LYNNWOOD — When Kristena Matthews walked into a south Snohomish County apartment earlier this month, the Compass Health worker saw medications strewn all over.

The resident recently had a stroke, but didn’t have a caregiver or follow-up appointments scheduled. Instead, they had been calling 911 almost every day, Matthews said.

There’s not much first responders can offer beyond emergency care. But they’re required to take the call.

For years, South County Fire’s first responders have referred people with chronic needs to “community resource paramedics” and Compass Health “care coordinators” — for ongoing support beyond a 911 call, more like social work than a lights-and-sirens response, with the goal of reducing trips to the emergency room. It’s part of a program called Community Transitions.

Other local police departments in Lynnwood, Mountlake Terrace and Mukilteo have similar programs adding a community health worker to the team.

This summer, the city of Edmonds tried something new: a program where the mental health professional isn’t directly embedded with police or firefighters. Instead the job falls under the city’s Human Services division, in a partnership with Compass Health.

In the first six months of this year, the teams in southwest Snohomish County have already met with nearly 200 people and helped 145 access services for mental health, substance abuse treatment and more.

South County Fire reduced the number of emergency calls by 48% for the 523 people enrolled in the program, and the number of their emergency room trips dropped by 49%, spokesperson Leslie Hynes said. The reason might seem obvious. If someone is calling 911 many times, often there’s an underlying issue.

‘How challenging it is’

Edmonds’ Human Services division is only two years old.

Head down the gray steps to the bottom floor of the Frances Anderson Center at 700 Main St. Past the old “classroom” signs hung near each door, you’ll see “HUMAN SERVICES” in blue on a frosted window.

Inside, the entire department — Erin Nathan and Mindy Woods — sifts through the priorities to tackle a wide array of social issues: elderly care, housing, food insecurity. One top concern? Behind them, a whiteboard touts a goal of “0%” homelessness in Edmonds.

Less than a decade ago, Woods and her son, then 13, were unhoused in Edmonds. They stayed in a hotel covered by the YWCA, while waiting for two shelter beds. Long before she worked for the city, she was an advocate for others who were without help in Edmonds.

“Mindy didn’t stop going to City Council and reminding them constantly this is a huge hole, a gaping hole in the services that the city offers,” said Shannon Burley, deputy director of Parks, Recreation, Cultural Arts and Human Services. “And how challenging it is to be a person who needs help and still try and maintain all your life and take care of your kids.”

Woods was hired part-time to help run the city division in 2020. This year, she became the city’s first full-time Human Services program manager.

Nathan, a Compass Health mental health professional, brings 15 years of experience in overseeing affordable housing programs, counseling and case management. She will receive referrals from Edmonds police and sometimes ride with an officer escort, but she won’t be part of the department.

Some days Nathan will meet with people at Edmonds Municipal Court. Other days, she may be sitting with someone in crisis outside a coffee shop. Her goal is to build relationships, then work to get people the help they need.

‘Marching orders’

The new Edmonds program is one piece of a shifting approach to social services in the city. Earlier this year, the Edmonds City Council adopted an ordinance banning people from living outside on public property. If people turn down shelter that’s available within a 35-mile radius, they may be charged with a misdemeanor, punishable by a fine of up to $1,000 or 90 days in jail. There are alternatives to a fine, including community service.

In the weeks leading up to its adoption, service providers, people who have been without housing and elected officials urged City Council members to start with proactive measures. No shelter exists in Edmonds city limits. The Human Services division has a handful of motel vouchers.

The only shelter in south Snohomish County, the Lynnwood YWCA, often has a wait list that’s months long. People may have to go to Everett or elsewhere for shelter, leaving their belongings behind.

Burley said she took the City Council’s vote as “marching orders” to address Edmonds’ lack of shelter.

In the future, the city could buy a motel to expand shelter in south Snohomish County. The goal is to create regional resource hubs and ease the burden on Everett in caring for the entire county, Burley said.

According to the city’s latest homelessness assessment, at least 450 people were unsheltered in the city as of 2021. That counts people without a physical address, who may be couch surfing or staying with friends or relatives. And at any given time, the Human Services division estimated no more than 15 people were more visibly homeless in Edmonds, as in sleeping outside.

For people struggling to pay rent or searching for housing, “figuring out the system is oftentimes the challenge,” Burley said, “and that’s where (Woods) and (Nathan) come in. That’s their superpower.”

Like the South County Fire program, Nathan and others seek to reduce the number of non-emergency calls by addressing their root cause.

“When (first responders) are here in emergency mode we need to fix a problem right now,” South County Fire paramedic Dani DeVos said. “A lot of these people that we see here in the community resource office don’t have things that can be solved right now.”

The newest programs, in Edmonds and Mukilteo, could help balance the workload where South County Fire has been stretched thin. Compass Health workers across south Snohomish County meet weekly to exchange notes.

“There’s a lot of opportunity here for the program to make an impact and it takes time,” said Charissa Westergard, director of healthcare integration at Compass Health. “… It takes time to engage people and build that relationship and that trust, and that’s an investment.”

Isabella Breda: 425-339-3192; isabella.breda@heraldnet.com; Twitter: @BredaIsabella.