Healthy and Safe Communities

Summary of objective implementation status

In 2023, the California Department of Health Care Services (DHCS) issued notice to county mental health plans a requirement to establish a Mobile Crisis Services Benefit for Medi-Cal beneficiaries; counties were required to provide community-based mobile services to Medi-Cal beneficiaries experiencing a behavioral health crisis effective December 31, 2023.  The mandate requires that county mental health plans provide community-based, mobile crisis intervention services to individuals experiencing a behavioral health crisis to anyone, anywhere, anytime across Sonoma County.  The requirements include:  the establishment of a crisis services hotline -one single telephone number-to serve as a crisis services hotline 24/7, 365 days/year, connected to the dispatch of mobile crisis teams.  Counties are required to provide a “live” response to all calls from the hotline and coordinate with 988, local law enforcement, 911 systems, and community partners. 

In 2024, the Department of Health Services Behavioral Health Division (DHS-BHD) established a Crisis Call Center Hotline at 1-800-746-8181 which operates 24/7 and expanded staffing the Mobile Support Team (MST) to provide services, 24/7, to all communities in Sonoma County; collaborating with inResponse in Santa Rosa, SAFE in Petaluma, CORE in Healdsburg, and responding to calls from the unincorporated areas of the County. 

The Crisis Call Center Hotline represents a major culture shift for DHS-BHD MST.  Previously 911 was used exclusively in MST crisis response.  The goal with developing a 24/7 call center to replace the use of 911 was to reduce the role of law enforcement in responding to behavioral health crises.  When safety is an issue, the partnership with law enforcement is invaluable and necessary.  However, behavioral health emergencies can often be de-escalated and stabilized with skilled, licensed and unlicensed, behavioral health staff, resulting in reduced 5150’s and psychiatric hospitalizations.

Key milestone update

Sonoma County’s Mobile Crisis Services implementation plan was approved by DHCS in 2024 and went live June 1, 2024.   Services must be provided at a beneficiary’s location by a multi-disciplinary team consisting of two BH providers, trained to administer Naloxone; and one team member must be trained to administer a crisis assessment.  Each team must include or have access to a licensed mental health professional. 

Hotline operators are required to use standardized dispatch tool and a set of procedures to triage crisis and determine dispatch needs and level of intervention necessary.  In urban areas, teams must respond within 60 minutes of being determined to require services. In rural areas, the response time is lengthened to 120 minutes.  Teams may also provide transportation to an appropriate level of care or treatment setting.

Coordination and partnership update

In an attempt to utilize existing resources that have been providing robust and well received mobile crisis services throughout the County, DHS-BHD has developed a “Crisis Collaborative” to coordinate the delivery of mobile crisis benefit services across the County with inResponse, SAFE, and CORE.  The County is developing MOUs with inResponse and SAFE to certify them as Medi-Cal ( M/C) providers of the mobile crisis benefit.  They will become part of the DHS-BHD M/C delivery system and will comply with the requirements for staffing teams and providing a non-law enforcement response.  MST will also partner with CORE in Healdsburg and work on developing MST protocols with CORE.

The Crisis Collaborative meets regularly and coordinates: data systems, call center/hotline processes, and countywide integration.

Community, equity and climate update

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If this objective received Strategic Plan funding, please provide amount spent to date for non-position related funding.

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