Jan 20, 2026 Public Safety Committee

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>> KAUR: LET'S GO AHEAD AND GET STARTED. THANK YOU AWESO ALL FOR COMING TODAY. THE TIME IS 2:06 P.M. AND OUR PUBLIC SAFETY COMMITTEE MEETING IS CALLED TO ORDER. MADAME CLERK, CAN YOU PLEASE CALL ROLL?

[Approval of Minutes  ]

>> KAUR: WE HAVE A FEW ITEMS ON THE AGENDA. DO WE HAVE ANY MINUTES TO APPROVE? YES? OKAY.

LET'S GO AHEAD AND TAKE A MOTION TO APPROVE THE MINUTES FIRST.

>> ANY DISCUSSION? OKAY. ALL IN FAVOR?

[Consent  ]

CONSENT, IT'S OUR CARB. >> VILLAGOMEZ: SO THIS PARTICULAR ITEM WILL CONSIDER APPOINTMENT OF INDIVIDUALS TO THE CITIZEN ADVISORY BOARD FOR THE POLICE CHIEF . AND WE BROUGHT AN ITEM TO THIS COMMITTEE BACK IN NOVEMBER AND THAT WENT TO COUNCIL AND WAS APPROVED IN JANUARY.

WE HAD ADDITIONAL VACANCIES THAT THE TERMS ENDED IN DECEMBER, SO WE CONDUCTED INTERVIEWS AND WE'RE RECOMMENDING THESE INDIVIDUALS TO FILL THOSE VACANCIES. IF THIS ITEM IS APPROVED, IT WILL GO BEFORE THE FULL COUNCIL IN FEBRUARY AND THEN ALL OF OUR VACANCIES AT THE CARB WILL BE FILLED.

>> KAUR: THANKS, MARIA. I KNOW WE RECEIVED THE INFORMATION AHEAD OF THIS MEETING, SO WOULD ANYONE LIKE TO PULL THE ITEM FOR DISCUSSION? OKAY. CAN I HAVE A MOTION TO APPROVE THE CONSENT AGENDA?

>> THERE'S A MOTION AND A SECOND. ALL IN FAVOR SAY AYE.

>> SORRY. AND WE HAVE ONE ABSTENTION. SO -- ALL RIGHT.

WE'RE GOOD. MOTION CARRIES.

GO BACK AND RETAKE IT? >> YES. >> KAUR: WE'RE ON CONSENT AND THIS IS FOR OUR CARB APPOINTMENTS. ARE YOU COMFORTABLE WITH LEAVING IT ON CONSENT? WE'RE GOING TO RETAKE THAT VOTE.

WE HAVE A MOTION AND A SECOND. DO WE NEED ANOTHER MOTION

AND A SECOND? >>

MOTION AND A SECOND. ALL IN FAVOR SAY AYE. >>

>> KAUR: ANY OPPOSED? ABSTENTION? 3-1.

[Briefing and Possible Action on  ]

MARIA'S TEAM PRINTED THEM. THEY'RE BY THE WATER BOTTLES.

AND THEN WE'LL HAVE SOME COUNCIL DISCUSSION BUT MARIA'S GOING TO GIVE US

SOME HIGHLIGHTS FROM IT. >> VILLAGOMEZ: THANK YOU, CHAIRWOMAN.

WE CAME TO THIS COMMITTEE IN DECEMBER AND WE PROVIDED AN UPDATE ON CRIME STATISTICS FOR CALENDAR YEAR 2025 THROUGH THE MONTH OF NOVEMBER.

AND WE REPORTED AT THE TIME THAT OVERALL OUR CRIME WAS DOWN IN THE CITY OF SAN ANTONIO. THE MEMO BEFORE YOU TODAY ADDS ONLY ONE MORE MONTH.

IN DECEMBER WE DID AN IN-DEPTH PRESENTATION OF CRIME STATISTICS SO WHAT WE DID FOR TODAY IS WE ADDED THE INFORMATION FOR DECEMBER.

AND THE GOOD NEWS IS THAT CRIME CONTINUES TO BE DOWN. OVERALL, CRIME FOR SAN ANTONIO IS 12.5 LOWER COMPARED TO 2024. INCLUDED IN THAT IS OUR VIOLENT CRIME THAT IS 7.7% LOWER WHEN COMPARED TO LAST YEAR.

AND PROPERTY CRIME IS DOWN 17.5%. WE ALSO PROVIDED TO THE COUNCIL IN THIS MEMORANDUM THE CRIME STATISTICS BY COUNCIL DISTRICT.

SO THAT IS OUR REPORT, CHAIRWOMAN. >> KAUR: THANK YOU, MARIA.

SO LIKE WE DID IN DECEMBER, WE ARE GOING TO PICK CERTAIN OF THESE TOPICS AND DO DEEP DIVES, RATHER THAN KIND OF DOING THE HOLISTIC SUMMARY. SO IF THERE'S ONE OF THESE AREAS THAT YOU WANT TO DO FOR A FUTURE PUBLIC SAFETY COMMITTEE WHERE YOU WANT TO REALLY EXPLORE HOW THE POLICE DEPARTMENT HANDLES IT OR HOW WE'RE DOING PROACTIVE MEASURES TO ADDRESS THAT, PLEASE LET ME KNOW SO WE CAN AGENDIZE THAT IN THE FUTURE.

WE'LL OPEN IT UP FOR DISCUSSION IN CASE ANYONE WOULD LIKE TO COMMENT ON THE

OVERALL STATISTICS. GO AHEAD. >> CASTILLO: THANK YOU, CHAIR. IN TERMS OF REDUCTION IN SEEING CRIME DOWN 17.5%, IT

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I SEE ON THE BREAKDOWN THAT MOTOR VEHICLE THEFT HAS DECREASED BY 25.6%.

A QUESTION I HAVE FOR STAFF. I KNOW THERE HAVE BEEN A NUMBER OF CAMPAIGNS IN TERMS OF PUBLIC EDUCATION ON SOME OF THE RISKS WITH MOTOR VEHICLE THEFT.

BUT I WOULD LIKE TO HEAR FROM PD IN TERMS OF WHAT Y'ALL BELIEVE HAS ATTRIBUTED TO THAT DRASTIC DECREASE IN MOTOR VEHICLE THEFT IN PARTICULAR.

>> GOOD AFTERNOON, PUBLIC SAFETY COMMITTEE. WE HAVE DONE A LOT OF AWARENESS CAMPAIGNS. WE HAVE ALSO DONE A LOT OF ENFORCEMENT.

WE SOLIDIFIED A LOT OF OUR EFFORTS AND WE WORKED WITH A LOT OF THE CAR COMPANIES THAT WERE RESPONSIBLE. THE KIA MOTORS, IN PARTICULAR.

HAVING TO INSTALL SOME OF THE ANTI-THEFT DEVICES TO MAKE THEIR CARS LESS EASY TO STEAL. I THINK IT WAS A COMBINATION OF ALL OF THOSE THINGS AND THE TASK FORCE WITH THE AUTO VEHICLE TASK FORCE HAS REALLY RAMPED UP EFFORTS TO TRY TO ADDRESS THIS ISSUE. THE VEHICLE THEFT IS LIKE THE MECHANISM FOR ALL THESE OTHER CRIMES BEING COMMITTED. SO THEY WILL TAKE THE CAR AND GO DO ROBBERIES AND DRIVE-BYES SO IT WAS IMPORTANT FOR US TO STOP THE VEHICLE THEFT. IT HAS BEEN 29.1% INCREASE, THAT'S MORE PEOPLE GETTING CAUGHT . I KNOW WITHIN DISTRICT 5 THERE'S A LOT OF CONCERNS WITH THE TRAP HOUSES IN THE COMMUNITY.

WOULD IT BE POSSIBLE OFFLINE TO RECEIVE A HEAT MAP WHERE WE'RE SEEING THIS INCREASE

IN TERMS OF WHERE THERE'S ACTION BEING TAKEN? >> YES, MA'AM.

WE'LL GET THAT TO YOU. >> CASTILLO: THOSE ARE ALL MY QUESTIONS.

THANK YOU. THANK YOU, CHAIR. >> KAUR: MAYBE, CHIEF, WE CAN WORK ON THE DRUGS AND NARCOTICS PIECE FOR THE NEXT PUBLIC SAFETY MEETING TO DO A DEEP DIVE INTO THAT. ONE QUICK FOLLOW-UP ON WHAT COUNCILWOMAN SAID.

WITH THE AUTO VEHICLE THEFT, I WAS WITH THE OFFICER. THEY TOLD ME YOU GUYS HAVE THESE NEW CAMERAS ON THE WINDSHIELD THAT CAN SCAN LICENSE PLATES.

HAS THAT BEEN HELPFUL OR HAS THAT ATTRIBUTED TO THE REDUCTION?

>> YEAH. THAT'S HELPFUL FOR IDENTIFYING THE VEHICLES.

>> KAUR: THAT WOULD MEAN THAT CRIME IS INCREASING IF WE WOULD BE CATCHING MORE.

>> IT IDENTIFIES THESE AREAS AND ALLOWS US TO -- OUR POLICY IS SUCH THAT IF IT WAS TAKEN IN A VIOLENT CRIME THEN WE CAN INITIATE A PURSUIT.

IF NOT, WE CAN FIGURE OUT OTHER WAYS TO TRY TO TRACK THAT INDIVIDUAL AND FOLLOW

THOSE INDIVIDUALS BEFORE THEY COMMIT VIOLENT CRIME. >> KAUR: IF YOU'RE TRACKING MORE, YOU ARE HOLDING MORE FOLKS ACCOUNTABLE, WHICH COULD BE A DETERRENT AS WELL. COUNCILMEMBER MCKEE-RODRIGUEZ OR COUNCILMEMBER SPEARS? THANK YOU FOR YOUR WORK AND WE LOOK FORWARD TO HAVING THAT DISCUSSION ON DRUGS AND NARCOTIC NEXT. LET'S GO TO ITEM NO. 4, WHICH IS A SUPER EXCITING ITEM THAT WAS BASED ON A CCR THAT COUNCILWOMAN CASTILLO PUT FORWARD . SO WE'RE LOOKING FORWARD TO THE CONVERSATION TODAY.

>> VILLAGOMEZ: YES. CHAIRWOMAN AND MEMBERS OF THE PUBLIC SAFETY COMMITTEE.

TODAY'S PRESENTATION WE HAVE TWO PRESENTERS. FIRST WE'RE GOING TO START WITH MARIA VARGAS, WHO IS THE DIRECTOR FOR THE INTEGRATED COMMUNITY SAFETY OFFICE . SHE'S GOING TO GO OVER THE CCR AND TALK ABOUT AUDIO] REQUESTING HERE IN TEXAS. ALSO TALK ABOUT SOME OF THE INITIATIVES THAT WE HAVE HERE IN BEXAR COUNTY, JUST FOR YOUR INFORMATION.

THE SECOND PART OF THE PRESENTATION, WE HAVE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CENTER FOR HEALTHCARE SERVICES, MS. JAMISON.

THE CENTER FOR HEALTHCARE SERVICES BOARD APPROVED RECENTLY A REQUEST FOR PROPOSAL TO DO A FEASIBILITY STUDY, SPECIFICALLY FOR A DIVERSION AND RECOVERY CENTER HERE IN BEXAR COUNTY WE, THE CITY, ARE INTERESTED IN PARTICIPATING IN THAT PROCESS SO WE ASKED HER IF SHE COULD COME AND PRESENT HER REQUEST FOR PROPOSAL.

WHEN WE DO THE RECOMMENDATION OF THIS ITEM, PART OF THE RECOMMENDATION THAT STAFF IS MAKING IS FOR US TO FINANCIALLY CONTRIBUTE TO THE STUDY IN THE TUNE OF $30,000. SHE'LL GO OVER THAT SPECIFIC RFP AND THE TIMELINE AND THE WORK THAT HER -- THE CENTER FOR HEALTHCARE SERVICES IS DOING.

WITH THAT, WE'RE GOING TO START WITH MARIA VARGAS. >> GOOD AFTERNOON.

MARIA VARGAS YATES. AS MS. VILLAGOMEZ SAID, I'LL BE PRESENTING ON THE CCR FOR CENTRALIZED DIVERSION AND RECOVERY. THIS CCR WAS SUBMITTED ON

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THIRD, TO REVIEW THE RECOMMENDATIONS FROM DR. TESTA'S BEXAR COUNTY INTAKE AND EVALUATION STUDY. FINALLY, TO CREATE A JOINT CITY AND COUNTY AD HOC COMMITTEE TO ESTABLISH A CENTRALIZED SYSTEM FOR DIVERSION AND RECOVERY .

I'D LIKE TO FIRST GO OVER THE TYPES OF CENTERS DISCUSSED IN THE CCR.

FIRST, WHAT IS A DIVERSION CENTER? DIVERSION CENTERS SERVE INDIVIDUALS WITH A MENTAL HEALTH COMMUNITY, ABBREVIATED AS IDD.

SOME COMMON FEATURES OF A DIVERSION CENTER INCLUDE 24/7 INTAKE, ON-SITE ASSESSMENTS TO IDENTIFY MENTAL HEALTH OR IDD NEEDS IMMEDIATELY.

THE FACILITATION OF LEGAL COOPERATION , ESPECIALLY WITH THE DISTRICT ATTORNEY'S OFFICE. AND TO PROVIDE STREAMLINED PROCESS FOR STABILIZATION TO PREVENT RECIDIVISM. THE OTHER TYPE OF CENTER MENTIONED IN THE CCR IS A RECOVERY CENTER. RECOVERY CENTERS FOCUS ON LONG-TERM RESTORATION, REHABILITATION BY PROVIDING CARE THAT ADDRESSES THE ROOT CAUSES OF INSTABILITY.

COMMON FEATURES INCLUDE COMPREHENSIVE ON-SITE CARE SUCH AS MEDICATION MANAGEMENT, PSYCHIATRIC CARE, SUBSTANCE USE DISORDER INTERVENTIONS AND REHABILITATION SERVICES PERMANENT SUPPORTIVE HOUSING. AND THEY MAY ALSO UTILIZE INDIVIDUALS WITH LIVED EXPERIENCE AS A PEER SUPPORT SYSTEM TO ASSIST IN THE STABILIZATION AND RECOVERY PROCESS. I WOULD ALSO LIKE TO DISCUSS THE PRIMARY MECHANISMS OF DIVERSION. THE FIRST BEING PRE-ARRESTS OR PRE-BOOKING, WHICH IS OFTEN CONCEPTUALIZED AS DIVERSION OR DEFLECTION.

THE SECOND BEING POST-ARREST OR POST-BOOKING, CONCEPTUALIZED THROUGH ADJUDICATION. THE PRIMARY MECHANISM IS FACILITATED THROUGH POLICE DROPOFF EITHER DIRECTLY FROM THE FIELD BY AN OFFICER OR BY TRANSFER BY THE MAGISTRATE BEFORE ARREST OR CHARGES ARE FILED. THE POLICE DROPOFF MEANS THAT THE INDIVIDUAL IS TAKEN TO A PHYSICAL LOCATION WHERE TREATMENT BEGINS IMMEDIATELY. IN CONTRAST, POST-ARRESTS AND POST-BOOKING IS OFTEN FACILITATED THROUGH JUDICIAL ORDER. TREATMENT IS ORDERED AFTER THE INDIVIDUAL HAS BEEN CHARGED AND TAKES PLACE OVER THE LEGAL PROCESS, OVER THE COURSE OF WEEKS OR MONTHS. PRE-ARRESTS OR PRE-BOOKING MEANS THAT CHARGES ARE SUSPENDED OR NEVER FILED. NO ARREST RECORD IS CREATED. WHEREAS POST-ARREST AND BOOKING CHARGES ARE FILED AND USUALLY REMAINS PENDING UNTIL PROGRAM COMPLETION.

SOME EXAMPLES IN SAN ANTONIO INCLUDE CITE AND RELEASE, WHICH IS FACILITATED BY SAPD AND THE BEXAR COUNTY D.A. THE PUBLIC SOBERING UNIT AND THE CRISIS CARE CENTER, BOTH OPERATED BY CHCS. FOR POST-ARREST, POST-BOOKING IN SAN ANTONIO WE HAVE THE PRE-TRIAL DIVERSION THROUGH THE BEXAR COUNTY D.A. AND SPECIALTY COURTS OF WHICH BEXAR COUNTY HAS APPROXIMATELY 14. WHERE JUDGES SUPERVISE TREATMENT AS A CONDITION OF OPERATION OR DISMISSAL. THIS SLIDE VISUALIZES THE CURRENT SAPD ARREST PROCESS. IT BEGINS WITH ARRESTS IN THE TOP LEFT OF THIS VISUAL WHERE THE ARRESTEE IS TAKEN TO THE ADMINISTRATIVE PROCESSING CENTER, ALSO REFERRED TO AS THE DETENTION CENTER. AS PART OF THEIR INTAKE AND PROCESSING, A MENTAL HEALTH SCREENING IS CONDUCTED IN WHICH THE ARRESTEE IS ASKED FOUR QUESTIONS: ONE, HAVE YOU EVER BEEN DIAGNOSED AS HAVING A MENTAL ILLNESS BY A DOCTOR OR MENTAL HEALTH PROFESSIONAL? TWO, HAVE YOU EVER OR ARE YOU CURRENTLY TAKING ANY MEDICATION FOR MENTAL ILLNESS? THREE, HAVE YOU EVER TRIED TO KILL YOURSELF? AND, FOUR, DO YOU CURRENTLY HAVE THOUGHTS OF KILLING YOURSELF? IF THE ARRESTEE ANSWERS YES TO QUESTIN FOUR AND THEY ARE ONLY BEING CHARGED WITH A CLASS C MISDEMEANOR THEN THEY ARE TAKEN TO THE HOSPITAL FOR EMERGENCY DETENTION.

IF THEY ANSWER YES TO QUESTION FOUR BUT ARE BEING CHARGED WITH A CLASS B MISDEMEANOR OR HIGHER, THEN THEY REMAIN WITHIN THE JUDICIAL FRAMEWORK AND THEIR PROCESSING IS EXPEDITED. SO THEY MOVE FORWARD WITH THEIR PROBABLE CAUSE HEARING

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THIS SLIDE SHOWS CURRENT SAPD POLICY THAT RELATES TO MENTALLY ILL PERSONS.

AT THIS MOMENT, WITH SUPERVISOR APPROVAL, OFFICERS MAY CONDUCT A WARRANTLESS EMERGENCY DETENTION FOR A PERSON WITH MENTAL ILLNESS IN LIEU OF AN ARREST FOR MISDEMEANORS. THIS EXCLUDES DWI AND FAMILY VIOLENCE.

FOR DWI AND FAMILY VIOLENCE, THE INDIVIDUAL MUST BE BOOKED ON THE APPROPRIATE CHARGE. OTHERWISE, ONCE MORE WITH SUPERVISOR APPROVAL, THE OFFICER MAY GATHER THE SUBJECT'S INFORMATION TO LIST THEM AS THE SUSPECTED PERSON FOR THE OFFENSE. THEY NOTIFY THE VICTIM THAT THEY HAVE THE OPTION TO PURSUE CHARGES THROUGH THE FOLLOW-UP UNIT AND THAT ARRESTEE, IN LIEU OF ARREST, IS TAKEN FOR EMERGENCY DETENTION. IF THE INDIVIDUAL IS TAKEN TO THE MAGISTRATE AND GONE TO THE CENTRAL MAGISTRATE, THOSE HEALTH CONCERNS ARE CONVEYED TO THE CENTRAL MAGISTRATE, THE NURSE, AND THE MENTAL HEALTH SCREENER.

AND THEY CAN THEN DETERMINE IF AN ASSESSMENT IS NEEDED PER TEXAS CCP16.22.

ADDITIONALLY, BOND AND SPECIAL CONDITIONS DO EXIST PER TEXAS CCP17.032 AND MAY INCLUDE SPECIAL NEEDS UNIT, CHCS TREATMENT AND FOLLOW-UP, SUBSTANCE ABUSE TREATMENT, AND DRUG AND ALCOHOL TESTING. AND OUR CHIEF MENTAL HEALTH OFFICER, JESSIE HIGGINS, WILL PROVIDE ADDITIONAL DETAILS ON THE MENTAL HEALTH RESOURCES AND SPECIALIZED UNITS DURING HER PRESENTATION SCHEDULED TO TAKE PLACE AS PART OF TODAY'S PUBLIC SAFETY COMMITTEE MEETING.

THIS SLIDE SHOWS CURRENT TEXAS COUNTY EFFORTS FOR PRE-ARREST DIVERSION.

WE HAVE DALLAS, HARRIS, AND TRAVIS COUNTY. THE FIRST TWO SHOW THE NAME OF THEIR NAME OR CENTER AND THE YEAR IN WHICH IT WAS ESTABLISHED.

THE THIRD ROW FOR FACILITY TYPE DESCRIBES WHETHER THE COUNTY DECIDED TO BUILD NEW INFRASTRUCTURE OR RETROFIT EXISTING INFRASTRUCTURE. ALL FOUR COUNTIES CHOSE TO RETROFIT EXISTING INFRASTRUCTURE. THE OPERATOR ROW DESCRIBES WHO IS OPERATING THE PRE-ARREST DIVERSION PROGRAM IN ALL COUNTIES EXCEPT FOR DALLAS. IT IS THEIR LOCAL MENTAL HEALTH AUTHORITY.

AN EXAMPLE FOR THE BEXAR COUNTY LOCAL MENTAL HEALTH AUTHORITY, THAT IS CHCS.

DALLAS HAS A NONPROFIT PARTNER THAT RUNS THEIR PRE-ARREST DIVERSION CENTER AND THAT IS HOMEWARD BOUND, INC. THEIR RETROFIT WAS A RENOVATION OF A WING WITHIN THAT EXISTING NONPROFIT FACFACILITY .

FOR GOVERNANCE, THERE'S A VARIETY OF STRUCTURES. DALLAS HAS A PUBLIC-PRIVATE PARTNERSHIP. HARRIS AND TRAVIS COUNTIES HAVE JOINT OVERSIGHT COMMITTEES WHICH SET POLICIES FOR THE PRE-ARREST DIVERSION PROGRAM JOINTLY.

AND TARRANT COUNTY HAS AN ADVISORY COMMITTEE COMPRISED OF COUNTY COMMISSIONERS, THE D.A., SHERIFF, AND THE LOCAL HEALTH AUTHORITY, MHMR, AND THEY MAKE RECOMMENDATIONS TO THE COMMISSIONER'S COURT ON POLICY. DALLAS AND TRAVIS HAVE MULTIPLE STREAMS OF FUNDING IN WHICH CITY, COUNTY, AND MENTAL HEALTH AUTHORITY FUNDS ARE SET TOGETHER TO FUND THE PRE-ARREST DIVERSION CENTER.

TARRANT COUNTY USES A MIX OF ARPA FUNDS AND STATE AND FEDERAL GRANTS.

HARRIS COUNTY HAS STATE ALLOCATION, WHICH IS MATCHED BY THE COUNTY GENERAL FUND PRIVATE FUNDS THROUGH PHILANTHROPY. THIS SLIDE SHOWS OUTCOMES FOR HARRIS COUNTY, TEXAS AS IT WAS LISTED AS A MODEL IN THE CCR.

THE FIRST SHOWS TOTAL CLIENTS SERVED OVER FISCAL YEARS.

IT SHOWS THE DIVERSION BETWEEN MENTAL HEALTH CLIENTS AND THOSE WITH INTELLECTUAL DEVELOPMENTAL DISABILITIES. AND I WOULD LIKE TO NOTE THAT THESE CLIENTS SERVED INCLUDE ALL OF HARRIS CENTERS' PROGRAMS SUCH AS OUTPATIENT CLINICS, SCHOOLS, JAIL, HEALTHCARE SETTINGS, AND TELEHEALTH.

THE SECOND TABLE FOCUSES ON THE JUDGE ED EMMITT DIVERSION CENTER AND IT

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THE SIZE OF THE INCIDENT REDUCTION WAS LARGEST AMONGST PEOPLE WHO WERE HOMELESS AT THE TIME OF PARTICIPATION. THIS SLIDE SHOWS AGAIN SPECIFIC REPORTED OUTCOMES FOR THE JUDGE ED EMMITT DIVERSION CENTER.

FROM 2018 TO AUGUST 2023, 8,835 INDIVIDUALS WERE DIVERTED TO RESPITE REHAB AND REENTRY CENTER INSTEAD OF THE HARRIS COUNTY JAIL. FOR EVERY ONE DOLLAR SPENT ON JAIL DIVERSION, HARRIS COUNTY REPORTEDLY SPENDING $5.54 ON CRIMINAL JUSTICE COSTS. INDIVIDUALS DIVERTED WITH FIVE OR MORE BOOKINGS FOR THREE TIMES LESS LIKELY TO BE BOOKED INTO JAIL. 89% OF OFFENSES WERE COMPRISEOF CRIMINAL TRESPASS. 46.5% OF INDIVIDUALS DIAGNOSED WITH SCHIZOPHRENIA AND SPECTRUM DISORDER. 77% OF THE INDIVIDUALS WERE HOMELESS. I WILL NOW REVIEW THE BEXAR COUNTY JUSTICE INTAKE AND ASSESSMENT AN ANNEX EVALUATION. THIS WAS HIGHLIGHTED AS A REQUEST IN THE CCR AND FOR THOSE RECOMMENDATIONS THAT PERTAIN TO THE CCR THE FIRST ONE IS TO INVEST IN A DEDICATED DIVERSION CENTER AND IT LISTS IN HARRIS COUNTY JUDGE ED EMMITT CENTER AS A MODEL. TO IDENTIFY MENTAL HEALTH IN IDD SERVICES. THIRD, TO IMPLEMENT MEDICAL-BASED SCREENING AT INTAKE WITH A HIGHLIGHT THAT THOSE SCREENINGS SHOULD BE CONDUCTED BY MEDICAL PERSONNEL. I WILL NOW INTRODUCE JILLI,N JAMISON TO PROVIDE AN

OVERVIEW ON THE FEASIBILITY STUDY. >> THANK YOU, MARIA.

GOOD AFTERNOON. SO WE ARE REALLY HAPPY TO BE HERE TO SHARE WITH YOU THE ASPECTS OF THE REQUEST FOR PROPOSAL FOR A DIVERSION CENTER IN BEXAR COUNTY.

YOU GUYS HAVE GOTTEN FANCY ON ME SO I'M ASSUMING THIS WILL ADVANCE THE SLIDE.

THANKS. I WANT TO TALK A BIT ABOUT THE POPULATION THAT WE'RE FOCUSED ON AND THEN SHARE WITH YOU THE ASPECTS OF THE RFP AND THE ROLE FOR CHCH.

WE ARE USING INFORMATION THAT WE GLEANED FROM DR. TESTA'S REPORT WITH HIS EVALUATION OF JIAA. BUT WE ALSO WORK VERY CLOSELY WITH OUR SHERIFF'S DEPARTMENT AND WE HAVE ACCESS TO THE INFORMATION OF THE INDIVIDUALS THAT ARE CURRENTLY BEING DETAINED AT OUR BEXAR COUNTY DETENTION CENTER.

SO I'M REFERENCING IN 2024 THERE WERE AN AVERAGE OF 550 INMATES BEING TREATED FOR MENTAL HEALTH NEEDS, ACCORDING TO UNIVERSITY HEALTH.

AND IN 2024, UNIVERSITY HEALTH WAS THE PROVIDER FOR PHYSICAL AND MENTAL HEALTH WHEN YOU WERE BOOKED IN JAIL. AT THAT TIME, C CHCS WAS RESPONSIBLE FOR ASSESSING 1100% OF THOSE INDIVIDUALS TO DETERMINE PRIMARY DIAGNOSIS BETWEEN MENTAL HEALTH AND/OR SUBSTANCE USE. AND THEN MAKING A RECOMMENDATION TO THE MAGISTRATE FOR DIVERSION OR DIVERSION INTO OUTPATIENT SERVICES OR THROUGH A PERSONAL RECOGNIZANCE BOND. WE HAVE DATA TO SHOW THE ACTIVITY UP TO SEPTEMBER 30 OF 2025. SO MARIA REFERENCED A SLIDE, I THINK IT WAS SLIDE 6, THAT TALKED ABOUT REFERRALS FROM THE SPECIAL NEEDS UNIT AND INDIVIDUALS BEING REFERRED AT JIAA TO CHCS. WE HAVE NOT PROVIDED THOSE SERVICES SINCE OCTOBER 1 OF 2025. I'LL EXPLAIN FURTHER ABOUT THAT. SO WE KNOW ALSO THERE'S A MONTHLY AVERAGE OF 152 BEXAR COUNTY DEFENDANTS THAT WERE ON A WAIT LIST FOR A BED IN A STATE FORENSIC PSYCHIATRIC HOSPITAL. SO FOR SOME YEARS NOW THE STATE OF TEXAS HAS USED ITS

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THE PRIMARY POPULATION HOUSED AT OUR STATE HOSPITAL SYSTEM, THROUGHOUT TEXAS, ARE THOSE INDIVIDUALS WHO ARE JUSTICE-INVOLVED FORENSIC PATIENTS.

WE HAVE LITTLE ACCESS TO STATE BEDS. MANY COMMUNITIES AROUND THE STATE HAVE EMBRACED THE CONCEPT OF TAKING CARE OF THIS ISSUE LOCALLY.

AND WE'LL DISCUSS THAT BEFORE THE END OF THE PRESENTATION.

THERE ARE ADDITIONALLY 300 INDIVIDUALS INCOMPETENT TO STAND TRIAL AND AWAITING COMPETENCY RESTORATION AT OUR ADULT DETENTION CENTER. CHCS PROVIDES A JAIL-BASED COMPETENCY PROGRAM AT BEXAR COUNTY JAIL. WE HAVE ABOUT 80 INDIVIDUALS IN THAT PROGRAM AND WE WORK IN CONCERT WITH UNIVERSITY HEALTH AS WELL AS BEXAR COUNTY SHERIFF'S DEPARTMENT TO IDENTIFY THOSE INDIVIDUALS THAT ARE ELIGIBLE FOR THIS PROGRAM . WE WORK CLOSELY WITH JUDGE RODRIGUEZ ALSO TO IDENTIFY THOSE INDIVIDUALS. THE OTHERS ARE PLACED ON A WAIT LIST.

THEY MAY HAVE MORE SEVERE CHARGES. THEY MAY BE NOT GUILTY BY REASON OF INSANITY. THEY MAY HAVE VERY SIGNIFICANT FELONY CHARGES.

BUT WE GO THROUGH CRITERIA AND IDENTIFY THOSE INDIVIDUALS THAT ARE ELIGIBLE FOR JAIL BASED. CURRENTLY, BEXAR COUNTY DOES NOT HAVE AN INPATIENT COMPETENCY RESTORATION PROGRAM SO THEY ARE EITHER IN OUR JAIL-BASED PROGRAM OR THEY'RE SITTING IN JAIL WAITING FOR A BED AT A STATE HOSPITAL.

WE ALSO KNOW THAT THE BEXAR COUNTY JAIL IS AT CAPACITY AND OUR SHERIFF'S DEPARTMENT SPENDS EVERY DAY MANAGING THAT NUMBER SO THAT WE DON'T EXCEED OUR COMPLIANCE.

AND MANY TIMES THEY ARE TAKING INDIVIDUALS AND PLACING THEM IN KERR AND BURNETT COUNTY SO WE CAN AVOID BEING OUT OF COMPLIANCE.

SO, IN OTHER WORDS, OUR JAIL HAS BECOME THE LARGEST HOSPITAL FOR MENTAL HEALTH HERE IN BEXAR COUNTY. WITH THAT NUMBER OF INDIVIDUALS UNDER CARE BY UNIVERSITY HEALTH. SO AS I MENTIONED, CHCS DID PROVIDE ASSESSMENT AND SERVICES FOR 100% OF INDIVIDUALS SCREENED BY LAW ENFORCEMENT.

WE WOULD MAKE RECOMMENDATIONS FOR DIVERSION.

BUT AFTER THE COUNTY COMMENCED THE STUDY BY DR. TESTA, WE BEGAN LOOKING VERY CLOSELY AT OUR YEAR OVER YEAR PERFORMANCE WITH THE NUMBER OF DIVERSIONS REQUESTED AND THE NUMBER OF INDIVIDUALS ACTUALLY ALLOWED TO DIVERT FROM THE JAIL AND RECEIVE SERVICES FROM CHCS. IN 2025 WE RECOMMENDED 486 DIVERSIONS.

285 OF THOSE INDIVIDUALS WERE ASSESSED FOR MENTAL HEALTH AND/OR SUBSTANCE ABUSE DISORDERS. 117 OF THEM WERE EMERGENCY DETAINED AND REMAINED IN JAIL. AND 82 WERE REFERRED TO CHCS FOR THAT YEAR.

FOR ACTUAL OUTPATIENT SERVICES. IN 2024, SIMILAR PERFORMANCE. WE RECOMMENDED 480 DIVERSIONS, 279 INDIVIDUALS WERE ASSESSED FOR MENTAL HEALTH OR SUBSTANCE ABUSE DISORDERS.

142 WERE KEPT AT BEXAR COUNTY ADULT DETENTION CENTER AND 96 WERE REFERRED TO CHCS. SO WE PROVIDED THE SERVICE AT BEXAR COUNTY FROM 2011 UNTIL 2025. BEXAR COUNTY WAS PAYING FOR THE STAFF TO CONDUCT THE ASSESSMENTS, A COMPLEMENT OF 11, TO COMPLEMENT, WE ASSESSED OVER 1500 MONTHLY.

IT WAS THE DR. TESTA STUDY WHERE WE DISCOVERED THAT WE WERE NOT MADE AWARE OF ALL OF THE INDIVIDUALS THAT WERE ELIGIBLE FOR ASSESSMENTS. WE THINK THAT NUMBER IS UPWARDS BETWEEN 2,000 OR 2500 ON A MONTHLY BASIS. SO WE RECOMMENDED TO OUR BOARD, BASED ON THE NUMBER THAT WERE ACTUALLY BEING REFERRED TO CHCS FOR DIVERSIONS, THAT WE WOULD NO LONGER PROVIDE THAT SERVICE. BEXAR COUNTY STAFF WAS ALSO MAKING A SUBSEQUENT REQUEST TO THE COMMISSIONERS TO NO LONGER HAVE CHCS PROVIDE THAT SERVICE BUT RELY ON UNIVERSITY HEALTH TO PROVIDE ALL MENTAL HEALTH ASSESSMENTS AND PHYSICAL ASSESSMENTS AT THE JAIL. THAT HAS BEEN THE SITUATION SINCE OCTOBER 1. WE ARE NOT RECEIVING ANY REFERRALS AT THIS TIME FROM BEXAR COUNTY JAIL. SO I MENTIONED THE JIAA ASSESSMENT BY THE UNIVERSITY OF TEXAS HEALTH SCHOOL AT HOUSTON . IT WAS VERY INFORMING TO US

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IT IDENTIFIED SIX MAJOR FINDINGS: IMPROVEMENTS FOR SEQUENTIAL PROCESSES, IMPROVEMENTS IN TECHNOLOGY, STAFFING, WAITING WITH INDIVIDUALS FOR PROCESSING AT THE JIAA. I CANNOT STAND BEFORE YOU TODAY AND SAY THAT WE HAVE AN UPDATE ON ANY OF THOSE RECOMMENDATIONS. THE SECOND STUDY THAT WE RELY HEAVILY ON WAS A STUDY COMMISSIONED BY UNIVERSITY HEALTH, WHICH LOOKED AT MENTAL HEALTH GAPS IN BEXAR COUNTY. AND THE TWO THAT I'M GOING TO FOCUS ON TODAY, ALONG WITH TREATMENT SERVICES AT CHCS THAT ARE REFERENCED IN THE STUDY WAS ONE FOR A PSYCHIATRIC HOSPITAL FOR OUR GENERAL POPULATION.

AND THE CREATION OF A DIVERSION CENTER. AND SO I'M GOING TO FOCUS ON THOSE TWO TODAY. SO AS WAS MENTIONED EARLIER, A DIVERSION CENTER IS A THERAPEUTIC ALTERNATIVE TO JAIL. OUR BOARD VISITED WITH DR. TESTA IN AUGUST TO FULLY UNDERSTAND THE FINDINGS AROUND HIS EVALUATION OF JIAA. AND THEY THEN GAVE US PERMISSION TO MOVE FORWARD WITH AN RFP TO HIRE A CONSULTANT TO VALIDATE THE DATA THAT'S BEEN UNCOVERED SO FAR WITH THE POPULATION THAT IS BROUGHT FORWARD TO JIAA.

AND TO DEVELOP A PLAN FOR A DIVERSION CENTER. HELPING US UNDERSTAND THE NUMBER OF BEDS, THE LOW-LEVEL OFFENSES THAT WOULD BE CONSIDERED WITH THESE INDIVIDUALS, THE ACTUAL WORKFLOW, HOW WE WOULD ENGAGE WITH THE DISTRICT ATTORNEY'S OFFICE, HOW WE WOULD ENGAGE WITH LAW ENFORCEMENT.

THE RESIDENTIAL TREATMENT PROTOCOLS, AS WELL AS RECOMMEND AFTER CARE.

AND ACKNOWLEDGING THAT WE WILL NEED TO GROW PARTNERSHIPS WITH ALL OF OUR ENTITIES THAT ARE INVOLVED IN SOCIAL SERVICES. BECAUSE AT THE POINT OF WHICH THESE INDIVIDUALS ARE DISCHARGED FROM DIVERSION, THEY WILL CERTAINLY NEED ASSISTANCE WITH ALL OF THE SOCIAL DETERMINANTS OF HEALTH, WHETHER IT IS FOOD OR SHELTER. SO WE KNOW THIS PARTNERSHIP WILL NOT ONLY BE WITH LAW ENFORCEMENT AND THE DISTRICT ATTORNEY'S OFFICE BUT IT WILL CERTAINLY RELY ON THE SOCIAL CONTINUUM WE HAVE HERE IN BEXAR COUNTY TO MAKE SURE THESE INDIVIDUALS ARE HOUSED, RECONNECTED WITH FAMILY, OR RECONNECTED WITH THE APPROPRIATE SERVICES SO THAT THEY CAN CONTINUE A SUCCESSFUL JOURNEY FOR TREATMENT.

THE RFP WAS POSTED ON DECEMBER 17. IT PROPOSES TO CLOSE ON JANUARY 30. WE ARE HERE TODAY TO SEE IF THERE ARE ANY OTHER ITEMS WE SHOULD CONSIDER BEFORE WE CLOSE ON JANUARY 30. THE CHCS BOARD MEETS ON FEBRUARY 10 AND WE HOPE TO BE IN A POSITION TO RECOMMEND TO THEM SO WE CAN ENGAGE THE CONSULTANT, START THE WORK, AND ENGAGE OUR STAKEHOLDERS AND BEGIN THE VALIDATION AND PLANNING WORK FOR THIS DIVERSION CENTER. SO I WON'T SPEND TOO MUCH TIME. THE PRESENTATION EARLIER DID A VERY GOOD JOB OF OUTLINING WHAT A DIVERSION CENTER DOES. IT ACTUALLY FOCUSES ON INTAKE. THERE IS A FOCUS ON RESIDENTIAL TREATMENT.

WE WILL NEED TO WORK WITH THE COMMUNITY TO DETERMINE ALL OF THE ELIGIBLE LOW-LEVEL OFFENSES. I WILL TELL YOU FROM ALL OF THE DATA OUT OF HARRIS COUNTY, THE LOW-LEVEL OFFENSE WITH THE HIGHEST PERCENTAGE IS CRIMINAL TRESPASSING AND THOSE INDIVIDUALS THAT ARE UNSHELTERED.

UNFORTUNATELY, THE AFRICAN AMERICAN COMMUNITY IN HARRIS COUNTY.

SO WE EXPECT TO WORK THROUGH OUR COMMUNITY DEMOGRAPHIC AS WELL AND WORK WITH ALL OF THE RESPECTIVE ENTITIES TO DETERMINE THE CRITERIA FOR ADMIT INTO THIS DIVERSION CENTER. SO THE GOAL WOULD BE TO MINIMIZE THE TIME THAT LAW ENFORCEMENT SPENDS WITH AN INDIVIDUAL EXPERIENCING A BEHAVIORAL HEALTH CRISIS.

RIGHT NOW WE ARE A PARTNER WITH STRAC AND WE ARE A PARTICIPANT IN THE SOUTH TEXAS CRISIS CONTINUUM . WE DO A VERY GOOD JOB WITH LAW ENFORCEMENT NAVIGATION, HELPING LAW ENFORCEMENT WHEN THEY ENGAGE AN INDIVIDUAL. WE ARE THEN IN A POSITION TO HAVE LAW ENFORCEMENT CONTACT OUR MED COM. THEY ASK FOR AVAILABLE BEDS.

THEY DESCRIBE THE INCIDENT WITH THE INDIVIDUAL. AND THAT INDIVIDUAL CAN THEN BE TAKEN VERY QUICKLY TO THE RIGHT TREATMENT AT THE RIGHT TIME.

AND THAT LAW ENFORCEMENT INDIVIDUAL CAN RETURN TO SERVICE IN AN APPROPRIATE AMOUNT OF TIME. THAT PROGRAM HAS BEEN IN EXISTENCE SINCE 2017.

I WILL SAY, IN MY PUBLIC SERVICE CAREER, IT WAS THE FASTEST ADOPTION OF A NEW PROGRAM I'VE EVER SEEN IN THIS COMMUNITY. WE STARTED WITH CENTRAL COMMAND AT THE POLICE DEPARTMENT. WITHIN THREE OR FOUR MONTHS, WE ROLLED OUT TO ALL OF THE DISTRICTS FOR SAPD. AND THEN ALL OF THE OTHER

[00:35:01]

IT PROPOSES TO PROVIDE A SHORT-TERM RESIDENTIAL PROGRAM WITH STAYS UP TO 14 DAYS FOR THOSE INDIVIDUALS THAT ARE ELIGIBLE. THIS DIVERSION CENTER WOULD HELP US -- IT WOULD NOT SOLVE THE OVERCROWDING AT THE JAIL BUT IT WOULD CERTAINLY BE A CONTRIBUTING FACTOR TO THE OVERCROWDING THAT CURRENTLY EXISTS AT BEXAR COUNTY DETENTION CENTER . IT WILL REDUCE THE UNNECESSARY EMERGENCY ROOM VISITS. WE ACKNOWLEDGE THAT WE WILL NEED TO COLLABORATE WITH ALL LAW ENFORCEMENT, THE DISTRICT ATTORNEY'S OFFICE, THE DISTRICT CLERK. AND WE JUST KNOW THIS WILL CONTRIBUTE TO BETTER OUTCOMES AND REDUCE OVERALL COMMUNITY HEALTHCARE COST AND EXTEND THE LIFE EXPECTANCY OF OUR CITIZENS. SO THIS IS A HIGH-LEVEL WORKFLOW OF A DIVERSION CENTER MODEL. WE STARTED OFF WITH LAW ENFORCEMENT.

AND I'M JUST GOING TO RELY ON THE EXPERIENCE THAT WE'VE HAD WITH THE SAN ANTONIO POLICE DEPARTMENT. GOING BACK TO THE SOUTH TEXAS CRISIS COLLABORATIVE, SAPD WAS VERY WILLING TO JOIN THIS PILOT AND FIGURE OUT LAW ENFORCEMENT NAVIGATION FOR OUR COMMUNITY. I THINK WITH THAT SUCCESS WE CAN BUILD UPON THAT SUCCESS AND WORK WITH SAPD TO FIGURE OUT THOSE LOW-LEVEL OFFENSES AND HOW WE MIGHT GET INDIVIDUALS TO DIVERT AND COME TO THE DIVERSION CENTER. THEY WOULD BE CHECKED IN, GO THROUGH AN INTAKE ASSESSMENT. COMPREHENSIVE SERVICES WOULD AGAIN.

THEIR RESIDENTIAL TREATMENT FOR UP TO 14 DAYS. THE DISCHARGE PLANNING WILL BE KEY. WE WORK WITH THE INDIVIDUAL TO DETERMINE HOW READY THEY ARE, WHAT ARE THE SOCIAL SERVICES THEY NEED, AND ALL OF THAT COORDINATION WILL NEED TO TAKE PLACE BEFORE WE DISCHARGE AND PREPARE FOR THEIR AFTER-CARE SERVICES.

WE ARE RECOMMENDING THAT WE DEFINITELY HAVE AFTER CARE. WE HAVE SEEN THE SUCCESS MODEL FOR UP TO 90 DAYS. BEFORE THEY ARE SUCCESSFULLY INDEPENDENT TO MAKE THAT TREATMENT JOURNEY. THE OTHER OPPORTUNITY THAT IS PRESENTED TO US IS WORKING WITH INDIVIDUALS WHO ARE BROUGHT TO JIAA AND WORKING WITH THE D.A.'S OFFICE AND PRE-TRIAL SERVICES AT BEXAR COUNTY, WE MIGHT BE ABLE TO ATTRACT AN INDIVIDUAL WHO IS ACTUALLY GOING THROUGH THE BOOKING PROCESS AND MIGHT BE WILLING TO ACCEPT DIVERSION OVER BEING BOOKED AND THAT WOULD REQUIRE A 24-HOUR DESK BY THE D.A.'S OFFICE. THAT STAFFING DOESN'T CURRENTLY EXIST TODAY.

SO THAT'S AN OPPORTUNITY FOR US AND ONCE THIS CONSULTANT DEVELOPS THE PLAN, THEN WE WILL KNOW HOW TO IMPLEMENT THIS WORKFLOW OR ANY WORKFLOW THAT THAT CONSULTANT BRINGS FORWARD THAT WE FIND IS REASONABLE FOR OUR COMMUNITY.

SO WITH THE PATIENT OUTCOMES, WE PROPOSE THAT IT WILL REDUCE THE RECIDIVISM RATES THAT WE SEE WITH THESE CONSUMERS WHO ARE PATIENTS WHO CONSTANTLY ENGAGE WITH LAW ENFORCEMENT BECAUSE THEY ARE UNSHELTER OR UNTREATED. IT WILL TEACH THE SKILLS TO EMPOWER INDIVIDUALS TO BECOME SELF-SUFFICIENT AND BECOME PRODUCTIVE MEMBERS OF SOCIETY. OUR GOAL IS TO EDUCATE THESE INDIVIDUALS ABOUT THEIR DIAGNOSIS AND HOW TO MANAGE 2 SYTHE SYMPTOMS AND ADDRESS THE DETERMINANTS OF HEALTH.

IT HELPS TO MANAGE OUR JAIL OVERCROWDING. SO WE ARE USING THE SAME COST ANALYSIS THAT WAS PRESENTED TO YOU EARLIER. HARRIS COUNTY IS THE BEST MODEL THAT WE HAVE TO DATE. WE DO KNOW THAT DALLAS COUNTY HAS MOVED AWAY FROM ITS DEFLECTION CENTER. THEY ARE WORKING WITH A NONPROFIT CALLED AUSTIN STREET CENTER TO CREATE A MODEL AFTER HARRIS COUNTY. THEY ARE IN THE SPACE THAT WE ARE CURRENTLY TRYING TO MOVE FORWARD WITH THAT MODEL.

BUT THE COST OF OUR JAIL IS AT $1750 A DAY. THERE IS A POTENTIAL TO HAVE COST AVOIDANCE OR SAVINGS TO OPERATE A DIVERSION CENTER VERSUS TAKING CARE OF THESE INDIVIDUALS. ANY GIVEN DAY WE KNOW WE HAVE BETWEEN 80 AND 100 INDIVIDUALS SITTING IN BEXAR COUNTY JAIL WITH A LOW-LEVEL OFFENSE WITH A MENTAL HEALTH AND/OR A SUBSTANCE USE DISORDER. SO THERE'S AN OPPORTUNITY FOR US TO TAKE 80 TO 100 INDIVIDUALS AND PUT THEM IN TREATMENT AT THE RIGHT TIME.

[00:40:06]

IT CAN'T BE TOO FAR OUT OF THEIR RANGE. IT CAN'T TAKE THEM OUT OF SERVICE FOR A LONG PERIOD OF TIME. WE WILL NEED TO HAVE THE SUFFICIENT STAFF SO WHEN THEY GET THERE, THEY CAN BE PROCESSED AND THEY CAN GET BACK INTO SERVICE. WE KNOW THAT IS VERY IMPORTANT FOR THEM.

WE ALSO WANT TO MAKE SURE THAT THIS IS A THERAPEUTIC LOCATION.

WE WANT IT TO BE A FACILITY OR AN ENVIRONMENT WHERE THE INDIVIDUAL FEELS LIKE THEY CAN BEGIN THEIR TREATMENT PROCESS. WE ARE NOT LOOKING FOR ANOTHER NICE BUILDING, WE ARE LOOKING FOR A BUILDING THAT MEETS THE NEED OF OUR COMMUNITY. THE OTHER IMPORTANT FACTOR WE'RE LOOKING FOR FOR THIS BUILDING IS THE ACTUAL NUMBER OF BEDS. HARRIS COUNTY HAS ABOUT 36 BEDS. BUT WE'RE LOOKING FOR THIS CONSULTANT TO LOOK AT OUR OVERALL DEMOGRAPHICS AND OUR ARREST DATA AND HELP US DETERMINE HOW MANY BEDS WE WILL NEED IN THIS FACILITY. AND, OF COURSE, WORKING WITH THE DISTRICT ATTORNEY TO DETERMINE WHICH LOW-LEVEL OFFENSES WILL BE ACCEPTABLE TO THE DISTRICT ATTORNEY.

SO I'M GOING TO SWITCH BRIEFLY HERE AND TALK A LITTLE BIT ABOUT THE NEED FOR A PSYCHIATRIC HOSPITAL. SO IN THE STUDY THAT I RECOMMENDED, THERE WERE SPECIFIC RECOMMENDATIONS TO ADDRESS THE MENTAL HEALTH GAPS IN BEXAR COUNTY.

SEVERAL OF THEM HAD TO DO WITH THE TREATMENT PROGRAMS THAT ARE CURRENTLY FUNDED BY CHCS BUT THE NEED TO INCREASE THEM. THOSE ARE CARE-INTENSIVE PROGRAMS CURRENTLY FUNDED BY CHCS AND WE CONTINUE TO FUND THOSE, NOT AT THE ENHANCED LEVEL, BUT WE CONTINUE TO HAVE FUNDING FOR THOSE PROGRAMS. THERE WERE THREE OTHER RECOMMENDATIONS. THE FIRST WAS TO EXPAND THE HOSPITAL CAPACITY AT THE BEXAR COUNTY DETENTION CENTER.

THE SECOND WAS TO BUILD A COMMUNITY PSYCHIATRIC CENTER FOR OUR COMMUNITY.

AND THE THIRD WAS TO BUILD THE DIVERSION CENTER. AND SO THE CHART IS REPRESENTING HOW MANY BEDS, HOW MANY ADDITIONAL BEDS BEXAR COUNTY WOULD NEED BY THE YEAR 2025. WE WOULD NEED 148 ADDITIONAL BEDS, SO WE'RE ALREADY BEHIND THE CURVE. AND THEN BY 2030, WE WOULD NEED AN ADDITIONAL 227.

SO THE INPATIENT PSYCHIATRIC CAPACITY CURRENTLY IN THIS COMMUNITY RESTS WITH THE FUNDING THAT CHCS RECEIVES FROM THE STATE OF TEXAS THROUGH GENERAL REVENUE.

WE RECEIVE ABOUT $16 MILLION A YEAR AND THAT FUNDS 52 BEDS.

SO WE HAVE A NUMBER OF HOSPITAL PARTNERS THAT PROVIDE ANYWHERE FROM 22 TO 8 BEDS IN THEIR FACILITY. WE USE A CONTRACT BED NAVIGATION PROCESS THAT WE MANAGE WITH OUR PARTNER AT STRAC. AND THE CURRENT OCCUPANCY RATE FOR THOSE BEDS RUNS ANYWHERE FROM 97 TO 98% ANNUALLY.

SO WE ARE A COMMUNITY OF 2.1 MILLION. ONE IN FIVE OF US LIVE WITH A MENTAL HEALTH OR SUBSTANCE USE DISORDER. THAT IS ABOUT 20% OF OUR POPULATION. THAT'S ABOUT 400,000 PEOPLE. AND WE HAVE 52 BEDS TO SERVE WOMEN AND CHILDREN IN THIS COMMUNITY. WE SEE ABOUT 38,000 INDIVIDUALS A YEAR. SO YOU CAN SEE WHERE THE GAP IS IN TERMS OF SERVICE FOR OUR MENTAL HEALTH POPULATION HERE IN BEXAR COUNTY. SO I JUST WENT OVER THESE STATISTICS WITH YOU. I WILL SAY THAT OUR SAFETY NET POPULATION HAS HAD A 14% INCREASE IN THE PREVIOUS FOUR YEARS. SO IT IS AT 400,000.

THAT HAPPENS TO MATCH THE POPULATION THAT LIVES IN BEXAR COUNTY WITH A SUBSTANCE USE OR A MENTAL HEALTH DISORDER. BUT OUR MEDICAID POPULATION HAS SEEN A DECREASE OF ABOUT 15%. SO THERE WERE A NUMBER OF INDIVIDUALS WHO LOST THEIR MEDICAID COVERAGE. ABOUT 2 MILLION IN THE STATE OF TEXAS. BUT IN BEXAR COUNTY, WE HAVE APPROXIMATELY ONLY 180,000 RESIDENTS WITH MEDICAID. SO YOU CAN SEE THE MAJORITY OF THEM WILL BECOME UNFUNDED INDIVIDUALS AND OBVIOUSLY BE POTENTIAL PATIENTS FOR CHCS. OR IN OUR EMERGENCY DEPARTMENTS OR ON OUR STREETS. I'M AVAILABLE TO ANSWER ANY

QUESTIONS THAT YOU MAY HAVE. THANK YOU. >> VILLAGOMEZ: THANK YOU.

I WANTED TO CLOSE WITH A RECOMMENDATION THAT WE'RE MAKING FOR THOSE TWO ITEMS

[00:45:02]

CHIEF MCMANUS, MYSELF, WE HAD AN OPPORTUNITY TO MEET WITH JALEN AND REVIEW THE RFP AND WE ARE COMFORTABLE WITH THE WORK, AS THE RFP HAS BEEN ISSUED.

SO OUR RECOMMENDATION IS THAT WE FUND ABOUT $30,000 OF THE EVENTUAL PROPOSAL THAT THE CENTER FOR HEALTHCARE SERVICES WILL RECEIVE.

THAT WILL COME FROM THE POLICE DEPARTMENT'S BUDGET SO THERE'S NO ADDITIONAL APPROPRIATIONS THAT WOULD NEED COUNCIL APPROVAL. IN ADDITION TO THAT, WE ARE RECOMMENDING THAT WE MOVE THE CCR TO A B SESSION TO BRIEF THE COUNCIL ON WHAT YOU HEARD TODAY, OUR RECOMMENDATION. AND ALSO TO RECOMMEND THE CREATION OF THE CITY AND COUNTY AD HOC COMMITTEE THAT COUNCILWOMAN CASTILLO

RECOMMENDED IN HER CCR. >> KAUR: THANK YOU SO MUCH, MARIA.

THANK YOU -- DO YOU WANT TO ADD? >> IS BETWEEN 100 AND 120,000. THAT WOULD BE VERY HELPFUL. WE HAVE RAISED OTHER MONEY.

AND UNIVERSITY HEALTH IS PARTICIPATING AS WELL. >> KAUR: THANK YOU FOR THAT CLARIFICATION. WE DO HAVE A COUPLE OF PEOPLE SIGNED UP TO SPEAK.

BUT ALSO I WOULD JUST LIKE TO READ INTO THE RECORD WE HAVE SOME WONDERFUL LETTERS OF SUPPORT. I WANT TO THANK THE COUNTY, SHERIFF SALAZAR, COMMISSIONER RODRIGUEZ, AND THE HEALTH SYSTEM FOR SENDING THEIR LETTERS OF SUPPORT. WE REALLY APPRECIATE IT. SUSAN Y.

>> HI. THANK YOU. I'M SUSAN AND I'M THE CHAIRMAN OF THE BEXAR AREA HARM REDUCTION COALITION . AND I JUST WANTED TO SAY THIS IS A REALLY WONDERFUL OPPORTUNITY FOR SOME OF THE FOLKS THAT WE SERVE.

CERTAINLY HAVE BOTH SUBSTANCE ABUSE ISSUES AND CLEAR MENTAL ILLNESSES.

AND THEY'RE HOMELESS ON THE STREETS. WE'RE AT THE CORNER OF ZARZAMORA AND EAST LAUREL. SO I JUST WANTED TO REALLY EMPHASIZE THAT IF THE MAIN ISSUE IS WELLNESS HERE RATHER THAN INCARCERATION, AND WE'RE ALL TOTALLY FOR IT. ANYTHING THAT OUR FOLKS CAN LEARN AND ANY KIND OF TREATMENT THAT IS LASTING. IT SOUNDS AS THOUGH THE PROGRAM WILL CONTINUE BEYOND THE 14 DAYS, WOULD BE REALLY WELCOME. ONE OF THE MAIN PRINCIPLES OF HARM REDUCTION IS COERCION. NO COERCION.

AND SO WE'RE HOPING THAT THIS WILL BE SOMETHING THAT FOLKS WHO ARE ABLE TO MAKE A CHOICE CAN ENTER INTO IF THEY WANT TO GO TO JAIL, YOU KNOW, FINE.

BUT REALLY, I CAN'T SEE ANYBODY NOT OPTING FOR THIS KIND OF TREATMENT.

AND THE FOLLOW-UP IS SO VERY IMPORTANT TO HAVE PEER COUNSELORS, TO HAVE PLACES THAT THESE FOLKS CAN GO SO THEY DON'T GO BACK ON THE STREET.

BUT WE THANK YOU AND HOPE THAT MAYBE YOU CAN INCLUDE FOLKS THAT ARE HELPING, LIKE CORAZON, LIKE US, IN THE ADVISORY CAPACITY THAT WE CAN DO.

SO, THANK YOU. >> KAUR: THANK YOU, SUSAN. JORGE ESTEVEZ.

>> GOOD AFTERNOON, ESTEEMED MEMBERS OF THE PUBLIC SAFETY COMMITTEE.

I WANT TO THANK YOU FOR HAVING US SPEAK HERE BEFORE YOU.

A SPECIAL THANKS TO COUNCILWOMAN TERI CASTILLO'S OFFICE WHO REACHED OUT TO US FROM THE HARM REDUCTION MOVEMENT TO OFFER SOME PERSPECTIVE.

THAT'S WHAT I WANT TO DO TODAY. MY NAME IS JORGE ESTEVEZ.

I AM A LOCAL ORGANIZER WITH THE HARM REDUCTION MOVEMENT. I AM A PERSON LIVING WITH HIV AND I AM A PERSON IN RECOVERY FROM SUBSTANCE USE. I HAVE WORKED AS A COUNSELOR AT CORAZON AND ORGANIZE WITH THE HARM REDUCTION COALITION.

WE FOCUS ON THE OCCURRENCES BETWEEN SYSTEMIC OPPRESSION, HIV, MENTAL HEALTH, AND SUBSTANCE USE IN LGBTQ COMMUNITIES. NOW, WHILE I UNDERSTAND THAT WE MAY NOT ALIGN ON CARE, I AM HERE TO PROVIDE SOME PERSPECTIVE AND URGE YOU TO CONSIDER THE ADOPTION OF A TRULY EFFECTIVE, HUMANE APPROACH TO DIVERSION, ONE BASED ON PUBLIC HEALTH AND HARM REDUCTION, NO COERCION. THE SYSTEMS TO ADDRESS

[00:50:05]

THE STANDARD TREATMENT OR JAIL MODEL IS FUNDAMENTALLY FLAWED.

IT USES THE THREAT OF INCARCERATION TO FORCE PEOPLE INTO PROGRAMS. COERCIVE TREATMENT IS NO MORE EFFECTIVE THAN VOLUNTARY CARE AND IT INCREASES THE RISK OF FATAL OVERDOSE WHEN TOLERANCE DROPS.

AT TIMES A LACK OF CARE FOR PEOPLE GOING THROUGH WITHDRAWAL CAN LEAD TO NEGATIVE OUTCOMES, ESPECIALLY FOR RECOVERY, AND SOMETIMES DEATH.

HARM REDUCTION IS NOT THE OPPOSITE OF RECOVERY, IT IS THE MOST EFFECTIVE PATHWAY TO GET THERE DUE TO THE FACT THAT ADDICTION, LIKE ALL MENTAL HEALTH CONDITIONS, CAN BE A COMPLEX, CLINICAL CONDITION THAT MERITS SOLUTIONS FOR THAT COMPLEXITY. HARM REDUCTION MEETS PEOPLE WHERE THEY ARE WITHOUT JUDGMENT AND REDUCES IMMEDIATE HARM WHILE BUILDING A BRIDGE TO WELLNESS. THE DATA IS CLEAR. THERE ARE MANY STUDIES THAT SAY SYRINGE SERVICE PROGRAMS LEAD TO THE LIKELIHOOD OF, YOU KNOW, BEING IN TREATMENT, SOMETIMES UP TO FIVE TIMES MORE THAN SOMEONE WHO DOES NOT PARTICIPATE.

STARTING MEDICATION AT THE POINT OF CONTACT DOUBLES ENGAGEMENT IN ONGOING CARE.

HAVING OVERDOSE REVERSAL MEDICATIONS AVAILABLE SAVES LIVES EVERY DAY.

A DIVERSION CENTER WORTHY OF COMMUNITY MUST INVEST IN NON-COERCIVE AND LOW-BARRIER SUPPORT. I INVITE YOU TO IMAGINE A PROGRAM WHERE INSTEAD OF PROBATION OFFICERS, A PEER NAVIGATOR WITH LIVED EXPERIENCE, LIKE MYSELF, CONNECTS SOMEONE TO A MENU OF REAL OPTIONS, IMMEDIATE MEDICATION FOR ADDICTION, TRAUMA-INFORMED MENTAL HEALTH CARE, HOUSING ASSISTANCE, OR ACCESS TO ANYTHING THAT IMPROVES THE QUALITY OF LIFE OF THE INDIVIDUAL.

TO SUPPORT THIS KIND OF PROGRAMMING, THERE IS A GREAT OPPORTUNITY FOR US TO WORK TOGETHER WITH THE FOLKS AT CORAZON SAN ANTONIO. AND US AT BEXAR AREA HARM REDUCTION AREA COALITION. SUCCESS SHOULD BE MEASURED BY THE INDIVIDUAL'S HEALTH AND THE INCREASE OF QUALITY OF LIFE, NOT BY PUNITIVE MEASURES LIKE INSTITUTIONALIZATION OR THE THREAT OF JAIL. IN MANY INSTANCES, ISOLATION IS THE KEY REASON WHY PEOPLE ARE SUFFERING FROM ADDICTION AND MENTAL HEALTH.

PEOPLE SHOULD RECOVER IN THE COMMUNITIES THEY BELONG TO WITH THE SUPPORT SYSTEMS BUILT BY THEIR PEERS. EVERYTHING I PRESENT TO YOU HERE IS JUST A SNAPSHOT OF THE EVIDENCE-BASED, MORE COMPASSIONATE APPROACHES TO SUBSTANCE USE.

IT RESPECTS HUMAN DIGNITY AND BUILDS A FOUNDATION FOR LASTING RECOVERY.

THANK YOU. >> KAUR: THANK YOU FOR SHARING YOUR STORY, JORGE.

WE'LL OPEN IT UP NOW TO COUNCIL DISCUSSION. GIVEN THAT THIS IS A CCR FROM COUNCILWOMAN CASTILLO, I'LL GIVE THE FLOOR TO COUNCILWOMAN.

I DO NEED A MOTION FIRST. >> AND A SECOND. ALL RIGHT. WE'LL OPEN IT UP TO

DISCUSSION. >> CASTILLO:

>> CASTILLO: ABBY OF UNIVERSITY HEALTH. >> HI THERE.

THANK YOU SO MUCH FOR HAVING US TODAY AND FOR PUTTING THIS VERY IMPORTANT SUBJECT ON THE TABLE. I WANT TO REITERATE SOME OF THE THINGS THAT MS. JAMISON PRESENTED AS WELL AS SOME OF OUR COMMUNITY MEMBERS. AND THIS HAS ALREADY BEEN SAID BUT I THINK IT NEEDS TO BE STRESSED. I AM DR. ABBY LOZANO FROM UNIVERSITY HEALTH. I'M A PSYCHIATRIST AND I THINK IT'S VERY IMPORTANT TO ESTABLISH THAT MENTAL HEALTH ISSUES ARE OFTEN CHRONIC AND LONG TERM.

AND SO IT'S IMPORTANT THAT AS WE TALK ABOUT THESE POINTS OF SERVICES, FOR EXAMPLE AT A DIVERSION CENTER ON AN INPATIENT PSYCHIATRIC UNIT, THESE POINTS OF SERVICES SHOULD BE ACUTE TREATMENT. AND SO AS THEY ARE MOVING TOWARDS LONGER-TERM TREATMENT, THAT ALSO NEEDS TO BE VERY ROBUST.

WHAT WAS MENTIONED, FOR EXAMPLE CASE MANAGEMENT, LINKAGE TO OUTPATIENT CARE, PSYCHIATRIC SERVICES, AND MEDICATION MANAGEMENT, ALL OF THOSE ARE VERY, VERY IMPORTANT THINGS. BUT I WANTED TO STRENGTHEN THE FACT THAT OUTPATIENT CARE IS GOING TO BE VERY VITAL TO THESE PROJECTS. THANK YOU.

>> KAUR: THANK YOU, DR. LOZANO. I WANTED TO THANK THE MEMBERS OF THE PUBLIC WHO GAVE COMMENT AND OF COURSE ALL THE STAKEHOLDERS WHO MET WITH MY TEAM AND I TO DISCUSS THIS CCR AND WHAT NEXT STEPS WOULD BE.

BUT ULTIMATELY JALEN AND HER TEAM FROM CENTER FOR HEALTHCARE SERVICES FOR ALL THE WORK THAT Y'ALL HAVE DONE AND CONTINUE TO DO WITH PUTTING THIS RFP OUT TO THE

[00:55:02]

AS STATED IN THE DATA, WHAT WE KNOW IS THERE ARE A NUMBER OF INDIVIDUALS WHO ARE DEEMED INCOMPETENT TO STAND TRIAL AND AWAITING COMPETENCY RESTORATION.

OVER 300. AND THAT'S A LARGE AMOUNT OF INDIVIDUALS.

AND DISTRICT 5 IS HOME TO MANY COUNTY AND CITY FACILITIES FROM THE MAGISTRATE OFFICE, THE COUNTY JAIL, THE CENTER FOR HEALTHCARE SERVICES, HAVEN FOR HOPE, AND SO MANY OTHER PARTNERS WHERE THERE'S OPPORTUNITY FOR US TO BETTER ALIGN TO ENSURE THAT WE'RE PROVIDING THE HEALTHCARE AND SERVICE.

AND OF COURSE THE PUBLIC SAFETY THAT SAN ANTONIO RESIDENTS DESERVE.

AS OUTLINED BY MARIA VARGAS IN HER PRESENTATION, MANY CITIES AND COUNTIES HAVE ESTABLISHED A SIMILAR DIVERSION MODEL. BUT THIS COUNCIL CONSIDERATION REQUEST WAS BORN OUT OF A CONSTITUENT SERVICES CASE AS WELL AS MY VISIT TO THE HARRIS COUNTY FACILITY AND THE AMOUNT OF CONSTITUENTS WE HAVE COMING BY OUR FIELD OFFICE TO ASK HOW WE CAN HELP ADVOCATE FOR THEIR FAMILY MEMBERS TO GET AN IDD TEST OR MEDICATIONS WHILE BEING INCARCERATED AT THE COUNTY JAIL.

SO I'M GRATEFUL TO SEE THAT COMMISSIONER RODRIGUEZ, SHERIFF SALAZAR, AND UNIVERSITY HEALTH HAVE SUBMITTED LETTERS OF SUPPORT FOR THE CITY OF SAN ANTONIO TO SUPPORT THIS RFP PROCESS. LAID OUT WITHIN THE COUNCIL CONSIDERATION REQUEST ARE A NUMBER OF STAKEHOLDERS. I'M PLEASED TO SEE MANY HERE.

TRISHA BERRY, WE REALLY VALUE YOUR WORK THAT YOU DID AT THE COUNTY.

TYING IN HOW INVESTING IN PUBLIC SAFETY IS ALSO ECONOMIC DEVELOPMENT.

SO A COUPLE OF DIFFERENT AREAS THAT I THINK THERE'S OPPORTUNITY FOR US TO CONTINUE TO HONE IN ON AS LAID OUT IN THE RFP IS TO CONTINUE TO HAVE THAT CONVERSATION AND COORDINATION WITH THE D.A. AND THE POLICE DEPARTMENT IN TERMS OF WHAT ARE THE LOW-LEVEL MISDEMEANORS THAT WE INTEND TO INTEGRATE INTO THIS RFP. I'M EAGER TO SEE WHAT THE CONSULTANT COMES UP WITH IN TERMS OF FACILITATION BUT I DO BELIEVE THERE'S VALUE IN CONTINUING TO MEET WITH ALL STAKEHOLDERS AS LAID OUT AND OF COURSE RECOMMENDED BY THE CONSULTANT.

I WOULD BE REMISS IF I DIDN'T THANK THE POLICE DEPARTMENT IN TERMS OF THE LAST PRESENTATION THAT WE'VE SEEN, WE'VE SEEN A DECREASE IN VIOLENT CRIME AND CRIME, IN PARTICULAR. THE CITY OF DALLAS RECENTLY PUT OUT AN ARTICLE WHERE THEY HAVE ALSO SEEN A DECREASE IN VIOLENT CRIME. THEY POINT TO THAT REDUCTION TO MODELS LIKE THEIR JAIL DIVERSION PROGRAM. AND WHAT THE D.A. HIGHLIGHTS IS THAT WHEN YOU HAVE FEWER OFFENSES, FEWER OFFENDERS, THAT'S FEWER VICTIMS. THAT'S THE GOAL HERE IS THAT WE DON'T SEE MORE VICTIMS AND WE'RE CONNECTING FOLKS TO THE TREATMENT, CARE, AND REHABILITATION THAT THEY NEED.

ULTIMATELY THIS IS A FIRST STEP FOR THE CITY OF SAN ANTONIO TO CONTINUE TO COORDINATE WITH ALL STAKEHOLDERS AND THE COUNTY. BUT IT IS GOING TO TAKE THAT COORDINATION AND HAVING GONE TO THE HARRIS COUNTY MODEL AND MEETING WITH SOME OF THE MOVERS AND SHAKERS WHO HELPED MATERIALIZE THAT MODEL, IT'S GOING TO TAKE A LOT OF CONVERSATIONS, A LOT OF DEBATE, BUT COORDINATION. I THINK AT THE CORE OF THIS MODEL AND MY EXPECTATION IS THAT WE CONTINUE TO COORDINATE AGAIN WITH THOSE LAID OUT IN THE CCR BUT I THINK IT'S IMPORTANT TO HIGHLIGHT, AS JALEN HAS MENTIONED, HOW CAN WE COORDINATE WITH THE RANK AND FILE OFFICERS IN TERMS OF HOW CAN WE BE MORE SUCCESSFUL AND EFFECTIVE WITH THIS MODEL.

SO I DO APPRECIATE THAT THAT'S HIGHLIGHTED WITHIN JALEN'S PRESENTATION WITH THE CONSULTANT IS HOW ARE WE INCLUDING EVERYONE. BECAUSE IT'S GOING TO TAKE THAT COORDINATION TO BE EFFECTIVE AND IMPACTFUL. I WANTED TO HIGHLIGHT THE CONSTITUENT SERVICES CASE THAT THIS WAS BORN OUT OF. IT WAS ABOUT A YEAR AND A HALF AGO WE HAD A FAMILY COME IN WHERE THEIR SON WASN'T RECEIVING THE CARE THAT THEY NEEDED. SO WHAT WE DID, RACHEL AND HER TEAM, IS SHE CONVENED AACOG, THE BEXAR COUNTY OFFICE, OUR COUNTY COMMISSIONER.

THERE WERE ABOUT TEN PEOPLE IN THAT ROOM TO ASSIST WITH ONE CONSTITUENT.

WHAT THOSE STAKEHOLDERS SHARED WAS A LOT OF DISCONNECTION AND GAPS THAT EXIST WITHIN THE SYSTEM AND WHERE THERE'S OPPORTUNITY FOR US TO WEAVE THOSE PIECES TOGETHER TO ENSURE THAT IF YOU ARE AN INDIVIDUAL WITH A MENTAL HEALTH NEED AND/OR MENTAL HEALTH -- OR SUBSTANCE USE, RATHER, THAT THERE'S OPPORTUNITY AND MODELS THAT WE CAN REPLICATE HERE IN THE CITY OF SAN ANTONIO.

BUT WITH THAT BEING SAID, I JUST WANTED TO THANK MARIA FOR HER RECOMMENDATION.

THIS IS SOMETHING THAT I AM SUPPORTIVE OF AND COMFORTABLE WITH MOVING TO A CONVERSATION TO TALK ABOUT HOW NOT ONLY IS THIS A DISTRICT 5 PROBLEM.

OFTENTIMES IN D5 I GET TASKED WITH HOW ARE YOU GOING TO ADDRESS VIOLENT

[01:00:02]

SO IT'S GOING TO TAKE ALL OF COUNCIL TO BE ON THE SAME PAGE TO IDENTIFY WHERE THERE'S OPPORTUNITY TO SUPPORT THIS CONCEPT BEYOND THE 30,000 FOR THE STUDY.

SO I'M EAGER TO MOVE THIS ALONG. AND, AGAIN, I ASK FOR THE COMMITMENT FROM MY COLLEAGUES FOR US TO KEEP IN MIND, WHILE WE'RE HAVING BUDGET CONVERSATIONS AND BOND CONVERSATIONS, HOW WE CAN HELP MOVE THIS ALONG.

I THINK, AS HIGHLIGHTED BY DR. TESTA IN HIS STUDY, WE ALSO HAVE A RESPONSIBILITY TO ADDRESS THE DOUBLE MAGISTRATION PROCESS. AS I ALLUDED TO EARLIER, D5 DOES HAVE THE MAGISTRATE, THE COUNTY JAIL AND THERE'S JUST A NUMBER OF OPPORTUNITY FOR CONVERSATION. SO I'LL CLOSE WITH, YOU KNOW, AS LAID OUT IN THE PRESENTATION, NOT ONLY IS THIS THE RIGHT THING TO DO IN TERMS OF ENSURING THAT WE HAVE TREATMENT AND NOT TRAUMA, BUT IT'S THE FISCALLY-RESPONSIBLE THING TO DO, AS HIGHLIGHTED IN THE PRESENTATION. JAILING COSTS $1,750 PER DAY VERSUS $510 PER DAY FOR A BEHAVIORAL HEALTH DIVERSION CENTER.

IT JUST MAKES SENSE. AND I WOULD BE REMISS IF I DIDN'T HIGHLIGHT THAT.

I MENTION THIS DURING EVERY BUDGET CONVERSATION BUT WHEN I ATTEND A NEIGHBORHOOD ASSOCIATION MEETING -- AND I'M SURE MANY OF MY COLLEAGUES CAN RELATE TO THIS. OUR SAFFE OFFICERS GET BOMBARDED WITH QUESTIONS ABOUT UNHOUSED INDIVIDUALS. I THINK THIS WILL HELP US ADDRESS THAT CONCERN FROM CONSTITUENTS BUT ALSO REMOVE THAT TASK FROM OUR SAFFE OFFICERS.

THEY'RE ASKED TO TACKLE VIOLENT CRIME. THEY'RE ASKED TO GO PUT THEMSELVES LITERALLY IN DANGER AND THEN WE ASK THEM TO ADDRESS THE HOMELESS ISSUE. SO I THINK THERE'S AN OPPORTUNITY FOR US TO REALLY COORDINATE AND TACKLE THIS ISSUE. BUT IT'S GOING TO BE A LOT

OF COORDINATION. THANK YOU, CHAIR. >> KAUR: THANK YOU, COUNCILWOMAN. ANYONE? YEAH.

GO AHEAD. COUNCILWOMAN SPEARS. >> SPEARS: THANK YOU, CHAIR. I THINK THIS CENTER IS REMARKABLE BECAUSE IT'S GOING TO PROVIDE A COMPREHENSIVE WAY FOR US TO MEET THE GROWING NEEDS THAT WE HAVE FOR MENTAL HEALTH CARE HERE IN SAN ANTONIO AND BEXAR COUNTY.

AND IT EASES OUR OVERBURDENED PUBLIC SAFETY INFRASTRUCTURE AT THE JAIL AND THE JIAA AND IN BEXAR COUNTY AND SAN ANTONIO OVERALL.

AND EVEN IN ALL OF THE DIFFERENT -- THE 52 OR 54 COUNTIES SERVED RIGHT NOW.

I KNOW THAT THE EARLIER WE ARE ABLE TO INTERVENE AND ASSIST THESE INDIVIDUALS WITH THEIR MENTAL HEALTH NEEDS, THE SOONER AND BETTER WE ARE ABLE TO INTEGRATE THESE INDIVIDUALS BACK INTO SOCIETY AND GIVE THEM A LIFE AND HOPE.

AND THAT IS SOMETHING YOU CAN'T PUT A PRICE TAG ON. AND BUT NOT ONLY THAT, IT HELPS REDUCE THE STRAIN ON OUR JAIL AND OUR JUSTICE SYSTEM AND THE COMMUNITY HEALTHCARE COSTS. IT GREATLY DECREASES OUR DAILY COST OF CARE, AS WE LEARNED TODAY, FOR MENTAL HEALTH INDIVIDUALS IN OUR JAIL BY INSTEAD UTILIZING

THIS DIVERSION CENTER. >> SPEARS: MY HOPE IS THAT THIS FEASIBILITY FOR THE DIVERSION CENTER IN BEXAR COUNTY CREATES A ROADMAP FOR A COMPREHENSIVE PLAN IN THE WAY WE APPROACH PUBLIC SAFETY.

I HOPE TO SEE A TAILORED APPROACH THAT ADDRESSES OUR COMMUNITY OF SAN ANTONIO AND BEXAR COUNTY, INCLUDING VETERANS AND THEIR NEEDS, AS WELL AS THE HIGH NUMBER OF DOMESTIC VIOLENCE CASES, INCLUDING HELP FOR BOTH ABUSERS AND THEIR VICTIMS AS WELL AS SENIORS AND YOUNG PEOPLE IN DIFFERENT PHASES OF LIFE. BUT IT'S KEY THAT WE UTILIZE PUBLIC AND PRIVATE STAKEHOLDERS. THIS IS A PROBLEM WE'RE SEEING NATIONWIDE AND I'M GRATEFUL TO COUNCILWOMAN CASTILLO FOR BRINGING THIS COUNCIL CONSIDERATION REQUEST FORWARD.

I BELIEVE THIS IS A MEANINGFUL APPROACH TO ADDRESS THIS PROBLEM IN SAN ANTONIO AND BEXAR COUNTY. AND THE ONLY LAST THING I WOULD ADD IS I WOULD LIKE TO INCLUDE US TO ENGAGE OUR -- AUDIO] -- AS WE MOVE FORWARD. SO THANK YOU SO MUCH FOR

THE PRESENTATIONS. GREAT WORK, EVERYONE. >> KAUR: THANK YOU, COUNCILWOMAN. COUNCILMEMBER MCKEE-RODRIGUEZ?

>> MCKEE-RODRIGUEZ: THANK YOU. I'LL BE BRIEF.

MY VOICE IS VERY STRAINED RIGHT NOW. THANK YOU SO MUCH FOR THE PRESENTATION, THANK YOU FOR EVERYONE WHO CAME OUT TO SPEAK IN SUPPORT OF THIS ITEM, THANK YOU TO COUNCILWOMAN CASTILLO FOR THE PROPOSAL.

I'M SUPPORTIVE OF THE RECOMMENDATION. I LOOK FORWARD TO THIS

[01:05:03]

COMING BEFORE US AT A B SESSION. >> KAUR: COUNCILWOMAN?

>> CASTILLO: I WANTED TO ADD SOMETHING THAT DR. LOZANO HAD MENTIONED AS WELL AS STAKEHOLDERS HAD MENTIONED IS THE AFTER-CARE COMPONENT AND THE NEED TO PLUG IN HOUSING. I THINK THERE WOULD BE VALUE IN MARC CARMONA SERVING ON THE AD HOC COMMITTEE BEING THAT HE DOES MEET WITH PROVIDERS AND I THINK THERE'S -- AND IN ADDITION TO THAT HE SERVES ON THE SAN ANTONIO HOUSING TRUST, SO I THINK HE WOULD OFFER A REALLY GOOD PPERSPECTIVE ON THAT AD HOC COMMITTEE.

THANK YOU. >> KAUR: THANK YOU. I WANT TO ECHO THE SENTIMENTS THAT WERE BROUGHT UP AND I'M GLAD YOU'RE TAKING THE INITIATIVE TO PUSH THE CITY TO WORK CLOSER TO OUR PARTNERS.

I HAVE QUESTIONS BECAUSE I JUST WANT TO KNOW A LITTLE BIT MORE, BUT I'M FULLY SUPPORTIVE. I'M NOT SURE IF JALEN OR MARIA, HOW YOU GUYS WANT TO TAG-TEAM THIS, BUT SPECIFICALLY ON THE DIVERSION CENTER PROCESS SLIDE, SO SLIDE 9, WHEN YOU HAVE GIA AND LAW ENFORCEMENT OFFICERS PROVIDING -- OR BRINGING THE INDIVIDUAL TO THE DIVERSION CENTER, DO THEY -- WHO DOES THE ASSESSMENT IN THIS SITUATION? IS IT WHEN THEY GET TO THE CENTER OR IS IT -- HOW DOES THAT PROCESS

WORK? >> SO RIGHT NOW ALL OF OUR LAW ENFORCEMENT IS TRAINED TO CONDUCT THE SCREENING, SO IT'S THOSE FOUR QUESTIONS THAT YOU SAW IN MARIA'S PRESENTATION EARLIER. SO AT THAT POINT, LAW ENFORCEMENT, WHEN THEY ARE BRINGING THE INDIVIDUAL FORWARD, THEY SAY THEY HAVE -- WE DID THE SCREENING AND HERE'S WHAT WE DISCOVERED.

SO AT THAT POINT THEN A FURTHER ASSESSMENT IS TAKEN TO DETERMINE THE PRIMARY DIEING MOW SIS, WHETHER IT'S MENTAL HEALTH OR SUBSTANCE USE.

. >> KAUR: SO THE 2,000 -- I'M TRYING TO RECONCILE THE NUMBERS. SO THE SLIDE -- A FEW SLIDES LATER SAYS THERE'S ABOUT 2,000 DIVERSION ASSESSMENTS THAT ARE CONDUCTED, WHO IS

CONDUCTING THOSE RIGHT NOW? >> I'M ASSUMING UH IS,

BECAUSE WE'RE NOT AT GIA ANY LONGER. >> KAUR: AND COULD YOU CLARIFY -- I KNOW THE RESULTS THAT CAME OUT THAT SAID THERE WAS MORE COMPREHENSIVE NEED, BUT WAS THERE A SPECIFIC REASON FOR THE PIVOT OF PULLING OUT OF THAT CONTRACTED SERVICES WORK ON Y'ALL'S END?

>> BEXAR COUNTY WENT TO COMMISSIONERS COURT AND INDICATED THEY NO LONGER WANTED US TO PERFORM THOSE SERVICES AND DID NOT PROVIDE ANY OTHER BASIS OTHER THAN THAT. SO WE MET WITH DR. TESTA TO GET AN UNDERSTANDING OF THE STUDY AND I CONCURRED WITH THAT RECOMMENDATION THAT UH -- IF THEY -- THE OVERALL RECOMMENDATION FROM DR. TESTA WAS TO STREAMLINE THE SEQUENTIAL PROCESS. AND HE DIDN'T SAY SOMEONE SHOULD BE REMOVED, HE JUST SAID STREAMLINED. SO WHEN THEY INDICATED TO COMMISSIONERS COURT, THEY NO LONGER WANTED US TO PROVIDE THOSE SERVICES, I CONCURRED WITH THAT RECOMMENDATION TO THE BOARD THAT WE SHOULD GO.

SO UH IS PROVIDING -- THEY ARE THE MENTAL HEALTH AND PHYSICAL PROVIDER. I DON'T KNOW IF THEY'RE CONDUCTING ASSESSMENTS.

SO UH IS PROVIDING THE MENTAL HEALTH ASSESSMENTS.

>> KAUR: BUT THEY'RE STILL RECEIVING TREEMENTD WITHIN THE JAIL.

>> UH IS THE PROVIDER. >> KAUR: AS FAR AS THE DATA COMPONENTS, IT WAS HELPFUL TO BE ABLE TO SEE -- OH, ONE MORE QUESTION BEFORE YOU GO TO MARIA ON THIS, BUT FOR THIS PSYCHIATRIC HOSPITAL, IS THAT ALSO GETTING A SEPARATE RFP OR IS THAT JUST A NEED THAT YOU WERE SHARING?

>> SO THE PSYCHIATRIC HOSPITAL, WHILE UNIVERSITY HEALTH IS OUR COMMUNITY HOSPITAL, I THINK WE ALL OWN THIS. THEY CANNOT DO IT BY THEMSELVES, THEY ARE THE COMMUNITY HOSPITAL, THEY DO RECEIVE A DEDICATED PROPERTY TAX TO PROVIDE HEALTH SERVICES FOR OUR COMMUNITY, MOREOVER THE INDIGENT COMMUNITY IN BEXAR COUNTY, BUT IT IS GOING TO TAKE THE CITY, THE COUNTY AND UH TO WORK TOGETHER TO COME UP WITH A SOLUTION FOR A PSYCHIATRIC HOSPITAL. IT IS A NEED IN THIS COMMUNITY.

THEY SHOULD CERTAINLY BE THE LEADER, THEY ARE THE EXPERTISE WE HAVE ON PHYSICAL AND MENTAL HEALTH INPATIENT CAPACITY, BUT THEY DON'T OWN IT THEMSELVES. WE WILL ALL NEED TO COME TOGETHER FOR A RECOMMENDATION, SO WE -- THE CHCS, THE LOCAL MENTAL HEALTH AUTHORITY, DOES NOT PRESENTLY HAVE AN RFP FOR THAT. WE WOULD -- MY OPINION -- I WOULD -- WE WOULD NEED TO WORK WEED BANOS, THE CEO AT UNIVERSITY HEALTH FOR FURTHER STEPS. I DID PRESENT TO THEIR BOARD MANAGERS IN DECEMBER AND ASKING THEM TO REPRIORITIZE THE MEADOW STUDY RECOMMENDING

A PSYCHIATRIC CENTER. >> KAUR: AND SO THE TOTAL NUMBER OF BEDS YOU MENTIONED THE 734, EXIST IN THE HOSPITAL RIGHT NOW --

>> THE TOTAL NUMBER OF BEDS -- SO WE HAVE CONTRACTS WITH SEVERAL HOSPITALS. SO WE HAVE CONTRACTS WITH LAUREL RIDGE, SAN ANTONIO BEHAVIORAL HEALTH, CLARITY FOR CHILDREN'S BEDS, CEDAR HILLS, A NEW

[01:10:01]

HEALTH. >> KAUR: IF IT'S ACCEPTABLE TO COUNCILWOMAN CASTILLO, I THINK THE AD HOC COMMITTEE COULD POTENTIALLY DISCUSS THIS AS WELL IN TERMS OF HOW WE CONTINUE TO SUPPORT.

BECAUSE IF FOLKS DO GET TREATMENT, WE DON'T WANT THEM TO HAVE TO GET ARRESTED AGAIN TO GET ADDITIONAL TREATMENT. WE WANT THEM TO HAVE LONG-TERM SUPPORT AND I THINK THE HOSPITAL WOULD BE HELPFUL FOR THAT.

>> YOU KNOW, DR. LOZANO MENTIONED THE NEED FOR OUTPATIENT SERVICES, AND THAT IS THE MISSION OF CHCS. WE ARE THE LOCAL MENTAL HEALTH AUTHORITY PROVIDING OUTPATIENT SERVICES FOR ADULT AND CHILDREN HERE IN SAN ANTONIO. AND SO THAT'S OUR MISSION. AND WE WILL CONTINUE TO FULFILL THAT MISSION.

>> KAUR: DID YOU WANT TO COMMENT ON THAT, COUNCILWOMAN CASTILLO? [INDISCERNIBLE] MEET THE DIVERSION, THERE IS A NEED FOR AFTER CARE, BUT WE WOULD NEED TO CONSULT WITH MARK CARMONA IN TERMS OF WHAT THAT

LONG-TERM CARE LOOKS LIKE. >> KAUR: THAT WOULD BE GREAT. MAYBE IF WE COULD ADD THAT TO THE RFP, IF POSSIBLE, TO SEE IF WE COULD CONSIDER WHAT THAT WOULD LOOK LIKE SO WE'RE NOT SHIFTING RESOURCES. ADDING MARC CARMONA TO THE SPECIFIC AD HOC COMMITTEE, BUT ALSO WORKING TO SEE WHETHER OR NOT WHAT KIND OF

ADDITIONAL AFTER CARE -- >> WE HAVE ALREADY BEGUN TO TALK TO OUR PARTNERS AT CORAZON AND SAM TO TALK ABOUT WHAT THAT AFTER CARE LOOKS LIKE, BECAUSE WHEN THEY ARE DISCHARGED, IT COULD BE SHELTER, IT COULD BE FOOD, IT COULD BE ANY OF THE ABOVE. SO ABSOLUTELY.

>> VILLAGOMEZ: AND JUST TO CLARIFY WITH THE COMMENT FROM COUNCILWOMAN CASTILLO AND THE CHAIR, IT SOUNDS LIKE THEY WOULD LIKE TO ADD THAT TO THE

CURRENT RFP FOR CONSIDERATION. >> KAUR: IF THEY FEEL LIKE IT'S OUT OF THE SCOPE, JUST TO -- I MEAN, WE WOULD UNDERSTAND,

BUT -- >> LET ME GO BACK AND -- I THINK THERE IS A REFERENCE, BUT IF WE NEED TO BEEF IT UP, THAT'S FINE.

WE CAN ISSUE AN ADDENDUM TO TAKE CARE OF THAT. NOT A PROBLEM.

WE STILL HAVE TIME. >> KAUR: THANK YOU. AND ONE MORE ADDITION THAT I WAS THINKING OF IS IN TERMS OF, LIKE, THE NEED WHEN THEY'RE ANALYZING THE NEED AND -- IS THERE A WAY -- LIKE I KNOW MARIA STARTED WITH SOME REALLY GREAT DATA, BUT IT WOULD BE ABLE TO BEEF THAT UP EVEN MORE.

IS THERE A WAY THEY CAN SHOW ADDITIONAL DATA POINTS FROM OTHER AREAS? IS -- SO SOME OF THE THINGS -- AND, MARIA, FROM YOU WANT TO COMMENT ON THIS, BUT I WAS THINKING OF LIKE THE NUMBER OF PEOPLE THAT DON'T HAVE MULTIPLE -- LIKE THE DECREASE IN MULTIPLE OFFENSES FOR FOLKS AND THEN I KNOW HARRIS COUNTY WAS PRESENTED, BUT I DON'T

KNOW IF THERE IS DATA ON THE OTHERS AS WELL. >> HARRIS COUNTY IS CERTAINLY PUTTING OUT THE MOST ROBUST REPORTED OUTCOMES AT THIS POINT COMPARED TO THE OTHER COUNTIES. I BELIEVE FOR EXAMPLE TAR RANT WAS A PILOT. WE'RE STILL WAITINGSOME REPORTED OUTCOMES FROM THEM. I CAN CERTAINLY LOOK AND PROVIDE OUTCOMES FROM THE OTHER COUNTIES. HARRIS CENTER HAS BEEN DOING IT FOR A WHILE AND THEY HAVE THE MOST ANALYTIC DATA THAT WE CAN USE.

>> KAUR: THIS IS THE STUFF THAT THEY WERE SELF-REPORTING, RIGHT? BECAUSE THE -- JUST GOING BACK TO THAT SLIDE, I THINK IT'S SLIDE 8, THE -- THOSE WERE TOTAL CLIENTS SERVED ACROSS ALL OF THE INSTITUTIONS,

RIGHT, NOT JUST THEIR DIVERSION CENTER? >> RIGHT.

THAT FIRST LONG TABLE WITH THE FISCAL YEARS, THAT'S FOR ALL OF THE SERVICES AND PROGRAMS THEY HAVE, NOT JUST THE JUDGE AT EMMITT DIVERSION

CENTER, CORRECT. >> B SESSION PRESENTATION, IF THERE'S ANY WAY TO EITHER JUST BEFORE IN BRIEFING OR IN BACKUP SLIDES TO SEND TO US A LITTLE BIT M MORE IN DEPTH ON THE SPECIFIC DIVERSION PROGRAM, AND I DON'T KNOW IF THAT'S PUBLICLY RELEASED, BUT THE MEMBER OF FOLKS THAT HAVE -- NUMBER OF FOLKS THAT HAVE GONE THROUGH THE PROGRAM. I KNOW YOU'VE PRESENTED THE DECREASE IN JAIL BOOKINGS, BUT MAYBE IS THERE -- HAVE THEY SEEN A CHANGE IN, LIKE I MENTIONED, MULTIPLE -- LIKE NOT HAVING -- GOING BACK FOR ANOTHER OFFENSE OR IN ADDITION JUST IF THERE'S ANY OTHER LIKE -- A GROUP THAT IS -- A CONTROL GROUP THAT WE COULD ANALYZE IT WITH TO

BE ABLE TO COMPARE A LITTLE BIT. >> YES, WE'LL LOOK AT EVERYTHING THEY HAVE PUBLISHED AND WE CAN PRESENT THAT.

>> KAUR: THAT WOULD BE AWESOME. THANK YOU SO MUCH.

THE LAST QUESTION -- SORRY, JALEN TO MAKE YOU STAND UP, ONE MORE -- THE LAST QUESTION THAT I JUST HAD WAS SPECIFICALLY CAN YOU JUST -- FOR THE COMMUNITY SHARE WHY IT'S SUCH A DIFFERENT COST BETWEEN THE BEXAR COUNTY COSTS FOR JAILING VERSUS PROVIDING MENTAL HEALTH SUPPORT?

>> I AM NOT A JAIL EXPERT, BUT JUST HAVING VISITED THE FACILITIES SO MUCH IS REQUIRED FOR SECURITY PURPOSES. SO THOSE INDIVIDUALS ARE TRAINED, AND THEY -- IT'S EXPENSIVE. THE INDIVIDUALS THAT THEY HIRE TO MAINTAIN THE SECURITY AND SAFETY OF THE INDIVIDUALS THAT ARE

[01:15:05]

THE NUMBER OF BEDS. SO OUR JAIL IS 5,000. HAS THE CAPACITY FOR A LITTLE MORE THAN 5,000. WE DON'T KNOW THE NUMBER OF BEDS.

HARRIS COUNTY HAS 36. SO WE COULD HAVE 20 OR 50, WHATEVER THE NUMBER OF BEDS ARE RECOMMENDED, SO THAT PER BED COST OR PER CELL COST WOULD BE VERY DIFFERENT FOR DETENTION VERSUS THE DIVERSION CENTER.

>> KAUR: GREAT. OKAY. THANK YOU FOR THAT

CLARITY. >> SURE. >> KAUR: THE LAST THING, MARIA, IF WHEN WE COME BACK TO B SESSION, IT WOULD BE GOOD TO -- WE TALKED A LOT, AND COUNCILWOMAN CASTILLO MENTIONED AT THE VERY END THAT OUR UNHOUSED POPULATION NEEDS LONG-TERM SOLUTIONS AND THIS IS, I THINK, A PART OF ONE INCLUDING HOUSING.

SO IT WOULD BE GREAT TO KNOW JUST AS MAYBE A SLIDE THAT PRESENTS HOW MUCH WE'VE SPENT ON ENCAMPMENT CLEANUP AND THINGS LIKE THAT LIKE IN THE HOMELESS DEPARTMENT -- OR NEW HSS BUDGET IN THE LAST FIVE YEARS AND WHAT WOULD IT LOOK LIKE IF WE ALLOCATED A PORTION OF THAT, MAYBE JUST SOME KIND OF WAY TO SEE HOW MUCH MONEY THAT'S BEEN SPENT THERE.

AND I DON'T KNOW IF WE CAN -- MARIA PROBABLY CAN COME UP WITH THIS BECAUSE SHE'S A DATA WHIZ, BUT SOMETHING TO, LIKE, FORECAST WHAT IT COULD BE LONG-TERM SAVINGS, LIKE HOW MUCH -- IF WE PUT IN X AMOUNT TO HELP X NUMBER OF PEOPLE, WHAT COULD OUR POTENTIAL LONG-TERM SAVINGS BE.

IT COULD BE A PART OF THE DASHBOARD THAT SHE'S WORKING ON, IF THERE'S A WAY TO INCORPORATE THAT. I THINK THAT'S ALL THE COMMENTS THAT I HAVE.

IS THERE ANYTHING ELSE FROM ANY OF MY COLLEAGUES? ALL RIGHT. WE HAVE -- OH, YES. DO WE HAVE A DATE FOR B

SESSION. >> VILLAGOMEZ: WE DO. AND I'M GOING OFF THE TOP OF MY HEAD. IT'S IN FEBRUARY. I THINK IT'S AT THE BEGINNING. DO YOU REMEMBER? SHE'S PULLING IT UP.

>> KAUR: OKAY. WHILE SHE'S PULLING IT UP, I JUST WANT TO SAY THAT THE NEW CCR PROCESS, CONGRATS TO ALL OF YOU GUYS THAT WORKED ON IT, BECAUSE THIS CCR WAS PUT IN IN OCTOBER, LOOK, IT'S ALREADY THROUGH COMMITTEE AND GOING TO B SESSION IN FOUR MONTHS, THAT'S LIKE RECORD PACE.

SO I THINK THAT'S GREAT. POLICY-MAKING IS WORKING.

I'M SORRY? OKAY. SO IT WILL BE A B SESSION FEBRUARY 11TH. SO WE HAVE A MOTION AND A SECOND.

LET'S GO AHEAD AND TAKE A VOTE. ALL IN FAVOR.

(AYES.) (ANY ZERO OPPOSED? ANY AB SEN SHUNS? THE MOST CARRIES CONGRATULATIONS. WE'RE GOING TO MOVE ON TO

ITEM NUMBER 5. >> VILLAGOMEZ: YES, CHAIRWOMAN, THIS ITEM IS AN UPDATE ON OUR SA-CORE PROGRAM. THIS IS OUR MENTAL HEALTH MULTIDISCIPLINARY TEAM AND WE HAVE THE TWO PARTNERS THAT WORK WITH US OUTSIDE THE CITY HERE PRESENT, YOU HEARD FROM JALEN, AND SHE PROVIDES THE CLINICIANS THAT HELP US WITH THE ACTUAL RESPONSE IN THE FOLLOW-UP WHICH IS VERY CRITICAL, AND I ALSO WOULD LIKE TO INTRODUCE ERIK EPLEY, HE IS THE EXECUTIVE DIRECTOR FOR THE SOUTHWEST TEXAS REGIONAL ADVISORY COUNCIL FOR TRAUMA OR STRAC. NOW, ONE OF THE -- AS WE WERE PREPARING FOR THIS PRESENTATION, ONE QUESTION THAT HAS COME OUT OF THIS COMMITTEE IS, IS THERE AN OPPORTUNITY FOR US TO ADD AN OPTION TO THE 9-1-1 SYSTEM FOR A MENTAL HEALTH CALL? SO WORKING WITH OUR PARTNERS, WE ARE -- YOU'RE GOING TO HEAR IN THE PRESENTATION, AND THAT'S ONE OF THE REASONS WHY ERIK EPLEY'S HERE TODAY, ONE IDEA THAT WE WILL BE EXPLORING IS USING EXISTING TECHNOLOGY. NOT TO ADD AN OPTION TO THE 9-1-1 SYSTEM, BUT A WAY TO BE ABLE TO ADDRESS MENTAL HEALTH CALLS THAT ARE LOW ACUITY AT THE 9-1-1 FLOOR. SO WE WANT TO INTRODUCE THE CONCEPT, WE STILL HAVE A LOT OF WORK TO DO, BUT IF THERE'S SPECIFIC QUESTIONS RELATED TO THAT, ERIK EPLEY'S HERE TO HELP US ADDRESS THOSE QUESTIONS. SO WITH THAT, I'M GOING TO TURN IT OVER TO JESSE HIKING AGAINS, OUR MENTAL HEALTH OFFICER FOR SAN ANTONIO.

. >> HELLO, EVERYONE. GOOD AFTERNOON, MARIA AND MEMBERS OF THE PUBLIC SAFETY COMMITTEE. I'M JESSIE HIKING AGAINS. I'M HAPPY TO BRING YOU AN UPDATE ON THE SA-CORE PROGRAM. TODAY WE'LL TALK ABOUT 9-1-1 MENTAL HEALTH CALLS, WE'LL DO AN OVERVIEW OF THE MISS CAL YEAR 25 SA-CORE OUTCOMES AROUND WE'LL ALSO LOOK INTO OLDER ADULT MENTAL HEALTH.

BEFORE JUMPING INTO SPECIFIC PROGRAMS, I WANT US TO LOOK AT THE BIGGER

[01:20:04]

BOTH THE POLICE AND FIRE DEPARTMENTS HAVE A HISTORY OF WORKING IN THE MENTAL HEALTH ARENA, INDEPENDENTLY WITH EACH OTHER AND WITH PARTNERS LIKE STRAC AND CHCS. ON THIS SLIDE WE'LL LOOK AT THE MENTAL HEALTH UNIT, THEN MIH AND THEN WE'RE THERE WORKING TOGETHER.

STARTING ON THE LEFT IN BLUE, SAPD'S MENTAL HEALTH UNIT HAS ONE LIEUTENANT, SIX SERGEANTS, FOUR DETECTIVES AND 33 STAWFERS. TO GET INDIVIDUALS IN A MENTAL HEALTH CRISIS TO THE RIGHT CARE AT THE RIGHT TIME SINCE 2017, SAPD PARTICIPATES IN LAW ENFORCEMENT NAVIGATION BY CALLING STRAC'S MED COM LINE AND GETTING NAVIGATED TO HOSPITALS WITH BEHAVIORAL HEALTH CAPACITY.

WHEN THERE ARE ESCALATED MENTAL HEALTH CALLS, SAPD HAS A PROTOCOL TO SUPPORT PATROL WITH THE MENTAL HEALTH UNIT OFFICERS. IF THERE'S AN ED WITH A WEAPON, OFFICERS MAY SEIZE THE WEAPON AND THE PERSON MUST GET AN ORDER FROM THE JUDGE TO RELEASE IT, AND THE MULTIAGENCY PARTNERSHIP FOR STABILIZATION OR MAPS TEAM IS A TEAM WITH MENTAL HEALTH OFFICERS AND CHCS CLINICIANS THAT CONNECTS PERSONS WITH CONCERNS TO SERVICES.

MIH HAS A NEW CHIEF POSITION. I'D LIKE TO INTRODUCE YOU TO CHIEF SEAN BIATRIC, HE'S HERE TODAY WITH US, TWO LIEUTENANTS, EIGHT FULL-TIME PARAMEDICS, FOUR DETAIL PARAMEDICS, 200 TRAINED ALTERNATES.

MIH WORKS WITH 9-1-1. THEY PROVIDE HOSPICE SERVICES TO CONTRACTED PATIENTS, THEY WORK DIRECTLY WITH MOLINA MANAGE CARE PATIENTS, THEY STAFF THE ACUTE CARE STATION AT HAVEN FOR HOPE TO ADDRESS PHYSICAL HEALTH CONCERNS ON SITE AND PREVENTS UNNECESSARY AMBULANCE TRANSPORTS TO HOSPITALS. THE OPIOID SUBSTANCE PREVENTION CRISIS RESPONSE TREATS PATIENTS EXPERIENCING WITHDRAWALS FROM OPIOIDS AND CONNECTS THEM TO SERVICES AND THEY HAVE A DEDICATED MIH NAVIGATOR WHO ASSISTS WITH PATIENTS AND HIGH-VOLUME UTILIZERS. IN THE MIDDLE YOU CAN SEE THE CITY'S MULTIDISCIPLINARY APPROACH TO MENTAL HEALTH.

PUBLIC SAFETY THREATS, SAPD AND SAFD TEACH CRISIS INTERVENTION TRAINING AND SAPD'S NEW CIT2.0 TRAINING TO THEIR CADETS, IN-SERVICE, DISPATCH AND OUTSIDE LAW ENFORCEMENT AGENCIES. THE PROGRAM FOR INTENSIVE CARE COORDINATION OR PICC TEAM DETAILS OFFICERS, MEDICS AND CLINICIANS TO CONNECT INDIVIDUALS TO SERVICES, ON THE IMPACT TEAM, OFFICERS AND MEDICS COLLABORATE TO WORK WITH MIH HIGH-VOLUME UTILIZERS.

THE SA-CORE PROGRAM WHICH WE'RE LOOKING AT TO DAY AND WE'RE ALL VERY ACTIVE IN STRAC BEHAVIORAL HEALTH COMMITTEE AND SUBCOMMITTEES WHICH WORK TO CONTINUALLY IMPROVE CRISIS MENTAL HEALTH SERVICES IN OUR COMMUNITY. THIS SLIDE SHOWS SAPD'S MENTAL HEALTH 9-1-1 CALLS FROM 2019 TO 2025. THROUGH THE PANDEMIC, WE HAD A PRETTY SIGNIFICANT INCREASE IN 9-1-1 MENTAL HEALTH CALLS, AND AS WE CONTINUE TO DESTIGMATIZE MENTAL HEALTH NEEDS AND OFFER RESPONSE LIKE SA-CORE, WE WILL CONTINUE TO HAVE HIGH CALL VOLUME. THIS STABILIZING AND NOW DECREASING ANNUAL NUMBER SHOWS THAT OUR COMMUNITY HAS FOUND A NEW BASELINE AND THAT PEOPLE ARE PERHAPS BECOMING MORE AWARE OF PROGRAMS THAT CAN HELP THEM IN A CRISIS. I'D LIKE TO POINT OUT THAT THERE'S MANY DIFFERENT WAYS TO SHOW DATA LIKE THIS, AND THIS IS PURE CALL VOLUME, WHICH SHOWS THE WEIGHT ON OUR 9-1-1 CALL CENTER.

THIS DOES NOT SHOW CALL VOLUME COMPARED TO THE POPULATION INCREASE THAT WE'VE SEEN OVER THE LAST FEW YEARS, WITH THE POPULATION INCREASE IN MIND, THESE NUMBERS WOULD SHOW A STEEPER DECREASE. AS YOU SAW ON THE LAST SLIDE IN CALENDAR YEAR 2025, WE HAD 28,800 9-1-1 MENTAL HEALTH CALLS COME INTO SAPD. WHEN CALL TAKERS RECEIVE A CALL WITH A MENTAL HEALTH NEXUS, THEY LOOK TO SEND SA-CORE FIRST AND THEN THE MENTAL HEALTH UNIT. SOMETIMES PATROL IS CLOSER AND READILY AVAILABLE AND PATROL HANDLED 54% OF THESE 9-1-1 CALLS.

IF SA-CORE OR THE MENTAL HEALTH UNIT IS AVAILABLE, ONE OF THOSE TEAMS IS SENT TO THESE CALLS. 34 OF THESE CALLS WERE ADDRESSED EITHER -- OR THEREFORE%, EXCUSE ME, OF -- 34% EXCUSE ME WERE ADDRESSED BY SA-CORE OR THE MENTAL HEALTH UNIT. 12% OF THESE CALLS OVERALL WERE EITHER CANCELED OR DUPLICATED. AS WE'RE TALKING ABOUT THE 28,800 9-1-1 CALLS

[01:25:03]

IT'S IMPORTANT TO UNDERSTAND, HOWEVER, THAT DISPATCHERS WILL SEND YOU THE BEST AND FASTEST RESOURCE AVAILABLE IN A CRISIS.

AND IF THESE SPECIALIZED TEAMS ARE NOT AVAILABLE BECAUSE THEY'RE ON ANOTHER CALL, THEY WILL BE SENDING PATROL. JUMPING INTO THE FY '25 SA-CORE OUTCOMES IT'S HARD TO BELIEVE THAT WE'RE JUST ABOUT TO BEGIN THE FOURTH YEAR OF THIS PROGRAM. THIS STARTED IN APRIL OF 2022, AND WE RAN A SIX-MONTHS OF A PILOT, WHICH WAS ONE TEAM AT 16 HOURS FOR A TOTAL OF -- YEAR OF ONE TEAM AT 16 HOURS, AND WE HAD TOTAL RESPONSES OF 1,326.

FY '24 HAD TWO PHASES OF EXPANSION. WE STARTED THE FISCAL YEAR IN OCTOBER WITH ONE TEAM. ON JANUARY 1ST WE WENT TO THREE TEAMS AT 16 HOUR, AND THEN ON JULY 1ST WE WENT TO THREE TIMES FOR 24 HOURS, AND WE ENDED THAT FISCAL YEAR WITH 3,211 RESPONSES.

AT FY '25 WE HAD ALL THREE TEAMS RUNNING AT 24 HOURS AND THEY HAD A TOTAL OF 5,567 RESPONSES. EACH OF THE THREE TEAMS THAT WORK IN THESE THREE GEOGRAPHICAL AREAS ARE MADE UP OF A MENTAL HEALTH UNIT OFFICER, A MOBILE INTEGRATED HEALTHCARE PARAMEDIC AND A MENTAL HEALTH CLINICIAN FROM CHCS. THE OBJECTIVES OF SA-CORE ARE TO, FIRST OF ALL, RESPOND TO 9-1-1 MENTAL HEALTH CALLS TO ASSIST PEOPLE EXPERIENCING BEHAVIORAL HEALTH CRISES USING THE LEAST RESTRICT APPROACH. YOU CAN SEE THAT ACROSS ALL THREE TEAMS THE MAJORITY OF THE 5,567 CALLS ARE RESOLVED ON SCENE, WHICH WAS 1,367 DAWLS, TAKEN TO A HOSPITAL BY EMERGENCY DETENTION, WHICH IS 1,368 CALLS, OR TRANSPORTED TO ADDRESS ANOTHER NEED, 667 OF THOSE CALLS.

THE SECOND OBJECTIVE IS TO REDUCE UNNECESSARY ARRESTS BY ROUTING PEOPLE TO THE CORRECT LEVEL OF CARE. YOU CAN SEE THAT ONLY ONE PERSON WAS ARRESTED BY THE SA-CORE TEAM IN 2025 -- IN FISCAL YEAR 2025. AND THE THIRD OBJECTIVE IS TO INCREASE ACCESS TO OUTPATIENT SERVICES THROUGH FOLLOW-UP CLINICIANS.

MOST OF THESE INDIVIDUALS ARE BEING ENGAGED BY FOLLOW-UP CLINICIANS.

OF THE 5,567 RESPONSES, THE ONES THAT ARE EMERGENCY DETAINED RESOLVED ON SCENE, TRANSPORTED ANYWHERE BY THE TEAM OR TO HOSPITAL BY EMS RESOLVED BY PHONE OR IF THE TEAM ASSISTS ANOTHER UNIT ARE ALL REFERRED TO FOLLOW-UP. 3,156 OF THESE RESPONSES MET THAT CRITERIA AND WERE REFERRED TO FOLLOW-UP. 2,715 INDIVIDUALS ENGAGED WITH THE FOLLOW-UP CLINICIAN IN SOME WAY. FOLLOW-UP CLINICIANS ENGAGE PEOPLE AT 24 HOURS, SEVEN DAYS, 14 DAYS, 30 DAYS, 60 DAYS AND 90 DAYS AFTER THAT INITIAL RESPONSE. 804 INDIVIDUALS RECEIVED CHCS APPOINTMENTS WITH A CASE MANAGER, THERAPIST OR PSYCHIATRIC PROVIDER OVER THIS TIME. THIS NUMBER OF 804 INDIVIDUALS WITH APPOINTMENTS IS 25% OF THOSE THAT WERE REFERRED TO FOLLOW-UP.

THIS IS A GREAT OUTCOME AND ALSO DOES NOT CAPTURE THOSE WITH APPOINTMENTS ELSEWHERE, WITH PRIVATE PROVIDERS, PEDIATRICIANS, PRIVATE THERAPISTS, THOSE TYPES OF PLACES. ONE THING I WANT TO BE SURE THAT YOU UNDERSTAND IS THAT THIS TEAM IS DEDICATED TO CONTINUOUS IMPROVEMENT FOR THE FRONT-LINE STAFF, BUT MOST IMPORTANTLY FOR THE PEOPLE WHO WILL RECEIVE THIS RESPONSE. WE'RE MEETING EVERY OTHER WEEK TO LOOK AT BARRIERS AND MAKE THINGS BETTER BECAUSE WE KNOW THAT THESE ARE LIFE-SAVING SERVICES AND EVERY PERSON IS DESERVING OF A COMPASSIONATE AND COORDINATED RESPONSE. SO WHAT'S NEXT? THIS YEAR WE'RE TAKING ON EXPLORING A MENTAL HEALTH OPTION FOR PEOPLE CALLING IN TO 9-1-1, AS MARIA STATED. WE'RE WORKING WITH OUR PARTNERS AT STRAC AND CHCS TO EXPLORE A PILOT TO ANSWER AND ADDRESS LOW ACUITY MENTAL HEALTH 9-1-1 CALLS THAT MAY NOT NEED AN EMERGENCY RESPONSE.

WE'RE LOOKING AT LEVERAGING EXISTING TECHNOLOGICAL RESOURCES AND WE'RE FOCUSING ON COLLABORATIVE MODELS THAT WE'RE SEEING WORKING IN OUR COMMUNITY AND OTHER COMMUNITIES. SINCE WE'RE TALKING ABOUT PUBLIC SAFETY AND MENTAL HEALTH, AND THIS COMMITTEE HAS CREATED A SUBCOMMITTEE TO ADDRESS CONCERNS IMPACTING SENIOR ADULTS, WE ALSO WANT TO BRIEF YOU ON OLDER ADULT MENTAL HEALTH. THERE ARE A MYRIAD ISSUES THAT AFFECT THE MENTAL HEALTH OF OLDER ADULTS, LIFE CHANGES, CHRONIC CONDITIONS AND SERIOUS ILLNESSES, GRIEF THAT COMES FROM LOSING LOVED

[01:30:02]

BECAUSE OF THE CHANGES THAT OLDER ADULTS EXPERIENCE AND STIGMA ASSOCIATED WITH MENTAL HEALTH DISORDERS, OLDER ADULTS CAN FEEL LIKE THESE DIAGNOSES ARE UNAVOIDABLE, BUT IN ACTUALITY, OLDER ADULTS USUALLY HAVE MORE ACCESS TO HEALTHCARE THROUGH MEDICARE AND THEIR EXISTING ENGAGEMENT WITH PRACTITIONERS, SO WE WANT TO ENCOURAGE SENIOR ADULTS TO SEEK MEDICAL ATTENTION IF THEY ARE FEELING P PERSISTENTLY SAD, ANXIOUS, LETHARGIC OR HOPELESS. THESE ARE NOT ISSUED THAT ARE TO BE EXPECTED AND TO BE WEATHERED ALONE AND IN ISOLATION.

THERE ARE UNDERLYING PHYSICAL HEALTH INDICATORS THAT PRESENT AT MENTAL HEALTH SYMPTOMS AS WELL. WHEN EMS IS WORKING WITH PEOPLE IN A MEDICAL CRISIS, THEY ARE LOOKING CLOSELY AT SYMPTOMS OF INTOXICATION OR MEDICATION SIDE EFFECTS, INFECTIONS, LIVER OR KIDNEY FAILURE, DIABETIC KETOACIDOSIS, HYPOGLYCEMIA OR DEHYDRATION ANDY MEN THAT TO DETERMINE IF THE MEDICAL EPISODE IS PHYSICAL OR BEHAVIORAL. THIS HELPS PEOPLE GET TO THE RIGHT EMERGENCY SERVICES THAT THEY NEED AT THAT TIME. DIAGNOSES LIKE ALZHEIMER'S ANDY MENTION MIGHT HAVE SYMPTOMS THAT OVERLAP WITH MENTAL HEALTH PROBLEMS -- TRAINED TO IDENTIFY ABUSE, NEGLECT AND EXPLOITATION OF CHILDREN, OLDER ADULTS AND PEOPLE WITH LIVING WITH DISABILITIES.

IF THERE'S ANY EVIDENCE OF ABUSE, NEGLECTED AND EXPLOITATION, FIRST RESPONDERS FOLLOW PROTOCOLS TO INCLUDE REPORTING TO THE FAMI.

JUSTICE SASS CENTER. THERE IS THE SAN ANTONIO OASIS SILVER CONNECT CHAT LINE WHICH THE NUMBER IS (210)756-5551, AND CAN BE ACCESSED MONDAY THROUGH FRIDAY FROM 5:00 P.M. TO 9:00 P.M. AND SATURDAY AND SUNDAY FROM 9:00 A.M.

TO 9:00 P.M. THROUGH DELEGATE AGENCIES WE SUPPORT MEALS ON WHEELS FRIENDLY VISITOR PROGRAM AND I ALWAYS WANT TO MAKE SURE THAT PEOPLE ARE AWARE OF THE MERNLT L HEALTH PORTAL ON -- AUDIO] -- SLIDING SCALE AND NO COST MENTAL HEALTH SERVICES.

THANK YOU FOR THIS OPPORTUNITY TO PRESENT TO YOU TODAY.

WE HAVE FOLKS FROM THE POLICE, FIRE AND HUMAN SERVICES DEPARTMENTS, STRAC, CHCS AND MYSELF HERE TO ANSWER ANY QUESTIONS YOU MAY HAVE.

>> KAUR: THANK YOU SO MUCH FOR THE PRESENTATION.

WE DON'T HAVE ANYBODY SIGNED UP TO SPEAK SO WE'LL GO AHEAD AND GO INTO COUNCIL DISCUSSION ON THIS. ANY OF MY COLLEAGUES LIKE

TO GO FIRST? COUNCILMEMBER SPEARS? >> SPEARS: THANK YOU, CHAIR. THANKS, JESSIE FOR THAT PRESENTATION.

IT WAS REALLY GOOD. I REMEMBER WHEN I TOURED STRAC AT THE COUNTY AND LEARNED SO MUCH ABOUT HOW WE INTEGRATE OUR SERVICES AND Y'ALL ARE DOING AN AMAZING JOB, AND WE'RE REALLY THANKFUL. I HAD A COUPLE OF QUESTIONS ABOUT SA-CORE. HOW MANY -- DO YOU HAVE AN IDEA OF HOW MANY MORE TEAMS WOULD BE HELPFUL OR BREAK EVEN POINT WHERE WE'RE MEETING THAT NEED

OVERALL, OR ARE WE GOOD WITH THREE? >> THAT'S A GREAT QUESTION. SO BU ONE OF THE THINGS THAT ALWAYS COMES UP AND WE ALWAYS WANT TO PAY ATTENTION TO THAT, ONE OF THE THINGS I WANT TO HIGHLIGHT IS THAT THE GEOGRAPHIC DISTRIBUTION SOMETIMES HAS TO DO A LITTLE BIT WITH HOW PEOPLE ARE ABLE TO NAVIGATE THE CITY, GET THROUGH TRAFFIC. YOU CAN SEE THAT THE REGIONS ARE PRETTY LARGE, AND SO WE'RE ALWAYS LOOKING AT HOW DO WE CUT DOWN THE RESPONSE TIME SO THAT PEOPLE -- SO THAT SA-CORE IS ABLE TO GET THERE FASTER.

WHEN WE THINK ABOUT EXPANSION, WE ALSO WANT TO LOOK AT CALL VOLUMES DURING TIMES OF DAY. YOU MIGHT THINK THAT WE WOULD HAVE MORE CALLS OVERNIGHT OR THINGS LIKE THAT, BUT ACTUALLY, ONLY ABOUT 27% OF OUR VOLUME CAME IN OVERNIGHT. YOU KNOW, PEOPLE DO SLEEP AND PEOPLE ARE IN BED OR MAYBE EVEN THE CALLS ARE MORE ACUTE AND THEY'RE HANDLED QUICKLY BY EMS, IF IT'S AN OVERDOSE OR BY PATROL BECAUSE THEY'RE ABLE TO GET THERE FASTER. SO WHEN WE LOOK AT EXPANSION, I THINK WE'RE INTERESTED IN THIS -- STEPPING INTO THE DISPATCH AND INTO THE

[01:35:02]

SO THAT'S NOT A PERFECT ANSWER, BUT WE DO THINK THAT THIS IS THE NEXT STEP IN HOW WE GET TO THAT ANSWER, IF WE NEED MORE TEAMS.

>> SPEARS: SO THAT WAS PART OF MY SECOND QUESTION.

AND ASKING, TOO, ARE WE TRACKING BEYOND THE VOLUME OF CALLS WITH REGARD TO REPEAT CALLS OR AVOIDED DETENTIONS AND JUST THE OUTCOMES THAT WE

CAN SEE THERE? >> SO REPEAT CALLS ARE ALSO KIND OF DIFFICULT.

9-1-1 CALLS COME IN, GEOSPZ LOCATED TO AN ADDRESS, NOT NECESSARILY TO A PERSON. AND SO WE ARE LOOKING AT ADDRESS-BASED CALLS, WE ARE LOOKING AT PHONE NUMBER AS WELL AS OF REPEAT PHONE NUMBERS THAT CALL IN. AND, OF COURSE, THERE ARE SOME REPEATS, SOME OF THOSE REPEATS ARE FACILITIES OR -- FACILITIES OR ORGANIZATIONS IN OUR COMMUNITY THAT HAVE A HIGH VOLUME OF PEOPLE THERE THROUGHOUT THE DAY OR EVENING, AND SO THERE ARE REPEATS, BUT IT'S NOT

ALWAYS THAT EASY FOR US TO IDENTIFY. >> SPEARS: I CAN SEE THAT. I CAN SEE THAT. OKAY.

ARE YOU -- HAVE YOU ALREADY LOOKED AT WHAT THE PILOTING OF THAT INITIATIVE WOULD COST US WITH REGARD TO, LIKE, STAFFING, TECHNOLOGY, OR

OPERATIONAL COSTS? >> SO WE'RE STARTING TO LOOK AT THAT.

WE ALSO HAVE GREAT PARTNERS, I THINK, HOUSTON AND AUSTIN ARE BOTH HAVING CLINICIANS THAT WORK IN THEIR -- CENTERS. WE'RE LOOKING AT IF WE CAN USE OTHER MODELS, IF WE CAN HOUSE PEOPLE IN THE PSAP, HOUSE PEOPLE AT STRAC AND MED COM, IF WE CAN USE EXISTING POSITIONS THAT ARE NOT FILLED, AND SO TO GET A PILOT, WE'RE TRYING TO LOOK AT THE LOWEST COST AS WE CAN FOR THE PILOT AND BUILDING OUT WHAT IT WOULD TAKE TO FULLY STAFF THAT.

>> SPEARS: OKAY. AND JUST -- I WANTED TO EMPHASIZE, I REALLY APPRECIATE THE INFORMATION ABOUT THE SPECIAL NEEDS UNIQUE TO OLDER ADULTS AND THAT THERE'S OFTEN THAT PHYSICAL PIECE TO IT THAT IS THE UNDERLYING ISSUE OR THE MAIN ISSUE REALLY, OFTEN, AND THE ISOLATION PIECE, BECAUSE I GO TO MY SENIOR CENTER AT LEAST A COUPLE TIMES A WEEK, AND EVEN I AT THIS -- YOU KNOW, NOTICE WHEN SOMEONE'S GONE FOR A WHILE, BUT I MEAN, GETTING TO THEM IS THE CHALLENGE AND REALLY IT IS THE MEDICAL TEAMS THAT -- OR THEIR PHYSICIANS THAT THEY SEE THAT ARE GOING TO BE BEST ABLE TO HELP US WHEN IT COMES TO THE ISOLATION PIECE AND THEN IDENTIFYING THE DEMENTIA AND ALL THOSE THINGS, SO I APPRECIATE YOU FOCUSING ON THAT AND IT'S SUCH A SAD STATE OF AFFAIRS IN OUR COUNTRY AND IN SAN ANTONIO THE WAY WE NEGLECT OUR OLDER POPULATION. SO I'M SUPER FOCUSED ON HOW WE CAN BETTER SERVE

THEM. SO THANK YOU FOR THAT. >> YEAH.

THANK YOU FOR BRINGING THAT UP AND ASKING US TO PRESENT ON THAT.

IT -- FEELING THE EFFECTS OF ISOLATION AND LONELINESS ISN'T SOMETHING THAT ANYONE SHOULD HAVE TO ENDURE ALONE, AND SO BECAUSE OLDER ADULTS DO HAVE MEDICARE OFTENTIMES AND DO HAVE ACCESS, WE WANT TO JUST MAKE SURE THAT THEY UNDERSTAND THAT THAT'S NOT JUST A NORMAL PHASE OF LIFE. IT'S SOMETHING THAT THEY CAN ADDRESS WITH THEIR TREATMENT TEAMS AND THEN -- LIKE IN THE COMMUNITY SERVICES THAT WE HAVE. WE'RE JUST ONE SLIVER OF THOSE PROVIDERS AS WELL.

YEAH. >> KAUR: THANK YOU, COUNCILWOMAN.

COUNCILWOMAN CASTILLO? >> CASTILLO: THANK YOU, CHAIR, AND THANK YOU, JESSIE FOR THE PRESENTATION. I'M PLEASED TO SEE UNDER THE CONTINUATION OF WORK THE MENTAL HEALTH OPTION FOR 9-1-1.

WHEN CAN WE ANTICIPATE THE IMPLEMENTATION OF A MENTAL HEALTH OPTION.

COUNCILWOMAN, WE JUST STARTED THE CONVERSATIONS, SO I DON'T HAVE AN ANSWER FOR THAT; HOWEVER, WE CAN -- ONCE WE START GETTING MORE INTO THE DETAILS, WE CAN BRING AN UPDATE OR SEND A FOLLOW-UP MEMO, JUST TO

KIND OF GIVE YOU AN IDEA. >> CASTILLO: OKAY.

THANK YOU. I APPRECIATE THAT. I KNOW THIS IS SOMETHING THAT'S BEEN COMING UP OVER THE LAST FEW YEARS, AND I JUST WANT TO HELP SUPPORT THAT MOVE ALONG. CAN YOU WALK US THROUGH IN TERMS OF EXPLORING A PILOT TO ANSWER AND ADDRESS LOW ACUITY MENTAL HEALTH CALLS? LIKE WHAT DO Y'ALL ENVISION IN TERMS OF THAT PILOT PROGRAM?

>> VILLAGOMEZ: SURE. IF I CAN ASK ERIK EPLEY, MAYBE, TO HELP US WITH THAT. HE'S BEEN WORKING MORE IN DEPTH.

[01:40:05]

>> EPLY: SO THERE'S SEVERAL MODELS WE'RE LOOKING AT, ONE OF THEM LEVERAGES THE SOFTWARE THAT WE'RE ALREADY USING IN SOME OF THE DISPATCH CENTERED CALLED GOODSAM. THERE'S SOME OTHER SOFTWARES LIKE BULSERA THAT [INAUDIBLE] AGENCIES AND LAW ENFORCEMENT ARE USING TODAY.

ONE OF THE THINGS WE'RE GOING TO LOOK AT SPECIFICALLY -- YOU KNOW, STRAC HAS MEDCOM, IT'S A 24/7 COMMUNICATION CENTER, IT'S BEEN TALKED ABOUT ALREADY WHERE THE LAW ENFORCEMENT NAVIGATIONS ARE OCCURRING. IT DAWNS ON US, ONE OF THE BIGGEST CHALLENGES THAT WE HAVE IS THE NUMBER OF LICENSED CLINICIANS, MENTAL HEALTH CLINICIANS THAT ARE AVAILABLE. WE STRUGGLE SORT OF TODAY WITH THE CORE TEAM AND WITH ALL OF THE OTHER TEAMS WE HAVE IN THESE COMMISSIONS, AND SO, ONE, I THINK, KELLY VERNUM IS HERE WITH ME, SHE'S OUR DIRECTOR FOR THE CRISIS COLLABORATIVE, ONE OF THE THINGS THAT KELLY AND I WORRY ABOUT LOOKING AT THE WHOLE SYSTEM IS, I THINK WE HAVE 13PSAPS IN BEXAR COUNTY. IF YOU IMAGINE HAVING TO STAFF THOSE 24/7 WITH COMMISSIONS -- AS SOON AS ONE HAS IT, ANOTHER ONE'S GOING TO WANT IT.

YOU KNOW, THE "ME TOO" EFFECT. AND SO A CONCEPT THAT WE'RE LOOKING TO AND WANT TO EXPLORE SOME IS MAYBE HAVING THAT CENTRALIZED, AND THEN IT WOULD LOWER COSTS FOR EVERYBODY AND IT WOULD LOWER THE IMPACT OF THE CLINICIANS. SO YOU COULD ACTUALLY TRANSFER THAT CALL AND HAVE THEM HOP ON OR WHAT THEY CALL BARGE ONTO THOSE CALLS SO THE MENTAL HEALTH'S PERSON'S ON WITH THE PSAP CALL TAKER, WHICH WOULD HELP EVERY PUBLIC SAFETY ANSWERING POINT IN TOWN, NOT JUST SAPD, SAFD.

THAT'S ONE IDEA THAT MIGHT WORK. I DON'T KNOW IF IT WILL WORK YET OR NOT. WE'RE REALLY JUST IN THE VERY EARLY BEGINNINGS OF THIS. ANOTHER BIG ADVANTAGE THAT WE JUST FINALLY EXECUTED TODAY IS AGREEMENT WITH CORY RUN. SO STRAC MED COM WILL ALSO BE COLOCATING AT CORY RUN WHICH IS WHERE PD AND FIRE CURRENTLY ARE COLOCATED AT THAT SITE AND WE WILL BE THERE A LITTLE BIT LIKE FIRE AND PD GO NOW, WHERE THEY GO OUT MAYBE ON THE WEEKENDS OR CERTAIN SCHEDULES, BUT THEY MAINTAIN BOTH SITES WHICH GIVES US REDUNDANCY.

WE'RE GOING TO BE BEYOND THE VISTA OF PHONE SYSTEM, WHICH WILL MAKE ALL OF THIS NAVIGATION REALLY, REALLY SIMPLE IN THE WAYS THEY CURRENTLY TRANSFER CALLS. I DON'T KNOW IF YOU KNOW, BUT A LOT OF 9-1-1 CALLS COULD BE IN ALAMO HEIGHTS ON ONE SIDE OF BROADWAY VERSUS THE OTHERS, SO HAVING A SYSTEM THE MIMICS THE WAY WE DO 9-1-1 NOW, WE'RE ALREADY ON THE REGIONAL CAD, SO THERE'S SOME REAL GOOD IDEAS THERE THAT YOU COULD TRUE UP AT THE END OF THE MONTH AND PAY WHAT YOU USED, BUT NOT HAVE TO FUND THE ENTIRE, YOU KNOW -- IT'S MUCH MORE IMPORTANT TO ME ABOUT THE CLINICIAN AVAILABILITY THAN IT IS THE -- I'D HATE FOR US ALL TO TRIP MRI KATE, DUPLICATE -- [INDISCERNIBLE] THAT ARE ON BOARD ARE THEY

CONTRACTED OR WITH A SPECIFIC ENTITY? >> SO ALL OF OUR CLINICIANS ARE THROUGH THE CENTER. WE THINK THAT'S THE SAFEST WAY, WE CAN CONNECT THEM BACK INTO SERVICES, IT'S AN

INTEGRATED PROCESS, SO YES. >> CASTILLO: I'M ASSUMING THERE HAVE BEEN CONVERSATIONS WITH THE UT SCHOOL OF NURSING ON

CREATING A TRACT? >> YEP, WE ALREADY HAVE A TRACT AND WE'VE BEEN WORKING WITH THE CENTER -- THEY'VE CREATED AN ENTIRE JOB DESCRIPTION CALLED CRISIS RESPONSE CLINICIANS, SO, YOU KNOW, MANY TIMES MENTAL HEALTH CLINICIANS THOUGHT THEY WERE GOING TO BE WORKING IN A -- YOU KNOW, COUNSELING ENVIRONMENT AND 72° AND IT'S NICE AND A FLUFFY HOUSE SLIPPERS, IT'S VERY COMFORTABLE. WE'RE TALKING ABOUT GOING OUT ON THE FRONT PORCH OF A 9-1-1 CALL AND THAT'S REALLY A DIFFERENT SHIFT FOR A MENTAL HEALTH CONDITION, SO FINDING THOSE PEOPLE THAT ARE INTERESTED IN PRACTICING MENTAL HEALTH IN A PUBLIC SAFETY-ISH-TYPE MINDSET HAS BEEN -- THE ONES THAT DO IT, LOVE IT. IT'S A PERCENTAGE OF, YOU KNOW, THE SUM OF CLINICIANS AVAILABLE. AND SO WE REALLY SPENT A LOT OF TIME TRYING TO MAKE SURE WE GET THE MOST BANG OUT OF THE BUCK OUT OF EVERY SINGLE

CLINICIAN. >> CASTILLO: THANK YOU SO MUCH FOR PAINTING THAT PICTURE. IT'S HELPFUL. I DID HAVE A QUESTION IN TERMS OF -- I THINK THIS MAY BE FOR PD, THANK YOU, REGARDING WHEN AN INDIVIDUAL CALLS 9-1-1 AND ASKS SA-CORE, IF THE SA-CORE UNIT IS NOT AVAILABLE, IS PD TRACKING THAT CORE IS OR IS NOT AVAILABLE TO RESPOND TO

THAT CALL? >> HI, COUNCILMEMBER. WE ARE NOT CURRENTLY

TRACKING THAT. >> CASTILLO: AND I THINK THERE WOULD BE VALUE TO HELP US, COUNCIL, UNDERSTAND IN TERMS OF WHERE WE SHOULD BE ALLOCATING FUNDING. I KNOW THERE'S BEEN AN INSTANCE WHERE WE HAD A CONSTITUENT SHARE THEIR EXPERIENCE AND IT WAS AN VAID THAT DID HAVE MENTAL HEALTH ISSUE, AND WHEN THEY SAW SOMEONE IN REGULAR UNIFORM, IT

[01:45:03]

>> YEAH, SO WHEN THE CALL COMES IN -- I'LL SPEAK FOR THE PD SIDE, THAT'S GOING TO BE DISPATCHED LIKELY AS A SUICIDE IN PROGRESS, SO THAT'S GOING TO BE THE NEAREST AND CLOSEST AVAILABLE UNITS TO MAKE THE SCENE.

NOW, IF THEY GET OUT TO THE SCENE AND THEY'RE TRYING TO TALK SOMEBODY OFF OF I-10, THEN WE WILL DISPATCH EITHER SA-CORE OR THE HOSTAGE NEGOTIATOR IF TIME PERMITS AND WE'LL MARSHAL UP ALL THE RESOURCES WE CAN GET.

SO I DON'T KNOW IF THAT ANSWERS YOUR QUESTION ON THE PD SIDE.

>> CASTILLO: OKAY. THANK YOU, CHIEF. THANK YOU, CHAIR.

>> KAUR: THANK YOU, COUNCILWOMAN. I WANT TO ECHO SOME OF THE COMMENTS AND HAVE A COUPLE OF ADDITIONAL QUESTIONS ON DATA.

I KNOW Y'ALL ARE SHOCKED BY THAT. SO ON THE SPECIFIC CALL SLIDE THAT YOU JUST HAD UP, THIS ONE ACTUALLY, THE 54% THAT ARE ADDRESSED BY PATROL, CAN YOU TELL ME A LITTLE BIT ABOUT HOW THAT OCCURS? LIKE HOW IS THAT PRIOR TO -- IS LIKE SA-CORE AD ATTEMPTED AND THEN THEY'RE NOT AVAILABLE AND SO THAT'S WHY IT'S TAKEN TO PATROL.

WHAT'S THE ORDER OF OPERATIONS, I GUESS? >> SURE.

SO WHEN WE HAVE MENTAL HEALTH CALLS THAT COME INTO 9-1-1, WE HAVE THREE MAIN CALL TYPES, THEY'RE MENTAL HEALTH ROUTINE, MENTAL HEALTH IN PROGRESS AND MENTAL HEALTH DISTURBANCE AND THEY ALL HAVE DIFFERENT TYPES, ACUITIES, AND THEY COULD ALSO HAVE TO DO IF THEY'RE A DUPLICATE CALL OR HAVE BEEN CALLED MULTIPLE TIMES. SO THE FIRST THING A CALL TAKER IS GOING TO LOOK AT -- THE FIRST THING A DISPATCHER IS GOING TO DO IS LOOK AND SEE IF SA-CORE'S AVAILABLE, IS THE MENTAL HEALTH UNIT AVAILABLE IF SA-CORE'S NOT AVAILABLE AND THEN TO CHIEF SALAMANE'S POINT IF IT'S SOMETHING ACUTE, EMERGENT, A SUICIDE IN PROGRESS, THEN WE NEED TO GET THE CLOSEST RESOURCE NO MATTER WHAT AS SOON AS POSSIBLE.

THAT'S WHOW HOW YOU GET THE 54% ANSWERED BY PATROL.

PATROL IS OFTENTIMES -- WE HAVE THREE SA-CORE TEAMS WORKING AT THE SAME TIME 24/7, BUT ONLY THREE. SO PATROL IS CLOSER, AVAILABLE, IF SA-CORE IS ALREADY ON A CALL, THEN WE'RE GOING TO SEND PATROL TO THOSE. AND THEN SOMETIMES THESE ROUTINE MENTAL HEALTH CALLS ARE -- YOU KNOW, OUR OFFICERS ARE ALL CRISIS INTERVENTION TRAINED, THEY'RE ALL GOING THROUGH THE CRISIS INTERVENTION 2.0 TRAINING, IF IT'S THAT TIME, AND SO THEY'RE ALSO ABLE TO ADDRESS THESE -- PERFORM AN EMERGENCY DETENTION, WHICH TAKES PEOPLE TO A HOSPITAL INSTEAD OF TO JAIL OR ANYWHERE ELSE, AND GET THE PEOPLE TO THE

TREATMENT THEY NEED AT THE RIGHT TIME. >> KAUR: FOR SURE.

AND JUST LIKE THE REASON WE'RE ASKING THAT, RIGHT, TO COUNCILWOMAN CASTILLO'S POINT, THESE CALLS ARE BEING ADDRESSED BY SOMEONE, RIGHT? SO WE CAN TAKE -- WE WANT THEM TO BE ADDRESSED BY THE INDIVIDUAL'S THAT ARE MOST PREPARED AND BEST SUPPORTED TO ANSWER THEM AND ARE GOING TO HELP THE CONSTITUENTS. AND THE DATA ON IT, I REMEMBER SEEING THE SLIDE -- THIS SLIDE 8 DURING BUDGET, AND IT'S INCREDIBLE, RIGHT? THERE'S NO ARGUING HOW SUCCESSFUL THE PROGRAM HAS BEEN.

AND SO I THINK IF MAYBE WHAT ONE THING MIGHT HELP IS IF YOU GIVE US COMPARISON DATA. SO IF YOU CAN SHOW US THIS SIMILAR SLIDE FOR THE MENTAL HEALTH UNIT AND ALSO FOR THOSE OTHER 54% OF CALLS, AND THEN MAYBE ASTERISKS ON THE BOTTOM THAT SAYS THESE ARE THE TYPES OF DAWLS OR SOMETHING BROKEN OUT. BECAUSE I UNDERSTAND SOMETHING MORE ACUTE IS GOING TO HAVE A LITTLE BIT OF DIFFERENT RESULTS. SO IF YOU CAN SHOW US, LIKE, THESE ARE THE -- MAYBE BREAKING DOWN THE TYPES OF RESPONSES OR THE TYPES OF CALLS AND DOING THIS STYLE OF RESPONSE FOR EACH OF THOSE THREE UNITS, SO WE CAN REALLY HAVE -- MAYBE KE CAN GET THAT IN A FOLLOW-UP MEMO SO WE CAN COMPARE. BECAUSE I THINK AT LEAST FOR WHAT WE'VE HEARD IS THE SENTIMENT -- AND WE TALKED ABOUT THIS, COUNCILMEMBER SPEARS MENTIONED THE OLDER ADULTS COMPONENT, AND I DON'T KNOW THE LEVEL OF SUPPORT THAT -- I'M FOR CERTAIN THAT THE ST. A CORE FOLKS ARE TRAINED ON LIKE HOW TO RECOGNIZE DEMENTIA AND THINGS LIKE THAT, AND SO MAKING SURE THEY HAVE THE OPPORTUNITY TO ANSWER CALLS WITH OLDER ADULTS IS IMPORTANT, TOO. SO ALL OF THAT TO SAY, I THINK IT WOULD BE HELPFUL

[01:50:02]

ANY COMMENTS? >> MCKEE-RODRIGUEZ: NO, JUST THANK YOU FOR THE

PRESENTATION. >> KAUR: COUNCILWOMAN CASTILLO?

>> CASTILLO: THANK YOU, CHAIR. I JUST WANTED TO HIGHLIGHT AN INTERSECTION, LAST WEEK MY TEAM MET WITH DR. LOZANO AND A COUPLE OF FOLKS FROM UNIVERSITY HEALTH, WHAT THEY HIGHLIGHTED IS THE TREND OF INDIVIDUALS AT THE COUNTY JAIL EXPERIENCING EARLY ONSET DEMENTIA OR HAVE DEMENTIA, AND I THINK THIS OVERLAPS WITH THAT WORK AND THE NEED TO ESTABLISH THAT DIVERSION CENTER, BECAUSE WE ARE SEEING THAT INCREASE. AND I THINK ABOUT ONE OF OUR CONSTITUENTS WHO HAS EARLY ONSET DEMENTIA AND HE OFTEN GETS INTO -- BACK AND FORTH WITH HIS LANDLORD, RIGHT, AND HE'LL COME TO OUR OFFICE.

BUT OFTENTIMES HE FINDS HIMSELF A BIT AGITATED AND WE'RE ALWAYS HAVING TO RELOCATE HIM AND GET HIM CONNECTED TO MORE HOUSING AND WALK HIM THROUGH THE PROCESS OF HOW TO NAVIGATE HIS HOUSING SITUATION, SOMETIMES HE FINDS HIMSELF LIVING IN HIS CAR UNTIL WE CAN GET HIM REHOUSED, BUT JUST HIGHLIGHTING THAT OVERLAPPING CONNECTION, PARTICULARLY WITH INDIVIDUALS WITH DEMENTIA.

AND I'M GRATEFUL FOR THE WORK AND OVERLAP THAT THE TEAM IS DOING WITH OUR SENIORS AND THE SENIOR CENTERS BECAUSE IT'S VERY MUCH NEEDED, AS THE

COUNCILWOMAN MENTIONED. THANK YOU, CHAIR. >> KAUR: THANK YOU, COUNCILWOMAN. ALL RIGHT. THAT'S ALL WE HAVE FOR OUR PUBLIC SAFETY AGENDA, BUT I DID WANT TO GIVE A QUICK SHOUTOUT, MANY OF Y'ALL HAVE PROBABLY HEARD, OUR LONG-TERM SERVING CHIEF HAS DECIDED TO RETIRE. I KNOW WITHER OO GOING TO HAVE MANY CELEBRATIONS FOR YOU THIS UPCOMING YEAR, BUT I -- AS THE PUBLIC SAFETY COMMITTEE CHAIR JUST WANTED TO SAY THANK YOU FOR SO MANY YEARS OF SERVICE AND FOR GIVING US A LONG RUNWAY, SO NOT -- SO WE HAVE TIME TO HELP YOU TRANSITION.

SO IF WE COULD ALL GIVE A ROUND OF APPLAUSE TO CHIEF MCMANUS FOR HIS YEARS OF SERVICE. [APPLAUSE] I THINK COUNCILWOMAN ALDARETE GAVITO RELEASED A STATEMENT TALKING ABOUT YOUR EFFECTIVE WAY OF COMMUNICATING WITH RESIDENTS, AND WE REALLY APPRECIATE EVERYTHING.

AT 3:59 P.M. THIS SESSION IS ADJOURNED AND I KNOW COUNCILWOMAN CAS TOE OWE IS HAVING A PRESS CONFERENCE IF ANYBODY WOULD LIKE TO

* This transcript was compiled from uncorrected Closed Captioning.