A Naperville Fire Department program devoted to tackling nonemergency medical service calls saved residents more than $5 million in 2024, Naperville Fire Chief Mark Puknaitis says.
Puknaitis lauded the estimated cost savings at the Naperville City Council meeting Tuesday night as part of a presentation on how the fire department’s Community Advocate Response Team (CART) program performed in 2024.
The program, piloted in 2022 and launched last year, created an ambulance unit solely dedicated to answering 911 calls that may not require a trip to the emergency room but still need attention. Those calls could include requests for help with mental health crises, drug and chemical dependencies, memory care and senior care issues.
CART responded to 1,488 incidents in 2024, according to Puknaitis’ presentation. Of those, 1,005 ultimately did not require transport to the hospital.
Estimating that an average trip to a medical facility for a nonemergency situation would cost about $5,000, Puknaitis said he believed CART helped the city save more than $5 million last year in avoided emergency room visits.
“This is a great program,” Puknaitis told council members. “It’s building, I can tell you that. There’s more people that are learning about this every single day. We do have a mental health situation that is occurring around Naperville. … (CART) is truly making a difference in people’s lives, and we’re learning from this every single day.”
When the fire department started piloting the CART program in January 2022, it operated on a limited, 40 hours a week basis. Three shift personnel were reassigned to the initiative and used a reserve ambulance.
In September 2023, the city council authorized the department to hire six new full-time employees to give the program the staffing it needed to be a 24/7 operation.
CART launched full time in January 2024.
Naperville Fire Chief Mark Puknaitis. (City of Naperville)
The types of incidents the unit responded to in 2024 were overwhelmingly — more than 80% — nonemergency and most related to mental health issues, Puknaitis said.
When the CART unit responds to a call, the team focuses on determining the root cause of the situation and typically treats the patient on scene, he said. Patients are then connected to applicable community resources for preventative care.
That’s different from the department’s pre-CART model — and the model used for regular ambulances — where a unit responding to a nonemergency situation would give patients two options: sign a release or go to the hospital.
The average time a unit spends on a scene with a “treat no transport” incident is about 20 minutes, Puknaitis said. On average, the team is spending 25% more time with patients compared to other units, and in some cases has spent as many as three hours on scene with a patient trying to find the right solutions, he said.
Beyond initial response, CART also performed 1,536 follow-up services for patients. Additional service calls exceeded the number of initial calls due to some patients needing repeated follow-up attention, Puknaitis said.
Follow-up services are centered on checking in with patients to ensure they are receiving the help they need to prevent their situations from becoming an emergency in the future, the chief said.
“There are many Naperville residents that … have conveyed to myself and members of my department how fortunate they are to have this program,” Puknaitis said.
As the program continues to grow, the department is hoping to “really get the message out” to residents that CART is an available resource to them, he said in a call Wednesday. Should someone want help through CART, they can call 911 and request the unit or call the department’s nonemergency number, 630-305-5900, during regular business hours, he said.
In addition to expanding the program’s reach in Naperville, Puknaitis said he could see similar initiatives taking shape in other communities in the future.
In the wake of its launch, several other municipalities — including Joliet, Elgin, Lockport and Naples, Florida — have reached out to Naperville fire to learn more about the initiative, he said.
Speaking at Tuesday’s meeting, Naperville Mayor Scott Wehrli commended CART’S impact.
“This is a real feather in Naperville’s cap, for (the fire department) to be on the frontline with this particular program,” he said.
