Cotati City Council
Agenda Staff Report
Item type: REGULAR AGENDA (ACTION)
To: City Council
Subject: APPROVAL OF SECOND AMENDED AND RESTATED SAFE
MEMORANDIUM OF UNDERSTANDING
Date: September 8, 2026
Written by: Damien O'Bid, City Manager
Recommendation
It is recommended that the City Council approve a resolution authorizing the City Manager to enter into and execute the Second Amended and Restated Memorandum of Understanding (MOU) with the City of Rohnert Park, Sonoma State University and Petaluma People Services Center to Operate and Manage the Rohnert Park/Cotati SAFE Team (Specialized Assistance for Everyone) to provide crisis response services to our communities, subject to final review and such revisions as may be approved by the City Attorney.
Background
In 1989, the City of Eugene, Oregon developed an innovative community-based public safety system to provide mental health first response for crises involving mental illness, homelessness, and addiction. As a result, the White Bird Clinic launched CAHOOTS (Crisis Assistance Helping Out On The Streets) as a community policing initiative.
The CAHOOTS model mobilizes two-person teams consisting of a medic (a nurse, paramedic, or EMT) and a crisis worker who has substantial training and experience in the mental health field.
The CAHOOTS teams deal with a wide range of mental health-related crises, including conflict resolution, welfare checks, substance abuse, suicide threats, and more, relying on traumainformed de-escalation and harm reduction techniques. They also can handle non-emergency medical issues, avoiding ambulance transport and emergency room treatment.
CAHOOTS staff are not law enforcement officers and do not carry weapons and are dispatched through 911 or through a non-emergency line for issues that do not involve an immediate safety threat to the individual in crisis or the general public.
After approval by the Cotati City Council, the City of Cotati (City), in partnership with Rohnert Park, launched a 12 hour per day crisis response team in November 2021. This has gradually grown to cover 18 hours per day, and then 24 hours per day in FY 2024-25. The program is run by Petaluma People Services (PPSC) and has been branded the “SAFE Team” (Specialized Assistance for Everyone), which was intended to align with the City of Petaluma’s pilot program that had already launched as the “SAFE Team”. This was intended to reduce public confusion over the service.
In October 2022, the City Council approved the partnership and addition of Sonoma State University to the SAFE MOU, resulting in the current composition today as the Cotati-Rohnert Park-SSU SAFE team. Operating separately, but very closely coordinated, is the Petaluma SAFE team, with both teams collectively known as the South County SAFE team. Currently, the other mobile crisis response teams operating in Sonoma County include the InResponse team (Santa Rosa) and the Mobile Support Team (MST) that serves areas of Sonoma County not served by SAFE or InResponse. While the teams are similar in function, the InResponse and MST teams are different in that they include a licensed clinician in the field and try to draw a distinction between a mental health call and homeless service.
Analysis/Discussion
The MOU identifies the roles and responsibilities of PPSC, the City of Rohnert Park, SSU and the City of Cotati. As in the current MOU, PPSC will continue to provide the personnel, supplies, management and oversight of the field program, while the City of Rohnert continues to provide and maintain the vehicle assigned to the SAFE Team. The revised MOU includes general clean up language throughout, including changes to re-align certain provisions with the Petaluma SAFE MOU and a two-year extension to the MOU term. However, the primary substantive change is to meet the requirements of the Measure O grant, which requires the City (via this MOU to PPSC) to meet the requirements necessary to bill for program costs for MediCal patients served, as part of the intermediate goal of program fiscal sustainability. In practice, this means that PPSC needed to bring on a telehealth licensed clinician, as staff believe putting a licensed clinician in the field full time is a very inefficient use of a highly trained and costly resource. As a result, the South County SAFE teams now have a licensed clinician overseeing the program and on-call when needed via telehealth. The vendor performing this service is the Committee on the Shelterless (COTS). Additionally, the SAFE team needed to be qualified to collect the necessary data for Medi-Cal billing through the SMART Care system as well as meet a variety of other health privacy and information security requirements. The fully Medi-Cal compliant SAFE teams began service on September 1, 2026.
The SMART Care system is also rolled out to MST and InResponse, with the goal of collecting the same data using the same data definitions so that data can be compared and other information, such as diversion numbers and health insurance information for non-Medi-Cal patients. This is not for billing, but for general tracking to allow the collective mobile crisis teams to have follow on conversations with the beneficiaries of the system so that they will participate financially and help build a sustainable County-wide program. In addition to tracking information for fiscal sustainability, the City continues to collect information on number of responses, response times and outcomes to determine program effectiveness.
In a recent report to the Board of Supervisors, Sonoma County Department of Health Services (DHS) stated that one of their goals was to move to a single model as soon as July 1, 2027.
Presumably, this will be discussed in a forthcoming working group of mobile crisis jurisdictions that DHS says that they intend to convene in the near future. In advance of the initial working group discussions, staff anticipate the following points of discussion when determining a unified mobile crisis model:
• Cost, service level and outcomes, based at least in part on the clinician model (telehealth vs in field).
• Mental Health vs. Homeless Service
• Available program funding
Finally, the attached draft MOU has been reviewed by PPSC, Rohnert Park, SSU and Cotati staff for program scope. However, each jurisdiction may also need final legal review, so final legal changes may still occur, which is reflected in the recommendation.
Financial Considerations
The additional requirements to be Medi-Cal eligible significantly increased the overall cost of the program and the additional reporting requirements are anticipated to create longer in-service times for the SAFE teams filling out forms. However, the City intends to continue tracking responses, response times, etc. to better understand the overall impact to service levels as we move into conversations about the ideal unified system, or potentially systems, for Sonoma County.
The intent is to pair the Measure O grant with the necessary direct General Fund contributions and in-kind services to support the SAFE service during the term of the MOU. City in-kind services primarily consist of program administration and support time, dispatch services and the share of the infrastructure costs needed locally to support the SAFE program. For Cotati, the unreimbursed General Fund contributions and value of the in-kind service has averaged approximately $113,000 per year since the inception of the program. By leveraging City resources, it allows the County to improve their services to our residents. For the South County teams, DHS has been able to leverage nearly $11 million to date in local resources by supporting the South County SAFE teams:
The companion Measure O grant agreement (see separate agenda item, this meeting) will fund the primary “hard“ costs in Year 1 (FY 26-27) and most of the hard costs in Year 2 (FY 27-28), but very little costs in Year 3. The intent is to work collaboratively with DHS and Santa Rosa over the next two years to develop a fiscally sustainable model. The primary funding risks are:
• A reduction in Medi-Cal from the current 85% to 50%, if the supplemental funding is not renewed in the State budget for FY 27-28.
• Non-renewal of Measure O.
• Inability to leverage funding from the program beneficiaries.
Without new sources of funding, it is unlikely that the SAFE teams could continue to operate in their current form in Year 3, therefore the MOU is limited to a term of two years.
Environmental Issues
Where it can be determined with certainty that there is no possibility that the activity in question may have a significant effect on the environment, the activity is not subject to CEQA review.
This general rule can be applied to activities which could be subject to the CEQA process, but which logic dictates should not be subject to CEQA review. Therefore, based on the information provided above, the proposed resolution is exempt from CEQA pursuant to Section 14.03.021 of the CEQA Guidelines in that there is no possibility that the activity may have a significant impact on the environment.