Inside one of the US’s busiest fire stations caring for LA’s homeless residents

“Nightline” embedded with LAFD Station 9, which averages about 80 calls a day and many of the 6,000 homeless residents in L.A. County rely on them as their primary health care provider.
8:45 | 01/17/20

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Transcript for Inside one of the US’s busiest fire stations caring for LA’s homeless residents
it really is. My personal mission is the same, I just want to help people. Reporter: In the shadow of downtown L.A., paramedic Scott lay czar pumps narcan into his latest overdose patient. The chaos of skid row playing out all around him. Watch out, I don't think he's going to want that back. Reporter: A 16-year veteran, Lazar and his partner Mike Contreras are used to mornings like this. Too often the same person, sometimes on the same day. Hey, Scott, you tended to him yesterday, what was yesterday? Same thing. Overdose? Deja Vu, yeah. Reporter: There are nearly 500,000 homeless people nationwide. Many of the unsheltered living here in California. Look at Los Angeles with their tents and the horrible, horrible, disgusting conditions. This issue is a crisis. It's a state of emergency. Reporter: A national outcry shining a spotlight on a city in crisis. Amidst the high rises in Hollywood, about 60,000 people live on the streets of L.A. County. It is not hard to find examples of the homeless problem. Infectious diseases that kill people back in the middle ages are affecting homeless populations. Firefighters say the fire started on 20th street, initially sparked by some homeless people. Reporter: Fears over disease and public safety clashing with the realities of mental illness, addiction, the cycle of poverty. California's governor proposing a nearly billion-dollar housing plan as debate here rages over long-term solutions. Fire station 9 is the busiest fire station in the entire country. And the area it services is skid row. Thousands of people living on the streets. This fire station does over 30,000 calls every single year. We embedded at this station over a period of five months, getting a rare look at the day-to-day operations of this team in a crash course in daily life for the city's most vulnerable. Station 9 averages about 80 calls a day. Many of the roughly 6,000 people who live here on skid row rely on them as their primary health care provider. Lazar and Contreras are members of a so-called fans response vehicles, whose job it is to dart ahead of fire engines, assess the situation, and gauge the resources needed. It's a temporary fix at best. So we just try and mitigate. Really, that'sal all it is. These guys have a lot of pride and they're proud of their station, and we're proud to help support them. Reporter: Amidst a sea of misery, washing up against those garage doors, there's a quiet domesticity at station 9. Shared meals. A workout. Most defining, a sense of brotherhood. Today is engineer mark tostato's turn to cook. He sweats over chicken sandwiches, worried they're dry. How's the chicken? This is my home away from home. We're getting a call. That's you? All right. Reporter: L.A. Fire department's medical director, mark Epstein, says the intensity of what station 9 members experience is unique. They're exposed to communicable diseases, exposed to needles, violent crime. And they're literally running nonstop. Reporter: And yet some like tostatos keep coming back. This is his 11th year here. And his second tour of duty. You have to want to be here. Because to see what's going on here, feces, throw-up, needles, overdoses, death. Reporter: Over the months visiting the station, we saw our fair share of misery. You got carpeting in there. Reporter: Also glimmers of This was hanging over the front of my tent here. Reporter: Like meeting this man, who calls himself mango. He's become a de facto aide to the firefighters here. He helps us a lot. He gets traffic for us. I know people, cars are coming, like who's this guy? Reporter: He gives us a tour of his neighborhood, where he's often treated like the mayor. Hey, mayor, what are you doing? Saving lives? Saving lives like we always do at station 9. Reporter: It's there we see a disabled woman struggling on the sidewalk. Are you okay, honey? You cover yourself like that and you'll be all right. Someone ran over your foot? Broke your foot? It's okay, it's okay. These people need to be in shelter. Dorms. Dorms? You want dorms? Because when it rains. You're all right. Okay, we're going to go but I'm going to come back and check up on you. Reporter: Moments later, tostato heading out on another call. A woman fighting with paramedics. Firefighters work to subdue here and assess the situation, binding her hands with cuffs borrowed from a security guard. How often in 10 years have you seen something like that? I couldn't even put a number on it. Daily, weekly? Yeah, probably weekly. It's not their fault. A lot of times it's a psych issue, or they're doing drugs and it's an effect of the drug. Reporter: That woman was on her way to the emergency room, but that's just the problem, says the LAFD's Epstein. Having paramedics roll on someone hearing voices, suicidal Ed ation, taken to E.R. With no mental health professionals, how does that help? They're just going to wind right back here? Yep. Reporter: Unlike police officers, paramedics can only transfer patients to the E.R., instead of mental health facilities or sober houses that can be more appropriate for a specific case. L.A. Fire department chief Ralph tarazas says one of the problems is regulatory. A paramedic can't take a patient to a mental facility? A psychological facility? Cannot, because it's not compliant with county protocol. Reporter: And that, he says, is what's causing the backlog at hospitals and sapping the city's budget. He and l.a.'s mayor, Eric garcetti, are lobbying the state to make those changes. It's been described that each homeless person is like a lock with its own unique key. There isn't a single solution that works for all of them. And it's something the firefighters know implicitly. You hope maybe, just maybe, they go to the hospital for the fifth time, the 12th time, maybe, just maybe, they'll find the right locksmith there. Hold on, we're brothers. We eat together. Best friends. Reporter: The crew at station 9 notches wins every day. As they say, treating each individual without bias, because their patients aren't human beings, it's the job. They respond on these types of people, with these problems, every day, and they street them with the same level of respect as a CEO working in a highrise two blocks from here. And that is quite noble and quite admirable. They do it day in, day out. Reporter: For "Nightline,"

This transcript has been automatically generated and may not be 100% accurate.

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