CITY OF PACIFICA
COUNCIL AGENDA SUMMARY REPORT
9/25/2023
1 SUBJECT:
Approve the agreement with the County of San Mateo, Behavioral Health and Recovery Services (BHRS) to expand the Community Wellness and Crisis Response Team (CWCRT) pilot program in the City of Pacifica and to share the costs of one full-time mental health clinician in Pacifica as part of the CWCRT pilot program.
RECOMMENDED ACTION:
Adopt the attached resolution approving a three-year agreement between the County of San Mateo and the City of Pacifica to share the costs of one full-time mental health clinician in Pacifica as part of the Community Wellness and Crisis Response Team (CWCRT) pilot program for an estimated annual cost of $88,369, which shall be prorated based on the clinician’s start date; and authorizing the City Manager to sign the Agreement.
STAFF CONTACT:
Maria Sarasua, Chief of Police
(650) 738-7310
[email protected]
EXECUTIVE SUMMARY:
The County, acting through BHRS of San Mateo County Health, and the City of Pacifica seek to expand an existing pilot program of the Community Wellness and Crisis Response Team (CWCRT) to improve City and County response to community members experiencing mental health crisis in Pacifica.
The services performed by the mental health clinician are conducted by an independent contractor under a separate Contract Agreement between BHRS and StarVista, known as the “StarVista clinician.” The StarVista clinician will remain an employee of StarVista while providing services under specific terms of a contract agreement with BHRS, and at no time shall the StarVista clinician be deemed an employee of the City of Pacifica or BHRS.
Pursuant to Assembly Bill 179, Chapter 249, Section 19.56, Item 4170-101-0001 of the California State Budget Act of 2022 (2022 Budget Act Funding), which made appropriations for the support of state government and local assistance for FY 22- 23, the County received funding for the purpose of expanding the law enforcement co-responder model CWCRT Program. The County will use a portion of this funding, under the terms of this Agreement, to expand the CWCRT Program to the City of Pacifica, specifically to add one full-time mental health clinician.
The CWCRT Pilot Program is dependent on funding provided through the 2022 Budget Act Funding as the County will use a portion of this funding for program operating costs. Per the Agreement, the County shall give written notice of its determination that the 2022 Budget Act Funding will be exhausted, and all parties agree to meet in the projected last quarter of funding availability to address the possible termination or continuance of the CWCRT Program.
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Continuance of the program will require that all parties provide independent funding for clinician services.
The mental health clinician start date is expected to be November 1, 2023. This date will be used for funding purposes and for the appropriation of FY 23-24 costs. The actual start date is contingent upon the completion of applicable contracts and agreements, and the clinician hiring process; however, the start date will not be prior to November 1, 2023.
BACKGROUND
Historically, due to a lack of behavioral health resources and services, law enforcement has been tasked as first responders to individuals experiencing mental health crisis. This deficit in resources has limited the level and quality of care that a person in crisis receives and can further strain the relationship between law enforcement and community. Law enforcement response to behavioral health crises calls occasionally has devastating results, such as trauma, injury, or death. Lastly, linking persons with mental health diagnoses to the justice system is often ineffective, inefficient, and would be more appropriately resolved through the behavioral health care system. For all these reasons, the community has reconsidered how to best provide optimal care to a vulnerable population and properly utilize law enforcement resources. The result is the CWCRT program.
On January 12, 2020, the San Mateo County Board of Supervisors adopted Resolution No.
R077937 which approved the CWCRT Pilot Program, a partnership among four City Police Departments (Daly City, South San Francisco, San Mateo, and Redwood City) and the County, to embed in each of those cities’ police departments one mental health clinician to provide a crisis co-response to crisis calls involving mental health issues. The County entered into a contract with StarVista to provide the mental health clinicians for the CWCRTs.
The Pilot Program, launched on December 6, 2021, was designed as a law enforcement coresponder mobile crisis model, based on best practice models in other jurisdictions. The CWCRT enhances City and County response to incidents involving individuals experiencing mental health crises, by supplementing that response with the engagement of a mental health clinician assigned to work with each partner police department. Under the Pilot Program, the StarVista clinicians contracted by BHRS assist in the first response by providing early intervention, crisis de-escalation, 5150 evaluation, involuntary holds, referrals to therapeutic hospitalizations, and guidance to support services for individuals in mental health crisis. BHRS provides ongoing clinical training, consultation, and clinical oversight on the crisis response work conducted by all the StarVista clinicians in addition to conducting contract monitoring responsibilities.
In furtherance of the implementation of the CWCRT Pilot Program, the County entered into an agreement with the John W. Gardner Center for Youth and Their Communities of the Stanford University Graduate School of Education (Gardner Center), to support the planning and implementation efforts (Gardner Center Agreement). Under the Gardner Center Agreement, the Gardner Center conducts an implementation and evaluation study which will examine the interventions and assessment methods utilized by the CWCRT participant cities, to assist the cities to better understand and most effectively support the population served through the CWCRT Program.
Program Goals as stated in the Agreement are the following:
Goal 1: Law enforcement staff and the mental health clinician will respond together to active crisis situations where mental health crisis is a factor.
Goal 2: Improve outcomes for individuals experiencing a crisis due to mental illness or Pacifica City Council 3
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suspected mental illness.
Goal 3: Increase access to appropriate behavioral health resources, services, and treatment.
Goal 4: Provide clinical consultation, training, and support to law enforcement personnel in the field.
Goal 5: Increase knowledge of mental health conditions and effective intervention strategies among law enforcement personnel.
Goal 6: Law enforcement will strengthen relationships with service providers and community.
DISCUSSION
In the event of a suspected mental health crisis incident within the City of Pacifica, the mental health clinician will respond to the scene together with law enforcement personnel, exercising their independent judgment and expertise. The goal of the immediate co-response will be to deescalate the crisis and to support the safety of the individual in crisis, those around the individual, and all responding to the incident. The mental health clinician will assess the person suspected to be in mental health crisis and determine the best course of action (e.g., temporary mandatory placement in a medical facility for psychiatric evaluation and treatment under Section 5150 of the Welfare and Institutions Code, referral for treatment, etc.) and provide needed follow-up support and linkages to further stabilize the crisis and prevent future similar crises from happening again. While a co-response with law enforcement will be standard practice, the clinician may operate independently during some contacts, such as follow-up contacts and when a call for service is deemed safe for law enforcement to leave the scene while the clinician continues to provide services.
The Pacifica Police Department will be required to provide the clinician with a workspace, desktop computer, access to the radio dispatch system, access to law enforcement database systems to the extent necessary to carry out job responsibilities, and all necessary office supplies. The Pacifica Police Department will orient and inform the clinician of community needs, work with the clinician and police personnel to build necessary relationships and understanding, and will participate in meetings with BHRS and StarVista to evaluate program operations.
BHRS, in combination with StarVista, will provide the clinician with all additional tools and equipment necessary to complete the expected work, such as a laptop computer and vehicle (fuel included). Also included are all required certification updates and training necessary for the clinician to remain in the program. BHRS will meet with StarVista for contract monitoring, quality assurance, and clinical adherence.
Analysis
From May 1, 2022 - May 1, 2023, the Pacifica Police Department responded to 274 welfare checks involving mental health evaluations pursuant to Welfare and Institutions Code 5150 (W&I5150), 151 responses resulted in the evaluated person being placed on a psychiatric detention.
A mental health clinician possesses training and knowledge specific to mental health crisis and would be a helpful resource for Pacifica Police Officers, the person being evaluated, and others who may be at the scene, such as family of the person being evaluated. A clinician may also recontact individuals following the initial contact; a significant benefit of the CWCRT Program is the opportunity for persons in need to receive mental health support beyond what may be offered during the initial contact. Considering there may be significant portions of time in which a clinician does not have calls for service to respond to, providing follow-up support services to community members in need will be a critical and achievable clinician service. This follow-up service may improve the quality of life for some community members and may reduce the Pacifica City Council 4
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frequency of calls for service having to do with mental health crisis.
In addition to calls for service involving W&I 5150 evaluations, the Pacifica Police Department responds to various other types of calls in which a mental health clinician may be beneficial to the community and responding officers, such as domestic and family disturbances, and welfare checks. Not all evaluations meet the threshold of W&I 5150, but a mental health component may still exist. A clinician can provide assistance and services not often available from Pacifica police officers. A mental health clinician co-responding with officers or following-up with people after a mental health crisis, may provide more in-depth understanding of a situation and be of more assistance to the person(s) in need of support and to the Pacifica Police Department.
San Mateo Police is one of the initial four San Mateo County law enforcement agencies to incorporate one full-time mental health clinician into their operations as part of the CWCRT Pilot Program. In a one-year period, August 2022 - July 2023, San Mateo Police reported they received over 1,400 calls for service that may have qualified for possible clinician response, including W&I 5150 evaluations, welfare checks and some domestic/family disturbances. Many of these calls for service occurred during the clinician’s time off; however, the clinician did respond to over 250 such calls in the one-year period. San Mateo Police management reported the clinician provided a level of expertise during calls for service that was not possible from officers, greatly assisting not only the person(s) in need of assistance, but also the officers responding with the clinician. In addition to co-responding to calls for service, the clinician reviewed officer’s mental health related reports and offered suggestions to better clarify and describe mental health topics and provided San Mateo Police staff with mental health related training to assist officers in the field and to improve the reporting and processing of mental health related incidents. San Mateo Police management reports the clinician program has been a success and has benefited the community and agency.
According to research completed by the Gardner Center pertaining to the first full year of a mental health clinician working with the San Mateo Police Department, the research showed significant community benefit, such as increased connection between clients and mental health services, decreased rates of mental health detentions, and closer collaboration between police and mental health professionals for client benefit.
CALIFORNIA ENVIRONMENTAL QUALITY ACT
Approval of the CWCRT agreement is not subject to review under the California Environmental Quality Act (CEQA) pursuant to Public Resources Code Section 21000, et seq. and the CEQA Guidelines (14 Cal. Code Regs. §§ 15000 et. seq.), including without limitation, Public Resources Code section 21065 and California Code of Regulations 15378 as this is not a “project” that may cause a direct, or reasonably foreseeable indirect, physical change in the environment.
FISCAL IMPACT
The adopted the budget for FY 2023-24 includes funding for the first year of a two-year pilot program to add a mental health clinician in the police department ($140,000). The total budgeted fully weighted salary and benefits for one full time mental health clinician by StarVista for FY 23-24 is $176,737.00. The City will cover fifty percent (50%) of the fully weighted salary and benefit costs of the StarVista mental health clinician, and the County will cover fifty percent (50%) of the fully weighted salary and benefit costs of the StarVista clinician.
The City of Pacifica would be responsible for an annual cost of $88,369 of the total amount; however, for FY 23-24, the cost will be prorated based on the clinician’s start date. The clinician’s expected start date of November 1, 2023 will result in a prorated cost of Pacifica City Council 5
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approximately $58,913. The provided non-prorated cost can be expected for FY 2024-25 and possibly FY 2025-26 if money remains from the 2022 Budget Act Funding. Cost-of-living increases will be applied for FY 2024-25 and FY 2025-26.
The County will be responsible for all costs associated with the Gardner Center Agreement. The Pacifica Police Department agrees to cooperate fully with the Gardner Center Evaluation process.
The County will bear one hundred percent (100%) of the StarVista operating costs for this expansion to the City for the term of this Agreement.
The County will bear one hundred percent (100%) of the administrative costs associated with the StarVista contract. The County will be responsible for 100% of personnel supplies, including cost of a County car, auto insurance, ongoing gasoline and maintenance, and County laptop with required licenses. The cost of supplies used in the offices of the Pacifica Police department will be the City’s financial responsibility.
ALTERNATIVE ACTION:
Council may choose not to approve the agreement between the County of San Mateo and the Pacifica Police Department and provide staff further direction.
RELATION TO CITY COUNCIL GOALS AND WORK PLAN:
Approval of the agreement is consistent with the Council adopted Goal #5, Strategy B: Increase communications, education, and connections for community mental health resources.
ORIGINATED BY:
Police
ATTACHMENT LIST:
Attachment A: Agreement Between The City of Pacifica and County of San Mateo (PDF) Pacifica City Council 6
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RESOLUTION NO. _____
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PACIFICA AUTHORIZING THE APPROPRIATION OF $88,369 FROM THE POLICE DEPARTMENT’S FISCAL YEAR 2023-2024 OPERATING BUDGET AND APPROVING A THREE YEAR
AGREEMENT BETWEEN THE COUNTY OF SAN MATEO AND CITY OF PACIFICA TO
SHARE COSTS OF ONE FULL-TIME MENTAL HEALTH CLINICIAN IN PACIFICA AS PART
OF THE COMMUNITY WELLNESS AND CRISIS RESPONSE TEAM (CWCRT) PILOT PROGRAM FOR AN ESTIMATED ANNUAL COST OF $88,369, WHICH SHALL BE PRORATED BASED ON THE CLINICIAN’S START DATE; AND AUTHORIZING THE CITY
MANAGER TO EXECUTE THE AGREEMENT
WHEREAS, the City of Pacifica wishes to partner with the County of San Mateo to retain the services of one full-time mental health clinician for optimal response to individuals experiencing behavioral health crises within the Pacifica community; and WHEREAS, the mental health clinician would respond jointly with police personnel to improve outcomes for individuals and families experiencing behavioral health crisis and increase access to resources, services, and treatment; and WHEREAS, this collaboration is designed to provide clinical consultation, training, and support to law enforcement personnel in the field to increase knowledge and effective intervention strategies; and
WHEREAS, the term of the CWCRT pilot program is expected to extend through FY2024-25, and possibly into FY 2025-26, and is dependent on 2022 Budget Act Funding provided to the County of San Mateo; and
WHEREAS, the City of Pacifica will be responsible for 50% of the fully weighted salary and benefits cost of the Star Vista mental health clinician amounting to $88,369 for FY 23-24; and
WHEREAS, the applicable FY 2023-24 costs will be prorated based upon the expected clinician start date of November 1, 2023, resulting in an adjusted cost of approximately $58,913 for FY 2023-2024; and
WHEREAS, subsequent years will include a cost-of-living increase to the originally agreed upon costs.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Pacifica approves a three-year agreement between the County of San Mateo and the City authorizing to share the costs of one full-time mental health clinician in Pacifica as part of the Community Wellness and Crisis Response Team (CWCRT) pilot program for an estimated annual cost of $88,369, which shall be prorated based on the clinician’s start date.
BE IT FURTHER RESOLVED, that the City Manager is hereby authorized to execute the Community Wellness and Crisis Response Team Agreement in the form attached hereto, with minor revisions that may be approved by the City Attorney, and to execute any other Pacifica City Council 7
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necessary documents to effectuate the terms of the Agreement. • • • • •
PASSED AND ADOPTED at a special and regular meeting of the City Council of the City of Pacifica, California, held on the 25th day of September 2023, by the following vote:
AYES, Councilmembers:
NOES, Councilmembers:
ABSENT, Councilmembers:
ABSTAIN, Councilmembers:
_________________________________
Tygarjas Twyrls Bigstyck, Mayor
ATTEST: APPROVED AS TO FORM:
______________________________ _________________________________ Sarah Coffey, City Clerk Michelle Kenyon, City Attorney