Community Well‐Being:
Crisis Intervention Response
Pilot Project
STOCKTON CITY COUNCIL
AGENDA ITEM 15.3
JULY 26, 2022
1 Background
• American Rescue Plan Act (ARPA) and Coronavirus Local Fiscal Recovery Fund (CLFRF) allocated $78,050,072 to City
• Treasury Goals:
• Provide resources to turn the tide on the pandemic
• Address economic fallout
• Lay foundation for a strong and equitable recovery
• Treasury approach is to provide flexibility to meet local needs • Funding Categories:
• Support urgent COVID‐19 response efforts
• Replace lost revenue
• Support economic stabilization for households, businesses • Address systemic public health and economic challenges 2 Timeline
• Treasury allocates $78,052,072 in ARPA funds to the City of Stockton, with funding awarded in two equal tranches.
• Council approves recommendations for use of the ARPA Coronavirus State and Local Fiscal Recovery Funds on June 22, 2021 (Motion 2021‐ 06‐22‐1501).
• Council approves updated recommendations for ARPA funds on September 14, 2021 (Motion 2022‐09‐14‐1501).
• ARPA City Council Study Session held on February 16, 2022. • At Study Session, staff proposes Community Well‐Being and Crisis Intervention project, with objectives to:
• Establish 3‐year pilot program
• Partner with local Community‐Based Organization
• Build and deploy crisis intervention teams to reduce the number of non‐emergency calls responded to by Police and Fire
3 Needs Assessment –N a t i o n a l Level
National Alliance on Mental Illness (NAMI) Mental Health Data in 2020 Experienced Mental Illness
• 1 out of 5 adults
• 1 out of 3 young adults, age 18‐25
Experienced a Serious Mental Illness
• 1 out of 20 adults
• 1 out of 10 young adults, age 18‐25
Experienced a Substance Use Disorder and Mental Illness • 6 percent of adults
• 1 in 8 of all visits to U.S. emergency departments
Adolescents, ages 12 –1 7
• 1 in 6 experienced a major depressive episode
• 3 million had serious thoughts of suicide
• 70 percent of youth in juvenile justice system have at least one mental health condition 4 Needs Assessment –L o c a l Level
Local Impact of Mental Health Data
• Approximately 6.4% of County population suffers from psychological distress • Statewide: 289 mental health providers per 100,000 residents • SJ County: 190 mental health providers per 100,000 residents • 2022 Point in Time (PIT) Count
• Volunteers counted 1,355 unsheltered individuals
• 66% or 894 individuals living in Stockton
• 33% reported a mental health issue
• 33% reported a problem with substance abuse
5 Mental and
Behavioral
Wellness
Pandemic
Homelessness
Project Goal and Objectives
GOAL
Through partnership with CBO, develop and implement an efficient and sustainable model to mental health intervention based on best practices, that supports and enhances the well‐being of Stockton residents.
OBJECTIVES
◦ Decrease recidivism or repeat callers to emergency lines ◦ Increase follow‐up with wraparound services
◦ Increase community trust
◦ Decrease costs related to emergency calls
◦ Decrease fear or hesitancy to call for police
◦ Divert individuals away from the criminal justice system 6 Partnership Framework
Enhancement
7 City
Of
Stockton
Partner
CBO
Sub‐Partners
Community Agencies
Community Based Organization
PROPOSAL
Community Medical Centers (CMC) will expand Care Link program in a collaborative partnership with the City to develop a pilot mobile crisis intervention model as an alternative approach to behavioral health first response services.
CMC CAPACITY
◦ Longest running medical outreach team to homeless
◦ Street medicine throughout Stockton
◦ Wound care, medication, behavioral health care, case management ◦ Social determinants of health
◦ Trauma‐informed and cost‐free services
◦ Federally Qualified Health Care (FQHC) designation
◦ Response developed in alignment with best practices of similar programs 8 Program Design
CMC Care Teams emphasize person‐centered care within existing infrastructure of programs and services:
Enhancement
9 Medical
Outreach
Team
Housing
Coordinator
Transitions of
Care Network
Vital Care
Program
Behavioral
Health
Department
CMC Respite
Center
SUD Outpatient
Services
HIV & Hep C
Programs
Measurable Results and Outcomes
• Align services with needs for low‐barrier, trauma‐informed care • Improve cost to patients through mobile outreach
• Improve efficiency of emergency responder and hospital resources • Increase responsiveness to Stockton’s diverse population through culturally and linguistically competent services
• Help bridge trust in collaboration with City of Stockton, Police, and Fire • Develop an evaluation plan for data collection and analysis through outside data evaluator
• Demonstrate program effectiveness through data metrics and measurable objectives
• Develop sustainability for maintaining service infrastructure and creating reliable funding mechanism
10 Presentation for City of Stockton
CMC, Care Link Alternative Behavioral
Health Response
Mission: Working together to enhance
health and well‐being in our
communities.
Community Medical Centers
is a Federally Qualified Health Center
Federally Qualified Health
Centers(FQHC’s) are Required to:
• Be a Nonprofit, 501(c)(3)
• Located in, and serve a medically underserved
community,
• Offer a comprehensive range of primary health
services;
• Medical, dental, behavioral health, SUD
• Sliding fee schedule for uninsured
• Accept Medi‐Cal, ACA insurance plans
• Be governed by a board, a majority of whose
members are health center patients
HISTORY OF CMC
• Community volunteers including
physicians, nurses, social workers,
and community organizers
• Services to farmworkers in 1965 in
San Joaquin county
• By the mid 1970s incorporated as
Agricultural Workers' Health
Centers.
• 1978: Incorporated as a 501(c)(3)
nonprofit organization
13 1992: Name change to Community
Medical Centers, Inc.,
1995: Opened Channel Medical Center downtown
2011: CMC, GLEASON HOUSE: Healthcare for the Homeless
2015: New Logo
2012: Added Behavioral Health
2017: Added Substance Use Programs
2020: Opened Site on Delta College Campus
HISTORY OF CMC
CMC Facts:
• 107,244 Patients served in 2021
• 430,000 Patient care visits in 2021
• 3 counties (San Joaquin, Solano, Yolo)
• 28 sites
• 10,968 Patients with a diagnosis of diabetes
• 96% of patients are below 200% of Federal
Poverty Level
• $99M budget FY 2021‐2022
• Staff: 900
CMC Services
• Services for All Ages
• Adult medicine
• Pediatrics
• Adolescent
• Women’s Health
• Geriatrics
• Dental
• Specialty
• Endocrinology/ GI/ Pulmonology
• Podiatry
• Chiropractic/ Physical Therapy/ Acupuncture
• Behavioral Health
• Counseling for individuals, families, children and adolescents • Substance use treatment
• Case Management
• Psychiatry
• Pharmacy
Stockton
Services
• 12 Clinic locations strategically located in
neighborhoods of need
• 2 Dental sites
• 2 pharmacies
• Waterloo Recovery (BH and SUD)
• Channel Respite Center ( BH, SUD and residential)
• Care Link Health Care for the Homeless
• Gleason House
• St. Mary’s Dining Room Health Center
• Street Outreach;
• Mobile Units and street outreach teams;
Adult and Adolescent
• Mobile Vaccination and Testing teams
Care Link
Community
Response
Proposal
• Use trauma informed and evidence‐based
interventions
• Build on trust developed over 20 years with street
and shelter outreach
• 3‐year pilot mobile crisis model (LCSW , outreach
worker, Case Manager
• Initially, one mobile response team, building up to
three, 7 days a week focusing on hot spots within
City of Stockton
• Follow‐up team , emphasizing prevention and
linkage to CMC wrap around services, ongoing case
management
• Evaluation partner for outcomes and program
evaluation
CMC Leadership
Christine Noguera
Chief Executive Officer
[email protected]
Office: 209‐373‐2826
Cell: 559‐960‐7779
Benjamin B. Morrison M.D.
Chief Medical Officer
[email protected]
Office: 209‐373‐2829
Jaime Allen
Chief Financial Officer
[email protected]
Office: 209‐373‐2851
Fax: 209‐762‐6927
Preethi Raghu
Chief Operating Officer
[email protected]
Office: 209‐373‐2832
Cell: 925‐548‐4449
Ginger Manss, DNP, RN, HACP, AOCN
Chief Nursing Officer
[email protected]
Office: 209‐373‐2840
Cell: 209‐609‐6759
Mical L. Cayton
Chief Information Officer
[email protected]
Office: 209.626.5525
Cell: 209.888.9146
Elle Karimkhani, Esq.
General Counsel & Compliance Officer
[email protected]
Office: 209‐373‐2847
Linh DeLuca, DDS
Chief Dental Officer
[email protected]
Office: 209‐940‐5618
Mobile: 508‐317‐5011
Alfonso Apu
Chief Behavioral Health Officer
[email protected]
Office: (209) 373‐2842
Recommendations
• Award a Professional Services Contract to Community Medical Centers of Stockton, CA in the Not‐To‐Exceed amount of $5,760,000 to develop and implement a crisis intervention response pilot program for three years with American Rescue Plan funds under Project MARP101. • Approve findings pursuant to Stockton Municipal Code section 3.68.070 in support of an exception to the competitive bidding process.
It is also recommended that the City Manager be authorized to take appropriate actions to carry out the purpose and intent of this motion. 20