
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