Measure O Newsletter Inaugural 2022
What is Sonoma County’s Measure O?
In November 2020 Sonoma County passed Measure O to provide essential funding for mental health and homeless services. Measure O, a one-quarter cent sales tax, passed with over 2/3 of the vote and generates $25 million each year for 10 years to help protect essential mental health and homelessness services.
In June of 2018, the need for expanded access to behavioral health and homeless services reached a crisis level in Sonoma County. The wildfires of 2017 exacerbated an already strained health care delivery system, decimated over five percent of the county’s housing stock, and increased the need for trauma-informed behavioral health services. The COVID-19 pandemic caused new challenges and obstacles throughout the County. At the same time that more and more residents needed treatment, budget shortfalls forced drastic reductions to services. These compounding issues demanded additional revenue to support the needs of the most vulnerable residents of Sonoma County.
The Measure O Sales Tax Ordinance identified five categories of services to be funded with the revenue: (1) Behavioral Health Facilities, (2) Emergency Psychiatric and Crisis Services, (3) Mental Health and Substance Use Disorder Outpatient Services, (4) Behavioral Health Homeless and Care Coordination, and (5) Transitional and Permanent Supportive Housing. The Expenditure Plan designates a set percentage of funding for each of the categories.
A diverse group of stakeholders came together to create Measure O - local health professionals, elected officials, labor union members and leaders, Santa Rosa Junior College administrators, professors, students, and local community advocates. This Measure O Newsletter is to keep our community updated on the work and progress the County is making in supporting our community.
If you have questions about Measure O or would like more information, please contact us at: MeasureO@sonoma-county.org
Measure O supporting Mobile Crisis Response throughout the County
If you or someone you know is experiencing a mental health crisis, it can be hard to know what to do. Calls made to 911 can sometimes result in a law enforcement response that creates more difficulty for the person in crisis, or result in costly hospitalization. In response, Sonoma County is developing new ways to deliver and improve crisis support in our communities. The most significant innovation of these new crisis support models is that behavioral health and emergency medical service teams act as first responders to service calls that do not require law enforcement resources.
The County-run Mobile Support Team (MST), created in 2012, already accompanies law enforcement on calls and provides crisis intervention to individuals in psychiatric and substance use disorder distress. Because these services are in high demand, Santa Rosa, Petaluma, Rohnert Park and Cotati are launching their own mobile support teams, modeling their programs on the CAHOOTS model (Crisis Assistance Helping Out On The Streets) out of Eugene, Oregon’s White Bird Clinic.
The Petaluma Specialized Access for Everyone (SAFE) program operated by Petaluma Peoples Services Center began providing mobile support services in Petaluma on July 1, 2021. The SAFE program deploys mobile teams of trained crisis-workers and EMT staff into the community. Rohnert Park and Cotati will also offer support programs through SAFE and started trainings in October 2021.
The Santa Rosa Police Department will soon be launching the inRESPONSE program in January 2022. This partnership includes the Santa Rosa Fire Department, Department of Health Services (DHS), Buckelew Programs, and Catholic Charities.
Working toward the same goal of reducing law enforcement interactions when medical/mental health care is a more appropriate response, each program will have a slightly different mobile crisis response model. These social workers do not carry weapons and are not trained in law enforcement; instead they replace or accompany armed, uniformed police officers. They are dispatched through 911 or the police nonemergency line. They respond to calls that do not involve an immediate safety threat to the individual in crisis or the general public including: welfare checks, reports of suspicious people, family disturbances, public drunkenness, a person lying on the ground or sleeping; mentally ill or suicidal people; missing persons cases; and more.
These new city-focused programs, SAFE and inRESPONSE, will be available in addition to the County of Sonoma’s Mobile Support Team program.
Making a Difference
In 2018-2020, MST answered 693 calls, serving 620 unique individuals in 1,679 encounters. Follow up contacts included 926, or 55 percent, of the encounters, enabling our clinicians to provide a deeper level of support. A quarter of all contacts resulted in a 5150, a temporary psychiatric hold of those in danger of hurting themselves or others.
Measure O was designed to support this type of innovation and collaboration in the County in response to mental health needs. Measure O funds will be used to cover start-up and operational costs not covered by other funding sources, including potentially a common database, vehicles, technology, and other infrastructure needed. Mobile crisis programs can decrease hospitalization rates for persons in crisis and can provide cost-effective psychiatric emergency services that benefit both residents receiving care and reduced cost of law enforcement. The Board of Supervisors are excited to support these pilot programs to provide a sustainable and successful mobile crisis response model to adopt, scale up, and offer them countywide.
Measure O supporting Psychiatric Health Facility
The greatest obstacle to getting patients out of the Emergency Departments (EDs) once medically stable is that the Department of Health Services’ Crisis Stabilization Unit (CSU) slots are not available when needed. The CSU provides 24 hour-a-day, 7 day-a-week crisis intervention, assessment, medication, and up to 23 hours of supportive care for individuals in an acute mental health crisis. This 16 bed facility is impacted by the inability to discharge clients within 24 hours as required, because there are no in-patient facilities in which to transfer them. The root cause of this problem is the shortage of psychiatric in-patient beds. Publicly and privately operated psychiatric inpatient facilities are in short supply in and around Sonoma County, as is the case across the state and nation.
In May 2020 the Board of Supervisors approved the Department of Health Services (DHS) establish a Psychiatric Health Facility (PHF) called the Sonoma County Healing Center. The PHF, located at the former Valley of the Moon Children's Center, will operate as a sixteen-bed psychiatric facility. The PHF will be a 24/7 locked 16-bed facility providing short-term treatment to individuals experiencing mental illness. 14 beds will be reserved for Sonoma County and 2 for Marin County. The PHF will be operated by Crestwood Behavioral Health, which is an accredited, Sacramento-based healthcare provider, in operation for over 50 years. Crestwood is a leading provider of mental health services in California, operating 33 programs across the state. DHS and Crestwood have had community engagements with local residents living near the PHF regarding the site, operations, and clientele who will receive services there.
The addition of a PHF to the local mental health services system of care is a significant advancement for Sonoma County. The services offered will help clients stabilize, gain self- reliance, build strengths, and independence with structure and support. The program utilizes psychosocial rehabilitation, healing arts, life skills, and peer providers to support stabilization and recovery. The addition of the PHF will create a Sonoma County continuum of intensive crisis services that includes a 16-bed crisis stabilization unit and 14-bed psychiatric health facility. The two programs, offering 30 beds, will work in tandem to move clients through the crisis system, providing the correct level of care to Sonoma County clients, supporting local hospital emergency departments’ ability to transfer patients in psychiatric crisis, and mitigate regulatory risk at the CSU.
The County would like to recognize our hospital partners for providing financial resources to launch this facility. The County, including DHS, worked with our community hospital partners Kaiser, Providence St. Joseph, and Sutter to ensure a psychiatric health facility was available in our community to support our residents in crisis.
Measure O supporting Substance Use Disorder Services
In July of 2021, DHS-Behavioral Health Division (DHS-BHD) mapped the complete continuum of Substance Use Disorder (SUD) Services including Prevention, Treatment and Recovery services in the County of Sonoma. This mapping included focus groups with key stakeholders, along with a comprehensive online survey, key informant interviews and an analysis of existing data sets looking at local substance use trends in the county. One of the conclusions of this mapping project was a determination that there is a gap in the continuum around youth and young adult SUD treatment services. There has been a significant increase in overdose deaths in the County among our adult and youth populations.
At the direction of the Sonoma County Board of Supervisors, Sonoma County DHS will utilize Measure O funds to issue a request for proposals (RFP) to bring new and/or expand existing youth treatment services to meet the needs of our younger residents at risk of developing or currently diagnosed with a substance use disorder. Further analysis is currently underway to identify the type of services, such as outpatient and/or residential treatment services, needed to support our youth and young adults. Additionally, DHS and local school districts are exploring expansion of substance use prevention, alcohol and other drug assessment, early intervention, treatment and recovery services in the school environment.
Anticipated release of the RFP is during the third quarter of the 2021-2022 fiscal year.
*If you are concerned that you or someone you care about is experiencing a substance use issue you can call the 24-hour, confidential phone line at (707) 565-7450.
* Sonoma County Behavioral Health Department is always open. Any Sonoma County resident experiencing a substance use issue can call the 24-hour, confidential phone Line at (707) 565-7450.