Sonoma County Mobile Crisis Services Continuum Update
October 7th, 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 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 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 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 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
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
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
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
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
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 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 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 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 Q&A and Closing
15