Common use of Crisis Services Clause in Contracts

Crisis Services. a. The County will continue to offer a countywide crisis system and expand crisis intervention services as follows: i. Maintain a 24/7 crisis hotline. The crisis hotline will provide screening and de-escalation services on a 24/7 basis. No later than eighteen (18) months after the Effective Date, the County will expand the 24/7 crisis hotline to provide triage and the identification of full service partnership (“FSP”) clients on a 24/7 basis. (1) Beginning no later than eighteen (18) months after the Effective Date, the crisis hotline will have a clinician available to support crisis hotline services 24/7. 1 IMD, as used in this Settlement Agreement, refers to Villa Fairmont Mental Health Rehabilitation Center, ▇▇▇▇▇▇▇ Mental Health Rehabilitation Center, and ▇▇▇▇▇▇ ▇▇▇▇▇ Center. (2) The County will coordinate with entities responsible for managing urgent and emergency care response lines, including but not limited to the crisis hotline, 911, FSP warmlines, and 988 (when and if such coordination is available), to ensure there is “no wrong door” for accessing appropriate crisis services. The County will have and will implement protocols for when to conduct warm handoffs from its crisis hotline to FSP warmline teams to provide appropriate services. The County will respond to 911-dispatch inquiries in order to facilitate an appropriate behavioral health response to crises. (3) The County will implement protocols and education efforts to ensure appropriate deployment of County mobile crisis teams in response to calls received through emergency response lines. ii. Provide mobile crisis response services on a county-wide basis. (1) Mobile crisis teams will provide a timely in-person response to resolve crises as appropriate. When clinically appropriate, mobile crisis services may be provided through the use of telehealth. (2) Mobile crisis services shall be provided with the purposes of reducing, to the greatest extent possible, interactions with law enforcement during a mental health crisis, reducing 5150 and ▇▇▇▇ ▇▇▇▇▇▇ psychiatric emergency services (“PES”) placement rates, and increasing use of voluntary community-based services (including diversion, care coordination, transportation, and post- crisis linkage to services). (3) The County has recently expanded its mobile crisis capacity to nine (9) mobile crisis teams, and agrees to maintain this as a minimum capacity. (4) The County shall complete an assessment of needs and gaps in mobile crisis coverage, no later than one year after the execution of this Agreement, that is designed to determine the amount and number of mobile crisis teams needed to provide mobile crisis services consistent with this Agreement (the “Mobile Crisis Assessment”). The Mobile Crisis Assessment will be informed by and will appropriately take into account (i) community and stakeholder input; and (ii) all necessary data and information sufficient to assess the need for crisis services in the County, which the County will collect and analyze as part of the Mobile Crisis Assessment process. (5) The County will provide a draft of the design of the Mobile Crisis Assessment to the Independent Reviewer (see section III.1.a of this Agreement) for review, feedback, and comment, and will appropriately take into account such feedback and comment before proceeding with the Mobile Crisis Assessment. As part of this review, the Independent Reviewer will provide the draft to, and consider input from, DRC and the United States. The assessment and conclusions in the final Mobile Crisis Assessment will promptly be made available to the public. (6) Based on the County’s Mobile Crisis Assessment, the County will reasonably expand2 its mobile crisis services as needed in order to operate a sufficient number of mobile crisis teams to provide timely and effective mobile crisis responses. (7) FSPs will provide crisis intervention as set forth in section II.2.m in this Agreement. (8) Each mobile crisis team shall include at least one mental health clinician. iii. Trained peer support specialists shall be part of the County’s crisis services team and shall be included in outreach and engagement functions. b. The County will provide crisis residential services as follows: i. Maintain forty-five (45) crisis residential treatment (“CRT”) beds. ii. Within two years of the Effective Date of the Agreement, the County will make all reasonable efforts to contract with one or more community-based provider(s) to add a mixture of 25 additional CRT and/or peer-respite beds. iii. A purpose of CRT facilities and peer-respite homes is to promptly de- escalate or avoid a crisis and reduce unnecessary hospitalization. CRT facilities and peer-respite homes are intended to be used by people experiencing or recovering from a crisis due to their mental health disability for short-term stays and to provide support to avoid escalation of a crisis. CRT facilities and peer-respite homes are unlocked. 2 A reasonable expansion, as used here, means an expansion that would constitute a reasonable modification, and not a fundamental alteration of the nature of the County’s services for people with disabilities, consistent with the Americans with Disabilities Act, as interpreted by ▇▇▇▇▇▇▇▇. Notwithstanding section III.1 of this Agreement, the Independent Reviewer will not render a legal conclusion as to whether the County’s expansion of its mobile crisis services is a “reasonable modification” or a “fundamental alteration”, and therefore will not render a compliance determination as to section II.1.a.ii.(6). If the Parties are unable to agree as to whether an expansion constitutes a reasonable modification or a fundamental alteration, the Parties will proceed through the dispute resolution process as set forth in sections III.2.b-c. iv. Peer staff will be on-site 24/7 at peer-respite homes. Peer-respite homes shall serve no more than six (6) individuals at a time. v. Individuals shall not be required to have identified housing as a condition of admission to a CRT facility. vi. CRT facilities and peer-respite homes shall be able to accept admissions directly from mobile crisis teams. c. The County’s crisis system will be designed to prevent unnecessary hospitalization, IMD admissions, law enforcement interactions, and incarceration.