Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Jei Africa, Director, Behavioral Health and Recovery Services
Subject: Agreement with StarVista for Law Enforcement Co-responding Behavioral Health Crisis Services - Cities of Redwood City and South San Francisco
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with StarVista for law enforcement co-responding behavioral health crisis services for the cities of Redwood City and South San Francisco, for the term of October 1, 2024 through June 30, 2025, in an amount not to exceed $368,598.
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BACKGROUND:
For over 20 years, Behavioral Health and Recovery Services (BHRS) has contracted with StarVista for mental health services, mobile crisis response team for youth, Girls’ Juvenile Court services, child abuse treatment services, the Early Childhood Community Team, substance use disorder treatment services, and the Community Wellness Crisis Response Team (CWCRT) for community members experiencing mental health crisis.
On January 12, 2020, this Board approved the resolution to enter into the Pilot Program of CWCRT, a partnership among four City Police Departments (Daly City, South San Francisco, San Mateo, and Redwood City) and the County, to embed one mental health clinician in each of these cities’ police departments to provide a co-response to crisis calls involving mental health issues. The County expanded its contract with StarVista, and the latter’s crisis intervention services, to include provision of mental health clinicians for the CWCRTs. Under the Pilot Program, StarVista clinicians assisted in the first response by providing early intervention, crisis de-escalation, 5150 evaluations, involuntary holds, referrals to therapeutic hospitalizations, and guidance to support services for individuals in mental health crisis.
DISCUSSION:
Under this agreement, the County will fund two full-time mental health clinicians to provide the first response mental health crisis services. The Cities of Redwood City and South San Francisco will each contribute 100% of the personnel costs of two mental health clinicians, one embedded in each of their respective cities, as well as administration and operations costs incurred by the contractor.
The County of San Mateo benefits from the implementation of this agreement by increasing its ability to directly respond to community members in mental health crisis; providing Medi-Cal reimbursable services to County clients; improving response time for those in need of mental health services and resources; and creating a broader and more effective continuum of care that results in a decrease in justice system contacts.
The services provided by StarVista through this agreement are an ongoing renewal of the current CWCRT program at the Cities of Redwood City and South San Francisco that were part of the “pilot” implementation with proven successes, for which StarVista has been a key provider. For these reasons, this Board is being asked to waive the County’s Request for Proposals process so that BHRS can contract with StarVista for these services.
The resolution contains the County’s standard provision allowing amendment of the County’s fiscal obligations by a maximum of $25,000 (in aggregate).
This agreement and resolution have been reviewed and approved by the County Attorney as to form.
This agreement is late due to extended negotiations with the Cities of Redwood City and South San Francisco.
It is anticipated that the CWCRT clinicians will respond in-person to provide crisis assessment and crisis evaluation for 100% of calls for which a mental health issue is suspected and to which the clinician is dispatched.
PERFORMANCE MEASURE:
|
Measure |
FY 2024-25 Estimated |
FY 2025-26 Projected |
|
Percentage of calls responded to in-person by CWCRT clinicians to provide crisis assessment and evaluation |
100% |
100% |
EQUITY IMPACT:
The purpose of this agreement is to deliver comprehensive behavioral health services to Medi-Cal eligible or non-insured individuals in San Mateo County, with a focus on marginalized communities including Latino/x, African American, Asian/Pacific Islander, and Native American groups (San Mateo Mental Health Plan Final Report, Table 7, FY2023-24) and disenfranchised, underserved populations with trauma, behavioral health histories, lack of or limited resources for effective coping resulting in behavioral health crises, using culturally informed and best practices to stabilize acute crises and promote longer-term service connection and well-being.
The contract aligns with County Health and BHRS’ Diversity, Equity, Inclusion, and Belonging priorities by:
1. Providing Crisis Support: Offering 24/7 crisis assessment, de-escalation, and emotional support, with in-person interventions by the Mobile Crisis Response Team.
2. Tailoring services to meet cultural needs: developing and implementing programs that hold an equity and trauma-informed lens and provide services that are culturally appropriate and accessible.
3. Building trust and relationships: collaborating with local police departments working with marginalized communities to build trust and ensure that services are delivered in a way that is respectful and accepting.
These services are backed by data indicating higher rates in the targeted communities of trauma, behavioral health challenges, and educational disparities, demonstrating the critical need for these interventions.
FISCAL IMPACT:
The term of the agreement is October 1, 2024, through June 30, 2025. The amount of the agreement is not to exceed $368,598 for the nine-month term and will be funded 100% by the Cities, with 50% by the City of Redwood City and 50% by the City of South San Francisco. There is no Net County Cost.