Federal Support for Alternative Crisis Response Teams
Last week, I sent the attached letter to our Congressional Delegation asking for their support of the federal CAHOOTS Act, a bill authored by Oregon legislators, Senator Ron Wyden and Congressman Peter DeFazio.
The CAHOOTS Act is named for the CAHOOTS program in Eugene, Oregon, which mobilizes two-person teams consisting of a paramedic or an EMT and a crisis worker, who has substantial training and experience in trauma-informed de-escalation and harm reduction techniques, to respond to a range of behavioral health crises. The model delivers better outcomes for callers and provides an added benefit of lifting calls off the police, freeing them to deal with more high-risk issues and saving taxpayers and health care systems a lot of money along the way.
I am proposing the kick off of a CAHOOTS style program in my 2021 Executive Budget. Support for this type of intervention from the federal government is much needed, and I was so pleased to hear that Congressman Mark Pocan is now signing onto the federal bill as a sponsor. The text of the letter is below.
October 29, 2020
Dear Senator Johnson, Senator Baldwin, and Representative Pocan,
Recognizing that an armed officer is not always the best response to every emergency call, many cities across the nation are experimenting with new models of crisis intervention and service delivery that better meet the needs of callers. Here in Madison, we hope to launch a mobile crisis response team to respond to non-violent crises and behavioral health emergencies early next year. A pilot of this model is included in my executive 2021 budget. For this reason, the City of Madison would benefit from your support of the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act (H.R. 7961 / S. 4441), which would help state Medicaid programs to support this type of community-based mobile crisis response service.
The federal bill and the Madison program are inspired by a 30-year-old program out of Eugene, Oregon called “CAHOOTS.” The idea is to mobilize two-person teams consisting of a paramedic or an EMT and a crisis worker, who has substantial training and experience in trauma-informed de-escalation and harm reduction techniques, to respond to a range of behavioral health crises. CAHOOTS crisis teams provide assessment, stabilization services, referrals for care, transportation, and coordination of a broad array of wraparound services, including housing assistance. se professionals can help guide those in need of services to those resources and treatment, instead of jail or another visit to the emergency room. The model delivers better outcomes for callers and provides an added benefit of lifting calls off the police, freeing them to deal with more high-risk issues and saving taxpayers and health care systems a lot of money along the way. In the small city of Eugene, CAHOOTS answers approximately 20% of police calls and saves an estimated average of $8 million worth of public safety dollars per year.
Senators Ron Wyden and Catherine Cortez Masto introduced the CAHOOTS Act in the Senate, while Congressman Peter DeFazio introduced the House companion bill. The legislation would provide States with enhanced federal Medicaid funding for three years to deliver mobile crisis services to individuals suffering from mental health issues or substance abuse. It would also provide $25 million for planning grants to States and direct the U.S. Department of Health and Human Services (HHS) to highlight best practices. States would evaluate the impact of “mobile crisis services on emergency room visits, the involvement of law enforcement in mental health or SUD events, diversion from jails, and other outcomes” according to the bill sponsors. This could lead to better care for those in crisis, better public safety outcomes, and cost savings across jurisdictions and importantly in the healthcare sector as well.
Through this single piece of legislation, we can act to reduce police violence, improve services to individuals suffering from behavioral health issues, and fundamentally reform our approach to public safety and the provision of treatment. I respectfully ask for your co-sponsorship of the legislation. Thank you for your consideration of this request. Our community is thankful for your partnership at the federal level.
Mayor Satya Rhodes-Conway
City of Madison, Wisconsin
CC: Governor Tony Ever