The Marin County Board of Supervisors will discuss expanding the service of the county’s Mobile Crisis Response Team at its 9 a.m. meeting on Tuesday, Jan. 23.
The County’s Mobile Crisis Response Team (MCRT) expanded its services to an “all day every day” operations on Dec. 31., and expanded its area of focus beyond mental health to include substance use disorder related crises. The Board will hear a request from Department of Health and Human Services’ Division of Behavioral Health and Recovery Services, to accept an informational update on the MCRT’s expansion of services. The Staff report follows:
SUMMARY: The federal American Rescue Plan Act of 2021 allowed states to add community-based mobile crisis intervention services as a covered Medicaid benefit for a five-year period. The California Department of Healthcare Services (DHCS) has provided guidance to counties regarding implementation of this new Medi-Cal Community-Based Mobile Crisis Intervention Services benefit for mental health and substance use-related response. Of note, mobile crisis services must be available to Medi-Cal beneficiaries 24 hours a day, 7 days a week, and 365 days a year by December 31, 2023.
Prior to December 31, 2023, the Marin County Mobile Crisis Team (MCRT) was operating Monday through Friday 8 a.m. – 9 p.m. and Saturdays from 11:00 a.m. – 9:00 p.m. and responding primarily to mental health-related crises with Licensed Crisis Specialist team members. For MCRT, the expansion is twofold, an expansion of services, such as responding to substance use related crises and post-crisis follow up, as well as an expansion of service hours.
The MCRT expansion of services to 24/7/365 operations occurred on December 31, 2023. Additionally, the MCRT expanded its area of focus beyond mental health to include substance use disorder related crises in response to the BHIN mandate. Prior to the expansion, the team’s mission was focused on responding to mental health crisis, though it was not unusual for individuals served by the team to have a co-occurring disorder. In preparation for the expansion, existing team members completed extensive training in the new benefit requirements, such as utilizing specific dispatch and crisis planning tools and Narcan training. Finally, BHRS has added new roles to the team, specifically Substance Use Counselors and Certified Peer Providers, and are endeavoring to hire bilingual team members whenever possible. The Crisis Specialists and Substance Use
Counselors are County staff, the Peer Providers are staffed through a contract with Mental Health Associates of San Francisco (MHASF).
COMMUNITY BENEFIT: Expanding the MCRT’s availability to operate 24/7/365 and respond to substance use-related crises is a transformative step toward enhancing community well-being. Round-the-clock support not only ensures that individuals facing a behavioral health crisis receive timely assistance during their most vulnerable moments, but also addresses a pressing public health concern. This expansion not only diminishes the burden on law enforcement, emergency services and hospitals, but also promotes a safer and more supportive community environment, reducing the harm that can be associated with a behavioral health crisis and bolstering overall community resilience and health.
EQUITY IMPACT: The expansion carries significant equity implications. It ensures that marginalized and underserved communities, who often face a disproportionate burden of behavioral health disparities, have equitable access to crisis resources and support. The expansion also helps combat systemic inequalities by facilitating a healthcare response to behavioral health crises whenever it is safe to do so. BHRS healthcare providers providing culturally sensitive, community-based interventions 24/7/365 represents a critical step toward reducing disparities in healthcare access and outcomes, promoting equity, and fostering a more just and inclusive society.
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