Loading...
HomeMy WebLinkAbout09 RESPONSE TO 2023-2024 ORANGE COUNTY GRAND JURY REPORT ENTITLED “LAW ENFORCEMENT’S RESPONSE TO MENDocusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 MEETING DATE TO FROM Agenda Item 9 AGENDA REPORT Reviewed: Initial City Manager a� Finance Director N/A AUGUST 20, 2024 ALDO E. SCHINDLER, CITY MANAGER STU GREENBERG, POLICE CHIEF SUBJECT: RESPONSE TO 2023-2024 ORANGE COUNTY GRAND JURY REPORT ENTITLED "LAW ENFORCEMENT'S RESPONSE TO MENTAL HEALTH CALLS FOR SERVICE" SUMMARY: On June 5, 2024, the Orange County Grand Jury issued its report titled "Law Enforcement's Response to Mental Health Calls For Service" which scrutinized how effectively law enforcement agencies address individuals experiencing mental health crises. The report requires the City to respond to five specific findings. In accordance with California Penal Code sections 933.05(a) and (b), the City must submit its response to the Presiding Judge of the Superior Court on or before September 3, 2024. RECOMMENDATION: It is recommended that the City Council review and approve the proposed response to the 2023-2024 Orange County Grand Jury report titled "Law Enforcement's Response to Mental Health Calls for Service" in the form attached as Attachment 2. FISCAL IMPACT: None. CORRELATION TO THE STRATEGIC PLAN: The required response to the Grand Jury advances Public Safety and Protection of Assets, Goal B in the Strategic Plan. BACKGROUND AND DISCUSSION: The 2023-2024 Orange County Grand Jury conducted an investigation interviewing law enforcement leaders, law enforcement educators, and mental health professionals to examine how Orange County supports individuals suffering from mental illness. Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 City Council Agenda Report Response to 2023-2024 Orange County Grand Jury Report, "Law Enforcement's Response to Mental Health Calls for Service." August 20, 2024 Page 2 The report identified five Findings and no Recommendations. Pursuant to California Penal Code Section 933, the City is required to respond to each of these Findings. California Penal Code Section 933.05 outlines the specific manner in which these responses and comments must be provided: Findings: As to each Grand Jury finding, the City must indicate one of the following: (1) The City agrees with the finding; or (2) The City disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefor. Tustin Police Department staff has prepared the recommended response to the Findings, attached hereto as Attachment 2. Because the Grand Jury Report was issued on June 5, 2024, the response is required to be submitted to the Presiding Judge of the Superior Court on or before Wednesday, September 3. Signed by: Police Chief Attachments: 1. 2023-2024 Orange County Grand Jury report, "Law Enforcement's Response to Mental Health Calls for Service." 2. Proposed Response to the 2023-2024 Orange County Grand Jury Report Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 a GRAND JVKY M,20�A Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Law Enforcement's Response to Mental Health Calls for Service Table of Contents SUMMARY......................................................................................................................1 BACKGROUND..............................................................................................................1 REASON FOR THE STUDY...........................................................................................2 INVESTIGATION AND ANALYSIS.................................................................................4 Legislative Acts to Support Mental Health Training for Law Enforcement .................... 4 Innovative Law Enforcement Mental Health Strategies ................................................ 5 Orange County Service Planning Areas (SPAs).......................................................... 9 LawEnforcement Partnerships.................................................................................. 10 COMMENDATIONS......................................................................................................13 FINDINGS.....................................................................................................................14 RECOMMENDATIONS.................................................................................................14 RESPONSES................................................................................................................15 REFERENCES..............................................................................................................17 GLOSSARY..................................................................................................................19 APPENDIX.................................................................................................................... 20 2023-2024 Orange County Grand Jury Page ii Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service SUMMARY Approximately 8.8 million Americans have a severe mental illness such as schizophrenia, severe bi-polar disorder, or major depression with psychiatric features. Almost half of these people are treated on a given day.2 Without proper treatment, people with severe mental illness are at risk of experiencing negative outcomes that seriously impact them and the people around them. Decades ago, law enforcement officers in Orange County became mental health clinicians without proper training. While State legislation has since required police agencies to increase mental health training, Orange County law enforcement agencies have surpassed the State's expectations. The Orange County Grand Jury (OCGJ) believes that law enforcement in Orange County is a model for training law enforcement personnel on mental health crisis intervention techniques and collaborating with behavioral health organizations to improve service and reduce stigma for those affected by mental illness. BACKGROUND In March 2021, two Los Angeles County Sheriff's Department (LASD) deputies responded to a call regarding a deaf and autistic male adult named Isaias Cervantes who was experiencing a mental health crisis. When deputies arrived, they asked Cervantes to stand up so he could be handcuffed as a safety precaution, and the incident escalated. Cervantes became combative with the deputies, which resulted in one of the deputies shooting him in the back. Consequently, Cervantes is paralyzed and recently won a $25 million settlement against the County of Los Angeles. The LASD Internal Affairs Bureau concluded that excessive force during this incident was warranted per departmental procedure, although Los Angeles County Risk Management prepared a Summary Corrective Action Plan that focused on numerous root causes for the escalation, including: Desk personnel (i.e., dispatch) failed to ask about the nature of Cervantes' mental impairment. Desk personnel (i.e., dispatch) failed to send the Mental Evaluation Team as part of the response.3 Treatment Advocacy Center, "Serious Mental Illness by the Numbers," 2022. https://www.treatmentadvocacycenter.org. 2 ibid. 3 The Times Staff Editorial, "Sheriff's Shooting Cost Taxpayers $25 Million. Where's the Accountability?" Los Angeles Times, April 8, 2024. 2023-2024 Orange County Grand Jury Page 1 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Approximately one-third of individuals with severe mental illness have their first exposure to mental health treatment through a law enforcement encounter.4 Law enforcement officers are often on the front lines of psychiatric care, charged with responding to, addressing, and preventing a mental illness crisis. Responding to and transporting individuals with mental illness occupies more than twenty percent of a law enforcement officers' time.5 Many law enforcement agencies across the United States are looking at an alternative approach to mental health calls for service by partnering with mental health professionals rather than handling these calls as the sole first responder. The OCGJ has found that law enforcement agencies throughout Orange County have adopted one or a combination of the following three models to address mental health calls: Police Model. All mental health calls for service are handled by police with a clinician back-up. • Co -Responder Model. Trained mental health professionals are dispatched along with the officers responding to certain calls. • Alternative Mental Health Response. Only a mental health professional is dispatched to nonviolent calls such as attempted suicide; mentally ill; drug violation; drunk pedestrian; person down; trespasser; and well-being check. REASON FOR THE STUDY Christian Glass was a geology enthusiast, a painter, and a young man beset by a mental health crisis when he called 911 for help getting his car unstuck in a Colorado mountain town last year. Convinced that supernatural beings were after him, he balked when sheriff's deputies told him to get out of his car. Body camera video shows that the officers shouted, threatened, and coaxed. Glass hoped that officers would not break his car window, but they did, and the young adult grabbed a small knife. Then he was hit with bean bag rounds, stun gun charges and, ultimately, bullets that killed him and led to a murder charge against one deputy and a criminally negligent homicide charge against another.6 Along with the Cervantes incident described above, this article is just one of numerous examples indicating that society needs to reevaluate police protocol when responding to mental health calls for service. 4 Treatment Advocacy Center, "Road Runners: The Role and Impact of Law Enforcement in Transporting Individuals with Severe Mental Illness," 2019. https://www.treatmentadvocacycenter.org. 5 Jody M. Litchford, JD., "Partnering with Mental Health Providers to Improve Outcomes," Police Chief, December 2023, p. 12. 6 Jennifer Peltz and Jesse Bedayn, "Many Big US Cities Now Answer Mental Health Crisis Calls with Civilian Teams — Not Police," Associated Press, August 27, 2023. 2023-2024 Orange County Grand Jury Page 2 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service The OCGJ felt it was vital to research via interviews with law enforcement leaders, law enforcement educators, and mental health professionals how Orange County assists individuals who suffer from mental illness. It is important to note that this report does not focus on mental health issues that exist within the homeless community, although the OCGJ learned that a significant number of unhoused individuals suffer from mental illness, including substance abuse disorder, which leads to a significant number of police calls for service. METHOD OF STUDY The OCGJ conducted thirty-one interviews. Twenty-three of these interviews involved key personnel from law enforcement agencies representing all cities and unincorporated areas in Orange County, including the police agency at the University of California, Irvine (UCI). The OCGJ also interviewed representatives from the Orange County Sheriff's Regional Academy and Golden West College Police Academy, Orange County mental health stakeholders including the Orange County Health Care Agency's Mental Health and Recovery Services Department, the National Alliance on Mental Illness — Orange County Chapter (NAMI OC), and Project Kinship. In addition, the OCGJ conducted the following tours: • Orange County Central Jail Complex, including the Intake Release Center (IRC), Men's Jail, and Women's Jail • Central Justice Center Holding Facility • James A. Musick Jail (under construction) • Theo Lacy Jail • Yale Navigation Center and Bridges at Kraemer Place • Orange County Juvenile Hall and Youth Leadership Academy • Be Well, Orange Campus Members of the OCGJ attended monthly meetings of the Orange County Criminal Justice Coordinating Council (OCCJCC), which is a planning body of County government, law enforcement, courts/corrections, and social service agencies responsible for improving public safety on behalf of Orange County residents. These meetings were insightful and provided an understanding of how Orange County leaders collaborate to enhance law enforcement services. The OCGJ also referred to previous Grand Jury reports, Peace Officer Standards and Training (POST) material, police training documents provided by the Orange County Sheriff's Regional Training Academy and Golden West College Police Academy, and local news articles and reports. 2023-2024 Orange County Grand Jury Page 3 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service INVESTIGATION AND ANALYSIS Legislative Acts to Support Mental Health Training for Law Enforcement Even in situations in which police officers have completed relevant mental health crisis training, the mere presence of armed, uniformed officers can exacerbate feelings of distress for people with behavioral health conditions. While mental health training in law enforcement is mandated, field experience is also essential in producing positive outcomes to mental health calls for service. Listed below is an overview of mandated mental health training for law enforcement personnel that is regulated by POST. Peace Officer, Public Safety Dispatcher and Public Safety Dispatch Supervisor Most often, law enforcement officers are the initial first responders for incidents involving untreated mental illness. On January 1, 2016, Senate Bill (SB) 11 went into effect mandating additional behavioral health training for peace officers. This legislation was codified in California Penal Code Section 13515.27, which requires every peace officer (other than a level III Reserve Peace Officer), Public Safety Dispatcher, and Public Safety Dispatch Supervisor to complete twenty-four or more hours of POST training every two years. The training includes three consecutive hours of a POST - certified mental health training course.' Training includes: • The cause and nature of mental illness, intellectual disability, and substance abuse disorders. • Indicators of mental illness, intellectual disability, and substance use disorders. • Appropriate responses to a variety of situations involving persons with mental illness, intellectual disability, and substance use disorders. • Conflict resolution and de-escalation techniques for potentially dangerous situations. • Appropriate use of language when interacting with emotionally distressed individuals. • Resources available to serve persons with mental illness or intellectual disability.$ Police Recruits SB 11 also added Penal Code Section 13515.26, which requires POST to include fifteen hours of behavioral health training in the basic academy course for new police recruits. Upon graduation from a police academy, police recruits must complete training on subject matter that covers forty-two different law enforcement topics, also known as State of California Commission on Peace Officer Standards and Training Website, "Mental Health Training in Law Enforcement." 8 https://california.public.law/codes/ca_penal_code_section_13515.27 2023-2024 Orange County Grand Jury Page 4 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Learning Domains (LD). One of the topics covered is in LD 37, identified as People with Disabilities. It provides trainees instruction on disability laws, developmental disabilities, physical disabilities, and mental illness.9 While in the academy, recruits learn to recognize general indicators of mental illness so that appropriate actions can be taken. The following indicators assist recruits in determining whether a behavior is related to mental illness: • Fearfulness • Inappropriate Behavior • Extreme Inflexibility and/or Frustration • Symptoms of Excitability • Impaired Self -Care • Hallucinations and Delusions • Disorganized Speech, Thought Patterns, or Disorientation • Clinical Depression • Bipolar Disorder • Schizophrenia • Postpartum -Depression • Psychosis • Post -traumatic Stress Disorder (PTSD) • Personality Disorder10 Supervisorial Police Officers SB 29, which also went into effect on January 1, 2016, requires police officers in supervisory roles who conduct field training to receive twelve hours of behavioral health training, including eight hours of crisis intervention instruction and an additional four hours in the Field Training Officer program, on how to interact with persons with mental illness or intellectual disability. Innovative Law Enforcement Mental Health Strategies The OCGJ interviewed high-ranking officers from twenty-three law enforcement agencies representing all cities and unincorporated areas in Orange County, including 9 California Commission on Peace Officer Standards and Training Website, "Mental Health Training in the Regular Basic Course." 10 California Commission on Peace Officer Standards and Training, Learning Domain 37, People with Disabilities, Version 6.0, Chapter 4. 2023-2024 Orange County Grand Jury Page 5 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service the police agency at UCI. The OCGJ found that each city and/or unincorporated area handles mental health calls for service in its own, unique way. This is especially true with smaller cities that lack special funding to establish innovative mental health programs. However, smaller cities also have a more modest unhoused population, which makes enforcement more manageable than in larger municipalities. Table 1 on page 13 of this report summarizes key interview results with Orange County law enforcement agencies. In Orange County, law enforcement's handling of mental health issues has evolved to include non -sworn mental health clinicians. This approach recognizes the need for specialized assistance in dealing with individuals experiencing mental health crises and provides a more tailored and compassionate response. Law enforcement representatives interviewed by the OCGJ agree that individuals experiencing a mental health crisis typically respond better when approached by clinicians who are not wearing uniforms, and emphasize the importance of sensitivity and understanding in these encounters. Seven Orange County cities plus UCI have contracted with Be Well Orange County to provide mobile response vans staffed with two mental health clinicians seven days a week. The Homeless Outreach and Proactive Engagement (HOPE) Center, serving cities in North Orange County, uses a mobile office vehicle to connect with individuals in the community. Although the HOPE Center is primarily focused on issues related to homelessness, outreach workers are equipped to provide links to service for individuals suffering from mental illness. Mental health clinicians from the Psychiatric Emergency Response Team (PERT) ride with law enforcement officers in seventeen Orange County cities. Law enforcement in any Orange County city can call the Crisis Assessment Team (CAT), a program that helps anyone in the county who is experiencing a behavioral health crisis. The PERT and CAT teams are staffed by clinicians from the Orange County Health Care Agency (OCHCA). Some of the smaller police departments may not need an in-house crisis intervention worker, but are familiar with households that include persons with mental health issues, and their officers have established relationships with these families. Officers are also acquainted with many homeless individuals in these cities because their homeless populations are relatively sparse. Although police agencies may differ in the way mental health calls for service are addressed, there is consensus that police departments would like more time to focus on crime -related calls for service. Orange County Sheriff's Department's Behavioral Health Bureau The Orange County Sheriff's Department (OCSD) receives approximately 10,000 calls for service each year involving mental health, individuals experiencing homelessness, 2023-2024 Orange County Grand Jury Page 6 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service and similar crises.11 In June 2023, the Orange County Board of Supervisors approved the County's budget for Fiscal Year 2023-24; and within its budget, allocated $2.8 million to expand the OCSD Behavioral Health Bureau (BHB).12 The bureau is a specialized crisis response team that consists of nine deputy sheriffs, three PERT deputy sheriffs and one PERT clinician. This specialized team responds to mental health crisis calls including calls related to homelessness and conducts proactive follow- up calls. The goal is to assist with de-escalation and diversion to treatment and services, when appropriate.13 Some police agencies in Orange County are adopting an alternative mental health approach when responding to mental health calls for service. While there is an appeal to the idea of removing police from nonviolent psychiatric crisis calls, the challenge is training 911 dispatchers to gauge these calls and having experienced clinicians available to expediently respond to them. In March 2024, the OCSD, in partnership with the OCHCA, launched a dispatch call diversion program that guides OCSD dispatchers to triage non-violent and non -criminal behavioral health calls (including homelessness) to determine if they can be diverted to OC Links, which is a 24/7 Behavioral Health Line.14 OC Links dispatches counselors to these non-violent and non -criminal calls instead of deputies, freeing up deputies to respond to traditional crime -related calls instead.15 Orange County Intake Release Center (IRC) The OCSD has partnered with the OCHCA to reduce inmate behavioral health crises. There are mental health hotlines available around the clock in each County jail so that deputies can report concerns regarding an inmate's mental health or behavior that might lead to self -harm. The IRC is part of the Central Jail complex in Santa Ana and houses inmates who suffer from severe mental illness. The facility can house up to 849 inmates and is staffed by sheriff's deputies from the BHB. The cells in the mental health unit have been modified to address safety and self -harm concerns. There are also visiting areas where inmates can use computer tablets for video calls with family, reading e-books, searching for jobs, receiving education, and playing cognitively stimulating games. 11 Orange County Sheriff's Department News Release, "OC Sheriff Partners with the OC Health Care Agency to Support Individuals in Crisis." https//ocsheriff.gov. 12 Minutes of the Orange County Board of Supervisors Meeting on June 27, 2023; Adoption of the Fiscal Year 2034-24 Final Budget Resolution. 13 OC Cares Justice Through Prevention and Intervention, 2025 Quarterly Status Report, October — December 2023, p 16. 14 Orange County Sheriff's Department News Release "OC Sheriff Partners with the OC Health Care Agency to Support Individuals in Crisis," httpsHocsheriff.gov. 15 Ibid. 2023-2024 Orange County Grand Jury Page 7 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Fullerton Police Department Social Worker Program In 2023, Orange County Supervisor Doug Chaffee allocated $1 million from the Fourth Supervisorial District Discretionary Grants to help fund the Fullerton Police Department Social Worker Program, which is a two-year pilot program.16 The objective is to dispatch licensed clinical social workers (LCSWs) alongside or in lieu of police officers when responding to mental health crises, domestic violence, or juvenile delinquency. The program consists of two LCSWs and focuses on crisis response, mediation, referrals to health care providers, treatment plans and case follow-ups, and de- escalation techniques for peaceful resolution. Irvine Police Department Mental Health Unit In 2014, the Irvine Police Department established a mental health unit that consists of three sworn police officers and two County PERT clinicians. The mental health sworn officers partner with the PERT clinicians in response to mental health calls for service. When not responding to mental health calls for service, the mental health unit is conducting follow-up calls for service with their clients. There is an additional trained clinician assigned to the mental health unit from the City's FOR Families program that provides short-term mental health support to Irvine residents on a variety of concerns including: • Stress/Depression • Substance Abuse • Family Violence • Relationship Problems • Legal/Financial Issues • Children/Teen Behavioral Difficulties Residents who are affected by a mental health issue can contact the City's dedicated email address at outreach (o)cityofirvine.org. City of Huntington Beach Police Department Huntington Beach was the first city in Orange County to enter into an agreement with Be Well OC where two professional crisis counselors respond to non-violent mental health calls relating to suicide, family disputes, drug/alcohol abuse, welfare checks, and general mental health crisis calls. Collaboration with Be Well OC has allowed sworn officers to dedicate more time responding to crime -related calls for service. 16 "Fullerton Police Department Get $1 Million to Start a Pilot Program," Fullerton Observer, July 22, 2023. 2023-2024 Orange County Grand Jury Page 8 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Orange County Service Planning Areas (SPAs) Service Planning Areas (SPAs) are divisions of Orange County into North, Central, and South cities to coordinate homeless shelters and services on a regional basis. The North Orange County Service Planning Area (North SPA) is the most active and innovative of the three SPAs. It coordinates collaboration among thirteen cities in North Orange County. In 2018, North SPA was given over $12 million dollars by the State of California to address the crisis of homelessness.17 The North SPA partnership is an effort to comply with a court ruling prohibiting enforcement of anti -camping laws on public property when local shelter beds are not available. The funding was used to open two homeless "Navigation Centers," one in Buena Park and the other in Placentia. The HOPE Center was opened in 2022 to gain more reliable relief and consistent support for homeless individuals in the North SPA area. The HOPE Center is designed as a central command center for case workers, mental health clinicians, resource providers, and homeless liaison officers working together to address public health issues with an emphasis on homeless individuals. The goal is to end homelessness in the North SPA cities by getting "the right resource to the right person at the right time.1118 The HOPE Center mobile office vehicle is used to respond to calls for service. Center clinicians engage in outreach activities when they are not on calls. At the opening of the HOPE Center, State Senator Josh Newman (D-Fullerton/District 29) said the HOPE Center will be "a critical hub for subject matter experts, health care workers, community -based organizations, and local law enforcement to coordinate and deliver resources efficiently under one roof."19 17 "North Orange County Service Planning Area (North SPA) Received $12,062,300 in Homeless Emergency Aid Program (HEAP) Funding to Open Navigation Center in Buena Park and Placentia," November 9, 2018, https://www.buenapark.com/T2 R49.php. 1S HOPE Center Orange County Mission Statement, https://ochopecenter.org. 19 Tess Sheets and Alicia Robinson, "Governor Gavin Newsom Visits to Help Open New Hub for North Orange County Homeless Services," Orange County Register, October 27, 2022. 2023-2024 Orange County Grand Jury Page 9 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service BUENA PARK W PALM LJICYPRESS SEAL BEACH REACH County of Orange Service Planning Areas BREA — FOLLERTON �'. YORBA LINOA PLACENYIA F$ ANANEIY I �LLA L ORANGE GARDEN GROVE } AANA �\ IUBTM ri NORTH REGION Anaheim Brea Buena Park Cypress Fullerton Lo Habra La Palma Los Alamitos Orange Placentia Stanton Villa Pork Yorbo Linda County Unincorporated CENTRAL REGION Costa Mesa Fountain Valley Garden Grove Huntington Beach Newport Beach Santa Ana Seal Beach Tustin Westminster County Unincorporated COSTANESA / / RVINE NEWPORTBEACH ALISO i NLLS SOUTH REGION \T Aliso Viejo Dana Point Irvine Laguna Beach Laguna Hills Laguna Niguel Laguna Woods Lake Forest Mission Viejo Rancho Santa Margarita San Clemente San Juan Capistrano County Unincorporated Law Enforcement Partnerships Be Well (Hope Starts Here) am JUAN CAWa7RANO UNRCORI Om7rED Hope Starts Here is the slogan for Be Well OC. It was established in 2017 (under the leadership of Mind OC) as a public -private partnership which provides mental health stabilization, a sobering center, and residential housing for both substance abuse and 2023-2024 Orange County Grand Jury Page 10 Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Law Enforcement's Response to Mental Health Calls for Service mental health treatment for the residents of Orange County. Insurance is not a requirement to receive treatment.20 The first of three proposed Be Well campuses opened in January 2021 in the City of Orange to serve North Orange County. Funding was provided by the County Board of Supervisors, CalOptima, private donors, and major hospital systems. In October 2023, construction began on the second Be Well campus located in Irvine's Great Park that will serve South Orange County. This facility will be larger than the Orange Campus and will have the additional ability to support children, youth, and families. The campus is expected to open in 2025. A campus to serve Central Orange County is proposed. Mind OC was established in 2017 as a California 501(c)(3) non-profit organization. The purpose of the non-profit is to partner with the County of Orange to establish behavioral health campuses in Orange County. When the Be Well Campus in Orange opened, it was under the responsibility of the OCHCA. In January of 2023, Mind OC assumed responsibility for the campus.21 In addition to the Be Well campuses, Be Well OC has a mobile response program. The slogan for the program is Hope Happens Here.22 Identifiable outreach vans with mental health crisis counselors (working in pairs) work in collaboration with law enforcement to respond to mental health calls. The counselors are trained in de-escalation, crisis stabilization, and counseling. Seven municipal police agencies (Anaheim, Garden Grove, Huntington Beach, Irvine, Laguna Beach, Newport Beach, and Westminster) and UCI currently have mobile response contracts. Law enforcement agencies without contracts with the mobile response program can transport people in need to the Be Well Orange Campus. Project Kinship (Hope Lives Here) In November 2014, California voters approved Proposition 47 that reduced some low- level felonies in the state to misdemeanors. The proposition required the Board of State and Community Corrections to use a portion of the annual savings from Proposition 47 to administer grant programs for diversion, mental health services, or substance abuse treatment.23 Since 2016, Orange County has received $12 million in grants from Proposition 47. Orange County's goal is to reduce the number of people with mild -to - moderate mental health and/or substance use disorders incarcerated in the county jail by reducing recidivism through intensive case management, linkages to treatment, housing and behavioral health services, and community supports upon release.24 20 https://bewelloc.org/ 21 Ibid. 22 https://mind-oc.org/ 23 Libby Doyle, Leigh Courtney, Bryce Peterson of the Urban Institute, "Evaluation of Orange County's Proposition 47 Grant -Related Services," Executive Summary, September 2021, p.v. 24 Ibid. 2023-2024 Orange County Grand Jury Page 11 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Located in Santa Ana, Project Kinship was established in 2014 as a non-profit organization to address people's basic needs upon their release from custody. Although Project Kinship offers a variety of services including Schools and Youth Programs and a Workforce Program, this report focuses on the Adult Re -Entry Program in which Correctional Health Services provides Project Kinship with a list of upcoming inmates scheduled for release. Project Kinship conducts a triage on those inmates who are willing to sign an agreement for assistance (for up to eighteen months) that addresses people's basic needs upon their release from custody, such as housing, referrals to treatment facilities, mental health counseling, clothing, or reunification with family. Upon release from jail, these individuals are at risk of recidivism, victimization, and homelessness when they do not have resources such as clothing and food. The OCSD collaborates with Project Kinship by providing office space at the IRC and the Theo Lacy Jail. Project Kinship assists releasees on a round-the-clock basis at these facilities. Project Kinship is unique in that more than fifty percent of its workforce and all of its peer navigators have had analogous life experiences.25 The Proposition 47 grant money has allowed Orange County to fund Project Kinship's relocation to a larger space and hire additional case managers, clinicians, and peer navigators.26 There are now approximately 120 Project Kinship employees who served 179 clients between July 2020 and March 2021.27 In a meeting at the OCCJCC, members from the OCGJ witnessed an inspiring story from a Project Kinship employee as she described how her repeat offenses were causing her to be institutionalized and comfortable knowing that jail provided her with housing, clothing, food, and some sort of socialization. It was Project Kinship that approached her when she was preparing to be released from jail for the last time. Project Kinship provided her with a comprehensive approach to addressing short -and long-term reentry needs that helped her realize she could start a new life for herself. City Net Seven cities throughout Orange County contract with City Net to work with police agencies on reducing homelessness through street outreach and engagement. 25 Id., p. 20. 26 ibid. 27 Id., p. 21. 2023-2024 Orange County Grand Jury Page 12 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Table 1: Interview Results with Orange County Law Enforcement Agencies Law Enforcement Agencies Be Well Mobile Response Team PERT City Net NorthSpa/Hope Center Behavioral Health Bureau Non -Sworn Crisis Worker Anaheim X X X X Brea X Buena Park X X Costa Mesa X Cypress X Fountain Valley X X Fullerton X X Garden Grove X X Huntington Beach X X X Irvine X X X La Habra X X La Palma X Laguna Beach X X Los Alamitos X X Newport Beach X X X Orange X X Placentia X X Santa Ana X X Seal Beach X Tustin X X X UCI X X ** Westminster X X Orange County Sheriff X *** X City of Fullerton is developing a pilot Social Worker Program within its police department. UCI has several student counseling services on campus. The cities of Stanton and Yorba Linda are members of North SPA. COMMENDATIONS Orange County Criminal Justice Coordinating Council (OCCJCC) — The OCCJCC is to be commended for its efforts to improve public safety through greater inter -agency communication, coordination and collaboration regarding law enforcement and administration of justice issues including mental health.28 28 Orange County Board of Supervisors Resolution No. 2001-38, Adopted February 6, 2001, OCCJCC Proposed Reorganization. 2023-2024 Orange County Grand Jury Page 13 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service Orange County Intake Release Center (IRC) — The IRC is to be commended for partnering with the OCHCA to reduce inmate behavioral health crises. FINDINGS In accordance with California Penal Code Sections 933 and 933.05, the 2023-2024 Grand Jury requires responses from each agency affected by the findings presented in this section. The responses are to be submitted to the Presiding Judge of the Superior Court. Based on its investigation described here, the 2023-2024 OCGJ has arrived at the following principal findings: F1. Mental health training for law enforcement officers in Orange County exceeds the State's requirements, resulting in law enforcement applying these skills to better evaluate and handle mental health calls for service. F2. Law enforcement agencies in Orange County have developed unique ways to deal with mental health calls in their communities based on their particular needs and budgets, enabling law enforcement to better serve their communities. F3. Law enforcement collaboration with County PERT clinicians and Be Well mobile response units has been an effective tool when responding to mental health calls for service. F4. People with mental illness respond more positively to "soft uniformed" police personnel, which can be effective in de-escalating situations. F5. Providing follow-up case management is not only necessary but critical for the wellbeing of people experiencing mental health issues. RECOMMENDATIONS Based on its investigation, the 2023 — 2024 OCGJ has determined that law enforcement agencies throughout Orange County have developed unique techniques to adequately address mental health calls, thus this report does not contain recommendations. 2023-2024 Orange County Grand Jury Page 14 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service RESPONSES California Penal Code Section 933 requires the governing body of any public agency which the Grand Jury has reviewed, and about which it has issued a final report, to comment to the Presiding Judge of the Superior Court on the findings and recommendations pertaining to matters under the control of the governing body. Such comment shall be made no later than 90 days after the Grand Jury publishes its report (filed with the Clerk of the Court). Additionally, in the case of a report containing findings and recommendations pertaining to a department or agency headed by an elected County official, such official shall comment on the findings and recommendations pertaining to the matters under that official's control within 60 days to the Presiding Judge with an information copy sent to the Board of Supervisors. Furthermore, California Penal Code Section 933.05 specifies the manner in which such comment(s) are to be made as follows: (a) As to each Grand Jury finding, the responding person or entity shall indicate one of the following: (1) The respondent agrees with the finding. (2) The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. (b) As to each Grand Jury recommendation, the responding person or entity shall report one of the following actions- (1) The recommendation has been implemented, with a summary regarding the implemented action. (2) The recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation. (3) The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency when applicable. This timeframe shall not exceed six months from the date of publication of the Grand Jury report. (4) The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation, thereof. (c) If a finding or recommendation of the Grand Jury addresses budgetary or 2023-2024 Orange County Grand Jury Page 15 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service personnel matters of a county agency or department headed by an elected officer, both the agency or department head and the Board of Supervisors shall respond if requested by the Grand Jury, but the response of the Board of Supervisors shall address only those budgetary or personnel matters over which it has some decision -making authority. The response of the elected agency or department head shall address all aspects of the findings or recommendations affecting his or her agency or department. The Orange County Grand Jury requires and requests the following responses, as indicated: Findings - 60 Day Response Required Orange County Sheriff -Coroner F1, F2, F3, F4, F5 Findings - 90 Day Response Required City Councils of: Anaheim F1, F2, F3, F4, F5 Brea F1, F2, F4, F5 Buena Park F1, F2, F3, F4, F5 Costa Mesa F1, F2, F3, F4, F5 Cypress F1, F2, F3, F4, F5 Fountain Valley F1, F2, F3, F4, F5 Fullerton F1, F2, F3, F4, F5 Garden Grove F1, F2, F3, F4, F5 Huntington Beach F1, F2, F3, F4, F5 Irvine F1, F2, F3, F4, F5 La Habra F1, F2, F3, F4, F5 La Palma F1, F2, F4, F5 Laguna Beach F1, F2, F3, F4, F5 Los Alamitos F1, F2, F3, F4, F5 2023-2024 Orange County Grand Jury Page 16 Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Law Enforcement's Response to Mental Health Calls for Service Newport Beach Orange Placentia Santa Ana Seal Beach Tustin Westminster Findings - 90 Day Response Requested University of California, Irvine REFERENCES Be Well OC website: https://bewelloc.org/ F1, F2, F3, F4, F5 F1, F2, F3, F4, F5 F1, F2, F4, F5 F1, F2, F3, F4, F5 F1, F2, F3, F4, F5 F1, F2, F3, F4, F5 F1, F2, F3, F4, F5 F1, F2, F3, F4, F5 California Commission on Peace Officer Standards and Training, Learning Domain 37, People with Disabilities, Version 6.0, Chapter 4. California Commission on Peace Officer Standards and Training Website, "Mental Health Training in the Regular Basic Course." "Fullerton Police Department Get $1 Million to Start a Pilot Program," Fullerton Observer, July 22, 2023. HOPE Center Orange County Mission Statement, https://ochopecenter.org. https://california.public.law/codes/ca penal code section 13515.27 "North Orange County Service Planning Area (North SPA) Received $12,062,300 in Homeless Emergency Aid Program (HEAP) Funding to Open Navigation Center in Buena Park and Placentia," November 9, 2018, https://www.buenapark.com/T2 R49.phphttps://www.buenapark.com/T2 R49.php. Jennifer Peltz and Jesse Bedayn, "Many Big U.S. Cities Now Answer Mental Health Crisis Calls with Civilian Teams - Not Police," Associated Press, August 27, 2023. Jody M. Litchford, JD., "Partnering with Mental Health Providers to Improve Outcomes," Police Chief, December 2023. 2023-2024 Orange County Grand Jury Page 17 Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Law Enforcement's Response to Mental Health Calls for Service Libby Doyle, Leigh Courtney, Bryce Peterson of the Urban Institute, "Evaluation of Orange County's Proposition 47 Grant -Related Services," Executive Summary, September 2021. Lili Robin, "Assessment of the Orange County, California, Homeless Mentally III Outreach and Treatment Services," Urban Institute, May 2021. Mind OC website: https://mind-oc.org/ Minutes of the Orange County Board of Supervisors Meeting, Public Hearing to Consider Adoption of the Fiscal Year 2034-24 Budget. OC Cares Justice Through Prevention and Intervention, 2025 Quarterly Status Report, October — December 2023. OCGJ Report, The Mental Illness Revolving Door: A Problem for Police, Hospitals, and the Health Care Agency, 2015. Orange County Board of Supervisors Resolution No. 2001-38, Adopted February 6, 2001, OCCJCC Proposed Reorganization. Orange County Sheriff's Department News Release, "OC Sheriff Partners with the OC Health Care Agency to Support Individuals in Crisis." https//ocsheriff.gov. State of California Commission on Peace Officer Standards and Training Website, "Mental Health Training in Law Enforcement." Tess Sheets and Alicia Robinson, "Governor Gavin Newsom Visits to Help Open New Hub for North Orange County Homeless Services," Orange County Register, October 27, 2022. The Times Staff Editorial, "Sheriff's Shooting Cost Taxpayers $25 million. Where's the Accountability?" Los Angeles Times, April 8, 2024. Treatment Advocacy Center, "Road Runners: The Role and Impact of Law Enforcement in Transporting Individuals with Severe Mental Illness," 2019. Retrieved from https-//www.treatmentadvocacycenter.org. Treatment Advocacy Center, "Serious Mental Illness by the Numbers," 2022. Retrieved from https-//www.treatmentadvocacycenter.org. Urban Institute Interim Evaluation Report, "Evaluation of Orange County's Proposition 47 Grant -Related Services," September 2021. 2023-2024 Orange County Grand Jury Page 18 Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Law Enforcement's Response to Mental Health Calls for Service GLOSSARY BHB Behavioral Health Bureau (Orange County Sheriff's Department) BHS Behavioral Health Services BRU Behavioral Response Unit CAT Crisis Assessment Team CIT Crisis Intervention Training HOPE Homeless Outreach and Proactive Engagement IRC Intake Release Center LASD Los Angeles Sheriff's Department LCSW Licensed Clinical Social Worker LD Learning Domain NAMI OC National Alliance on Mental Illness — Orange County Chapter OCCJCC Orange County Criminal Justice Coordinating Council OCGJ Orange County Grand Jury OCHCA Orange County Health Care Agency OCSD Orange County Sheriff's Department PERT Psychiatric Emergency Response Team POST Peace Officer Standards and Training SB Senate Bill SPA Service Planning Area UCI University of California, Irvine 2023-2024 Orange County Grand Jury Page 19 Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Law Enforcement's Response to Mental Health Calls for Service APPENDIX National Alliance on Mental Illness, Orange County (NAMI OC) Warm Line If you or someone you know is experiencing a mental health crisis, it is essential to take immediate action. Why a "Warm Line" and not a "Hot Line?" Imagine a pot left unattended and beginning to boil over —it requires immediate intervention to prevent avoidable damage. Distress left avoided for too long is similar to a boiling pot. The Warm Line aims to be an accessible mental health resource people can use for support before they've reached their boiling point. Our research shows that immediate support will prevent crisis later. The Warm Line aspires to bring authentic human connection to every conversation. Because our counselors are peers with their own experiences of mental health challenges, MHASF provides support from a place of empathy, understanding, and constant hope for recovery. Source- Warm Line - Mental Health Association of San Francisco (mental healthsf.org) NAMIOC Warm( 24/7 MentaL Health Support Toll Free: (877) 910-9276 Text or Call Local: (714) 991-6412 LiveChat at: namioo.org Email: wl@namicc,org pnflmi heal® Oraogr Uul, xun ac Warm OLYdrig Giay THAN TINH N9ng RS sirc khde tinh thin 2417 Oi@n Thoai Mien Phi: (877) 920-9276 Tin Nhin hay Go! Oia Phvcrng� (714)991-6412 Dam Thoai TrVc Ti6p tai: namioc.org Dikn Thin. wl@namioc.otg (&nnmi 4h a(® Orange Caunlp NAM10C Warm Apoyo de Salud Mental 24/7 Llamada Gratuita: (877) 910-9276 Llame c envie mensaje: (714) 991-6412 Chat an Vivo: namioc.org Corroo Electr6nico: wl@namiuc.org . COW health Orangt Cmmh NAM110C Warm 24/7 &A.L.0 _sbls wL— (877)910-9276: ;,&i, ;,a (714)991-6412 "Ia o ,. W L Se namioc.org :y e�;j 0�� =^z wl@namioc.crg:j—I � ®nHllfi hal[h Orangc Gnum 2023-2024 Orange County Grand Jury Page 20 Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Office of the City Council August 20, 2024 Honorable D. Maria Hernandez, Presiding Judge Superior Court 700 Civic Center Drive Santa Ana, CA 92701 Re: Response to 2023-2024 Orange County Grand Jury Report "Law Enforcement's Response to Mental Health Calls for Service" Your Honor: On May 30, 2024, the Orange County Grand Jury issued a report entitled "Law Enforcement's Response to Mental Health Calls for Service" that examined the degree to which law enforcement agencies provide for those experiencing a mental health crisis. At the conclusion of its analysis, the Grand Jury made five findings, with no recommendations, and required the City to respond to each of the five findings. In accordance with California Penal Code 933.05(a) and (b), the Orange County Grand Jury requires responses of each of the findings. The City of Tustin responds as set forth below. FINDINGS Finding 1. Mental health training for law enforcement officers in Orange County exceeds the State's requirements, resulting in law enforcement applying these skills to better evaluate and handle mental health calls for service. Response to Finding 1: The City of Tustin agrees with Finding 1. Tustin PD officers attend 15 hours of "People with Disabilities" training when they attend the Police Academy. Every two years all Tustin PD officers and sergeants attend 4 hours of "Strategic Communication" training. This training includes mental health and de-escalation tactics. California Penal Code 13515.28(a)(1) requires Field Training Officers (FTO) who are instructors for the field training program to attend 8 hours of "Crisis Intervention Training" (CIT). This training better prepares officers in effectively addressing incidents involving persons with a mental illness or intellectual disabilities. Tustin PD sends all FTO's to 16 hours of Advanced CIT training. In addition, the Homeless Liaison Officer, Community Impact Officer, and Behavioral Health Response Unit (BHRLI) Manager has also attended 16 hours of Advanced CIT training since they regularly interact with individuals experiencing mental health problems. Mayor Austin Lumbard • Mayor Pro Tem Ryan Gallagher • Letitia Clark • Rebecca "Beckie" Gomez • Ray Schnell 300 Centennial Way • Tustin, California 92780 www.tustinca.org Docusign Envelope ID: 894C1C3C-2C3E-4BFD-9DB8-1D23481F1D15 Honorable D. Maria Hernandez, Presiding Judge August 20, 2024 Page 2 Finding 2. Law Enforcement agencies in Orange County have developed unique ways to deal with mental health calls in their communities based on their particular needs and budgets, enabling law enforcement to better serve their communities. Response to Finding 2: The City of Tustin agrees with Finding 2. Tustin PD has a Homeless Liaison Officer and Community Impact Officer who works side by side with the BHRU Manager. Together they handle day-to-day calls for service received from dispatch, engaging with individuals who may be struggling with mental health problems. Often these calls require further follow-up and the BHRU Manager re-engages with these individuals; checking on their well-being and linking them to resources. Finding 3. Law enforcement collaboration with County PERT clinicians and Be Well mobile response units has been an effective tool when responding to mental health calls for service. Response to Finding 3: The City of Tustin agrees with Finding 3. An Orange County Health Care Agency PERT clinician rides with the Homeless Liaison Officer and Community Impact Officer every Tuesday. Together they respond to mental health calls for service. While Tustin PD does not partner with Be Well's mobile unit, the City has used Be Well's Orange facility to assist individuals who need immediate mental health services or who need assistance with sobering from alcohol or drugs. Additionally, Tustin PD outsources homeless outreach and engagement services through City Net. Many of these contacts are done in conjunction with the Tustin PD BHRU Manager, Homeless Liaison Officer and Community Impact Officer. Finding 4. People with mental illness respond more positively to "soft uniformed" police personnel, which can be effective in de-escalating situations. Response to Finding 4. The City of Tustin agrees with Finding 4. The BHRU Manager, Homeless Liaison Officer and Community Impact Officer wear non-traditional police uniforms which assist in de-escalating contacts and allow for non -confrontational encounters. Furthermore, the BHRU Manager and Homeless Liaison Officer drive unmarked vehicles. Finding 5. Providing follow-up case management is not only necessary but critical for the well-being of people experiencing mental health issues. Response to Finding 5: The City of Tustin agrees with Finding 5. Tustin PD's BHRU Manager provides comprehensive follow-up services to individuals in need; ensuring they receive the support and assistance necessary to address any issues they may be facing. Should you have any questions or need any additional information, please contact Lieutenant Sarah Fetterling at Tustin Police Department at 714.573.3308 or via email at SFetterling@tustinca.org. Respectfully, Docusign Envelope ID: 894C1 C3C-2C3E-4BFD-9DB8-1 D23481 F1 D1 5 Honorable D. Maria Hernandez, Presiding Judge August 20, 2024 Page 3 Austin Lumbard, Mayor cc: Orange County Grand Jury