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Though Del Norte County’s new mobile crisis unit is set to roll out on Monday, it probably won’t be available 24-7 just yet, Deputy Director for Behavioral Health Shiann Hogan told Del Norte County supervisors Tuesday.

In addition to still waiting on the actual van, Del Norte Behavioral Health Branch’s Providing Access To Hope (PATH) program is in the process of recruiting staff. It’s also struggling to find a dispatch service that can field calls from people needing help, Hogan said.

“We have reached out to countless partners, including 988, the National Suicide [Prevention] Hotline — we have a regional office that handles calls in our area. Right now they don’t have the capacity to do it,” she said. “We reached out Bay City Ambulance dispatch that works with Del Norte Ambulance and they don’t have capacity at the moment either. And we also reached out to our current after-hours crisis line to see what they have. They also don’t have the capacity right now.”

Behavioral Health is prepared to handle those calls, Hogan said. The mobile crisis hotline is established and currently rings to her desk, but she doesn’t have the staff to answer those calls 24 hours a day.

“The initial roll-out in July may not be the 24-7 we envisioned,” Hogan said. “It may be Monday through Friday from 8 to 5 or Monday through Friday from 10 to 7 or something. We’ll figure that out in the next week here.”

According to Hogan, California counties are required to offer community-based mobile crisis services. This came about after the American Rescue Plan Act in 2021 allowed states to add those services as a covered benefit under Medicare.

They can respond to a variety of crises, including someone who is suddenly without their psychiatric medications and begins to feel symptoms as well as someone in recovery who is feeling the need to use again.

Del Norte County began setting up its mobile crisis response unit back in 2021 when it received a $500,000 Behavioral Health Community Infrastructure Program grant. Those dollars paid for a needs assessment for the program through the Indigo Project and, after the award was increased to more than $2 million, is being used toward PATH’s infrastructure.

According to Hogan, the Behavioral Health Branch has already purchased the needed computers and cell phones. Though the county has received quotes for the van itself, which is expected to cost about $260,000, it likely won’t be available until this fall.
Hogan showed supervisors a visual concept of what the van will look like.

“It will have two desk spaces,” she said. “There will be a spot where somebody can come in and sit and be seen by our team.”

Behavioral Health aims to hire eight people to staff the mobile crisis unit. This includes certified peer support specialists and behavioral health specialists. The application period for the peer support specialist closed June 20. The county will start to recruit for behavioral health specialists soon, though they’re also looking internally, Hogan said.

The Behavioral Health Branch is expected to bring side letter agreements with the Del Norte Employees Association SEIU 1021 before the Board of Supervisors related to the roll-out of the PATH program, Hogan said.

Supervisors will also see proposed memorandums of understanding (MOUs) with Behavioral Health and the Del Norte County Sheriff's Office and Crescent City Police Department soon as well, she said.

“There will definitely be times when we may need to hand off calls to one another,” Hogan said. “This MOU will outline those types of responsibilities, along with training, and some kind of mutual aid [agreement] with each other.”

Behavioral Health will also seek an MOU with Del Norte Ambulance  in the future outlining a collaborative response if someone also has a medical need in addition to a mental health need, she said.

The mobile crisis unit’s staffing challenges prompted comment from Board Chairman Dean Wilson on state mandated programs and whether Del Norte will be penalized for the delay in fully implementing the program.

“I’m sure we’re not going to be the only one that is having problems,” he said.

Hogan said she anticipates the state to implement some kind of corrective action if Del Norte County is unable to meet the state mandate. Those actions could include requiring the county to offer internal recruitment incentives such as loan forgiveness and having ongoing recruitment and advertising those jobs in certain places.

She said she also anticipates there will be some kind of sanctions involved, though state officials haven’t mentioned what they might be.

“I think as long as the state sees we have a corrective action plan, that we’re trying to get to the mandate and we can show them through meetings what steps we’ve taken, I imagine they will allow us to continue,” she said. “In my experience with the state, as long as we’re showing forward progress we’re usually fine and in compliance.”

During her presentation, Hogan included a list of the agencies Behavioral Health has partnered with to implement PATH.

This includes Sutter Coast Hospital. According to Hogan, the hospital provided $286,000 in Carestar Funding dollars to help the Behavioral Health Branch staff PATH. Those dollars are used to provide street-based care to patients in an effort to avoid a trip to the hospital, according to Hogan.

Hogan also mentioned the hospital’s effort to establish its EMPATH Unit.

“The EMPATH Unit would be an adjunct to the emergency room,” she said. “The EMPATH Unit would have a psychiatric focus and be a comfort environment. Our staff would go in and safety plan and/or seek hospitalization [for a patient] or whatever is necessary.”

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