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HomeMy WebLinkAboutStaff Report 2410-3573CITY OF PALO ALTO CITY COUNCIL Special Meeting Tuesday, January 21, 2025 Council Chambers & Hybrid 5:30 PM     Agenda Item     10.Final Summary Report on North County TRUST (Trusted Response Urgent Support Team) Augmentation Pilot and related Use of $2,000,000 Consolidated Appropriation Act of 2022 Award. CEQA Status – Not a Project City Council Staff Report From: City Manager Report Type: INFORMATION REPORTS Lead Department: City Manager Meeting Date: January 21, 2025 Report #:2410-3573 TITLE Final Summary Report on North County TRUST (Trusted Response Urgent Support Team) Augmentation Pilot and related Use of $2,000,000 Consolidated Appropriation Act of 2022 Award. CEQA Status – Not a Project. RECOMMENDATION This is an informational report and no Council action is required. EXECUTIVE SUMMARY In September 2022, the City received a $2 million Community Project Funding grant for an alternative response program in Palo Alto, Mountain View, and Los Altos. Since Santa Clara County had already set up an alternative response program (“TRUST”) serving the Palo Alto area, the City instead focused on a pilot augmenting TRUST with outreach and marketing, case management, and Mental Health First Aid trainings. Staff contracted with Resource Development Associates (RDA) Consulting to evaluate the augmentation and report on its performance in relation to the goals of the grant.1 The full report is available online2 and some highlights from it include: •Community members, Police Departments, and staff from the three Augmentation Cities have developed new and enhanced awareness of how to respond in a mental health crisis, including awareness of the availability of TRUST as a resource. •Utilization of TRUST steadily increased over time. •Case Management services resulted in positive client outcomes. The pilot ran from July 2023 through August 2024. 1 April 3, 2023, Council Consent Report, https://cityofpaloalto.primegov.com/meetings/ItemWithTemplateType?id=1852&meetingTemplateType=2 2 TRUST Augmentation: Palo Alto, Mountain View, and Los Altos, Final Evaluation Report, 2024 https://www.cityofpaloalto.org/files/assets/public/v/1/intergovernmental-affairs/trust-augmentation- evaluation_final-report.pdf BACKGROUND Following national discussions on policing, the City launched its Race and Equity framework, which included changes citywide and within the Police Department, as detailed in the April 3, 2023 Council report.3 In 2020, while establishing the Psychiatric Emergency Response Team (PERT), the City Council sought to invest in alternative response programs for non-emergency calls, inspired by Oregon's CAHOOTS model.4 Relating to that interest in an alternative response program, on July 16, 2021, Representative Anna Eshoo secured $2 million for such an effort in Palo Alto, Mountain View, and Los Altos.5 The following year, in September 2022, this was officially awarded to Palo Alto in the form of a one-year grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). In November 2022, Santa Clara County launched its own alternative response program, TRUST (Trusted Response Urgent Support Team). The new County TRUST program included a team operated by Momentum for Health in Palo Alto. Rather than set up a duplicative alternative response program, the City pivoted and proposed a pilot leveraging the SAMHSA grant to augment TRUST. In April 2023, the City Council approved the use of the SAMHSA grant and a contract with Momentum to add outreach, crisis support, mental health training, and follow-up services to TRUST in Palo Alto, Mountain View, and Los Altos.6 In October 2023, SAMHSA granted Palo Alto a 12-month extension to spend the federal grant, moving the deadline from September 2023 to September 2024. In December 2023, the contract with Momentum was amended to align with this new deadline.7 The amendment also shifted invoicing from monthly to quarterly for greater efficiency, revised compensation language to better match SAMHSA’s guidelines, and adjusted staffing rates to address hiring challenges. Additionally, the original Momentum contract that was approved by Council in April 2023 incorrectly indicated the full amount of $2,000,000. The amendment corrected that error and revised the Momentum contract to match the grant budget at a not-to-exceed amount of $1,931,706. The remaining $68,294 was awarded8 to RDA for evaluation of the services Momentum provided. 3 April 3, 2023, Council Consent Report. https://cityofpaloalto.primegov.com/meetings/ItemWithTemplateType?id=1852&meetingTemplateType=2 4 https://www.eugene-or.gov/4508/CAHOOTS CAHOOTS (Crisis Assistance Helping Out on the Streets) is a program providing alternative mental health response. 5 July 16, 2021 U.S. Rep. Eshoo, press release. 7 Council Consent Report, December 11, 2023 https://cityofpaloalto.primegov.com/meetings/ItemWithTemplateType?id=3460&meetingTemplateType=2&comp iledMeetingDocumentId=8692 8 Council Information Report, April 15, 2024 https://cityofpaloalto.primegov.com/meetings/ItemWithTemplateType?id=4710&meetingTemplateType=2&comp iledMeetingDocumentId=9592 The TRUST pilot program developed through the grant, focused on augmenting TRUST with outreach and marketing, case management, and mental health first aid (MHFA) training in Palo Alto, Mountain View and Los Altos. The pilot ran from July 18, 2023 to August 31, 2024. The effort included eight "promotores" who conducted outreach to raise awareness about TRUST, with each aiming to make 480 contacts annually. Two case managers provided follow-up support, assisting individuals with mental health services, benefits, and system navigation. Additionally, the pilot included training over 1,000 individuals in MHFA, equipping them to handle mental health crises and make appropriate referrals. The training also incorporated information on the TRUST program to boost community engagement. ANALYSIS Evaluation Findings Staff contracted with RDA Consulting to evaluate the pilot and report on its performance from through April 2024 in relation to the goals of the grant. The following section highlights from the recently released report, the full report and data is available online. •Increased Awareness of How to Respond in a Mental Health Crisis Community members, Police Departments, and staff from the three Augmentation Cities have developed new and enhanced awareness of how to respond in a mental health crisis, including awareness of the availability of TRUST as a resource. The evaluation found that 59% of surveyed stakeholders felt prepared to handle some mental health crisis situations, while 40% recognize the TRUST program by name. Despite the presence of two other mental health crisis programs in the County, this name recognition of TRUST is noteworthy. •Increased Utilization of TRUST TRUST usage steadily increased throughout the evaluation period. Countywide, the calls increased five-fold from 57 calls in November 2022 to 333 in March 2024. In the pilot cities, this was a much sharper increase of eleven-fold from 2 calls in November 2022 to 22 in March 2024. •Case Management Resulting in Positive Client Outcomes Case management services led to positive outcomes for clients. For example, one client who frequently called TRUST for support was connected to a case manager, who guided the client to other mental health resources. Now, the client calls less often and has ongoing support. The evaluation also identified some challenges and areas for improvement. For example, Momentum for Health was unable to connect clients to case management during TRUST follow- up phone calls. Momentum indicated County Behavioral Health disallowed TRUST provision of case management referrals in the pilot cities (Palo Alto, Mountain View, and Los Altos) because it would create variation in the countywide TRUST service delivery. In response, Momentum adapted by sending case managers with the TRUST team for initial client contact and attending community events to reach potential clients. Another challenge related to meeting the Mental Health First Aid (MHFA) training goal of 1,040 participants. Momentum experienced staffing turnover and difficulty with the virtual curriculum's pre-work requirements, leading to low enrollment and cancellations in 2023. After stabilizing staff and shifting to more in-person trainings in 2024, enrollment improved significantly and fewer trainings were cancelled. In terms of ways to improve, the evaluation noted a need for a clearer understanding of what TRUST is/does, easier access to services, faster response times, and provision of services in Spanish. Overall Performance in Relation to Goals In addition to the evaluation, City staff monitored the pilot’s progress on a monthly basis and reported to the federal grantor on performance. From the beginning of the pilot’s activities on July 18, 2023 through the end of the pilot on August 31, 2024, some of the achievements include: •Providing 74 clients with case management services, including connecting 26 clients to housing resources and 6 clients to substance use resources. •Training nearly 100% of sworn officers in Palo Alto and almost 80% of sworn officers in Mountain View to provide resources relating to TRUST/mental health. •Holding 34 MHFA trainings, resulting in 415 people trained. •Placing 25 ads about TRUST in multiple languages at bus and transit shelters in Palo Alto, Mountain View, and Los Altos. •Reaching 300,000 users and resulting in over 10,500 clicks through social media ads about TRUST. Besides the above achievements and performance metrics, the pilot program was able to respond when a local loss of life impacted the community. In February 2024, the Momentum for Health CEO and TRUST leadership attended a faith-based roundtable to share information about TRUST and MHFA training. This event helped a wider group of North County faith leaders learn about services and training available in community during this time of heightened concern. FISCAL/RESOURCE IMPACT As mentioned elsewhere, the original $2 million grant was intended for the creation of an alternative response program, including staffing and a van for the team to use. With the advent of a North County-dedicated alternative response program provided by the County, the City instead proposed a pilot augmenting that program. Through the course of the pilot, the City realized that the original number of staff proposed was ambitious given nationwide hiring challenges for mental health personnel. This resulted in being able to deliver the pilot at a slight cost savings of $1,738,753.54. The $2 million was administered by SAMHSA on a reimbursement basis, meaning the federal government retains the remaining $261,246.46. STAKEHOLDER ENGAGEMENT A significant portion of the pilot activities focused on engagement and outreach. This included in-person attendance at community events, meetings with key stakeholders, and marketing via advertising on bus and transit shelters, as well as on social media. ENVIRONMENTAL REVIEW This item is presented only for Council’s information and therefore it is not a project subject to environmental review by the California Environmental Quality Act (CEQA). APPROVED BY: Ed Shikada, City Manager