20250328-004B: FY2025-2026 DACC Budget Recommendation — original pdf

Recommendation

DOWNTOWN AUSTIN COMMUNITY COURT ADVISORY BOARD RECOMMENDATION 20250328-004B March 28, 2025 Fiscal Year 2025-2026 Budget Recommendations for Community Programs Date: Subject: Motioned By: Mikaela Frissell Seconded By: Katy Jo Muncie Introduction The Downtown Austin Community Court Advisory Board’s highest priority this budget cycle is discussed in Recommendation 20250328-004A. The Board also wants to recommend continuation of two critical community initiatives whose contracts are funded and managed by DACC, both of which strengthen connection to mental health services and are key components of Austin’s diversion efforts, including those directly served by DACC. These programs include the Therapeutic Diversion Program component of the Mental Health Diversion Pilot1 and continuation of 24/7 operations for the Expanded Mobile Crisis Outreach Team. The most recent Point in Time Count results from 2023 approximated that about 31% of the total population in the Travis County Jail were likely to be experiencing homelessness. Of these individuals, 67% were people of color. Advancing these programs helps improve equitable access to services, while taking an evidence-based and person-centered approach to addressing the intersections between homelessness, criminal justice involvement, and mental health needs. Both of these programs were funded in Fiscal Year 2024-25 with one-time funding, but the community need for these programs continues. Without additional investment from the City of Austin, these critical services for the Austin community will be negatively impacted. The Board recommends Council identify funding to ensure both programs are able to continue at full capacity. Recommendations 1. $2,000,000 annually in Fiscal Years 2025-26 and 2026-27 for the Therapeutic Diversion Program component of the Mental Health Diversion Pilot 2. Ongoing funding to continue 24/7 operations for the Expanded Mobile Crisis Outreach Team (EMCOT) Description of Recommendation to Council 1. $2,000,000 funding annually Fiscal Years 2025-26 and 2026-27 for the Therapeutic Diversion Program (TDP). The Mental Health Diversion Pilot is a collaboration between Central Health, the City of Austin, Integral Care, and Travis County, which leverages existing programs and facilities to immediately address unmet deflection and diversion needs through 1 This program is now referred to as the Crisis Care Diversion Pilot; more information on the Pilot is available here. provision of critical services for individuals experiencing a mental health crisis. This Pilot, designed to be a three-year program, needs $2 million in City funding in FY 2025-26 and FY 2026-27 to continue at full capacity. The TDP component of the Mental Health Diversion Pilot, funded by the City and Travis County, with services provided by Integral Care, provides approximately 90 days of inpatient care including behavioral health services, peer support, and working toward connection to stable exit options through housing-focused case management services. Additional justification for this program includes:  Uninterrupted Services for Current Clients: TDP will be operating at full capacity providing inpatient services and helping to create linkages to programs that can provide long-term housing solutions for unhoused clients. If funding is not continued to keep this program whole, there will be service interruptions for individuals actively working toward addressing their mental health needs and resolving their experience with homelessness.  Data-Informed Program to Address Identified Community Need: This program stemmed from recommendations in the Travis County Forensic Mental Health Project Final Report, published after a 10-month extensive, data-driven process led by Dell Medical School including a broad array of community stakeholders and service providers working to, “find solutions for the large and growing number of people within the county jail needing care for mental health and/or substance use disorders.”  Informing Long-Term Mental Health Diversion Center: Lessons learned from the three-year Mental Health Diversion Pilot will help inform the broader community plans for a Mental Health Diversion Center, allowing providers to learn from challenges and to implement and improve upon program successes. 2. Ongoing funding to continue 24/7 field operations for EMCOT – This program has been serving the community by providing real-time response to and treatment for psychiatric crisis, diverting individuals from emergency rooms and jails, since 2013. During the Fiscal Year 2024- 25 budget process, Council allocated funds to expand the EMCOT Field Response Team from 6:00am-10:00pm Mon.-Fri. and 10:00am-8:00pm Sat. and Sun. to 24 hours a day, seven days a week operations, with implementation beginning April 1, 2025. Data shared in the budget amendment passed by Council justifying this need includes:  Effective Outcomes: In FY 23, 86% of calls taken from a police response were diverted to a more appropriate resource, improving health outcomes and ensuring first responders can return to what they do best – responding to medical emergencies and public safety issues.  Increased Capacity to Respond to Calls: The current program only operates from 6am- 10pm Mon. – Fri., and 10am-8pm Sat. and Sun. This staffing model covers only 25% of APD calls, 40% of EMS calls, and 60% of calls at the 911 Call Center or Combined Transportation Emergency and Communication Center (CTECC). By contrast, 24/7 operations will support responding to approximately 75% of APD calls, 85% of EMS calls, and 80% of CTECC calls. EMCOT will respond to psychiatric calls that ATCEMS, APD, and other law enforcement jurisdictions receive; partner with a Community Health Paramedic; and provide up to 90 days of follow-up services to each individual served, reducing the likelihood of future crises.  Key City Resource Identified in Resolution 20250130-080: This Resolution, which is related to gathering data and developing recommendations around the City’s police and non-police responses to mental health related incidents, states: o “There is strong scientific and policy consensus that mental health is a major factor in multiple areas of government responsibility and plays a particularly critical role in public safety” o “The City has taken steps to rethink and reimagine how to best respond to mental health needs,” which includes, “the Expanded Mobile Crisis Outreach Team (EMCOT), which sends qualified mental health workers with specialized crisis intervention training to respond jointly with law enforcement and provide follow up services” o “Evidence and experience strongly supports the efficacy of such programs in providing more appropriate response to mental health needs and producing improved outcomes, along with a more efficient use of City resources” o “Council has taken a number of recent steps to further expand and support such programs,” which includes, “additional funding for EMCOT, call center clinicians, and Collaborative Care, with a goal of 24/7 coverage” Rationale: Both of these programs align with DACC’s mission and with our community values and goals around connecting individuals to appropriate care while supporting diversion from our jails and hospitals. Our community does not have the capacity to meet the full mental health crisis response need that exists; a decision not to fund these programs will expand that service gap. Additionally, both programs help first responders maximize limited resources by allowing them to return their focus more quickly to medical emergency and public safety call responses. Continuation of these services is vital to protect Austin’s service continuum around mental health services for all of Austin’s residents, inclusive of all types of housing status. While these programs are broader community initiatives that serve residents across the City of Austin, they also have immense benefit for DACC clients and play a key role in Austin’s Homelessness Response System. The Downtown Austin Community Court Advisory Board recommends that the City Council allocate funds to these vital community programs to ensure continued access to critical services and advance efforts around connection to appropriate services during mental health crises, supporting diversion from jails and hospitals while maximizing limited resources for our first responders. Vote 6-0 For: Against: 0 Abstain: 0 4 Absent: Attest: Dr. Anu Kapadia, Vice Chair ____________________________