Alternative Street Response
Portland, OR
Population: 500,000 - 1,000,000 | Government type: County | Topic: First Response
Photo: Portland Street Response
The Program
Portland Street Response (PSR) is a new civilian first response program for non-emergency calls regarding individuals who may be experiencing houselessness and/or a mental or behavioral health crisis.
In June 2019 the city funded the PSR program with $500,000 in one-time general funds for its pilot year starting July 1, 2019. The following month, five working groups convened to begin drafting the program implementation plan, focusing on (1) community engagement, (2) call transitioning, (3) internal logistics, (4) external logistics, and (5) system mapping and alignment. More than 50 stakeholders contributed to the plan development, including advocates, service providers, nonprofit organizations, public safety officials, researchers, and government staff. The office also solicited additional feedback and engagement from advocates and providers unable to participate in the stakeholder group.
In November 2019, the Portland City Council unanimously approved the pilot program implementation plan, to be housed at Portland Fire and Rescue. The plan allocated one team, or unit, of two staff members each assigned to a geographically-bound area within the city.
Finally, for the FY 2020–21 city budget, Commissioner Hardesty successfully worked to divest $15 million from the police bureau, $4.8 million of which was reallocated to Portland Street Response. The program has been allocated $4.8 million ongoing, which is estimated to fund at least six units of two team members operating 24/7. The goal is to incrementally add units until there is service citywide around the clock. The process to determine cost per unit is ongoing as the program assesses the number of teams required, along with the varying levels of certification and skill sets needed for each team, all of which will impact the final cost.
The first Portland Street Response pilot team will operate with a Firefighter Specialist/Paramedic and a Licensed Mental Health Crisis Clinician. Teams will be joined by two community health workers that are responsible for initial response as well as follow-up care to connect individuals with additional resources. Responders will be housed at Station 23, initially serving the Lents neighborhood in southeast Portland.
Teams will be equipped with radios and mobile data computers (MDC) to communicate with dispatch and other 911 responders should they find themselves in a situation that has escalated beyond their capacity. Police, fire, and EMS may also request that police come to a scene if needed. For data tracking purposes, calls dispatched to PSR will also have a secondary code to track the types, frequency, and time of calls. In an effort to prepare the program to operate outside of the designated pilot area, the city is considering applying this secondary code on calls outside of the pilot area in order to get a better sense of call loads and types.
The program will initially focus on individuals who
Need a welfare check due to being intoxicated or drug affected
Need a wellness check if laying outdoors with their condition unknown
Need referral services without phone access
Need a mental health check
The team can self-dispatch based on observed need or they may be called in to assist by community groups or as a co-response or mutual aid response from other emergency responders. Calls will be prioritized based on the individual having no known access to weapons and not displaying physically combative or threatening behavior. PSRs will likely be brought in to respond to individuals who are suicidal, but as of now police response to these calls is still required by Criminal Justice Information Services of Oregon.
Collaborative Governance
The pilot program is inspired by the White Bird Clinic’s CAHOOTS program in Eugene, OR, but the advocacy to make Portland Street Response came from Street Roots, an organization serving houseless Portlanders.
In 2019, Street Roots launched a community-based campaign to get the Portland City Council to dedicate funding for a pilot program, with endorsements coming from houseless Portlanders to elected officials throughout the state. They also helped lead the community engagement stakeholder working group.
Stakeholders chose a working group based on their areas of interest. Groups were composed of residents of the city, residents of Multnomah County, local service providers, advocates, and peers. The working groups included:
Community Engagement - The Commissioner held listening sessions with local houseless advocate groups, which led to Portland State University Homelessness Research and Action Collaborative assembling a report based on the community survey called “Believe Our Stories and Listen.” Houseless individuals were hired and trained to go to local encampments to survey members of the houseless community. They collected valuable input into the kinds of programs the respondents would like to see the city provide, what kinds of backgrounds/training the people on the team should have, what their interactions with the police have been like, and other logistical information. This information was used to help inform the launch of the first team.
Call Transitioning - The call transitioning team was composed of individuals from the Bureau of Emergency Communications (911), police, fire, and county EMS. The group collaborated to determine the criteria, circumstances and scenarios for calls PSR should take the lead on.
Internal Logistics - The internal logistics working group created a pilot proposal for how the program would operate if it were to be housed within the city of Portland.
External Logistics - The external logistics working group created a pilot proposal for what a program would look like and how it would operate if it were to be contracted out to a third-party agency.
System Mapping & Alignment - The Local Public Safety Coordinating Council (a Multnomah County division) conducted a day-long Sequential Intercept Mapping exercise to look at intercepts 0-1 (pre-justice system involvement) to see how the program would fit within current systems. The exercise identified current services, system gaps, overlaps, etc. This exercise involved many stakeholders from the city, Multnomah County, and community-based organizations.
Emphasis on equity
The city council made a deliberate decision to divert funding from their police department. In a 2012 intervention by the Department of Justice, the Portland Police Department was shown to use excessive force towards BIPOC Portlanders and Portlanders experiencing mental health crises.
Since 2003, 40 people have been shot and killed by the Portland Police Bureau. Analysis showed that those fatally shot were disproportionately Black, and at least half of the cases involved people with mental illness. This non-police first responder program disrupts the status quo by shifting responsibility for responding to mental health and behavioral health crises to unarmed civilians. The teams will be unarmed and will not run any kind of warrant or ID check, nor conduct Director or Civil holds which require an individual to be involuntarily held for psychiatric evaluation. Because of this, it removes the possibility of going to jail and replaces it with direct resources to help mitigate the root causes of an individual's crisis.
This approach envisions community safety that does not rely on law enforcement or policing to keep people safe. Rather, it depends on the principles of compassion and care, and on centering health and decriminalizing people who have mental or behavioral health issues. This is one step towards dismantling the carceral system that is rampant across the country.
Analysis
Preemption: The state of Oregon does not prevent localities from budgetary decisions in terms of expenditure decisions. However, the state does have requirements around when police are required to be on scene, and other states may do the same.
Local government dynamics: The proposal has had significant support from the Portland City Council since its beginning in 2019.
Policy: This initiative is still in the early stages, with evaluation and expansion to come. However, it incorporates many elements of a successful and well established program in Eugene OR.
OTHER PROGRAM EXAMPLES
San Francisco’s Street Crisis Response team launched at the end of 2020 as part of the city’s Mental Health SF program, with funding over two years from the General Fund and gross receipts from business tax funding. The San Francisco Fire Department in collaboration with the Department of Public Health and the Department of Emergency Management runs the response team, which will respond to emergency calls relating to mental health distress, substance abuse, and behavioral health issues. Eventually, the program will stand up multiple three-person teams consisting of a paramedic, behavioral health clinician and health peer specialist with lived experience who are directly employed by the city. At first the response team will operate during daytime hours, but the city plans to expand the service to 24/7.
Denver’s Support Team Assisted Response (STAR), overseen by the Denver Police Department, started operations in June 2020 with $208,000 for a six month pilot phase. The program is staffed by mental health clinicians and paramedics from the Mental Health Center of Denver, who operate out of a van and are dispatched out of the 911 communications center or from non-emergency calls. They respond to non-criminal emergencies such as drug overdoses, mental health distress, intoxication, welfare checks, and homelessness related calls from 10AM - 6PM Monday through Friday in the downtown core. The city allocated a total of $2.8 million in the FY2021 budget, funded through the Caring for Denver sales tax fund and the general fund, and the Mayor has proposed an expansion to additional police districts after the 6 month pilot phase.
Last updated: January 19, 2021
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