
This Black History Month, we are reflecting on the many contributions Black people have made and continue to make to our nation. One such contribution is the pivotal part Black hospital workers played in the creation of our modern Emergency Medical Services (EMS).
Prior to the 1960s, ambulance service was provided by a hodgepodge of services, mainly funeral homes. In Pittsburgh, Pennsylvania, police responded to medical emergencies, and there was a wide disparity of service between predominantly white neighborhoods and Black neighborhoods. Seeing an opportunity to improve health outcomes, visionary physicians at Presbyterian-University Hospital embarked on a novel experiment: Outfit a van with medical equipment, emergency lights and sirens, and train Black orderlies from the hospital on lifesaving interventions like CPR.
They partnered with a local non-profit, Freedom House Enterprises, and in 1968 the first paramedics hit the streets of Pittsburgh. Freedom House was so successful that other cities created EMS agencies of their own, and in the 1970s the city of Pittsburgh took over EMS response from Freedom House. You can read a fuller account of Freedom House’s history here.

Today, Freedom House serves as a model for decoupling crisis response from overburdened first responders and investing in a new dedicated resource staffed by professionals specially trained in behavioral health. The Biden administration, at Senator Ron Wyden’s urging, has provided some grant funding to stimulate planning of mobile crisis intervention units based on the model of Eugene’s innovative CAHOOTS program.
Of course, Deschutes County has a Mobile Crisis Assessment Team (MCAT) and a Stabilization Center. But from 2019 to 2021, the county reduced its funding of behavioral health services, and the stabilization center’s ability to maintain 24/7 operations beyond June of this year remains in doubt. The MCAT team has never been adequately funded. As a result, the burden of responding to behavioral health emergency calls continues to fall heavily on our police and firefighters.
To provide compassionate and equitable care to community members experiencing behavioral health crises and their families, Deschutes County and its partners can learn from the lesson of Freedom House and commit to stable, sustainable funding for dedicated services. The Deschutes County Sheriff’s Office is already a key partner, contributing $570,000 in annual funding, and Commissioner Phil Chang is pushing for increased funding from the county’s general fund and partnering cities to shore up the stabilization center.