Title
Community Assistance Program Expansion Overview and Discussion
Description
This report provides an update on the expansion of the City's Community Assistance Program (CAP), an overview of efforts to date and a timeline for full implementation.
THIS ITEM IS FOR DISCUSSION AND POSSIBLE ACTION.
Report
Summary
The Phoenix City Council recently approved $15 million in the Fiscal Year 2021-22 budget for the Community Assistance Program. This expansion is intended to enhance accountability, responsiveness, transparency and trust from the public by expanding the City’s longtime civilian-only program to respond to mental and behavioral health calls for service.
Community members, public safety responders and mental health professionals have all identified the need for enhanced mental health and crisis response support in Phoenix. Vulnerable communities including children and the elderly, individuals experiencing abuse, poverty and homelessness, residents with behavioral and mental health disorders, or people with alcohol and drug dependencies all require additional support. In order to bridge this gap and to improve service delivery to individuals contacting 911 experiencing behavioral and mental health issues or in need of emergency crisis response, the City Council approved additional resources to expand the Community Assistance Program.
Program History
The Community Assistance Program was established in 1995. This all-civilian group handles 4,000 calls annually, and includes five crisis response units comprised of 17 full-time positions and 23.3 part-time Caseworker II, Caseworker III, Program Coordinator, and administrative positions that were majority grant-funded over the years using Department of Justice Victims of Crime Act (VOCA) grants in addition to program volunteers. The program responds 24/7 to mental and behavioral calls for service and is managed by licensed civilian professionals in social work and counseling.
Budget and Research Study
In April 2021, the Budget and Research Department (B&R) conducted a study on Public Safety Behavioral Health and Crisis Response Calls for Service. The purpose of the report was to identify an alternative model to delivering services to individuals suffering from behavioral and mental health conditions and who require crisis response care. Budget and Research staff researched eight cities including Albuquerque, N.M. (Albuquerque Community Safety Department - ACSD); Austin, Texas (Expanded Mobile Crisis Outreach Team - EMCOT); Denver, Colo. (Support Team Assisted Response - STAR); Eugene, Ore. (Crisis Assistance Helping Out On The Streets - CAHOOTS); Redmond, Wash.; Salt Lake City, Utah; San Antonio, Texas (Mental Health Detail - MHD); and San Diego, Calif. (Resources Access Program - RAP). The study recommended adding resources to the CAP program to increase the number of crisis response units and to establish new behavioral health units across the city based on where the highest concentration of calls take place. The concept was to create an effective City of Phoenix behavioral and mental health crisis response program where multiple city departments including Police, Fire, Human Services, Neighborhood Services, and Housing all work together alongside community-based organizations and the behavioral health community to improve the quality of life for residents in need (Attachment A).
Progress to Date
A multidisciplinary team of staff from the City Manager’s Office, Fire, Police, Finance Procurement, Budget and Research, Human Resources and Public Works departments have been working since the Community Assistance Program expansion was approved by City Council and went into effect on July 1, 2021. Over the last four months, the following actions have been taken:
- Worked with Human Resources and Human Services departments to hire the Community Assistance Program Administrator (Deputy Human Services Director).
- Worked with Finance Procurement Division to issue a Request For Information (RFI) for Telehealth Services and received 10 responses.
- Worked with Finance Procurement Division to develop three Scopes of Work for Telehealth, Public Outreach and Community Engagement, and Behavioral Health Units Request For Proposals (RFPs). Finance Procurement Division to let RFPs in late Fall/early Winter 2021 and bring to City Council for approval by February 2022.
- Worked with Public Works Department Fleet Division to procure and order 23 vehicles for additional CAP fleet. Vehicles due to arrive in May 2022.
- Worked with Human Resources Department to conduct three recruitments for the Caseworker Service Coordinator (CWSC), Caseworker II (CWII) and Caseworker III (CWIII) positions in August 2021. Five of the five CWSC supervisor positions have been filled to date and interviews are underway for the CWII positions and being scheduled for the CWIII positions with positions to be filled over the next two to three months.
Crisis Response Units
The Crisis Response Units (CRUs) are staffed by City employees. The CRUs will continue to be utilized on calls for service that involve trauma and social service needs including homelessness, child/vulnerable adult abuse, sexual and domestic violence, drownings, house fires, death (natural, homicide, and suicide), and frequent utilizers of the 911 system for non-emergency calls. The CRU employees also will be trained to provide services related to a behavioral health crisis. When appropriate, CRUs will make referrals for follow up to the Behavioral Health Units (BHUs) or request a BHU to respond if the main issue is a behavioral health crisis.
Behavioral Health Units
The Behavioral Health Units (BHUs) will be staffed utilizing one City employee and a community partner employee. The teams will comprise a Master level clinician (City caseworker) and a peer support specialist (community partner). The BHUs will be dispatched on incidents in which the main concern is a behavioral health crisis. The units will provide short-term case management for up to nine months to ensure customers are connected with appropriate long-term supportive services. The BHUs will provide transportation to emergency psychiatric agencies, non-emergency behavioral health agencies, and/or recovery (substance abuse) agencies. The units will respond, as appropriate, to calls for service without police or fire personnel. Both the CRUs and the BHUs also will be available for co-response with public safety first responders when appropriate.
ASU Calls for Service Study
The City has engaged Arizona State University to conduct a study to determine the natural call codes for behavioral health calls and to assess which calls for service BHUs should respond to, which could include a variety of calls including hangings, overdoses, unknown medical, trespassing, etc. The City’s 911 call takers use 10 questions to determine how to best dispatch calls for service. Many times, behavioral health calls do not show up as the primary call for service but show up as a secondary or tertiary reason for the call for service once assessed.
Alternative Response Program Implementation Assistance
Recently, the City of Phoenix was selected as one of 14 cities to participate in the Bloomberg Philanthropies’ What Works Cities (WWC) Alternative Emergency Response Sprint hosted in partnership with White Bird Clinic. A 17-member team representing City departments, community partners, healthcare and mental health providers participated in an eight-week sprint, which was a collaborative online learning opportunity for cities and community stakeholders to learn about alternative models of emergency response and how to advance the implementation of such models.
In August, the City hosted the 2021 CIT International Conference “Turning Up the Heat with CIT: Transforming Crisis Response Systems” in Phoenix. The Phoenix Police Department’s Crisis Intervention Team (CIT) was also recognized by Mutual of America with the 2020 Community Partnership Award on Oct. 15, 2021 as a partner on the Community and Law Enforcement Collaboration Project along with EMPACT-Suicide Prevention Center and the Tempe Police Department.
In September 2021, the City of Phoenix was selected as one of five cities and counties from a pool of 60 jurisdictions to participate in the Harvard Kennedy School’s Government Performance Lab (GPL) one-year technical assistance grant to assist with program implementation. Phoenix along with Long Beach, Calif., Philadelphia, Pa., Durham, N.C. and Harris County, Texas were selected as the GPL’s inaugural Alternative 911 Emergency Response Implementation Cohort. Phoenix also was highlighted in Harvard GPL’s 10-Year Anniversary kick-off event “Shifting from Planning to Doing: Implementing Alternative 911 Emergency Response Systems."
Program Implementation Timeline
Originally, full implementation of the expanded Community Assistance Program was anticipated to take 18-24 months. City plans included seeking input from the community and mental and behavioral health stakeholders to ensure that the program meets the needs of all. The following outlines the program implementation based on a one-year accelerated implementation schedule (Attachment B).
Continued Investment
The Mayor and City Council continue to invest in improving mental health and behavioral health services and support for individuals in Phoenix. In addition to the CAP expansion for mental health calls for service, City Council also approved adding 10 positions for Fire Emergency Medical/Dispatch Services, a Traumatic Incident Liaison in the Human Services Department (HSD), and four family advocates at HSD’s Family Advocacy Center as a part of the City’s budget process.
Recently, City Council approved an additional $9 million in American Rescue Plan Act (ARPA) funds to further address mental health in the community. While the CAP expansion focuses on individuals experiencing a mental health crisis, the mental health program administered through a third-party vendor on behalf of the Human Services Department using the ARPA funds will focus on individuals not in crisis but seeking mental health services.
These investments form a collective effort to create an effective City of Phoenix behavioral and mental health crisis response and services program where multiple City departments work alongside nonprofit organizations and the behavioral health community to improve the quality of life for residents in need.
Staff also is exploring rebranding and renaming the Community Assistance Program.
Department
Responsible Department
This item is submitted by City Manager Jeffrey Barton, Deputy City Manager Ginger Spencer, Fire Chief Kara Kalkbrenner, the City Manager’s Office and the Fire Department.