AGREEMENT BETWEEN
THE CITY OF PACIFICA AND
THE COUNTY OF SAN MATEO FOR THE PROVISION OF
The purpose of this Agreement between the County of San Mateo (County), acting through the Behavioral Health and Recovery Services (BHRS) of San Mateo County Health, and the City of Pacifica Police Department (City) (Agreement) is to expand the pilot program of Community Wellness and Crisis Response Team (CWCRT) to improve City and County response to community members experiencing mental health crisis.
This Agreement sets forth the terms and conditions between the County/BHRS and the City, collectively referred to as the Parties, for the provision of embedding one full-time mental health clinician in the City Police in support of the expansion of the CWCRT for three (3) fiscal years, FY 2023 through 2026.
The County agrees to the following:
1. Background Information
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 a contract with StarVista to provide the mental health clinicians for the CWCRTs, as StarVista was already providing a mobile youth crisis response team.
The Pilot Program, launched on December 6, 2021, was designed as a law enforcement co-responder 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 hold, and 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 (Program), the County entered 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.
The current Agreement will expand the CWCRT Program to Pacifica to specifically add one full-time mental health clinician in the City Police department to provide the first response mental health crisis services as described above. The Agreement will address the roles and responsibilities between the City and the County.
2. Purpose or Scope of Work
The City enters into this cooperative and reciprocal agreement with the County, acting through BHRS, for expanding CWCRT to enhance its response to community members in mental health crisis. In the event of a suspected mental health crisis within a community, once informed, the mental health clinician will respond to the scene together with the City law enforcement officer, exercising their independent judgment and expertise and in collaboration with the officer. The goal of the immediate co-response will be to de-escalate 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 then assess the person suspected to be in mental health crisis (“the client”) 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. One of the goals of the CWCRT program is that clients in mental health crisis contacting and interacting with law enforcement receive early intervention and guidance toward appropriate health services. The mental health clinician will be trained in the range of available mental health resources both within BHRS and in the community, and together the law enforcement/mental health clinician response team will decide on the best course of action and/or resources or program for the client.
The County of San Mateo derives direct benefit from the implementation of this Agreement, by way of, for example, increasing its ability to directly respond to community members in mental health crisis; providing Medi-Cal reimbursable services to County clients; enhancing response time for those in need of mental health services and resources; and creating a broader and more effective continuum of care that results in a decrease in justice system contacts.
To achieve a healthy and integrated community, this Agreement represents a collaboration among the Parties to jointly exercise their common powers to enhance community linkages and help stabilize and improve the health and well-being of persons experiencing mental health crisis. Important outcomes include, but are not limited to: residential stability, improved mental health and connection to needed services and treatment, reduced use of acute and emergency services, and reduced contact with the criminal justice system.
3. Relationship of Parties
The Parties acknowledge and agree that the services performed under this agreement 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 is part of the StarVista workforce and remains 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 or BHRS.
Neither the County of San Mateo nor the StarVista clinician acquire any of the rights, privileges, powers, or advantages of the employees of the City.
4. Mutual Responsibilities of the Parties
4.1 The Parties agree to review, adopt, and modify as needed, policies and procedures that may be developed by the participants in the CWCRT Program regarding, but not limited to, scope of work, chain of communication, necessary training, grievance process, performance concerns, ongoing monitoring of the Program, supervision of job performance of the StarVista clinician, and handling and disposition of data generated by all the Program participants. The policies and procedures will reflect the Parties’ mutual understanding that the StarVista clinician is a contracted StarVista employee and professional who exercises independent clinical judgment and expertise in the performance of their scope of work complying to all the County’s requirements related to crisis mental health services, applicable laws and ethics, and the required documentation and reporting procedures under the BHRS Documentation Guidelines.
4.2 The Parties will participate, as needed, in efforts to obtain and analyze data to document the effectiveness of the Program in reaching the anticipated goals and objectives, while protecting and respecting individuals’ confidentiality and privacy rights per HIPAA requirements. These efforts will include partnering with the Gardner Center to evaluate the Program’s effectiveness during the term of the Agreement (Gardner Center Evaluation).
4.3 The Parties will participate in all the collaborative trainings when appropriate, follow the developed program strategies and protocol of the response team, in a manner that respects the dignity and diversity of community members.
5. Responsibilities of the Parties
5.1 The City shall be responsible for each of the following:
• Providing the StarVista clinician with a workspace and access to the City’s computer and radio dispatch systems, including but not limited to law enforcement data base system, to the extent necessary to carry out job responsibilities of this co-responder Program, as necessary; • Orient and familiarize the StarVista clinician with the City Police department workspace, technology and operations, and specific community needs • Support and collaborate with the StarVista clinician in clinical decisions and referrals
• Work collaboratively with the StarVista clinician to provide necessary law enforcement-related information to assist the clinician in achieving the agreed upon outcomes of the Program
• Participate in meetings with city partners, BHRS, and StarVista for progress status, data collection, outcomes evaluation, coordination, and sustainability.
5.2 BHRS shall be responsible for each of the following:
• Contract out provision of the mental health crisis response to StarVista for a trained full-time mental health clinician to be embedded in the City Police department
• The Scope of Work provided by this mental health clinician will be clearly defined in the BHRS contract agreement with StarVista, which includes crisis response, crisis de-escalation, crisis assessment, involuntary 5150 hold, short-term follow-up intervention support and case management linkage connection to needed treatment and services. Related training, documentation requirements and data collections will all be detailed in the County’s agreement with StarVista and monitored on an ongoing basis • Ensure required onboarding documentation orientation, needed 5150 certification training, BHRS and community mental health/substance use services and resources training, and periodic training related to crisis response, crisis de-escalation, crisis assessment, 5150 involuntary hold, laws and ethics are arranged for or provided
• Provide the StarVista clinician with all needed County equipment and materials necessary to perform the function of a mental health crisis response clinician in the CWCRT Program (i.e. County laptop with needed applications, County car, auto insurance, auto maintenance, ongoing gasoline), and technical support to address related technical issues as they may arise in the use and maintenance of this equipment
• Provide Avatar electronic health record log-in for the purpose of client lookup and documentation of billable and nonbillable mental health services • Hold meetings with StarVista for the purpose of contract monitoring, quality assurance, and clinical adherence
• Exercise reasonable care to ensure compliance with all legal and clinical requirements related to the contract with the County and the crisis work performed by the StarVista clinician
6. Goals of the CWCRT Program
Goals of the CWCRT Program are:
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 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.
The Parties agree to meet and confer periodically to assess and revise program goals, and to add new program goals, as appropriate.
7. Special Terms and Conditions
7.1 Coordination and Oversight
The assigned BHRS Clinical Services Manager will be responsible for the oversight of the StarVista contract and its progress status with StarVista, provide ongoing clinical consult, training, and quality assurance/quality improvement of the services provided by the StarVista clinician.
The Chief of the Pacifica Police Department, or their designee, will participate in the quarterly oversight CWCRT Advisory meetings, in the Working Group meetings as needed to monitor the progress of the CWCRT expansion towards its objectives, review any operational issues that have arisen, and identify items for ongoing work plan as needed.
7.2 Conflict Resolution
In the event of disagreements or conflicts between the Parties to this Agreement, the disagreement or conflict will be referred initially and in writing to the assigned Captain and Clinical Services Manager from Pacifica Police and BHRS, respectively. In the event consultation at that level does not resolve the disagreement or conflict, then the Chief of Police or their designee, BHRS Clinical Services Manager, and BHRS’ Deputy Director of Adult and Older Adult Services shall meet and confer and attempt to resolve the matter. Finally, in the event the disagreement or conflict remains, the BHRS Director (or designee) and the Chief shall meet and confer. BHRS will obtain the participation of StarVista in the resolution process, as BHRS determines is appropriate.
If the disagreement or conflict pertains to the performance of the assigned StarVista clinician, the disagreement or conflict will be referred initially and in writing to the assigned StarVista Program Manager/Assistant Director and the BHRS Clinical Services Manager. In the event consultation at that level does not resolve the disagreement or conflict, above-noted meet-and-confer steps shall be followed. Finally, in the event the disagreement or conflict remains, StarVista shall remove the assigned mental health clinician and exercise reasonable diligence to identify and provide a qualified replacement. These conflict resolution steps will be clearly detailed in the BHRS-Star Vista Contract Agreement.
7.3 Staffing and Supervision
The CWCRT expansion under this Agreement will consist of one full time mental health clinician who must be licensed or license-eligible to provide mental health services by appropriate State of California licensing authorities.
Under the BHRS Contract Agreement, StarVista will be responsible for hiring the mental health clinician and the hiring processes. The City will be entitled to assign one member to the StarVista hiring panel, if so prefer.
7.4 Records and Confidentiality
Records created by the StarVista clinician under the CWCRT program, shall be considered the County’s records, free from the control and direction of any other party to this Agreement. Such records will be subject to all federal, state, and local laws and regulations regarding the protection of client/patient privacy and confidentiality.
The Parties agree that the StarVista clinician must adhere to the privacy requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). BHRS will train the StarVista clinician on federal, state, and local policies and procedures with respect to the confidentiality and use or disclosure of protected health information of clients as necessary and appropriate for the StarVista clinician to carry out their functions. BHRS will provide the StarVista clinician with the appropriate Health System policies and procedures, which are subject to change from time to time.
The County reserves the right to take appropriate action for violation of its policies, and such action may include the immediate termination of the contract work with StarVista or strong recommendation of the immediate termination of the specific StarVista clinician who violates Federal, State, or local law and policy.
BHRS shall maintain beneficiary medical and/or clinical records for a period of ten (10) years, except that the records of the persons under age eighteen (18) at the time of treatment shall be maintained: a) until one (1) year beyond the person's eighteenth (18th) birthday or b) for a period of ten (10) years beyond the date of discharge, whichever is later. This rule does not supersede professional standards (BHRS is allowed to maintain records for a longer period if required by other regulations or licenses).
8. Hold Harmless and Indemnification
8.1. It is agreed that the County shall defend, hold harmless, and indemnify the City and their officers, employees, agents, and servants from any and all claims, suits, or actions of every name, kind, and description brought by a third party which arise out of the terms and conditions of this Agreement, and which result from the acts or omissions of the County and/or its officers, employees, agents, and servants.
8.2. The County shall defend, hold harmless, and indemnify the City from and against any and all claims for wages, salaries, benefits, taxes, and all other withholdings and charges payable to, or in respect to, the County's representatives for services provided under this Agreement.
8.3. It is agreed the City shall defend, save harmless, and indemnify the County and its employees, agents, and servants from any and all claims, suits, or actions of every name, kind, and description brought by a third party which result from the acts or omissions of the City and/or its respective officers, employees, agents, and servants.
8.4. The duty of each party to defend, hold harmless, and indemnify the other as set forth herein shall include the duty to defend as set forth in Section 2778 of the California Civil Code.
8.5. In the event of concurrent negligence (or intentional/reckless acts) of the City and/or its respective officers and employees, on the one hand, and the County and/or its officers, employees, agents, and servants, on the other hand, then the liability for any and all claims for injuries or damage to persons and/or property which arise out of terms and conditions of this Agreement shall be apportioned according to the California theory of comparative fault.
9. Term and Termination
9.1 Term
The Agreement shall be effective immediately upon signature by each of the Parties pending contract completion between BHRS and StarVista and the hiring of the mental health clinician by StarVista. The term of the Agreement shall end in three fiscal years on June 30, 2026.
9.2 Amendment/Modification Process
All subsequent modifications or amendments to this Agreement shall be in writing and signed by each of the Parties hereto before they will be effective.
9.3 Termination
Subject to the Parties’ understanding as to the term of the Agreement, detailed in Section 9.1, each Party agrees to remain a party to this Agreement for the entire duration of the Agreement term, subject only to termination for cause.
Cause for termination of this Agreement will include only a material breach of this Agreement by another Party or impossibility of performance. Prior to termination for cause, the terminating party must give the other party 30 days written notice of the alleged material breach and notice of an opportunity to cure such breach during the notice period.
10. Funding/Financial Responsibilities
10.1 Personnel Cost Sharing
Unless amended by the Board of Supervisors and Pacifica City Council, the annual contributions of the City and the County to the CWCRT expansion expenses shall be as follows:
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. Total budgeted fully weighted salary and benefits for one full time mental health clinician by StarVista for FY 23-24 is $176,737.00.
BHRS shall pay to StarVista the costs of salary and benefits of the StarVista clinician, as invoices come due. The City shall reimburse the County for fifty percent (50%) of these salary and benefit costs of the clinician on a bi-annual basis, upon invoice by the County. BHRS Fiscal will invoice the City Fiscal directly every six months; reimbursement from the City is expected within twenty (20) business days. The City shall provide the contact information of its Fiscal to BHRS at the time of signing this Agreement.
• For FY 23-24, the maximum obligation of the City and the County jointly for personnel costs shall not exceed $176,737.
• For FY 24-25 and FY 25-26, the maximum obligation of the City and the County will be subject to a Cost-of-Living Adjustment (COLA).
The Parties agree to meet at the beginning of the last quarter of FY 2025-26 to address the handling of termination of the CWCRT Program, and/or the continuance of the Program beyond the Agreement term.
All costs described in Sections 10.1 - 10.2 will be adjusted for FY 23-24, to account for the actual start date of the StarVista clinician.
10.2 Gardner Center Agreement
The County will be responsible for all costs associated with the Gardner Center Agreement. The City agrees to cooperate fully with the Gardner Center Evaluation process.
10.3 Operations Costs incurred by StarVista
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.
10.4 Administration and Supplies Cost Allocation
The County will bear one hundred percent (100%) of the administrative costs associated with the StarVista contract. As noted in Section 5.2, 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.
11. Contact Information
The following is contact information of the persons responsible from each party/entity for the completion and maintenance of this Agreement:
11.1 Party A (County of San Mateo) Information
Name:
Address:
Contact number:
Email:
11.2 Party B (City of Pacifica) Information
Name:
Address:
Contact number:
Email:
11.3 Party C (BHRS) Information
Name:
Address:
Contact number:
Email:
Effective Date and Signatures:
This Agreement shall be effective upon the signature of all parties authorized officials. All Parties indicate agreement with this Agreement by their signatures.
Signatures and dates:
_______________________
Mike Callagy
County of San Mateo
_________________________________
Date
__________________
Jei Africa
BHRS
_________________________________
Date
__________________
Chief
City of Pacifica
_________________________________
Date