The City of San Antonio will soon launch a pilot program that will send specially-trained police officers, paramedics and licensed clinicians to certain 911 calls that involve mental health.
The multidisciplinary team, now called SA Core, for Community Outreach and Resiliency Effort, is aimed at reducing arrests by instead connecting people to the mental health services they need during a crisis. The one-year, $1.7 million pilot is funded through the city’s 2022 fiscal year budget.
A formal launch is slated on April 18.
The program has been in development for at least a year and a half. The need for a specialized team emerged as part of the city’s police services review in 2020 in response to protests in the wake of the police killing of George Floyd. By August of last year, the city had largely settled on a model based in part on the Dallas police department’s successful and growing program.
SA Core will start by covering the San Antonio Police Department’s Central substation’s territory, which includes downtown and much of the near west and north sides, seven days a week. Two shifts will cover 7 a.m. to 11 p.m., answering mental health-related calls that do not involve weapons, Eric Epley, executive director of Southwest Texas Regional Advisory Council, told a council committee on Monday.
The police officer’s role will be to ensure that the scene is safe for the patient and the other team members. The clinician — provided by the Center for Health Care Services — will perform behavioral health assessments, and the paramedic will address physical health concerns, Epley said. The team will then decide how to proceed.
Epley said he hopes most situations can be resolved on-site by connecting patients with their existing physician or medication. The team can also provide voluntary courtesy rides to family members, physicians or facilities. Per state law, only the police officer has the authority to order emergency detention against a patient’s will.
The work won’t stop once the call is done, Epley said. SA Core will connect patients to follow-up care through a case manager provided by various nonprofit partners or a private provider if they have insurance.
“It’s not just about their mental health care, but also things like social services and food, housing and benefits,” he said. “We want to make sure we take care of all those things for patients.”
Bexar County started a similar program in 2020, two months after a sheriff’s deputy killed a combat veteran experiencing a mental health episode. The Specialized Multidisciplinary Alternate Response Team (SMART) has seen promising results, expanding to two teams in 2021 and increasing coverage to include weekends, 24 hours a day, earlier this year.
Of the 934 calls SMART responded to from October 2020 to December 2021, the vast majority, 84%, resulted in someone receiving help from the Center for Health Care Services for the first time.
None of those calls required use of force, Epley told Bexar County Commissioners in February. Police reform advocates have argued that police officers aren’t needed on these calls. But Center for Health Care Services CEO Jelynne LeBlanc Jamison said for a small percentage of calls, a law enforcement presence is required, for everyone’s safety.
“I take sending my employees out on these calls very seriously,” Jamison said. “We have exclusionary criteria before we send our teams out to respond to these calls. If there’s an individual with an active warrant, if there’s an individual known to be violent, we call on law enforcement, because they are the ones trained to manage those situations.”
For the SMART team, fewer than half of calls were resolved at the scene or with a patient transported to a care facility, meaning the call was resolved relatively quickly, and did not result in detention.
STRAC, along with Meadows Mental Health Policy Institute, will collect similar metrics to measure SA Core’s results, Epley said. They will also track calls that could have received a SA Core response, but are outside of the central substation’s service area, to help gauge citywide need for possible future program expansion.
Councilwoman Ana Sandoval (D7) said the city should fund “at least one more” SACore team in next year’s budget, even though the pilot program will have less than five months of data by the time Council votes on the 2023 budget in September.
Her suggestion got pushback from Councilman Clayton Perry (D10), who said he wouldn’t support an additional unit “until we start to get some input from this pilot.”
Police reform groups, including Texas Center for Justice & Equity and ACT 4 SA, have called for the creation of a community advisory group to oversee the pilot, review the metrics and make recommendations for improvement. Such boards have been formed in other cities that have similar multidisciplinary response teams.
“It’s obviously important that we’re tracking meaningful data and that data is tracked in an accessible and transparent way, but what is also important is that the community has a voice in what that meaningful data looks like,” said Justin Martinez, a policy analyst for the Texas Center for Justice & Equity, “… and in every other key decision-making process in this program.”
The Center for Health Care Services offered up its existing Center Advisory Council, which includes people who have first-hand experience with mental health, to serve as an oversight board.
But Councilman Jalen McKee-Rodriguez (D2) suggested that a separate advisory group could be formed, perhaps appointed by council members.
City staff will return to the committee next month with options for how to structure that group, including the Center for Health Care Services option.
