Public Safety Committee
September 26, 2023
AGENDA REPORT
TO: Jestin D. Johnson FROM: Damon Covington
City Administrator Interim Fire Chief
Oakland Fire Department
SUBJECT: Informational Report on MACRO
Program Operations
DATE: September 5, 2023
City Administrator Approval Date:
RECOMMENDATION
Staff Recommends The Oakland City Council Receive An Informational Report On The Progress Of The City Of Oakland's Mobile Assistance Community Responders Of Oakland (“MACRO”) Pilot Program
EXECUTIVE SUMMARY
Under the direction of the Program Manager and the dedicated responders, the MACRO pilot program, which was launched in April 2022, continues to meet the needs of the community with a compassionate care first response model grounded in empathy, service, and community. This informational report is an update on the current operational outcomes.
BACKGROUND / LEGISLATIVE HISTORY
On November 17, 2022, Councilmember Treva Reid, Councilmember At Large, and Public Safety Committee Chair Rebecca Kaplan for the Rules Committee to have the Public Safety Committee receive a bi-monthly informational report on the progress of the City Of Oakland's Mobile Assistance Community Responders of Oakland (“MACRO”) Pilot Program and the work of the advisory board.
ANALYSIS AND POLICY ALTERNATIVES
Update On MACRO Operations For Summer 2023 (June, July, & August)
In June 2023, the MACRO responders in the field made six hundred and seventy (670) contacts with community members. Of that total, four hundred and seventeen (417) engagements were on-view responses, meaning that a MACRO crew self-dispatched to an incident based on observed behavior, a prior incident response the crew was following, or a perceived health condition. Seventy-one (79) were initiated by community referral emails, one hundred and twenty-six (172) from calls that came through the 911 dispatch system, and two (2) were Sep 14, 2023
Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 2
Public Safety Committee
September 26, 2023
initiated by an OFD request. Dispatches and community referral emails initiated 30% of all incidents for the month for a daily average of seven (7) requests for service.
In July 2023, the MACRO responders in the field made four hundred and forty-two (455) contacts with community members. Of that total, two hundred and forty-one (241) engagements were on-view responses, meaning that a MACRO crew self-dispatched to an incident based on observed behavior, a prior incident response the crew was following, or a perceived health condition. Seventy-one (71) were initiated by community referral emails, one hundred and forty (140) from calls that came through the 911 dispatch system, and three (3) were initiated by an OFD request. Dispatches and community referral emails initiated 48% of all incidents for the month for a daily average of eight (8) requests for service.
In August 2023, the MACRO responders in the field made four hundred and seventy-nine (479) contacts with community members. Of that total, two hundred (200) engagements were on-view responses, meaning that a MACRO crew self-dispatched to an incident based on observed behavior, a prior incident response the crew was following, or a perceived health condition.
Ninety-four (94) were initiated by community referral emails, one hundred and seventy-six (176) from calls that came through the 911 dispatch system, and nine (9) were initiated by an OFD request. Of the total incidents in August 2023, 58% were dispatched, averaging nine (9) dispatches a day. In August 2023, MACRO averaged 2.5 teams in service per day.
Communications division managers from Oakland Fire and Oakland Police continue to work together to ensure that their respective dispatchers have the utmost clarity on the criteria for MACRO call types and the available hours of service so that all eligible calls are appropriately dispatched, and MACRO teams are utilized. Ongoing training and communication between dispatchers, MACRO responders, and police officers and firefighters in the field should continue to generate greater community familiarity with MACRO and a higher volume of non-emergency calls successfully being dispatched to MACRO.
In September 2023, the City Administrators Office requested that a monthly report be developed by Oakland Police which demonstrates the number of non-emergency calls that align with MACRO call criteria that where MACRO was unable to respond due to staffing, hours of service or other factors.
Table 1 – Source of Incident: Summer Months and Program Lifetime Totals Source of Incident / Call June 2023 July 2023 August 2023 Lifetime Totals On-View (self-dispatch) 417 (-7%) 241 (-42%) 200(-17%) 13,182 911 Dispatch (OPD) 172 (+20%) 140 (-19%) 176(+26%) 946 Fire Communications
Request for Service (OFD)
2 (-89%) 3 (+50%) 9(+200%) 65
Community Referral (Email) 79 (-27%) 71 (-10%) 94(+32%) 872 Total 670 (-21%) 455 (-32%) 479(+5%) 15,065
Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 3
Public Safety Committee
September 26, 2023
Types of MACRO Incident Responses for Summer 2023 (June, July, & August) (with the percentage change from month to month):
Table 2 – Incident Types: Summer Months and Program Lifetime Totals Incident Type June 2023 July 2023 August 2023 Lifetime Totals Wellness Checks 273 (-49%) 227 (-17%) 212(-7%) 10,145
Sleeper 222 (-+19%) 124 (-44%) 154(+24%) 3,586
Panhandling 1 5 (+400%) 2 (-60%) 127
Behavioral Concern 107 (-9%) 89 (-17%) 100(+12%) 1,067 Public Indecency 6 (-25%) 10 (+67%) 11 (+10%) 88
Total 609 (-21%) 455 (-32%) 479(+5%) 15,013
*Included in the total but not the graph is “other” incident types.
As the number of responses initiated by community referrals and dispatches has grown, we are seeing that the on-view (self-dispatches) have declined. MACRO has worked closely with our dispatch partners to make improvements to operations and ensure that more calls are coming to MACRO from police dispatch, as the stats show. We have highlighted below how number of responses we have had to Oakland serving institutions such as the Oakland Public Library system and Oakland Parks and Rec Centers. We expect these numbers to increase as we move into summer.
Supporting Oakland Institutions
Table 3 – Response Totals for City of Oakland Agencies
Institution Lifetime Response Totals
Oakland Public Library System (OPL) 284
Oakland Schools (OUSD + Private) 136
Oakland House Authority (OHA) 10
Oakland Parks + Rec Centers (OPRC) 889
Total 1,319
All MACRO Impact Reports, including the MACRO 1 Year Impact Report for (April 9, 2022 – April 9, 2023), the June 2023 Impact Report, the July 2023 Impact Report, and the August 2023 Impact Report, are available in the documents section at the bottom of the MACRO homepage on the City website.
Three Examples From Incidents In June 2023, July 2023, And August 2023 Demonstrate The Evolution Of The Program And The Many Different Opportunities For Impact.
1. Found Elderly Individual Transported to Hospital for Medical Attention
On June 29, 2023, the MACRO team was called out for a “found senile” for an older Vietnamese community member who had been standing on a strip of sidewalk for almost two (2) days. The reporting party stated they had seen them on their ring door camera on Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 4
Public Safety Committee
September 26, 2023
Saturday night, and Macro was given the dispatch Monday night. The individual was cold and exhausted, barely verbal, and with weak vitals. After putting them in their vehicle with the heater on and providing water, the team worked with the individual for some time, one MACRO responder even speaking in their native language to get as much information as they could. Ultimately the team opted to call an ambulance unit to transport them to the emergency room for medical care. MACRO responder helped bridge the language gap between the responding paramedic/Emergency Medical Technician (EMT) and the community member. The team had the individual smiling and warm and in the hands of medical personnel when they left them.
2. Provider Fatigue for Community Member
July 14, 2023, MACRO was dispatched via Oakland Police Department (OPD) to a community member (CM) who was said to be with their belongings covered with blankets on the sidewalk adjacent to the grocery entrance. Upon arriving, MACRO was able to locate an individual matching the description from dispatch. MACRO engaged with CM, who was receptive to MACRO. CM did mention provider fatigue and mentioned that she has spoken to multiple agencies but has yet to hear back for a follow-up. MACRO encouraged CM to follow-up via phone and in person.
Action steps -MACRO attempted to connect CM with a local service provider, Eddie’s Place, for medical respite to some of their medical issues. CM refuses to go to a medical respite and prefers senior home care. MACRO provided information to St. Vincent De Paul and St.
Mary’s Center but was not interested. No medical attention needed. MACRO provided three (3) water bottles, two (2) hygiene kits, and two (2) blankets.
MACRO and CM agreed to future check-ins to follow up with services. No further assistance required. MCC.
3. August 28, 2023, MACRO Unit 2 responded to OPD’s request to provide a wellness check for an individual lying on the sidewalk with belongings.
Responders arrived on the scene, locating an individual sitting on the sidewalk with belongings, including three (3) large suitcases and a laundry basket. MACRO Community Intervention Specialist (CIS) engaged individual, who informed they were previously connected with BACS but expressed some provider fatigue, saying they received a referral to attend townhouse but wasn't very motivated to go.
MACRO CIS provided some information about accessing social services to obtain a phone as well as how to contact MACRO later today should they require further assistance.
Individual denied need for medical intervention. MCC.
Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 5
Public Safety Committee
September 26, 2023
Local Service Referrals
In Summer 2023 (June, July, & August), MACRO made a total of three hundred and twenty- three (323) referrals to the following service providers:
Table 4 – MACRO Service Referrals: Summer Months and Program Lifetime Totals Organization June 2023 July 2023 August 2023 Lifetime
CARES Navigation 9 4 2 441
West Oakland Health Clinic 1 4 1 147
Lifelong Mobile Clinic 23 19 12 190
ACHCH 5 1 5 62
Dignity on Wheels 5 1 4 362
HEPPAC 6 0 0 41
BACS 0 1 4 48
Bridge Housing 1 0 1 25
Amber House 2 2 1 16
Roots Community Clinic 20 14 5 373
St. Mary’s Center 22 13 11 206
St. Vincent DePaul 54 37 33 528
Total 148 96 79 2,439
Staffing Update
The MACRO Community Intervention Specialists (CIS) and the Emergency Medical Technician (EMT) positions were publicly posted on July 14, 2023, and closed on August 1, 2023. For the eighteen (18) available positions, we received 209 applications. - 120 for CIS
- 24 for CIS Bilingual
- 54 for EMT
- 11 for EMT Bilingual
Screening interviews for the CIS positions will begin September 11, 2023, followed by a Civil Service Exam and Department Level Interviews. The Tentative start date for new hires is projected to be November 13, 2023.
The actions and updates as outlined in this report advance the Citywide Priorities of Holistic Community Safety and Responsive, Trustworthy Government.
Potential Transition of the Advisory Board
The current iteration of the MACRO advisory board is made up of eleven (11) volunteers which were selected through an open application process. With the completion of the eighteen (18)- month pilot, the city council might consider developing a plan to have a MACRO board-like Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 6
Public Safety Committee
September 26, 2023
entity become a full-fledged city board or commission. The current board does not have public meetings or keep official minutes, is not required to adhere to standard public meeting protocols such as the Brown Act and does not have dedicated staff or policy analysts to evaluate its agenda or actions items. To create a new city board or commission, staff recommends that enabling legislation to be drafted and brought to Council this fall for consideration.
FISCAL IMPACT
This item is for informational purposes only and does not have a direct fiscal impact or cost.
PUBLIC OUTREACH / INTEREST
No outreach was deemed necessary for the proposed policy action beyond the standard City Council agenda noticing procedures. . .
COORDINATION
No coordination with other City departments was necessary for the completion of this report.
SUSTAINABLE OPPORTUNITIES
Economic: There are no economic impacts related to this report.
Environmental: There are no environmental impacts related to this report.
Race & Equity: Over the lifetime of the program, over 83% of MACRO service recipients are BIPOC individuals, fulfilling the mandate of serving BIPOC set forth in Resolution 88553 by Council in 2021. The breakdown of perceived racial demographics of the total 83% BIPOC are as follows: 66% Black, 12% Latinx, 2% Asian, 1% Middle Eastern, and 1% other.
Over 70% of MACRO incidents involve providing service to BIPOC community members, as MACRO designated to do. Over 50% of MACRO incidents served Black community members, while only accounting for 23% of the population in the city of Oakland. Comparing the racial breakdown of MACRO incidents with citywide racial demographics shows us that Black Oaklanders are the only racial group that is overrepresented receiving care from the MACRO team, while all the other races are underrepresented, including Latinx, Asian, White, Middle Eastern, and Native American.
Table 5 – Racial Breakdown of Incidents Summer Months and Program Lifetime Race June July August Lifetime Citywide
Demographics1
Latinx 10% 10% 11% 12% 27%
Black 59% 58% 50% 66% 23%
Other 1% 0% 1% 1% <1%
Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 7
Public Safety Committee
September 26, 2023
Middle Eastern 1% 0% 1% 1% <1%
Native American 0% 0% 0% 0% <1%
White 14% 15% 19% 14% 34%
Asian 4% 4% 3% 2% 16%
Total *89% *87% *85% *96% 100%
*Percentage totals that do not total to 100% are due to incidents with missing race data. 1Based on census data from census.gov.
Over the lifetime of the program, approximately 92% of MACRO service recipients are unhoused.
Over the lifetime of the program, approximately 45% of MACRO service recipients are frequent users of emergency services, having interacted with the MACRO program before.
Insurance Coverage of Population Served
From the start of the program (4/9/2022) until yesterday (9/5/2023), MACRO collected insurance data on 4,130 incidents, which is 29% of all incidents (~14.2k total incidents). The question is not required, so not every incident has this information. While 29% is not a high percentage of the total incidents, the total volume of incidents with data is high enough to be a valid indicator of the population that MACRO serves.
Of those MACRO serves, 61% of recipients have no medical insurance, and nearly the remainder of the recipients, 37%, are on MediCal (also called Covered California). Only 8 incidents involved individuals with private insurance and the remaining 1% of individuals have stated they’re on Medicare.
Table 6 – Program Lifetime Totals Patient’s Medical Insurance Status Patient Medical Insurance Status # %
No Health Insurance 2,533 61%
MediCal 1,546 37%
Medicare 43 1%
Private Health Insurance 8 <1%
Total 4,130 100%
% of total incidents with insurance data 29%
Jestin D. Johnson, City Administrator
Subject: Informational Report on MACRO Program Operations Date: September 5, 2023 Page 8
Public Safety Committee
September 26, 2023
ACTION REQUESTED OF THE CITY COUNCIL
Staff Recommends The Oakland City Council Receive An Informational Report On The Progress Of The City Of Oakland's Mobile Assistance Community Responders Of Oakland (“MACRO”) Pilot Program
For questions regarding this report, please contact Michael Hunt, Chief of Staff, Oakland Fire Department, at [email protected] and Elliott Jones, MACRO Program Manager, at [email protected].
Prepared by: Elliott Jones
MACRO Program Manager &
Dena Delaviz, Data Analyst
Respectfully submitted,
Damon Covington
Interim Fire Chief