SMART Policy Podcast
Podcast by the UT SMART Initiative. Host Jeremy Kourvelas speaks with experts from across the recovery ecosystem - representing healthcare, prevention, law enforcement and more - about local, state and federal drug policy to find out what is and isn't working to make this fight against addiction a little easier.
SMART Policy Podcast
First on Scene, Still on Duty: How These EMTs-Turned-Mayors Tackle the Opioid Crisis
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You're listening to the Smart Policy Podcast, a production of the University of Tennessee's Institute for Public Service. Small business owners, industry leaders, law enforcement officers, teachers, and even other elected offices like city councilperson, these are some of the most common professions that people have before becoming a county mayor in Tennessee. But it may surprise you that a fair number of our county executives were once EMTs, paramedics, or first responders before they sought out public office. Now, on the one hand, a path like this makes a lot of sense. If one is drawn to the kind of leadership that responding to literal fires, injuries, and disasters requires, surely that mindset would be put to good use in a mayor's or a county executive's office.
SPEAKER_00It kind of gives you a perspective on things. A lot of times when people think they're having a bad day, it's not really a bad day. Nothing's on fire, nobody's bleeding out. We've dealt with several large-scale natural disasters since I've taken office. And that background absolutely helps out.
SPEAKER_02On top of that, as far as the opioid crisis is concerned, we at Smart have found that few people are more aware of the complexities of the overdose crisis than EMTs and paramedics. And that degree of expertise goes a long way towards making effective decisions on allocating the opioid settlements.
SPEAKER_01Me being a county mayor and being able to utilize these funds, I know it. I didn't have to be educated on what the problem is. I need to know how to address it.
SPEAKER_02My guests this month are Montgomery County Mayor West Golden and Jefferson County Mayor Mark Potts, two Tennessee leaders that have dedicated their careers to public safety and now hold elected office. In this conversation, we talk about how their past experiences prepared them for mayoral life and the benefits of a career in public safety, as well as why a career in public service is life-changing.
SPEAKER_01People in public service are usually better informed when it comes to local government in most of that space. Maybe not so much in policy, but in the nuts and bolts of it.
SPEAKER_00Even if you don't know what you want to do, going into public safety can prepare you for so many other things. Some of my friends that are probably the most successful entrepreneurs were once in public safety.
SPEAKER_01One thing I learned a long time ago is Paramedic, you can't have fear.
SPEAKER_02It is.
SPEAKER_00Hey, my name is Wes Golden, mayor of uh Montgomery County, Tennessee. I was uh 25 years old when I started as a firefighter, and I really enjoyed it. It's uh probably one of the most rewarding jobs I've ever had. When I was there, I always sought for more training. I became an EMT, um, a hazmat technician. Went on later on to be a hazmat specialist, and it's a great job. I think I ended up leaving because of wanting to provide more for my family. I was always working three jobs and I was looking to work one.
SPEAKER_02Yeah, I I know the feeling. Um public service is definitely an interesting and yet very rewarding experience, but at the same time, it could be very demanding, uh especially if you're facing the public in a anything touching on EMT or paramedics or emergency medical services. What drew you to this line of work?
SPEAKER_00Oh, you know, I always liked public safety. Uh I felt like I've always thrived when high stress levels. Anytime we would have a new firefighter come on board, I'd tell them, if we get on the emergency scene and I yell at you, it's not because I'm upset. I just really need you to hear what I'm saying the first time I say it. Right. I think it's really helped me too in other jobs because it kind of gives you a perspective on things. When a lot of times when people think they're having a bad day, it's not, it's not really a bad day. You know, nothing's on fire, nobody's bleeding out.
unknownRight.
SPEAKER_01In graduate school, I pastored a small church in a rural community in Kentucky, uh, just uh just north of the Capitol. Uh it's a small fire department volunteer. The fire department organized and uh and hosted their own EMT class. So I became an EMT in 1995. It was hosted at our church. So we met there twice a week, went through, got my EMT license. And um after I got through with the EMT, I said, you know, there's gotta be a lot more to this. I believe I'd like to be a paramedic. And so during that time, I was going through some transition, doing career change, stuff like that. Parents back here, I'm from East NC, Jefferson County. My parents uh were getting older, my dad was sick. I thought to myself, I said, but some way I could be a paramedic, I'd like to do that the rest of my life. So sold our house, moved back here, went to paramedic school, went to work for Jefferson County. Uh and that's pretty well the rest of the story from there until 2018. Served as paramedic. Also worked on the ER uh full time. So I saw it on both sides. Um prior to ER, during the ER. The ER only enhanced my paramedic experience out in the field.
SPEAKER_02Yeah, there's no way it didn't. And frankly, this time period too, from 95 through 2018, uh that was all throughout the opioid crisis. You saw the prescription opioid wave, you've seen the rise of heroin and then fentanyl. All this happened uh almost overlapping perfectly with your career.
SPEAKER_01I saw opioid destroy lives in the ER firsthand. Can still vividly see some of the people that just got addicted, and and it's just a bad outcome. I I wish I had pictures of this one one young woman, young girl that started coming in. And uh, you know, it's kind of innocent when they first start. You know, they come back, oh, I'm still in pain. They'll give them another script of opioids. And I've stood and argued with the doctors. I said, you need to quit giving them all this pain medicine. They said, and at that time they was going, well, I've got to because my patient satisfaction scores will go down. And then uh I'm like, but they're in here every week. You're and and they were going, Well, well, management, you know, the hospital management, everything was driven on those patient satisfaction scores.
SPEAKER_02Yeah.
SPEAKER_01So, you know, I I've watched us um healthcare-wise, enable people. And then, of course, the drug company said it wasn't addictive when everybody knew it was. I mean, that's like, you know, you have to put a warning on a pack of cigarettes, tell people it's bad. I mean, so on the opioid, this one this one woman, young girl, really, as she would come in and go through. I wish I had photos to document her physical change over about five years. Because she went from healthy to just um skin and bones, and ultimately died of an overdose. And you know, we got and have sat and talked with her and said, if you don't stop, you're going to die.
unknownYeah.
SPEAKER_01I know. And it's not that they didn't know, she knew, but the addiction was so strong, she could not pull herself out of it. So that's the reason when the opioid settlement came to the county. Me being the county mayor and being able to utilize these funds, I know I I didn't have to be educated on what the problem is. Right. I need to know how do we address it. And I'm committed that any money we spend in what we do, we're gonna get the data and we're gonna find out is this working or not. If it's not working, we're gonna try something else.
SPEAKER_00I was a firefighter. I went on to environmental health and safety management. I worked for Dal Corning for a chemical company, and then I went into work in the automotive industry as an environmental health and safety professional. And then I ended up going back to the city of Clarksville, uh, working as the health and safety manager for the city. I did experience um some involvement through the opioid crisis during that time. My time as a hazmat technician and hazmat specialist really helped out on that side as well. I have a very diverse background. I've actually done a lot of construction work and things like that too. So sometimes when you when you get out in the field, whether the environment is uh a construction site or it's in a manufacturing facility, trying to relate with the people that are doing the work and telling them the why behind what you're selling, which you're selling safety, right? And not everybody wants to buy it.
SPEAKER_02Yeah.
SPEAKER_00But if you've done the work that they've done or you can understand how things work or why they're doing the work that they're doing, it makes it a lot easier to relate and just to sell them on the safety side of things.
SPEAKER_02So considering all these past experiences, how then does your prior role as an EMT or as a paramedic influence your position as mayor, especially in the context of responding to the opioid crisis?
SPEAKER_00Well, if you think about serving as mayor, a lot of your large departments are going to be public safety. So we have our sheriff's office, uh, EMA, fire department, EMS department. It really helps when we're going through the budget and we're trying to identify their needs and what they're looking for. When you've when you've had your boots on the ground and you've you've served alongside those people, it makes it a lot easier to justify. And you know, when a an EMS chief or a fire chief is talking to the budget committee, it's nice when I can chime in and I can say, they're absolutely right, and here's why. So when they come to me and they say, I need this device, it's gonna be$70,000, but it's gonna identify exactly what chemical we're dealing with. I'm able to justify that and sell it to the budget committee and to the commission as well. Because I also understand if an area, a patrol car has been contaminated, what that risk level is.
SPEAKER_02Yeah.
SPEAKER_00Where if if we do not decontaminate that that space, well, now we have a car out of commission. Now we have this other problem. You know, or we have might have a room or a facility that's out of commission until it can be decontaminated.
SPEAKER_02Absolutely. You know, it's it's prescient you bring that up. We we just published a briefing uh on the use of portable spectrometers that identify uh uh drugs in this ever-changing drug market and the benefit to how that can be paired in a relationship between public health and public safety uh to stay on top of what's in the communities. It's uh just prescient you bring that up. I couldn't help but notice that. I didn't see the article, but no, it's all right.
SPEAKER_01No, we're not in the rehab recovery business as a county, but we're in the business of supporting people who do. So we're looking for people who are doing it, who are successful. They present to us, we award them a grant, then we evaluate. Did you reach what you said you would do? Is there something you need to change? Is this someone we need to stay committed to on what you're doing, or should we look for another? We're not opposed to trying anything or anyone doing anything they can. But if your program's not working, you're going through us, you need to re-evaluate because I am committed and Jefferson County's committed. We're gonna do what it takes to save as many lives and as many people as we can through our programs here. And that brings us into the leave behind, Jefferson Has Heart, healing, addiction, treatment, and recovery, you know.
SPEAKER_02Yes, sir. This is the uh leave behind program that partners with an EMS uh service, correct, right?
SPEAKER_01Yes. So, you know, basically leave behind Jefferson Has Heart. Uh anywhere there's an overdose, we will leave a Narcan and a packet on here's Narcan in case this happens again, or somebody else in the household, here's some resources. You can reach out to Rescue 180 for counseling. We can get you into treatment, we can help you out. It's just a phone call or a click on your computer, and we're gonna track that data to see it's a great idea. But I don't know whether it works. So we're gonna do it, we're gonna get the data. If we're reaching people and it's making a difference, then we'll put more into it. We'll expand the program. But right now it's kind of a hate to say pilot, but it's a trial, it's an idea, and we're gonna see if it works.
SPEAKER_02You know, it it's there is a lot of innovation in this time period. Uh so it is it is refreshing to see that boldness and embracing, hey, we're gonna we're gonna try it, we're gonna take a look at the data and see if it works. In the meantime, I guess what I want to say is it's undeniable, just even listening to you now, that your past direct experience in responding to the opioid crisis has influenced your approach as mayor. Uh I I think it goes without question that that's the case. So I was wondering if you might give some insight into how it's maybe changed your thought processes compared to uh uh a mayor who may not have that past experience. And uh more so, what might you say to any first responders out there, especially EMTs or paramedics, that might consider a run for an elected office?
SPEAKER_01What's your passion? Why do you even want to run? If you think you're running to have some sort of power, you're gonna be certainly surprised when you get there because power brings responsibility. So then all of a sudden they give you millions of dollars and they say, all right, fix the opioid prices. What are you gonna do? I think you know people in public service are usually better informed when it comes to local government in most of the aspects. Maybe not so much in policy, but in the nuts and bolts of it. And so I had to kind of move from nuts and bolts to looking at the whole county, all the employees and everything else, because I was EMS oriented and still there, you know. I still teach uh like 25 ACLS and PALS classes a year. I teach doctor's office and everything else. And I'm like, why do y'all want me? And they said, Well, you've been doing it for 25 years, you know, 30 years. We like your stories. So, but yeah, so I'm still connected that way. And every now and then people will come up. I had a guy not too long ago that's a county commissioner in another county, he said, How'd I move from this to county mayor? And I said, Yeah, come up with a plan, systematically do it. Um you have to wait at the right opportunity. I mean, you it's timing, timing, timing, timing on on the political process, but you need to be formulating your opinions, your policies, you need to be thinking ahead. And so as you think ahead, if you're looking into going into this, your opinions on how you how you deal with stuff, on how you approach it, you know, this is your opinion on addiction, this is your opinion on that. As you have those opinions and people ask you, and you you convey those in time more and more people, and then when you get ready for your political run, you've kind of established some stuff and people know where you stand. And so they will help you to get into that office by knowing, hey, he's a good guy, and here's what he's trying to do on opioid. He he gets it.
SPEAKER_02Right.
SPEAKER_01Or any field you get, you have to research it out. If you go out here and people go, well, he don't get it, you're not gonna get elected. No. So that's the best advice I can give you is you know, figure out what's best and what's best for everyone, not just not just one group.
SPEAKER_00So for us, we're doing several different things here and trying to bring all those different resources together. Many times in a community, a lot of the residents don't understand what resources are already available. So to me, we should work as the hub of pulling those resources together. I'll give you one example. We're we're doing that. We've started a uh a youth coalition where we bring all the nonprofits and and some for-profit, right? All the groups together along with some of the church community so that everybody understands what resources we have. In the first meeting, we had over a hundred people there, and there were groups serving in this community that I was unaware of. So if I'm unaware, our court system's gonna be unaware. And yeah, how can we get our residents the best services possible? Well, pulling those resources together, I think, is a is a great start because I do believe we have a role, but we're not the best at everything. The government's not the best at a lot of things, but there are people who are, yeah, and we can pull those resources together so that everybody understands who our partners are and where as a leader, we should know what our resources are and where to send people to get those resources. And as a first responder, you get a lot of classes about the incident command system. You know, after after 9-11 happened, there was this huge push about the incident command system because they saw so many breakdowns and failures during some of those emergency operations.
SPEAKER_02Right.
SPEAKER_00And it teaches you a lot about span of control, uh, logistics, who's in charge of what, who should be in charge of what. So that really I think any leader would benefit from from that type of learning. And it and it's really helped me too. One of the things that I saw when I first came into office, I looked at the whole scope, what are we working with? We've got 43 departments. I'm on about 60 boards and committees. Well, Spanish control is out the window. So I met with all the different department heads, elected officials, and said, okay, tell me about some of the history here. And there was a common theme that came up. They said the last chief of staff was very focused internally, and the one before him was very focused externally. But both are in need. So we were able to bring another person on board who was who was already a county employee. He ran our veteran service organization, and he made it the number one BSO in the state, arguably, probably the country. Uh 37042 received more VA benefits than any other zip code after the PAC Act. So that's a direct correlation to the work that those guys did. So, but he had done all he could over there and he built a great program. He's looking for the next thing. So I brought him over, and now Andrew is on our team, and he's focused internally, where the chief of staff is focused externally. The span of control and learning through that span of control in the public safety world through the incident command system, it does teach it a lot. So still thinking about that span of control mindset, right? There was already a monthly department head and elected officials meeting that was happening. So there's 50 people in the room during that time. It's hard to have a meeting with 50 people in the room. Yeah. So we first of all we changed the name from department head elected official meeting to our leadership meeting. And then we decided how we were going to break this down into small groups. So we still have the larger meeting, but now we have quarterly small group meetings where folks that are involved with the court system, we meet together. So we broke it down into different categories like that. And that type of two-way communication has really helped fill some of those gaps.
SPEAKER_02That makes a lot of sense. And it sounds like it really improved efficiency.
SPEAKER_00Oh, yeah. And then from the leadership side, there's been some times where we've dealt with several large-scale uh natural disasters since I've taken office. Wow. And that that background absolutely helps out during those times. I make sure that I'm actually in the emergency operations center when those things are happening so so that I can make sure everybody has the resources they need. I don't always need to take charge. I look at my role as the person who removes roadblocks and speed bumps from their path and make sure they have the tools to do their job and give them the autonomy to do their job.
SPEAKER_01Yeah. So at one point I became an EMS supervisor and EMA, and I supervise P22 paramedics. Scheduling, ordering all the supplies and all that nuts and bolts stuff. So I got a crash course. Some personnel in the HR. No kidding. I handled the workers' comp claims for the county, did their schedule, their time off, and this and that and the other. So that greatly helped. I mean, but everybody that's in EMS, everybody can't be the supervisor or the scheduler. So you may or may not get that opportunity. But that was good help for me. You got to learn to pass stuff on. So a medic rolls into a chaotic scene. You're on the interstate, six-car wreck, multiple patients. You roll in if you've been doing it a while, you know, if you've been a medic there for 15 years and you roll in, everybody knows you're in charge. They're looking to you because you're going to do medical treatment. Not that you asked for it, but you've seen more of it as they're younger. And so you've got the like triage at that moment. What resources do I need? Same thing on mayor. Like when the uh pandemic hit, had to evaluate our resources, how we're going to respond to it. And all my training is uh EMA and EMS on triage, uh, instant command and all that just bled right over for into being county mayor. What's the resources? Who've I got to do this? What I need to do here. So, like on that rec scene, you know, I've got six patients, I need four more amps, need a helicopter, need another fire truck, need more traffic control. So you learn those critical thinking skills. And the difference between being paramedic and mayor is oftentimes paramedic, you gotta make it the first three or four minutes. Mayor, you may have a day or two, or you may not, but it's still the same process. The other thing I would advise you is uh advise somebody as make as big a network as you can. Get your network big. You never know when you're gonna have to reach back to your EMS people, put them in a position, give them a job or whatever, but you need to keep those networks strong. Have a strong mayoral network across the state, Tennessee. I'm uh executive board member, um, County Executive America. That's every county in the United States. So uh the other thing I've learned is uh ask somebody. Just ask. I've gone to a lot of conferences, absolutely abhor them, hate them, hate them. Sit there and look at my watch, like, oh my god, this is the same speech you gave last year. But then we go to dinner and we're seated at the table and people are talking about their shared responses and what they're doing. I need to take my notepad to dinner and my pillow to the conference because I'm gonna learn something at dinner. When I ask somebody, I says, How are you handling this situation? What are you doing with the opioid and that? And occasionally there's conferences good, but there's just an inherent amount of stuff that has to be repeated every year at these conferences. Nothing on the speaker is just, you know, after 20 years, you know, this is the 21st time I've heard this. So but expand those resources and get out.
SPEAKER_02If you could go back to your early days as a first responder, if there's advice you could give yourself now that you've been mayor for a while, what what advice would you give your first responder self?
SPEAKER_00Stay teachable. It's definitely uh a philosophy I've taken on later in life. I took a lot of classes and did a lot of things back then, but I I definitely could have done more.
SPEAKER_01Spend more time thinking and formulating in areas that's difficult. Hmm. Because you can only postpone it, but it's coming. Right. So I would tell myself that hardest issue that I don't want to deal with, you need to deal with it now, and everything else gets easier from there. How do you deal with people who disagree with you? How do you deal with people when you know what they're advocating is the wrong thing, those those skills and how to do that? And the other thing is how to learn how not to take stuff so personal. Don't take it home. Don't take it home. And even, you know, 20 years, you know, I was city mayor for 12 years with Jefferson City, four years as vice mayor. So, you know, I'm I'm I'm finishing 20 years as a mayor, either city or county. You know, sometimes I'll still take it home. And if I could go back in 1996 and figure out, you know, how can I leave this here? And I know people that do or say they do. I don't know whether you do actually everything. But um your own mental well-being, and I I guess what I would advise myself this can't do everything. Can't do it all, can't please everybody. You need to figure out some limits and some boundaries on what you're gonna do. Yeah, set your time constraints and stay there. That's what I should have told myself. Whether I would hurt it or not would have been a different story. But I should have said, you know, I'm only gonna do this for so many hours a day, and I'm gonna set aside this much time for me and my family, and kind of prioritize the family things over the political, over being mayor. That that's a mistake. And and you know, I've been rectifying that. I've been changing that balance of time. Now I spend more family time, but I'm closer, you know, be 67 years old in July.
SPEAKER_02Why should young people consider public service? This could be paramedic or mayor, either way, or anything in between.
SPEAKER_01If not you, who? No harder than that. Who's gonna do it? I'm not much on teaching new people. I'm not as patient. I'm old. I'm I'm old enough to be a grouchy old man now. So somebody else needs to needs to do the new ones. But I tell you why I'm always impressed with them is their enthusiasm. I'm that youth, that vigor, that ready to go, no fear. And uh one thing I learned a long time ago is paramedics, you can't have fear. I mean, you got to know when you go in you can handle this situation. If you can't, you're in trouble. And I've worked with medics that can't. And I did scheduling and stuff. And oftentimes you would pair a weaker with a stronger, you you pair a follower with a with a leader. If the follower was there and nobody was there to lead, it's disastrous. And if you're gonna be in public, you're gonna get elected, you're gonna have to be a leader, not a follower.
SPEAKER_00Even if you don't know what you want to do, going into public safety can prepare you for so many other things. I have some of my friends that are probably the most successful entrepreneurs were once in public safety. Because they're gonna understand customer service, what it means to serve others, how to handle stressful situations, all things that you're gonna need, both in public safety, but as a business owner and many other jobs, right? If you're gonna be the CEO of a company, you need to understand all of those things.
SPEAKER_02What advice do you have for public officials that don't have that past experience as an EMT or a paramedic?
SPEAKER_00I would say lean on your subject matter experts, know who your people are. I think it's very important to uh understand where they are and where they're coming from. So as much time as you can spend with those folks, your your public safety professionals, I absolutely would. Sometimes they come in and they forget that they're they're talking in firefighter terms or law enforcement terms. Yeah, you know, it's just like very similar to the military, right? Yes, sir. They have some of their own language. Being able to speak their language and uh under understand what their needs are is extremely important.
SPEAKER_01So probably in the beginning, I really didn't understand addiction. Probably pigeonholed certain group people, certain societal group. These are the people who are addicted, they don't have the uh ability to have self-restraint. And then as I've learned about addiction and seeing what's happened, it could hit any element of society, any person is is subject to addiction's addiction, it's a disease. So the fact just you know, it's like uh just say no. That's kind of trite. And another thing that's kind of changed that I've realized through the years as I've talked with addicts and the ER is they want to change. They really do. They don't, I mean, after after each one, they're like, I got to quit. And it doesn't last very long. So there's got to be some uh perseverance there, some type of tool, encouragement, mentor, you know, I don't know, uh, during that idle time, but but I've never ran across an addict that said, I want to keep doing this when you talk to them. I know this is bad, I know it can kill me, I need to stop. And then and then sometimes they would say, I just can't stop.
SPEAKER_02Yeah.
SPEAKER_01So if you're considering being elected official, public servant, DMT, or whatever, you you should always be encouraging.
SPEAKER_02What policy do you think would more effectively help fight back against the opioid crisis? This could be federal, state, local.
SPEAKER_01Transportation. Don't have a driver's license, don't have a car. It's expensive to get these things. So they're totally dependent upon somebody else to go to the county clerk and get their driver's license, to go here and do this, to get their follow-up appointments and stuff. So we're I've got a meeting today where we're addressing the transportation issue, trying to work on a fixed bus route from Morestown, Jefferson City. So we're working on that. And so rather than wherever you're staying, whether you're in a treatment halfway, rehab, or wherever you're at, those people are usually responsible for your transportation wherever you're going. And then they have to sit there and wait and then bring you back. So we're trying to get this fixed bus route to where you can drop them off at this bus station or what we're stabbing bus station, and then the bus will be back at two, three. And so we're not tying the staff up from our entities to do that. So that's a policy shift, that's a policy change. And the other thing that that would help policy-wise, there's not enough treatment centers. There's not enough intake facilities. I mean, if somebody comes in and say they they want the rehab, they want to go into recovery, they want to dry out, you can't wait three days and go get them. No. They need to go in right then. So, you know, alcoholics probably need vivitrol, or people need, they need uh boxone or equivalent. So these medicines that have in addiction need to be more readily available. They don't need to be so dang expensive. I mean, it needs to be subsidized to where we can afford to give them. We're not having to weigh, well, we're gonna have to cut this just to give these meds. I think that may be where we need to use some of our opioid money. But there's not a clear path. So you asked me about policy. That's that's what I'm thinking. I'm I'm just giving you preliminary thoughts on where to go. Don't know how to get there.
SPEAKER_02Well, hey, um, that was I think that was.
SPEAKER_01Well, you exercised my mind this morning.
SPEAKER_02Well, Mayor Golden and Mayor Potts, uh, thank you both so much for joining me on the Smart Policy Podcast. I really appreciate it.
SPEAKER_00Thank you, brother. I appreciate it. It was good talking with you today.
SPEAKER_02Okay, thank you. For more episodes on in depth discussions on Tennessee policies related to substance use disorder by a range of local experts. Please subscribe to us wherever you get podcasts and visit our website at smart.tennisd.edu. I'm Jeremy Corvellis. Thank you for listening and see you next month.