CITY OF SEBASTOPOL CITY COUNCIL
AGENDA ITEM REPORT FOR MEETING OF: October 7, 2025
=========================================================================================== To: Honorable Mayor and City Councilmembers
From: Mayor Stephen Zollman
City Council Liaison to Homeless Service Organizations
Homeless Coalition Board
Subject: Informational Presentation: Mobile Support Team/Sonoma County Mobile Crisis Services Continuum Update from the Sonoma County Department of Health Services
Presentors: Wendy Tappon – Mobile Crisis Team Manager and Dr. Jan CobaledaKegler – County Behavioral Health Director =========================================================================================== RECOMMENDATION:
That the City Council receive an informational presentation from Wendy Tappon – Mobile Crisis Team Manager and Dr. Jan Cobaleda-Kegler – County Behavioral Health Director. =========================================================================================== EXECUTIVE SUMMARY:
At the August 5, 2025 City Council meeting, the Council requested Department of Health Services to provide a presentation to the City Council following the scheduled presentation to the Sonoma County Board of Supervisors on August 26, 2025. The presentation will provide an update on the Mobile Support Team and the County’s Mobile Crisis Services Continuum.
PROCESS OF AGENDA ITEM:
a. Presentation of agenda item by the Mayor/Introduction of Speakers b. Questions and discussion from Councilmembers
c. Public comment period
d. Council receives the report. No action required.
BACKGROUND:
The Sonoma County Department of Health Services (DHS) works to protect and promote the health and wellbeing of our community through its core divisions: Public Health, Behavioral Health, Homelessness Services, and Administration. The department oversees a wide range of services and has recently made stronger efforts to collaborate regionally with cities.
DISCUSSION:
The presentation will provide information on the Mobile Support Team and Sonoma County’s Mobile Crisis Services Continuum.
The FY 2025–26 revised budget includes $13,463,019 in funding for mobile crisis services, derived from monthly taxpayer revenue received through the Mental Health Services Act (MHSA) and Measure O.
The County MST:
• Provides coverage in the City of Santa Rosa when the inRESPONSE program is not operating. • Supports SAFE teams when the acuity of a call exceeds their operational capacity.
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
• Serves as the sole provider of mobile crisis coverage for the cities of Cloverdale, Healdsburg, Windsor, Sebastopol, and Sonoma, as well as all unincorporated areas of the County.
The presentation will include information previously submitted to the Sonoma County Board of Supervisors. No Council action is required.
CITY COUNCIL GOALS/PRIORITIES/GENERAL PLAN CONSISTENCY:
This agenda item represents the City Council goals/priorities as follows:
Goal 2: PUBLIC SAFETY
Strengthen the public’s safety and improve the quality of life. Includes supporting our first responders (police, fire, public works), responding to emergencies, protecting people, property, and businesses, and engaging in emergency preparedness community outreach, public education and prevention activities.
Explore Ways to Address Homelessness
Pursue no additional costs and or low cost solutions to homelessness
FISCAL IMPACT:
There is no fiscal impact associated with receipt of the presentation.
COMMUNITY OUTREACH:
This item has been noticed in accordance with the Ralph M. Brown Act and was made available for public review at least 72 hours prior to the scheduled meeting date. The City has also used social media platforms to promote and advertise the City Council meeting and agenda items.
As of the writing of this report, the City has not received any public comment. Any comments received after the publication of this report will be shared with the City Council as supplemental materials before or during the meeting.
RESTATED RECOMMENDATION:
That the City Council receive the informational presentation.
OPTIONS:
None; No action is required on this item.
ATTACHMENTS:
Presentation
Sonoma County Board of Supervisors Agenda Report and Attachments APPROVALS:
Department Head Approval: Approval Date: 9-30-2025
CEQA Determination (Planning): Approval Date: 9-30-2025 The proposed action is exempt from the requirements of the California Environmental Quality Act (CEQA) Administrative Services (Financial): Approval Date:
Costs authorized in City Approved Budget: ☐ Yes ☐ No XXX N/A Account Code (f applicable)
City Attorney Approval: Approval Date: N/A
City Manager Approval: Approval Date: N/A
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Sonoma County Mobile Crisis Services Continuum Update
October 7th, 2025
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda
• Introduction
• Mobile Support Team - 24/7 Launch
• Mobile Crisis Services Outcomes
• Medi-Cal Mandate Implementation Update
• Medi-Cal Billing and Claiming Projections
• Future of Mobile Crisis Services Continuum
• Q&A
2 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Introduction
o Mobile Support Team (MST) launched in 2012, Specialized Assistance for Everyone (SAFE) in 2021 and inRESPONSE in 2022 o Department of Health Care Services (DHCS) mandate - by 2024 all counties provide mobile crisis response countywide 24/7/365 o 3 separate teams exist currently in Sonoma County
o Building a 4th system of emergency response
o All teams agreed to adopt DHCS requirements
3 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Medi-Cal Mandate Requirements
• Crisis Service Hotline – 24/7/365 - One number to serve as hotline for the dispatch of mobile crisis teams
1-800-746-8181
• Standardized dispatch tool and procedures to triage crisis, determine dispatch needs, level of intervention.
• Service must be provided at an individual's location
• Teams must consist of two providers with access to an LPHA or licensed MH Professional. One must be trained to conduct crisis assessment. One must carry/be trained to administer Naloxone 4 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Mobile Support Team Medi-Cal Response Launch
New service model soft launch on April 16, 2024
24/7 on June 2, 2024
Initial successes:
• Removed barriers to crisis services
• Can directly call MST rather than wait for law enforcement • Expanded service times and locations leading to an immediate increase in utilization
5 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
6 15
93 15
119
17 132
32 149
24 107
19 147
22 153
26 158
13 129
36 171
75 190
97 133
99 191
199
183
144
178
163
161
154
21 161
77 144
73 151
JULY
23 - 24
JULY
24 - 25
AUG
23 - 24
AUG
24 - 25
SEPT
23 - 24
SEPT
24 - 25
OCT
23 - 24
OCT
24 - 25
NOV
23 - 24
NOV
24 - 25
DEC
23 - 24
DEC
24 - 25
JAN
23 - 24
JAN
24 - 25
FEB
23 - 24
FEB
24 - 25
MARCH
23 - 24
MARCH
24 - 25
APRIL
23 - 24
APRIL
24 - 25
MAY
23 - 24
MAY
24 - 25
JUNE
23 - 24
JUNE
24 - 25
MST CALLS BY MONTH: FY 2023-2024 VERSUS FY 2024-2025
Dispatched Not Dispatched
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Mobile Support Team Service to Sebastopol
Sebastopol MST calls FY 2024-2025
• Total 278 calls
• 142 calls without Law Enforcement
• 60 calls with Law Enforcement
• Sebastopol makes up 12% of Mobile Support Team’s
in-person response call volume.
• Who is calling?
• Criminal Justice
• Health Care Providers
• Family and Friends
• Individuals in Crisis
• Schools
• Social Services
• Other
7 MST In-Person Responses:
Total County Compared to Sebastopol by
Quarter
FY 24-25
Quarter
County
Responses
Sebastopol
Responses
First 344 45
Second 403 39
Third 440 54
Fourth 494 64
Total 1681 202
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
SAFE Impacts May 2024 - May 2025
10,049 Calls for Service, 80% did not
require Law Enforcement Involvement
Next steps
• Medi-Cal Site Certification
• SmartCare Credentialing for all staff
• Continue seeking sustainable funding
8 Emergency
Department, 138
Law
Enforcement,
51 Ambulance,
245
SAFE DIVERSIONS MAY 2024 - MAY
2025
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
inRESPONSE Impacts January 2024-December 2024
4,977 Calls for Service, 4,301 did not
require Law Enforcement Involvement
Next steps
• Continue mandatory trainings
• Medi-Cal Site Certification
• SmartCare Credentialing for all staff
9 Law
Enforcement,
4301
Criminal
Justice, 49
EMS/Fire,
1772
Emergency Department, 209
inRESPONSE DIVERSIONS JANUARY
– DECEMBER 2024
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
10 City/
Jurisdiction FY 22-23 MO FY 23-24 MO FY 24-25 MO
FY 25-26
Approved
Santa Rosa $ 85,887 $ 514,440 $ 1,450,000 $ 3,043,114
Petaluma $ 428,000 $ 500,000 $ 1,137,072 $ 1,493,003
Cotati $ 68,480 $ 60,000 $ 136,449 $ 188,329
Rohnert Park $ 359,520 $ 410,000 $ 921,028 $ 1,173,436
Sonoma State $ - $ 30,000 $ 79,595 $ 86,921
Total $941,887 $1,514,440 $3,724,144 $5,984,803
Funding Source FY 23/24 FY 24/25 FY 25/26
Measure O $150,866.60 $1,238,600.38 $1,045,884
MHSA $3,521,602.01 $6,503,213.35 $6,432,332
Total Expenditures $3,672,468.61 $7,741,813.73 $7,478,216 Full-Time Equivalent
(FTE) Count 15.39 33.64 32.5
Growth of MST Staffing and
Operations
Measure O Investment
in SAFE and
inRESPONSE
Increased Funding Required for Implementation
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Where We Are Headed
Maximizing Revenues
• All teams billing – maximizing Medi-Cal Billing and FFP - tracking Federal Policy impacts • Off-set use of Measure O
Aligning Data and Metrics
• Data standardization –accurate population-level data in SmartCare • Standardized reporting and performance metrics
Reducing Duplication and Waste
• All teams will be following standardized practices - streamlining operations, better client outcomes
• Look for opportunities to share services and leverage resources 11 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Collaboration Timeline with SAFE and inRESPONSE
• Both making significant changes to infrastructure to be compliant with state requirements
• Staff are now trained in mandatory state trainings & credentialing process to bill Medi-Cal
• SmartCare benefits:
– consistent data protocols
– analysis and program evaluation
– increased care coordination across jurisdictions
12 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Challenges with Medi-Cal Mandate Compliance
Transition
– Credentialing
– Developing supervision plans
– Revamping call center
Staffing, billing, and service protocols
– New documentation requirements and EHR
– Overtime for staff to complete required trainings
Strategies implemented
– Stay updated
– Work through credentialing
– Meet regularly, communicate regularly
Federal Policy Landscape and potential Medi-Cal impacts – Uncertainty around revenue stability
13 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Next Steps
-Evaluate fiscal sustainability across all available funding sources – a focus on maximizing Medi-Cal billing.
-Continue working with regional stakeholders, city partners and CBO providers to refine model to ensure long-term fiscal sustainability - Finalized shared performance metrics.
-Utilize SmartCare data to track trends and adapt resources -Collaborate with partners for continuous quality improvement -Execute long-term MOUs with all partners outlining guidelines for singular system
14 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Q&A and Closing
15 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
COUNTY OF SONOMA
SUMMARY REPORT
575 ADMINISTRATION
DRIVE, ROOM 102A
SANTA ROSA, CA 95403
Agenda Date: 8/26/2025
To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services Staff Name and Phone Number: Nolan Sullivan, 707-565-4774; Jan Cobaleda-Kegler, 707-565-5157 Vote Requirement: Informational Only
Supervisorial District(s): Countywide
Title:
Mobile Support Team/Sonoma County Mobile Crisis Services Continuum Update Recommended Action:
Receive an update on Mobile Support Team/Sonoma County Mobile Crisis Services Continuum Executive Summary:
This item gives an overview of each service model and an update on efforts to implement the Medi-Cal Mobile Crisis Services benefit in Sonoma County.
In 2022, the Department of Health Care Services (DHCS) notified county Mental Health Plans (MHPs) that effective December 31, 2023, they would be required to implement the Medi-Cal Mobile Crisis Services Benefit, providing 24/7 mobile crisis services to individuals experiencing a behavioral health crisis throughout Sonoma County. The implementation of the Medi-Cal Mobile Crisis Services Benefit would enable Sonoma County Department of Health Services (hereinafter, “DHS” or “the Department”) to access funding through Federal Financial Participation in the Medi-Cal program. County MHPs were also required to implement a 24/7 call center with the capacity to field calls from all over Sonoma County and provide a non-police response to individuals in crisis. To meet these requirements, DHS planned to expand its existing Mobile Support Team (MST) program to provide 24/7 crisis response, develop and implement a 24/7 call center, and establish a regional coverage model.
On June 2, 2024, Sonoma County MST began providing 24/7 Medi-Cal Mobile Crisis Services Benefit, including the operation of a 24/7 crisis call center which can be accessed by dialing 1-800-746-8181. Planning efforts also included developing a Mobile Crisis Continuum to collaborate with regional stakeholders, city partners, and mobile crisis services providers to implement a regional model to coordinate the provision of the Medi-Cal Benefit in Sonoma County. The current Mobile Crisis Services Continuum consists of DHS’s MST, Petaluma People Services Center’s Specialized Assistance for Everyone (SAFE), and the City of Santa Rosa and Buckelew Programs’ inRESPONSE. Healdsburg Police Department’s Community Oriented and Equity (CORE) withdrew from participation of the Mobile Crisis Services Continuum because of implementation challenges associated with meeting DHCS requirements for Medi-Cal Mobile Crisis Services Benefit.
Discussion:
Medi-Cal Mobile Crisis Services Benefit Requirements
As of December 31, 2023, the DHCS benefit model requires a two-person crisis team consisting of at least one
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda Date: 8/26/2025
licensed clinician and an alcohol or drug counselor and/or other mental health counselor. Additionally, the County must operate a 24/7 call center (accessed by calling 1-800-746-8181) with the capacity to field calls from all over the county and provide a non-police response to individuals in crisis.
Medi-Cal Mandate Implementation Update
Beginning in early 2024 and with the goal of implementing the Medi-Cal Mobile Crisis Services benefit by June 30, 2025, DHS initiated discussions with the cities of Santa Rosa, Petaluma, Rohnert Park, Cotati, and Healdsburg along with our mobile crisis services providers, SAFE and inRESPONSE. DHS encountered challenges throughout this implementation year, as several unforeseen complexities were identified which ultimately prevented both SAFE and inRESPONSE from being able to claim for Medi-Cal services by the planned deadline. Challenges include one crisis service partner dropping out of the Mobile Crisis Services Continuum; contracting delays; crisis service providers needing additional lead time to recruit, train, and credential new staff to support 24/7 coverage models; and navigating a change in leadership within the SAFE organization.
Despite setbacks, DHS believes continued partnership with cities and local crisis services providers have laid the groundwork for successful implementation within the first quarter of FY 2025-2026. Until then, DHS MST, SAFE, and inRESPONSE will continue to operate as integral partners of the Mobile Crisis Services continuum providing 24/7/365 crisis response services throughout our community.
Service Providers and Models
The three providers within Sonoma County currently use different operational models. Of these, Petaluma People Services Center’s SAFE and Buckelew’s inRESPONSE do not currently meet DHCS’ requirements for reimbursement through Medi-Cal. For information about each of the models, please see Attachment 1.
Mobile Crisis Services Outcomes
Mobile support service models and data collection practices vary by program and jurisdiction. As a result, meaningful comparisons across programs are not possible until all services of the Mobile Crisis Services Continuum are fully integrated and documented within SmartCare, the County’s centralized electronic health record system. DHS anticipates having all mobile crisis services integrated into SmartCare sometime during the first quarter of FY 2025-2026.
For a detailed breakdown of service calls, deployments, and diversions, see Attachment 2.
Funding
The FY 2025-2026 revised budget includes $13,463,019 in funding through monthly taxpayer revenue received from the Mental Health Services Act (MHSA) and Measure O for mobile crisis services. The County MST covers the City of Santa Rosa when inRESPONSE is not operating as well as providing support for SAFE teams when the call acuity exceeds their operational capacity. County MST is the sole provider of coverage for the cities of Cloverdale, Healdsburg, Windsor, Sebastopol and Sonoma as well as all unincorporated Sonoma County.
MST is currently updating its data collection process to track services by address and determine whether they are provided in an unincorporated area or within a city jurisdiction. This transition will align with inRESPONSE and SAFE as they migrate to the same electronic health record system used by the County (SmartCare). The volume of MST services calls by city/region for each fiscal year is reflected in the chart found on Attachment 3:
Transitioning mobile crisis programs to 24/7, with a fully staffed call center and adequate clinician staffing, has significantly increased the funding required for MST. For highlights on the growth of DHS MST over the last
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda Date: 8/26/2025
fiscal year, utilizing Measure O and Mental Health Services Act (MHSA) funding, see Attachment 3.
SAFE and inRESPONSE have also increased staffing to meet the current requirements and will continue to as they continue building out their Medi-Cal response. The Measure O investment in SAFE and inRESPONSE is outlined in the chart on Attachment 3.
Medi-Cal Billing and Claiming Projections
In 2024, DHS-Behavioral Health Division was placed on a corrective active plan by the Department of Health Care Services (DHCS) for delays in implementing the Medi-Cal Mobile Crisis benefit by January 1, 2024. Prior to resolving corrective action plan with DHCS, DHS was only able to claim Medi-Cal for crisis intervention services for the period of April 2024 - July 2024. On July 30, 2024, DHS received confirmation from DHCS that our corrective action plan was approved and considered resolved. As such, DHS was able to begin claiming for services provided under the new Medi-Cal Mobile Crisis Benefit. Initial Medi-Cal Mobile Crisis claiming projections for the Sonoma County MST program for FY 24/25 are estimated to be $1,503,399 which is identified for August 2024 through June 30, 2025. Estimates for FY 2025-2026 remain flat, as billing Medi-Cal for SAFE and inRESPONSE has not yet commenced, and the timeline for when it will begin is currently uncertain as the onboarding requirements for each external provider, including site-certification, credentialing, and training required to begin billing is an intense process with many steps the teams are currently working through. To maintain a conservative and responsible forecasting approach, we have opted not to project potential increases at this time, even though growth is likely.
Because both SAFE and inRESPONSE programs have yet to begin to claim for Medi-Cal Mobile Crisis Services Benefit, it is difficult to project potential Medi-Cal revenue for both programs as not all calls for crisis services or subsequent encounters in the community will result in being able to successfully claim for Medi-Cal services. Reasons for this include type of insurance, inability to complete the entire crisis service, or locate the client, and calls to locations where crisis services are already being delivered, also known as locked out locations.
DHS anticipates both SAFE and inRESPONSE programs to complete the DHCS Medi-Cal certification process and begin to claim for the Mobile Crisis Services Benefit in FY 2025-2026 Quarter 1. Data on revenue projections for the entire Mobile Crisis Services Continuum should be available by year end. DHS will provide an update to the County Executive Officer on revenue generation from Mobile Crisis no later than September 30, 2026.
Future of Sonoma County Mobile Crisis Services Continuum Providing Medi-Cal Mobile Crisis Services Benefit in Sonoma County is a state mandated obligation for MediCal beneficiaries of county Mental Health Plans. Federal policy is creating a significant amount of uncertainty regarding impacts to Medi-Cal dollars and the future of Sonoma County Mobile Crisis Services Continuum in its current design will depend on developing a fiscally sustainable regional model while prioritizing funding available through the Medi-Cal Mobile Crisis Benefit. To achieve this, DHS will continue to lead efforts on supporting our Mobile Crisis Service partners, SAFE and inRESPONSE, in becoming Medi-Cal certified, allowing for claiming under the Medi-Cal Benefit. As more becomes known about the impacts of the federal budget changes, the model will evolve to maximize reimbursements and provide a more accurate projection of future revenue.
The regional crisis services needs of our community continue to change over time. Unifying the Mobile Crisis Services continuum under the Medi-Cal Benefit mandate will allow for consistent data collection and reporting across the Mobile Crisis Continuum as metrics will be universal to the work being performed, regardless of
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda Date: 8/26/2025
across the Mobile Crisis Continuum as metrics will be universal to the work being performed, regardless of region. DHS intends to continue to collect and report on data related to crisis calls, type of diversions, individuals demographics pertaining to race, ethnicity, age, gender, and deployments by city, region, and location in order to best identify changing needs and service gaps.
Over the next year, DHS will evaluate the fiscal sustainability of the current model and work with stakeholders, city partners, and mobile crisis services providers to identify improvements and modifications to ensure sustainability of the entire Mobile Crisis Services continuum. DHS will do this through established quarterly meetings held with partners to review data and share trends and best practices, as well as internally through monthly review of Medi-Cal claiming data and projections. The Director will return to the Board on or before 9/30/26 with the next annual update on the progress of the Mobile Crisis regional model, financial sustainability, and community-level outcomes.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit? No
Prior Board Actions:
On July 22, 2025, the Board authorized the Director of Health Services to execute five funding agreements for Mobile Support Crisis Programs.
On December 12, 2023, the Board received an update on the mobile crisis team regional plan submitted to the California Department of Health Care Services on October 31, 2023.
On May 16, 2023, the Board received an update on mobile crisis teams in Sonoma County; authorized DHS to execute agreements with Sonoma State University and the cities of Cotati, Rohnert Park, Petaluma, and Santa Rosa for continued support of mobile crisis services; and directed staff to continue current program evaluation, and work with city and community-based organization partners to develop regional model for ongoing Measure O funding that incorporates existing mobile crisis teams and integrates requirements of DHCS Medi-Cal Mobile Crisis Unit benefit.
On October 26, 2021, the Board accepted the staff report on MST/ Crisis Assistance Helping Out on the Streets (CAHOOTS) Programs; allocated a one-time investment of $428,000 to Cotati/Rohnert Park and Petaluma each and $85,887 to Santa Rosa to assist their MST program for a total of $941,887; and directed staff to lead a collaborative evaluation in January - December 2022 of all mobile crisis support programs.
FISCAL SUMMARY
Expenditures FY 25-26
Adopted
FY26-27
Projected
FY 27-28
Projected
Budgeted Expenses
Additional Appropriation Requested
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda Date: 8/26/2025
Expenditures FY 25-26
Adopted
FY26-27
Projected
FY 27-28
Projected
Budgeted Expenses
Additional Appropriation Requested
Total Expenditures
Funding Sources
General Fund/WA GF
State/Federal
Fees/Other
Use of Fund Balance
General Fund Contingencies
Total Sources
Narrative Explanation of Fiscal Impacts:
There is no fiscal impact; this item is provided for informational purposes only.
The Fiscal Year 2025-2026 Board adopted budget, includes a total of $13,463,019 in expenditures is allocated for MST services. Funding sources include $6,386,332 from ongoing Mental Health Services Act (MHSA), $46,000 in anticipated Federal Financial Participation (FFP) claimed reimbursement, and $7,030,687 from Measure O. The federal policy landscape does create uncertainty around the Federal Financial Participation and Medi-Cal reimbursement estimates. As more becomes known about the potential impact to funding the mobile crisis programs, DHS will return to the Board with an update.
Staffing Impacts:
Position Title (Payroll Classification) Monthly Salary Range (A-I Step)
Additions
(Number)
Deletions
(Number)
Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Mobile Crisis Service Providers and Service Models Attachment 2 - Deployments, Service Calls, and Diversions Attachment 3 - Funding Charts
Attachment 4 - Presentation
Related Items “On File” with the Clerk of the Board:
None
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Sonoma County Mobile Crisis Services Continuum Update
August 26, 2025
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Agenda
• Introduction
• Mobile Support Team - 24/7 Launch
• Mobile Crisis Services Outcomes
• Medi-Cal Mandate Implementation Update
• Medi-Cal Billing and Claiming Projections
• Future of Mobile Crisis Services Continuum
• Q&A
2 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Introduction
o Mobile Support Team (MST) launched in 2012, Specialized Assistance for Everyone (SAFE) in 2021 and inRESPONSE in 2022 o Department of Health Care Services (DHCS) mandate - by 2024 all counties provide mobile crisis response countywide 24/7/365 o 3 separate teams exist currently in Sonoma County
o Building a 4th system of emergency response
o All teams agreed to adopt DHCS requirements
3 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Medi-Cal Mandate Requirements
• Crisis Service Hotline – 24/7/365 - One number to serve as hotline for the dispatch of mobile crisis teams
1-800-746-8181
• Standardized dispatch tool and procedures to triage crisis, determine dispatch needs, level of intervention.
• Service must be provided at an individual's location
• Teams must consist of two providers with access to an LPHA or licensed MH Professional. One must be trained to conduct crisis assessment. One must carry/be trained to administer Naloxone 4 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Mobile Support Team Medi-Cal Response Launch
New service model soft launch on April 16, 2024
24/7 on June 2, 2024
Initial successes:
• Removed barriers to crisis services
• Can directly call MST rather than wait for law enforcement • Expanded service times and locations leading to an immediate increase in utilization
5 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
6 15
93 15
119
17 132
32 149
24 107
19 147
22 153
26 158
13 129
36 171
75 190
97 133
99 191
199
183
144
178
163
161
154
21 161
77 144
73 151
JULY
23 - 24
JULY
24 - 25
AUG
23 - 24
AUG
24 - 25
SEPT
23 - 24
SEPT
24 - 25
OCT
23 - 24
OCT
24 - 25
NOV
23 - 24
NOV
24 - 25
DEC
23 - 24
DEC
24 - 25
JAN
23 - 24
JAN
24 - 25
FEB
23 - 24
FEB
24 - 25
MARCH
23 - 24
MARCH
24 - 25
APRIL
23 - 24
APRIL
24 - 25
MAY
23 - 24
MAY
24 - 25
JUNE
23 - 24
JUNE
24 - 25
MST CALLS BY MONTH: FY 2023-2024 VERSUS FY 2024-2025
Dispatched Not Dispatched
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
SAFE Impacts May 2024 - May 2025
10,049 Calls for Service, 80% did not
require Law Enforcement Involvement
Next steps
• Medi-Cal Site Certification
• SmartCare Credentialing for all staff
• Continue seeking sustainable funding
7 Emergency
Department, 138
Law
Enforcement,
51 Ambulance,
245
SAFE DIVERSIONS MAY 2024 - MAY
2025
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
inRESPONSE Impacts January 2024-December 2024
4,977 Calls for Service, 4,301 did not
require Law Enforcement Involvement
Next steps
• Continue mandatory trainings
• Medi-Cal Site Certification
• SmartCare Credentialing for all staff
8 Law
Enforcement,
4301
Criminal
Justice, 49
EMS/Fire,
1772
Emergency Department, 209
inRESPONSE DIVERSIONS JANUARY
– DECEMBER 2024
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
9 City/
Jurisdiction FY 22-23 MO FY 23-24 MO FY 24-25 MO
FY 25-26
Approved
Santa Rosa $ 85,887 $ 514,440 $ 1,450,000 $ 3,043,114
Petaluma $ 428,000 $ 500,000 $ 1,137,072 $ 1,493,003
Cotati $ 68,480 $ 60,000 $ 136,449 $ 188,329
Rohnert Park $ 359,520 $ 410,000 $ 921,028 $ 1,173,436
Sonoma State $ - $ 30,000 $ 79,595 $ 86,921
Total $941,887 $1,514,440 $3,724,144 $5,984,803
Funding Source FY 23/24 FY 24/25 FY 25/26
Measure O $150,866.60 $1,238,600.38 $1,045,884
MHSA $3,521,602.01 $6,503,213.35 $6,432,332
Total Expenditures $3,672,468.61 $7,741,813.73 $7,478,216 Full-Time Equivalent
(FTE) Count 15.39 33.64 32.5
Growth of MST Staffing and
Operations
Measure O Investment
in SAFE and
inRESPONSE
Increased Funding Required for Implementation
Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Where We Are Headed
Maximizing Revenues
• All teams billing – maximizing Medi-Cal Billing and FFP - tracking Federal Policy impacts • Off-set use of Measure O
Aligning Data and Metrics
• Data standardization –accurate population-level data in SmartCare • Standardized reporting and performance metrics
Reducing Duplication and Waste
• All teams will be following standardized practices - streamlining operations, better client outcomes
• Look for opportunities to share services and leverage resources 10 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Collaboration Timeline with SAFE and inRESPONSE
• Both making significant changes to infrastructure to be compliant with state requirements
• Staff are now trained in mandatory state trainings & credentialing process to bill Medi-Cal
• SmartCare benefits:
– consistent data protocols
– analysis and program evaluation
– increased care coordination across jurisdictions
11 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Challenges with Medi-Cal Mandate Compliance
Transition
– Credentialing
– Developing supervision plans
– Revamping call center
Staffing, billing, and service protocols
– New documentation requirements and EHR
– Overtime for staff to complete required trainings
Strategies implemented
– Stay updated
– Work through credentialing
– Meet regularly, communicate regularly
Federal Policy Landscape and potential Medi-Cal impacts – Uncertainty around revenue stability
12 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Next Steps
-Evaluate fiscal sustainability across all available funding sources – a focus on maximizing Medi-Cal billing.
-Continue working with regional stakeholders, city partners and CBO providers to refine model to ensure long-term fiscal sustainability - Finalized shared performance metrics.
-Utilize SmartCare data to track trends and adapt resources -Collaborate with partners for continuous quality improvement -Execute long-term MOUs with all partners outlining guidelines for singular system
13 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025
Q&A and Closing
14 Agenda Item Number: 13 Agenda Item Number: 13
City Council Meeting Packet of: October 7, 2025