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_BbAgenda Item No:Bb. City Commission Agenda Item Report Meeting Date: September 15, 2020 Submitted by: Thomas Pepe Submitting Department: City Attorney Item Type: Resolution Agenda Section: Subject: A Resolution of the Mayor and City Commissioners of the City of South Miami requesting County funding of part-time licensed clinical social workers and funding of mental health training for Miami-Dade Fire Rescue Department paramedics so that they can be dispatched on mental health 9-1-1 calls and fund a mental health database that will automatically alert 9-1-1 operators, the responding EMS team, and the police, of the place of residence of the person with mental health issues. 3/5 (Vice Mayor Welsh) Suggested Action: Attachments: Reso re Mental Health Training for MDFD paramedics.doc 1 Page 1 of 3 RESOLUTION NO. _________________1 2 A Resolution of the Mayor and City Commissioners of the City of South Miami3 requesting County funding of part-time licensed clinical social workers and funding4 of mental health training for Miami-Dade Fire Rescue Department paramedics so5 that they can be dispatched on mental health 9-1-1 calls and fund a mental health 6 database that will automatically alert 9-1-1 operators, the responding EMS team,7 and the police, of the place of residence of the person with mental health issues.8 9 WHEREAS,nationally, 9-1-1 Emergency Medical Services (EMS) systems are strained 10 by serving large and increasing volumes of callers who disproportionally need 9-1-1 EMS 11 resources, for reasons mainly related to substance abuse, mental illness, homelessness, and some 12 combination thereof1; and 13 14 WHEREAS,Miami-Dade County is home to the largest percentage of people with 15 serious mental illnesses of any urban community in the United States 2; and16 17 WHEREAS,from time to time there have been instances where police have been 18 dispatched to the scene of a mental health crisis and the situation ended badly for the person 19 experiencing the crisis; and20 21 WHEREAS,in 1988, a program known as Crisis Intervention Team (CIT) or the 22 “Memphis Model” was developed as a first-responder model of police-based crisis intervention 23 training to help persons with mental disorders and/or addictions access medical treatment rather 24 than place them in the criminal justice system due to illness-related behaviors3; and25 26 WHEREAS,Miami-Dade County has implemented the Crisis Intervention Team (CIT) 27 model since 2000. In the period from 2010 to 2017, there were a total of 83,427 CIT calls of 28 which: 38,838 cases received assistance in accessing treatment; 15,894 cases were diverted from 29 the county jail; and only 149 arrests were made 4; and30 31 WHEREAS,a study published in Psychiatric Services in 2016 determined that CIT 32 training alone does not reduce trauma, unnecessary hospitalizations, and detentions and that a 33 number of other elements beyond police training are needed in order to avoid police involvement 34 when it really is not needed5; and35 36 1 https://smhs.gwu.edu/urgentmatters/news/innovations-upstream-crisis-intervention-unit 2 http://www.citinternational.org/resources/Documents/TEAM%20UP%208.25.19%20CIT%202019%20wit hout%20video.pdf 3 http://www.cit.memphis.edu/aboutCIT.php 4 http://www.citinternational.org/resources/Documents/TEAM%20UP%208.25.19%20CIT%202019%20wit hout%20video.pdf 5 https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201600348 2 Page 2 of 3 WHEREAS, law enforcement officers often express reservations regarding the lack of 1 training and resources devoted to the engagement and treatment of people with mental illness 2 and addictive disorders6; and3 4 WHEREAS, many of the problems associated with police involvement in behavioral 5 health crises can be avoided by creating alternatives, such as a co-responder model; and6 7 WHEREAS,in the co-responder model, trained police officers work together with 8 behavioral health workers to respond to crisis calls and ensure that appropriate services and 9 resources are provided. The goals of the co-responder model are to deescalate the crisis, prevent 10 injuries, provide appropriate services, and reduce the number of arrests. An initial assessment 11 conducted with a trained behavioral health worker at the scene can prevent unnecessary arrest or 12 hospitalization7; and13 14 WHEREAS, cases of non-behavioral medical emergencies, such as heart attacks, strokes 15 and non-vehicular accidents are often handled by the 9-1-1 system but rather than dispatching a 16 police officer, an ambulance is sent; and17 18 WHEREAS, similarly, mental health crises could be treated using specialized mental 19 health personnel, such as licensed clinical social workers (LCSWs) trained in mental health 20 instead of only using law enforcement officers; and21 22 WHEREAS,a pilot program at the George Washington School of Medicine in 2013 23 sought to decrease the amount of inpatient psychiatric treatment by dispatching “mobile crisis 24 units” staffed with a paramedic and a licensed social worker to co-respond to 9-1-1 calls triaged 25 as mental health treatment calls. The program was found to be successful 8; and26 27 WHEREAS,9-1-1 operators are capable of learning from the caller if there is a person 28 experiencing a mental health crisis and, if resources such as paramedics trained in mental health 29 and specialized mental health personnel are available, the crisis can be dealt in way that benefits 30 all parties.31 32 NOW THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY 33 COMMISSIONERS OF THE CITY OF SOUTH MIAMI, FLORIDA:34 35 Section 1.The foregoing recitals are hereby ratified and confirmed as being true and they 36 are incorporated into this resolution by reference as if set forth in full herein.37 38 Section 2.The Mayor and City Commission of the City of South Miami calls on Miami-39 Dade County Board of County Commissioners (“MDCBOCC”) to 40 41 (a) fund mental health training for at least one paramedic per shift per Fire Rescue42 station so that if 9-1-1 advises the Miami-Dade Fire Rescue Department that a person is 43 6 https://www.mhanational.org/issues/position-statement-59-responding-behavioral-health-crises 7 Ibid. 8 Ibid. 3 Page 3 of 3 having a mental health crisis that employee trained to handle mental health crises can be 1 dispatched to the call and the Police Department will then act as a back-up to the 2 Emergency Medical Services (EMS); and3 (b) fund the part-time hiring of licensed clinical social workers (LCSWs) trained in 4 mental health who can be dispatched to the scene of a mental health crisis to assist the 5 EMT’s in dealing with the crisis; and6 (c) fund a mental health database that will automatically alert 9-1-1 operators who are 7 dispatching police to an address that a person with mental health issues has been 8 registered as a person residing at that address.9 10 Section 3. Instructions to the City Clerk.The City Clerk is instructed to forward a 11 copy of this resolution to:12 13 All municipalities in Miami-Dade County;14 Miami-DadeCounty League of Cities;15 All members of the Miami-Dade County Board of County Commissioners;16 Miami-Dade County Manager; and17 Miami-Dade County Mayor18 19 Section 4.Corrections. Conforming language or technical scrivener-type corrections 20 may be made by the City Attorney for any conforming amendments to be incorporated into the 21 final resolution for signature.22 Section 5. Severability.If any section clause, sentence, or phrase of this resolution is for 23 any reason held invalid or unconstitutional by a court of competent jurisdiction, the holding shall 24 not affect the validity of the remaining portions of this resolution.25 26 Section 6. Effective Date.This resolution shall become effective immediately upon 27 adoption.28 29 PASSED AND ADOPTED this ____ day of _____________, 2020.30 31 ATTEST:APPROVED:32 33 ___________________________________________34 CITY CLERK MAYOR35 36 READ AND APPROVED AS TO FORM, COMMISSION VOTE:37 LANGUAGE, LEGALITY AND Mayor Philips:38 EXECUTION THEREOF Vice Mayor Welsh:39 Commissioner Harris:40 Commissioner Liebman:41 _______________________Commissioner Gil:42 CITY ATTORNEY43 4