DATE: March 6, 2018
TO: Board of Supervisors
SUBMITTED BY: Dawan Utecht, Director, Department of Behavioral Health
SUBJECT: Fresno Metropolitan Area Mental Health Crisis Intervention - Team
RECOMMENDED ACTION:
TITLE
1. Approve and authorize the Chairman to execute a retroactive Agreement with the City of Fresno Police Department, to perform Crisis Intervention Team duties within the Fresno metropolitan area, effective September 1, 2017, not to exceed five consecutive years, which includes a three-year base contract and two optional one-year extensions, total not to exceed $1,338,585.
2. Approve and authorize the Chairman to execute a retroactive Facility Use Agreement with the City of Fresno Police Department, effective September 1, 2017 through June 30, 2022, for County-owned space located at 1925 E. Dakota Avenue, Fresno, CA 93726, Building 658 (approximately 300 square feet) to be used by police department staff to co-locate with Department of Behavioral Health staff to perform Crisis Intervention Team duties within the Fresno metropolitan area.
REPORT
Approval of the recommended actions will allow Mental Health Services Act - Prevention and Early Intervention (MHSA - PEI) to fully fund costs incurred by the City of Fresno Police Department (Fresno PD) while partnering for joint response with the Department of Behavioral Health (DBH) Crisis Intervention Team (CIT) within the Fresno metropolitan (Metro) area. In furtherance of CIT co-response, it is recommended that the assigned Fresno PD officer and DBH mental health clinician be co-located.
ALTERNATIVE ACTION:
Should your Board not approve the recommended actions, Metro co-located, co-response services to address the increased number of crisis mental health emergency calls will not be resolved or met with CIT trained officers and clinicians. The trained staff are able to deescalate situations to relieve on-scene patrol officers for the next crime-related emergency call. Additionally, if not approved, Fresno PD will be required to continue to respond to such metro calls without the immediate on-site assistance of a County mental health clinician.
RETROACTIVE AGREEMENT:
The recommended agreement is retroactive to September 1, 2017. Due to the collaborative and critical nature of this community-based CIT, Fresno PD was able to commit officers prior to completion of this Board item. Although working out all of the details of this agreement has taken several months, DBH and Fresno PD understood and jointly and publically committed to the urgent nature of this crisis response program. There were additional delays due to the coordination of deadlines between two large governmental agencies; the proposed agreement was presented to the Fresno City Council on February 15, 2018 for their review and approval prior to presentation to your Board for approval.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended actions. The costs will be fully funded by MHSA - PEI ($1,338,585). The maximum annual contract award for FY 2017-18 shall not exceed $462,925, which includes ramp up of the program involving the specialized officer training as well as purchase of purposefully dressed-down uniforms for the Fresno PD officers and the initial lease payments of 5 uniquely designed vehicles meant to reassure clients in lieu of a patrol cruiser. In FY 2018-19, the annual contract award will decrease to $218,915 and will remain at the same annual amount for the remainder of the contract term.
Sufficient appropriations and estimated revenues are included in DBH’s Org 5630 FY 2017-18 Adopted Budget and will be requested in future fiscal year budgets for the duration of the term.
DISCUSSION:
On September 1, 2017, DBH, pending your Board’s approval, initiated a partnership with Fresno PD to perform CIT duties within the Metro area. The CIT consists of a co-located Fresno PD officer and a DBH mental health clinician to respond to calls from individuals suffering a mental health crisis or someone reporting an individual in crisis. On scene, the CIT will:
• quickly respond to and assess the initial crisis;
• enlist the assistance of a case manager, if necessary, for further care coordination; and,
• connect the individual to linkage services.
The collaboration allows for joint identification, triage, assessment, and connection to individuals who may need treatment while mitigating unnecessary law enforcement expenditures.
The services provided by the DBH mental health clinician may include, but are not limited to assessment, crisis intervention, community referrals and linkages, and short-term/brief case management. In addition, time permitting, services shall also include community outreach, engagement, education, and prevention to those potentially in need of services for mental illness and/or co-occurring substance use disorders
The goal of the CIT is to respond to mental health crisis situations with crisis intervention techniques trained staff to, not only assist the individual and their family, but if necessary, to simultaneously engage the criminal justice system.
Upon your Board’s approval, the proposed agreement would be retroactive to September 1, 2017. Approval of the recommended Facility Use Agreement with Fresno PD will allow the officer and mental health clinician to co-locate for co-response from a County-owned property located at 1925 E. Dakota Avenue, Fresno, CA 93726, Building 658 (approximately 300 square feet) and utilize the County’s contracted janitorial and security staff. There is no cost to Fresno PD for use of the County-owned space. The County will provide building maintenance, landscaping, and utilities. Additionally, Fresno PD will provide worker’s compensation, general and professional liability insurance coverage for all staff. The recommended agreement allows the County, Fresno PD, or DBH Director, or designee, to provide written notice of non-renewal no later than 60 days prior to the close of the initial three-year base contract and for termination without cause upon 30-days advance written notice of the intention to terminate.
Continued negotiations has led to several non-boilerplate contract clauses being recommended. A mutual hold harmless clause has been added, as well as modifying County insurance contract language; specifically removing Real & Personal Property, All Risk Property Insurance, and Fire Insurance & Extended Coverage protections. It is the recommendation of the Department, with consultation and approval from Fresno County’s Human Resources Department, that due to the City of Fresno also being another government agency, a comprise of insurance requirements is required in order to move forward with this critical community crisis based collaboration. Fresno County Risk Management has recommended that these insurance protections remain however, within the contract.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was informed of the recommended agreement at its November 15, 2017 meeting.
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Agreement with the City of Fresno Police Department (Crisis Intervention Team)
On file with Clerk - Agreement with the City of Fresno Police Department (Facility Use)
CAO ANALYST:
Ronald W. Alexander, Jr.