Calling 911: “His aunt has lived in the apartment for 30 years. The thought of trying to find another place for her to live was daunting.”

Calling 911: “His aunt has lived in the apartment for 30 years. The thought of trying to find another place for her to live was daunting.”

Here’s the second story from the frontline of a pioneering collaboration between Partners in Care Foundation and the Los Angeles City Fire Department (LAFD) aimed at reducing non-emergency calls to 911. This story illustrates how one family contacted emergency services to try to solve a housing problem, and how health coaching intervention helped avoid a potentially devastating situation for one elderly woman. Names have been changed to protect privacy.

Roberto felt he was out of options when he dialed 911 in September this year. His aunt, Mariana, 97, who is frail and bed bound, needed to be moved from her apartment so that it could be fumigated for bed bugs. Roberto’s own home, which is some distance away and accessible only via a flight of stairs, was out of the question. His hope was that by calling 911 Mariana would be hospitalized while the exterminators did their job. Although they were sympathetic to Mariana’s situation, the LA Fire Department Nurse Practitioner Response Unit (NPRU) that attended the scene had to inform Roberto that this was not a valid reason to transfer Mariana to the hospital. Instead they offered another solution – a referral to Partners in Care Foundation.

A Partners health coach, Francisco Moreno, visited Mariana the next day. He spoke first with the building manager who explained that, reluctantly, he was going to be forced to evict Mariana if the apartment could not be fumigated soon. Two previous attempts had been unsuccessful and he was concerned that the bedbugs could spread through the whole building. He was also concerned that as a mono-lingual English speaker, he was having difficulties communicating the severity of the situation to Mariana and Roberto, who are both mono-lingual Spanish speakers.

“Roberto was shocked when I explained,” says Francisco. “He hadn’t understood the eviction threat his aunt was under. Mariana has lived in the apartment for 30 years. The thought of trying to find another place for her to live was daunting.” Although Francisco knew it was unlikely that Adult Day Health Care Centers or Assisted Living Facilities would accept Mariana, out of concern that she could bring bed bugs into their facilities, he proceeded to call around, also reaching out to Adult Protective Services and to the Housing Rights Center. None could offer any help.

“The situation was getting really bad and the apartment manager informed me that he would have to begin eviction proceedings if he had to cancel the next fumigation appointment,” explains Francisco. “That was a hard conversation to have with Roberto, who was very worried about the situation.” At Francisco’s suggestion, another solution was found. Roberto took a day off work and, together with one of the In-Home Support Service (IHSS) workers who cares for Mariana on weekdays, they were able to lift her into a wheelchair and find a comfortable spot outside while the fumigation proceeded. A week later a second fumigation took place, during which Mariana spent the afternoon at the nearby home of a friend. The second fumigation successfully rid Mariana’s home of the infestation. Roberto disposed of and replaced the bed, while her IHSS care worker made sure she was bathed and personally free of any bed bugs.

Meanwhile, Francisco reached out to Mariana’s doctor, providing a list of medications he’d inventoried at her apartment, and to check on whether Mariana needed any treatment related to the bed bug bites. The doctor was grateful for the outreach but reported that he had conducted a home visit and not seen any significant skin irritation as a result of the infestation.

“This was a tough case made worse by the language barrier between Mariana’s family and the apartment manager,” says Francisco. “Although it was frustrating not to be able to get Mariana into any form of temporary housing, once Roberto was made aware that she faced eviction they were able to rally and find a solution. The apartment manager was also relieved. He really didn’t want to evict Mariana, but was at a loss to know what else to do. I’m glad the situation had a positive resolution and that the family has a better idea of when and why to call 911. And most importantly, Marina can now sleep soundly in a bug free bed.”

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