Phoenix Historic Preservation Report

This report provides an overview of the key findings from the Historic Preservation
Impact Study.

THIS ITEM IS FOR DISCUSSION AND POSSIBLE ACTION.

Summary
The City of Phoenix has had a historic preservation program since the Historic
Preservation Ordinance was first adopted in 1985. The goal of the program has been
the protection, enhancement and preservation of properties and areas of historical,
cultural, archaeological and aesthetic significance that are in the interests of the
health, prosperity and welfare of the people of the City of Phoenix.
PreserveHistoricPHX, adopted by City Council in 2015, further sets goals relating to
connectivity, sustainability, diversity and prosperity.

At the request of the Historic Preservation Commission, City Council authorized on
Oct. 7, 2020 for PlaceEconomics, a national consultancy that analyzes the impacts of
historic preservation efforts, to prepare a study to determine the economic, social,
cultural and environmental dividends of the city's historic preservation efforts (See
Attachment A). The kick-off meeting for the study was held Nov. 19, 2020, followed by
the data gathering and analysis stage of the study. Data included economic, social,
cultural and environmental metrics. In addition, an analysis was done on the
contributions of pre-1970 housing stock toward affordable housing in Phoenix.

PlaceEconomics met twice with a 12-member focus group including leaders of several
preservation related organizations, on June 22, 2021 and Aug. 10, 2021. The focus
group provided invaluable input regarding the status of preservation in Phoenix.
PlaceEconomics also met during that period with small business owners, adaptive
reuse developers and key community members involved with the early efforts of the
preservation program, Terry Goddard and Grady Gammage, the Mayor and
Councilwoman Laura Pastor, department heads Alan Stephenson and Christine
Mackay, Historic Preservation Chair Dan Klocke and State Historic Preservation
Officer Kathryn Leonard. PlaceEconomics also toured several historic sites including
Phoenix Indian School, First Baptist Church, Beth Hebrew Synagogue, Rise Uptown


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Hotel, Phoenix College, and the Arizona Sash, Door and Glass Company Warehouse
as well as multiple properties in the Warehouse District. A driving tour was also
conducted through the city’s historic neighborhoods.

Key findings of Preservation Phoenix Style are:
· The historic neighborhoods of Phoenix are dense, 1,000 people per square mile
more dense than residential neighborhoods in the rest of the City.
· Historic neighborhoods in Phoenix are walkable -- most rated “Very Walkable” --
whereas the city as a whole is rated “Car Dependent."
· During the real estate crisis which accompanied the Great Recession, foreclosure
rates in historic neighborhoods were measurably lower than the rest of the city, a
pattern that has continued every year since.
· Even during the last five years of a boom cycle in real estate, property values in
historic districts have outperformed the city as a whole.
· Phoenix historic neighborhoods are diverse neighborhoods, by race, ethnicity, and
income.
· Phoenix historic neighborhoods are also diverse in their housing stock with a much
wider range of housing options than most Phoenix subdivisions.
· These neighborhoods also have a diversity of housing prices, with two-thirds of the
housing stock having values in the mid-market range of $200,000 to $400,000.
· The tree cover typically found in historic areas sequesters five times the CO2, five
times the value of water saved, and six times the value of air quality benefits per
acre than the rest of the City.
· Commercial areas with a concentration of heritage buildings are magnets for small
businesses, legacy businesses, and businesses in the creative and knowledge
categories.
· 95 percent of all businesses in the heritage commercial areas employ fewer than 20
workers.

Additionally, the study found that the housing stock in historic neighborhoods is a
crucial source of affordable housing. With 46 percent of Phoenix households
considered low, very low or extremely low income, the city's older housing stock is
providing affordable housing stock largely without subsidy, likely due to its age,
condition and smaller unit size. Maintaining this affordable older housing stock is a
crucial piece of efforts to respond to the affordable housing crisis.

Though the study does not make recommendations, it tells the story of our mid-century
desert city and how it has used innovation, creativity and persistence to protect the
city's historic resources to provide tangible benefits to the local economy, environment
and culture. Staff recommends City Council formally adopt the findings of the


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PlaceEconomics Study. To read the full study please visit:
https://www.phoenix.gov/pddsite/Documents/Preservation Phoenix Style Report_Draft
for Council (4).pdf 20Phoenix%20Style%20Report_Draft%20for%20Council%20(4).pdf.


Responsible Department
This item is submitted by Deputy City Manager Ginger Spencer and the Planning and
Development Department.




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A Study of the Impacts of
Attachment A




Historic Preservation in Phoenix
Executive Summary | October 2021
Completed by PlaceEconomics
Page 8
20% of all jobs in arts,
Executive Summary entertainment, and
recreation are in these
Preservation Phoenix Style has paid dividends for the citizens of Phoenix—dividends
measured economically, socially, culturally, and environmentally. The findings of this heritage commercial areas. PROXIMITY
Connectivity
report demonstrate in numbers, pictures, and words those dividends. Preservation
Phoenix Style has advanced established public goals including Prosperity,
Prosperity Proximity to parks, businesses, transit,
and cultural amenities improves quality of life, is more
Connectivity, Sustainability, and Diversity. HERITAGE COMMERCIAL AREAS environmentally sustainable, and supports the efficient
This study looked at undesignated commercials use of infrastructure.
LAND AREA areas with a concentration of older buildings.
These areas experienced greater job growth than Historic districts have an
average Walk Score of 64,
Collectively, local historic districts make
up just under 30 square miles, or 6%,
the rest of the city between 2010 and 2018 in key
creative class and knowledge sector industries.
4 6 which is 23 points higher than
the city average.
of Phoenix’s land area. However, a large
percentage of that land area comprises South
Piestewa Freeway


Jobs in Arts, Entertainment, and Historic districts also have
Mountain Park Historic District, a 25.5 square
mile natural land preserve. When South
Mountain Park Historic District is excluded,
the land area coverage of Phoenix Historic
Black Canyon Freeway
6 Recreation increased by 94%, compared
to only 12% in the rest of the city.
significantly higher Bike
and Transit Scores than
neighborhoods in the rest of
the city.
Districts shrinks to just over 1%. These
historic districts are home to just over 1% of Jobs in Accommodations and Food
91% of historic district
Phoenix’s population. Maricopa Freeway
Services increased by 71%, compared
residents live within walking
to only 14% in the rest of the city.
distance of a park, compared
to 49% of residents in the rest
Page 9 Phoenix’s Local Historic of the city.
Jobs in Information increased by
Districts cover just 32%, compared to only 2% in the rest
over 1% of the land of the city.
area, meaning 99% of
the city is not subject
to Historic Preservation
Commission regulation.
PROPERTY VALUES
Even during the last five years of a boom cycle in
FORECLOSURES
During the real estate crisis which accompanied the Great
South Mountain Freeway real estate, property values in historic districts have Recession, foreclosure rates in historic neighborhoods were
outperformed the city as a whole. measurably lower than the rest of the city, a pattern that has
continued in every year since.
POPULATION DENSITY 6š³‹ AVERAGE VALUE PER SQUARE FOOT
The historic neighborhoods of Phoenix are dense, home Homes in Local Historic Districts vs Rest of Phoenix FORECLOSURES PER 1000 SINGLE FAMILY HOUSES
Residential Historic
to 1,000 more people per square mile than residential Districts (2009-2012 Crash)
neighborhoods in the rest of the City. Non-Residential
Historic Districts
Freeways




Historic Districts Rest of Phoenix
4,965 people per square mile 3,970 people per square mile
TREE COVER BENEFITS
Phoenix’s Tree Keeper program demonstrates that historic
neighborhoods have 7 times as many trees per acre as the rest of the
city. These trees provide benefits such as shade to temper the urban
heat island effect, enhanced biodiversity, energy savings, and carbon
sequestration.
6 Sustainabi
li ty




Trees in historic Trees in historic Trees in historic
districts sequester 71 lbs of districts save 742 gallons of districts save 144 kWh
BŎ
ďÆ
x†ÆĀ
compared to water per acre, compared to ¸™
³Æšå
ďÆ
x†ÆĀ

14 lbs per acre in the rest of 144 gallons per acre in the rest compared to 23 kWH per
the city. of the city. acre in the rest of the city.




Diver si t y DEMOGRAPHIC AND HOUSING DIVERSITY
There is a persistent misconception that historic districts are only home to
wealthy white people in big homes. However, historic districts in Phoenix
mirror the diversity of the city as a whole. Far from being exclusive, they offer
a variety of housing options that support neighborhood diversity.


RACE IN HISTORIC DISTRICTS VS
REST OF CITY (2019) Despite making up only
1% of the land area,
historic districts
account for 15% of all
parcels with 2 housing
units, like this duplex.



HOUSEHOLD INCOME IN HISTORIC DISTRICTS
VS REST OF CITY (2019)




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Older Housing and Affordability
Older housing stock plays an important and often overlooked role in providing unsubsidized affordable
housing. In Phoenix, older neighborhoods have a greater share of housing units affordable to low-
and moderate-income households. Demographic analysis shows that these neighborhoods provide
housing for moderate-income, long-term, Hispanic homeowner households.

A city cannot be truly prosperous without an adequate supply
of affordable housing for people of all incomes—and Phoenix HOME COSTS RISING FASTER THAN
is in a housing affordability crisis. Forty-six percent of Phoenix
INCOME (2010-2018)
households are considered low income, very low income, or
extremely low income. Both rents and home prices have risen faster
than wages since 2010, making it increasingly burdensome for low-
income households to live and work in the city. With nearly half the
population considered “low income,” Phoenix cannot build itself
out of this crisis. Therefore, the preservation of existing affordable
housing must be a key strategy.


Phoenix’s inventory of older housing stock is providing
affordable housing largely without subsidy, likely due to its
age, condition, and smaller unit size. While new construction
must be part of the affordable housing solution, that will be
Source: Housing Phoenix Report, American
neither cheap nor sufficient. It is critical that older affordable Community Survey, US Census Bureau (2018)
housing be maintained.


In order to get a general understanding of the patterns of older housing in Phoenix, this analysis selected census
block groups where 50% or more of the housing units were built prior to 1970. Of the 967 block groups in Phoenix, 254
met that test. Only 14.5% of the City’s land area is covered by these block groups. 70% of housing units in these block
groups where built prior to 1970, but these areas are largely undesignated - historic districts cover only 5% of the land
area in these study block groups.



DEMOGRAPHIC CHARACTERISTICS OF ETHNICITY
PRE-1970 BLOCK GROUPS
When looking at demographic characteristics
of Pre-1970 block groups, it is clear that older
neighborhoods are housing low-to-moderate
income, long-term, Hispanic homeowner
households.



HOUSEHOLD INCOME OWNER - LENGTH OF RESIDENCY




Page 11
HOUSING COSTS IN PRE-1970 BLOCK GROUPS
The best indicator of housing affordability is housing cost, specifically the number of units available at a price point
that is affordable to lower income households. An analysis of monthly rents and owner costs in these pre-1970 block
groups reveals that older neighborhoods offer units at a diverse range of price points. Moreover, it reveals that areas
with a concentration of older housing have a greater share of housing affordable to both low-and-moderate income
households than the rest of the city.


SHARE OF UNITS BY RENT SHARE OF UNITS BY OWNER COST




HOUSING COST BURDEN Even though there are
Households are considered housing cost burdened if they spend more lower-income
more than 30% of their monthly income on housing costs. Overall, households in these areas,
33% of Phoenix households are cost burdened, 25% of which live they are not significantly

in block groups with a concentration of older housing. Within
those block groups with a concentration of older housing, 26% of
homeowners and 47% of renters are housing cost burdened. This
is just slightly more than the share of cost burdened homeowners
and renters in the rest of the city. Even though there are more lower-
income households in these areas, they are not significantly more
cost-burdened, likely due to the lower rents and monthly owner
costs demonstrated above. There being
little statistical difference in cost-burden
more cost-burdened,
likely due to the lower
rents and monthly owner
costs demonstrated above.



SHARE OF RESIDENTS THAT ARE COST BURDENED
between pre- and post-1970 block groups
suggests that housing costs in these older
areas are proportional to the incomes of
households that live there. Simply put, lower
income households choose to live in the
older neighborhoods, where costs are lower,
because it puts less burden on their monthly
income. It is worth noting, that in both pre-
and post-1970 block groups, renters are
significantly more likely to be cost burdened
than homeowners.



Page 12



Report




Review of Vacant Storefronts and Retail Spaces

This item presents an overview of options available to assist activation of vacant
storefronts and commercial spaces throughout Phoenix.

THIS ITEM IS FOR INFORMATION AND DISCUSSION.

Summary
The Workforce and Economic Development Subcommittee at its May 26, 2021
meeting, requested that staff explore options to assist property and business owners to
better activate vacant commercial storefronts. The Planning and Development
Department (PDD) led the effort with the Community and Economic Development
(CEDD) and Neighborhood Services (NSD) departments as internal partners. In
addition, PDD hired Glancy Consulting to assist with this effort as a subset of the
larger departmental process improvement work that is the primary focus of the
consulting contract. Staff organized and attended 14 listening sessions with a variety
of stakeholders, meeting with 46 stakeholders representing 31 different organizations,
developers and elected officials (Attachment A). These listening sessions were
designed to create an open dialogue, gain insight into some of the obstacles and
potential solutions for vacant commercial storefront properties, and identify
opportunities for reusing or redeveloping these sites.

An internal staff working group met to evaluate comments received from the listening
sessions and held numerous internal discussions with key supervisors to analyze
various comments and concerns raised and to develop the list of recommendations
below. The recommendations broadly focus on the following:

1. Planning and Zoning Recommendations regarding land use and development
standards to encourage reinvestment in the centers;
2. Development Process Improvement Recommendations to streamline process
requirements for existing centers;
3. Other Market and Financial Considerations to help address redevelopment costs for
these centers.

Combined, these efforts will give the City the best opportunity to address the vacant


Page 13

storefront issue, while also helping to implement other adopted plans such as the
Housing Phoenix Plan and the Tree and Shade Master Plan.

Staff requests City Council input and direction on the following potential
recommendations. Based on City Council input and direction, staff will develop a more
defined implementation strategy and timeline. Staff would then work to implement the
various changes through the required processes, which may include City Code
amendments, text amendments, and policy modifications. Based on the potential cost
and scope, some items may be included in the upcoming 2022-23 budget process.

Planning and Zoning Recommendations
In addition to the process improvements and expansions listed below, PDD staff
identified a number of potential changes and updates to the Phoenix Zoning Ordinance
that could facilitate activation of vacant storefronts. These concepts would require
Zoning Ordinance Text Amendments through the normal public hearing and City
Council adoption process:

1. Expand permitted use list in the Planned Shopping Center (PSC), Neighborhood
Retail (C-1) and Intermediate (C-2) zoning districts. The language in the
parenthesis outlines key issues that need to be discussed as part of developing the
exact language. The identified uses might include, but are not limited to, small-scale
breweries and distilleries (scale); neighborhood fulfillment centers (scale); outdoor
recreation uses (parcel size, time); expanded outdoor dining/roll-up doors (time);
and artisan manufacturing (scale);
2. Evaluate required parking relief options for shopping centers that meet size,
location or use criteria to reduce parking requirements by-right. Develop a use
permit public hearing process to allow for creative parking proposals, directional
signage subject to standards and potential revocation of an approved use permit if
not met;
3. Request City Council authorization for a general-fund position within the Office of
Customer Advocacy to help property owners/business owners/small developers
work together in an area to help with property/business owner understanding and
paperwork processing to share existing parking spaces. This has the potential to
increase property owner revenue by maximizing use of existing parking spaces
instead of requiring more spaces be built with a change of use;
4. Expand Multi-family Residential Development allowances within the C-1 and C-2
zoning districts to allow more than existing R-3 density and development standards
(15 du/acre-30 feet-up to 48-feet with building step-backs). Explore up to R-5
density and development standards (43 du/acre-48-feet). Parcel size limits, height
step-back requirements and use permit provisions will be explored as part of this
process;


Page 14

5. Evaluate Landscape Standards for reuse of older commercial centers/buildings.
This effort will streamline responses on existing conflicts between policies and
ordinances regarding landscape requirements for older shopping centers;
6. Review all special permit and use permit applications filed in the last three years
and propose to modify some of them to make it a use by-right subject to
performance standards or make it a use permit instead of a special permit public
hearing process. Examples of potential uses include Licensed Massage Therapy
and Self-storage.

Development Process Recommendations
These will require modifications to existing policies, additional staff training and
resources, depending upon the exact program expansion and/or popularity:
1. Expand use of the existing Annual Facility Program (AFP) to include larger
shopping centers. This is a premium program that combines plan review and
inspections for projects that are embedded in larger existing industrial and
manufacturing buildings. Staff proposes to create a new shopping center program
that will allow for quicker review and on-site work for tenant improvements and
other commercial permits for existing centers or portions of existing centers;
2. Expand the Office of Customer Advocacy (OCA) Program to include conversion of
older shopping centers to assist with smaller multi-family developments and for
centers deemed no longer economically viable;
3. Develop a retail team for site plan and civil plan reviews to assist the expanded AFP
and OCA programs;
4. Develop a generic fact-finding meeting process to make it easier for developers to
gather some basic information prior to expending funds on site plans and other
development details. This will provide a basic list of possible uses, along with
known parking and infrastructure data;
5. Work with CEDD to conduct outreach to a few shopping center parcel owners that
are ready for redevelopment to help identify big picture issues and areas where the
City can offer help to encourage private investment in the center;
6. Provide additional staff training on development process requirements to ensure
compliance with relevant case law, improve the appeal process and ensure timely
staff decisions;
7. Evaluate Policies and Ordinances regarding on-site trash/recycling pick-up and Fire
lane requirements when redeveloping some smaller shopping centers into multi-
family uses;
8. Refine process to better help customers obtain a Certificate of Occupancy for
existing uses in older buildings.

Other Market and Financial Considerations
Staff also identified other potential solutions for City Council consideration that will help


Page 15

address this issue. These include City tracking and marketing, potential additional
sources of funding for required infrastructure improvements, and enhancement or
expansion of existing programs. If the City Council directs staff to explore these
options staff will further develop program criteria and potential costs and return to City
Council for additional discussion and direction. That direction could then be
incorporated into the budget discussions for next year. Ideas to consider include the
following:

1. Create a Vacant Store Front Registry to help connect brokers, investors, site
selectors and business owners;
2. Explore creation of additional financial solutions such as construction sales tax
reimbursement, or infrastructure reimbursements to help address unique
development challenges for aged shopping centers;
3. Explore creation of additional demolition/site preparation resources to
remove/minimize some of the risks with redeveloping aged shopping centers.
These resources could include cataloging existing programs/grants related to
Phase I environmental, or archeology resources. In addition, if funding is allocated
an annual grant program could be created to allow for property owners/developers
to apply for grants to cover some of these costs so the properties are better able to
be marketed for reuse or redevelopment of the site;
4. Explore creation of infrastructure/street/sidewalk/landscaping funding to create a
grant program for improvements in the right-of-way that typically are requirements
of shopping center owners when they redevelop. A grant program could be
developed to work with adjacent property owners to spur investment in their
parcels. This would encourage private investment that builds upon the public
investment to create a better appearance for the larger community. The scope of
the grant would be determined by City Council funding but conceptually it could
address extenuating water/sewer requirements, street requirements, cracked
curb/gutter/sidewalks, or landscaping in the right-of-way;
5. Install public infrastructure such as streets, sidewalks, water/sewer infrastructure for
designated areas through Capital Improvement Plan or bonds to revitalize the
public infrastructure in an area. This will help attract private investment in an area
and the larger community will benefit from an improved appearance of the area.
The areas would be chosen with City Council input and market analysis to
maximize the potential to capture private reinvestment in these centers.
6. Expansion of the Neighborhood Commercial Rehabilitation Program in areas
designated by CEDD to increase funding and the eligibility scope for more
participation.

Responsible Department
This item is submitted by Deputy City Managers Ginger Spencer and Gina Montes and


Page 16

the Planning and Development, Community and Economic Development, and
Neighborhood Services departments.




Page 17
Attachment A


PDD Process Improvement Stakeholder Meeting Participants


Stakeholder Date
Adaptive Reuse: Venue Projects 8/11/2021
Vacant Commercial: Betts Commercial Advisors 8/24/2021
Downtown Development: 9/1/2021
Downtown Phoenix Inc. 9/1/2021
Metrowest Dev. 9/1/2021
CCGB Architects 9/1/2021
SmithGroup 9/1/2021
Council District 3 9/9/2021
Council District 7 9/28/2021
Development Industry Representatives: 9/28/2021
Valley Partnership 9/28/2021
HBACA 9/28/2021
Arizona Multihousing Association 9/28/2021
North American Industrial and Office Properties (NAIOP) 9/28/2021
Pulte 9/28/2021
Ashton-Woods 9/28/2021
DR Horton 9/28/2021
Mayor Gallego 9/28/2021
Mayor's Staff 9/28/2021
Downtown Phoenix Inc. 9/28/2021
Phoenix Community Alliance 9/28/2021
American Solar, DAB 9/28/2021
Huellmantel Real Estate Lawyer 9/28/2021
JAG Development 9/28/2021
Metrowest Development 9/28/2021
Rose Law Group 9/28/2021
Sign Company Owner Representative 9/28/2021
Gorman & Company 9/28/2021
Native American Connections 9/29/2021
Affordable Housing: Trellis 9/29/2021
Council District 1 10/6/2021
Council District 8 10/11/2021
Council District 6 10/18/2021




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Report

Community Assistance Program Expansion Overview and Discussion

This report provides an update on the expansion of the City's Community Assistance
Program (CAP), an overview of efforts to date and a timeline for full implementation.

THIS ITEM IS FOR DISCUSSION AND POSSIBLE ACTION.

Summary
The Phoenix City Council recently approved $15 million in the Fiscal Year 2021-22
budget for the Community Assistance Program. This expansion is intended to enhance
accountability, responsiveness, transparency and trust from the public by expanding
the City’s longtime civilian-only program to respond to mental and behavioral health
calls for service.

Community members, public safety responders and mental health professionals have
all identified the need for enhanced mental health and crisis response support in
Phoenix. Vulnerable communities including children and the elderly, individuals
experiencing abuse, poverty and homelessness, residents with behavioral and mental
health disorders, or people with alcohol and drug dependencies all require additional
support. In order to bridge this gap and to improve service delivery to individuals
contacting 911 experiencing behavioral and mental health issues or in need of
emergency crisis response, the City Council approved additional resources to expand
the Community Assistance Program.

Program History

The Community Assistance Program was established in 1995. This all-civilian group
handles 4,000 calls annually, and includes five crisis response units comprised of 17
full-time positions and 23.3 part-time Caseworker II, Caseworker III, Program
Coordinator, and administrative positions that were majority grant-funded over the
years using Department of Justice Victims of Crime Act (VOCA) grants in addition to
program volunteers. The program responds 24/7 to mental and behavioral calls for
service and is managed by licensed civilian professionals in social work and
counseling.



Page 19

Budget and Research Study

In April 2021, the Budget and Research Department (B&R) conducted a study on
Public Safety Behavioral Health and Crisis Response Calls for Service. The purpose of
the report was to identify an alternative model to delivering services to individuals
suffering from behavioral and mental health conditions and who require crisis response
care. Budget and Research staff researched eight cities including Albuquerque, N.M.
(Albuquerque Community Safety Department - ACSD); Austin, Texas (Expanded
Mobile Crisis Outreach Team - EMCOT); Denver, Colo. (Support Team Assisted
Response - STAR); Eugene, Ore. (Crisis Assistance Helping Out On The Streets -
CAHOOTS); Redmond, Wash.; Salt Lake City, Utah; San Antonio, Texas (Mental
Health Detail - MHD); and San Diego, Calif. (Resources Access Program - RAP). The
study recommended adding resources to the CAP program to increase the number of
crisis response units and to establish new behavioral health units across the city based
on where the highest concentration of calls take place. The concept was to create an
effective City of Phoenix behavioral and mental health crisis response program where
multiple city departments including Police, Fire, Human Services, Neighborhood
Services, and Housing all work together alongside community-based organizations
and the behavioral health community to improve the quality of life for residents in need
(Attachment A).

Progress to Date

A multidisciplinary team of staff from the City Manager’s Office, Fire, Police, Finance
Procurement, Budget and Research, Human Resources and Public Works
departments have been working since the Community Assistance Program expansion
was approved by City Council and went into effect on July 1, 2021. Over the last four
months, the following actions have been taken:

· Worked with Human Resources and Human Services departments to hire the
Community Assistance Program Administrator (Deputy Human Services Director).
· Worked with Finance Procurement Division to issue a Request For Information
(RFI) for Telehealth Services and received 10 responses.
· Worked with Finance Procurement Division to develop three Scopes of Work for
Telehealth, Public Outreach and Community Engagement, and Behavioral Health
Units Request For Proposals (RFPs). Finance Procurement Division to let RFPs in
late Fall/early Winter 2021 and bring to City Council for approval by February 2022.
· Worked with Public Works Department Fleet Division to procure and order 23
vehicles for additional CAP fleet. Vehicles due to arrive in May 2022.
· Worked with Human Resources Department to conduct three recruitments for the


Page 20

Caseworker Service Coordinator (CWSC), Caseworker II (CWII) and Caseworker III
(CWIII) positions in August 2021. Five of the five CWSC supervisor positions have
been filled to date and interviews are underway for the CWII positions and being
scheduled for the CWIII positions with positions to be filled over the next two to
three months.

Crisis Response Units

The Crisis Response Units (CRUs) are staffed by City employees. The CRUs will
continue to be utilized on calls for service that involve trauma and social service needs
including homelessness, child/vulnerable adult abuse, sexual and domestic violence,
drownings, house fires, death (natural, homicide, and suicide), and frequent utilizers of
the 911 system for non-emergency calls. The CRU employees also will be trained to
provide services related to a behavioral health crisis. When appropriate, CRUs will
make referrals for follow up to the Behavioral Health Units (BHUs) or request a BHU to
respond if the main issue is a behavioral health crisis.

Behavioral Health Units

The Behavioral Health Units (BHUs) will be staffed utilizing one City employee and a
community partner employee. The teams will comprise a Master level clinician (City
caseworker) and a peer support specialist (community partner). The BHUs will be
dispatched on incidents in which the main concern is a behavioral health crisis. The
units will provide short-term case management for up to nine months to ensure
customers are connected with appropriate long-term supportive services. The BHUs
will provide transportation to emergency psychiatric agencies, non-emergency
behavioral health agencies, and/or recovery (substance abuse) agencies. The units
will respond, as appropriate, to calls for service without police or fire personnel. Both
the CRUs and the BHUs also will be available for co-response with public safety first
responders when appropriate.

ASU Calls for Service Study

The City has engaged Arizona State University to conduct a study to determine the
natural call codes for behavioral health calls and to assess which calls for service
BHUs should respond to, which could include a variety of calls including hangings,
overdoses, unknown medical, trespassing, etc. The City’s 911 call takers use 10
questions to determine how to best dispatch calls for service. Many times, behavioral
health calls do not show up as the primary call for service but show up as a secondary
or tertiary reason for the call for service once assessed.



Page 21


Alternative Response Program Implementation Assistance

Recently, the City of Phoenix was selected as one of 14 cities to participate in the
Bloomberg Philanthropies’ What Works Cities (WWC) Alternative Emergency
Response Sprint hosted in partnership with White Bird Clinic. A 17-member team
representing City departments, community partners, healthcare and mental health
providers participated in an eight-week sprint, which was a collaborative online
learning opportunity for cities and community stakeholders to learn about alternative
models of emergency response and how to advance the implementation of such
models.

In August, the City hosted the 2021 CIT International Conference “Turning Up the Heat
with CIT: Transforming Crisis Response Systems” in Phoenix. The Phoenix Police
Department’s Crisis Intervention Team (CIT) was also recognized by Mutual of America
with the 2020 Community Partnership Award on Oct. 15, 2021 as a partner on the
Community and Law Enforcement Collaboration Project along with EMPACT-Suicide
Prevention Center and the Tempe Police Department.

In September 2021, the City of Phoenix was selected as one of five cities and counties
from a pool of 60 jurisdictions to participate in the Harvard Kennedy School’s
Government Performance Lab (GPL) one-year technical assistance grant to assist with
program implementation. Phoenix along with Long Beach, Calif., Philadelphia, Pa.,
Durham, N.C. and Harris County, Texas were selected as the GPL’s inaugural
Alternative 911 Emergency Response Implementation Cohort. Phoenix also was
highlighted in Harvard GPL’s 10-Year Anniversary kick-off event “Shifting from
Planning to Doing: Implementing Alternative 911 Emergency Response Systems."

Program Implementation Timeline

Originally, full implementation of the expanded Community Assistance Program was
anticipated to take 18-24 months. City plans included seeking input from the
community and mental and behavioral health stakeholders to ensure that the program
meets the needs of all. The following outlines the program implementation based on a
one-year accelerated implementation schedule (Attachment B).

Continued Investment

The Mayor and City Council continue to invest in improving mental health and
behavioral health services and support for individuals in Phoenix. In addition to the
CAP expansion for mental health calls for service, City Council also approved adding


Page 22

10 positions for Fire Emergency Medical/Dispatch Services, a Traumatic Incident
Liaison in the Human Services Department (HSD), and four family advocates at HSD’s
Family Advocacy Center as a part of the City’s budget process.

Recently, City Council approved an additional $9 million in American Rescue Plan Act
(ARPA) funds to further address mental health in the community. While the CAP
expansion focuses on individuals experiencing a mental health crisis, the mental
health program administered through a third-party vendor on behalf of the Human
Services Department using the ARPA funds will focus on individuals not in crisis but
seeking mental health services.

These investments form a collective effort to create an effective City of Phoenix
behavioral and mental health crisis response and services program where multiple City
departments work alongside nonprofit organizations and the behavioral health
community to improve the quality of life for residents in need.

Staff also is exploring rebranding and renaming the Community Assistance Program.

Responsible Department
This item is submitted by City Manager Jeffrey Barton, Deputy City Manager Ginger
Spencer, Fire Chief Kara Kalkbrenner, the City Manager’s Office and the Fire
Department.




Page 23
Attachment A




B.R. REPORT NUMBER

RESEARCH REPORT 2021-01
BUDGET AND RESEARCH DEPARTMENT DATE ISSUED
April 20, 2021
TO: FROM:
Jeff Barton Amber Williamson
Assistant City Manager Budget and Research Director
SUBJECT
Public Safety Behavioral Health and Crisis Response Calls for Service


PURPOSE

The purpose of this report is to identify an alternative model to delivering services to individuals
suffering from behavioral and mental health conditions and who require crisis response care. The
report recommends expanding the City of Phoenix Community Advocacy Program (CAP) to provide
additional resources for responding to behavioral and mental health and crisis response calls for
service received by the Police and Fire Departments. The intent is to have civilian crisis response and
behavioral health teams respond to these types of calls for service in order to improve Public Safety
outcomes for the community and to connect individuals in need to appropriate behavioral and mental
health services. Surveys of other cities which have implemented similar type models is also included
in this report (Attachment A).

ISSUE

The Phoenix community has been challenged for many years in providing effective crisis response
care to individuals who experience traumatic events, who are suffering from mental illness, substance
abuse disorders, are victims of crime and assault or are considered to be vulnerable or experiencing
homelessness. Impacts from the Coronavirus pandemic have exacerbated negative circumstances
for these individuals and has increased the demand for mental health services. The Phoenix Police
and Fire departments encounter individuals daily and in some cases provide transport to area
hospitals, psychiatric institutions, or unsuccessfully attempt to provide connectivity to community
health resources. In some cases, the lack of an appropriate response can lead to an arrest or a
negative interaction with sworn personnel, which otherwise could be avoided and ultimately does not
benefit the individual or the community. This leaves residents in desperate need of services without
alternatives and results in a continuation of suffering for the individual and repeat calls for service to
public safety departments.

The CAP resides in the Phoenix Fire Department (PFD) and provides non-sworn 24-hour on-scene
victim assistance and crisis response to individuals experiencing traumatic events. The program
specializes in crisis stabilization, safety and needs assessments, grief support, education on
community resources, victim’s rights and advocacy services. However, the program lacks sufficient
funding and is not equipped to respond to all mental and behavioral health calls for service resulting
in a significant gap in service delivery. Increased funding and expansion will allow the CAP to be a
fully comprehensive behavioral and mental health crisis response program to meet the needs of the

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community. The expanded program would not take the place of other community resources provided
at the county, state or private sector level, but rather enhance the community healthcare connectivity
for Phoenix residents. The proposed solution would provide 24/7 behavioral health, crisis intervention,
victim advocacy, short-term follow up, access to on call telemedicine services, and navigation to long
term case management support.

BACKGROUND

The Phoenix Police Department (PPD) and PFD respond to thousands of calls each year relating to
behavioral health related and crisis response calls for service. On many of these calls, the expertise of
a behavioral health team or crisis response unit to de-escalate situations and connect people to
appropriate health resources is simply not an option due to the lack of resources. In some cases where
a crisis response unit is requested sworn personnel and individuals in need of help are either waiting
an unreasonable amount of time for assistance or do not receive services at all. This ineffective
response creates barriers to people receiving help, but also discourages sworn personnel from
requesting crisis response services in the future.

Behavioral and Mental Health Needs

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over
300,000 adults in Arizona live with serious mental health conditions such as schizophrenia, bipolar
disorder, and major depression. Only 40.3% of adults with mental illness in Arizona receive any form
of treatment from either the public system or private providers. The remaining 59.7% receive no
mental health treatment1. According to Mental Health America, Arizona is ranked 47 out of 50 states
for providing access to mental health services2.

Public mental health services in Arizona are administered and provided by the Arizona Health Care
Cost Containment System (AHCCCS)–Regional Behavioral Health Authorities (RBHAs). Substance
use and addiction treatment services are overseen by the Office of the Arizona Governor–Arizona
Substance Abuse Partnership (ASAP). These agencies, along with private mental health providers,
create a tremendous network of mental health support in Phoenix. Unfortunately, these resources
often have long response times to help those in need or are not available after-hours when a mental
health crisis is occurring. Phoenix’s emergency responders respond daily to mental health issues
without the appropriate training or resources to provide the customer with the help they need.

Fire Crisis Response

The PFD responds to over 180,000 EMS calls for service each year. For years 2009 – 2019, total calls
for service increased 3.6% per year. The Fire Department does not “hold” calls, but due to demand that
has outpaced Fire Department growth, fire and ambulance incident response times are below published
standards. The department is working toward better data management, but so far, is unable to identify
how many behavioral health calls for service are received each year. This is difficult, in part, because
many calls for service are for medical events that are complicated by co-occurring behavioral issues.
The Fire Department has frequently engaged the existing Maricopa County behavioral health crisis
mobile team system, but struggles with mobile team availability, response times, and patient outcomes.
While the City sees the value of the existing crisis system to the members of the community, the
consensus is that the system is not built to meet the needs of emergency crisis care.

The PFD developed the CAP Crisis Response (CR) team in 1995 to provide support to victims of
violent crime, fires, deaths and other emergencies. Over the past 25 years the program has continued
to develop and now provides crisis services to over 7,000 Phoenix residents each year. The CAP CR
teams are funded by both general and grant funds, but is largely dependent on grant funding, part-
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time positions, volunteers and interns from Arizona State University and other universities for much of
its staffing. Teams are located at either fire stations or family service centers and are strategically
placed based on call volume (Attachment B).

The current program consists of five CR units and staff includes 17 full-time and 23.3 part-time FTE
with Caseworker II’s and III’s, a program
coordinator, administrative staff and several
volunteers. CR Response Availability

The CAP responds to an average of 4,000 calls for
service each year, however due to a lack of
resources and available units approximately 600 43%
calls for service each year went unanswered during
the two-year period 2018-2019. Additionally,
because units are often not available sworn 57%
personnel do not request units because they
assume one will either not be available or the
response times will be too long. As mentioned
earlier, the PFD staffs five CR units throughout
All CR Units in Service
Phoenix, however as illustrated in the pie chart, for
Q2 of 2020 the units were only in-service about 3 or Fewer Units Available
57% of the time because of staffing challenges.
Insufficient resources and a lack of full-time city staff are major barriers to responding to all calls for
service.

Adequate response times are also a challenge for the program due to insufficient resources. For
example, from a random sample of one of the CR units, response times ranged from 10 minutes to 49
minutes. When CR units are available to help, they have a significantly longer response time than other
emergency services like Police, Fire or EMS. This gap leaves first responders as the only resource to
help behavioral health patients in-need. In 2019 PFD had a 90th percentile response time of 6:59 and
the Phoenix Police Department had a 6:42 on priority 1 response time for emergency calls; while the
CR program had a response time of 39:15. The CR team is staffed with trained experts in de-escalation,
mental health support and substance abuse treatment, but the program is far too small to meet the
level of demand for these services.




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Police Crisis Response

According to PPD, sworn personnel respond to over 2,000 behavioral health-related calls for service
each month across the City of Phoenix (Attachment B), or roughly 3% of total calls for service. In
addition, on average Police officers on scene refer 150 calls per month to the Maricopa County
Behavioral Health Crisis Mobile Team, but units are not always available or can take several hours to
respond. PPD also transports individuals to mental health facilities when required. Additionally, an
internal review by Police revealed officers are less likely to request a crisis mobile team due to (1) the
extended wait time for the mobile unit (2) other types of calls for service holding for an officer response
(3) the inherent nature of the patrol function to resolve situations quickly. These factors can negatively
impact Phoenix Police relationships with the community and prevent appropriate behavioral and mental
health service delivery.

In an effort to improve crisis response services to the community the PPD has provided training
resulting in crisis intervention certification of 540 officers, with 300 from patrol, and created the Crisis
Intervention Team (CIT) Squad comprised of 14 detectives and 2 sergeants. CIT is an innovative and
evidence based first responder model of police-based crisis intervention with community, health care
and advocacy partnerships. In order to be certified, officers receive 40 hours of crisis intervention
training taught by key community members and facilitated by a collaboration between Mercy Care,
Phoenix PD and Tempe PD. CIT trained officers assist individuals dealing with behavioral and mental
illnesses and act as gatekeepers to connect individuals to behavioral health partners to improve the
quality of life for these residents, and help to ensure the safety of officers and the community.
Community partnership and education are primary goals of any CIT program and Phoenix partners
with hundreds of community organizations to meet these goals. Through some of these partnerships,
Phoenix police have access to licensed clinicians to help individuals navigate the behavioral health
system to ensure a continuum of care. Further, all new recruits receive a minimum of 40 hours of
mental health related training at the academy.

In addition, PPD provides training to 911 communications dispatchers through the Crisis Intervention
Network, a local non-profit organization, to triage calls for service where a crisis response unit may be
able to assist. However, making this determination can be extremely difficult due to the nature of calls
and direct diversion of calls to a crisis response unit is not possible most of the time, therefore the
majority of calls where a behavioral response or crisis response unit can assist requires a co-response
with PPD to ensure appropriate public safety outcomes.

Survey Results

Staff surveyed eight cities in the country who provide some type of crisis response or behavioral health
service for residents who contact public safety for assistance. Survey cities include Albuquerque, NM,
Austin, TX, Denver, CO, Eugene, OR, Redmond WA, Salt Lake City, UT, San Antonio, TX, and San
Diego, CA. Survey results vary with some cities in the early stages or continuing to develop their
programs. Most programs are either located in the Police Department or work directly with Police and
Fire Departments as a co-responder model with calls coming in through the 911 dispatch centers. Each
city plans or does connect individuals to local behavioral or mental health services where available for
continuing care or treatment. Three cities either currently or are developing their programs to be
independent of public safety departments in service delivery. Most programs utilize mental health
specialists, licensed clinicians and/or social workers to provide services with two cities relying solely on
sworn police officers trained to provide crisis response services. Only two cities provide 24/7 service
and all cities are either funded by grants, non-profit organizations or with general funds. Attachment
A provides a description of responses received for each city.


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Proposed Solution

In order to improve service delivery to individuals contacting 911 experiencing behavioral and mental
health issues or in need of emergency crisis response, PPD and PFD propose adding resources to
the CAP program to increase the number of crisis response units to a total of 10, and to establish 9
new behavioral health units across the city based on where the highest concentration of calls are
received. The concept is to create an effective City of Phoenix behavioral and mental health crisis
response program where multiple city departments including Police, Fire, HSD, NSD, Housing and
Municipal Court all work together alongside non-profit organizations and the behavioral health
community to improve the quality of life for residents in need (Attachment C). The solution would
also include utilizing a third-party telemedicine platform to provide access to licensed medical
professionals who can access the Health Information Exchange (HIE). This platform could be used
for calls where residents would benefit from not only crisis response and mental health services, but
also medical services.

The proposed solution would accomplish several goals including:

• Increase behavioral health resources to the community by focusing on timely immediate
response to individuals in need
• Crisis de-escalation and improved relationships in the community with public safety
• Return PPD and PFD first responders to core public safety emergency incidents
• Prevent criminalizing behavioral health issues and unnecessarily incarcerating and/or
hospitalizing individuals with mental illness
• Provide alternate behavioral health care and connect community members in crisis through a
coordinated system-wide collaborative approach
• Avoid duplicating behavioral health services
• Outreach and connection to long term case management services to reduce repeat calls to
• Access to licensed medical professionals where needed to improve service outcomes
• Better use of taxpayer resources

The idea is to create an enhanced program to augment the existing crisis system network, not
compete with it. The system is designed around patient safety, appropriate utilization of behavioral
services, reducing healthcare costs, and connecting patients with existing resources to improve their
lives.

The enhanced CAP would involve adding five additional crisis response units (for a total of 10) and
establishing nine new behavioral health units. Each unit type is described on page 6. The program
would also seek to establish a contract for a public-private partnership with a behavioral healthcare
provider to create a comprehensive model where individuals will receive both immediate service from
the CAP units and be connected to multiple different services through the contracted provider.
Additionally, the proposed model recommends expanding the existing city contract with IMD medical
group to offer telemedicine services to residents who are experiencing comorbidities, where both a
mental and behavioral health problem exists along with a medical issue. This on call medical platform
would be accessible to the CAP program 24/7 so that individuals can receive comprehensive care for
all needs.




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Each unit type is described as follows:

Crisis Response Unit (CRU)
These units are staffed with 2 Caseworker II crisis response professionals. These individuals usually
have a bachelors or masters level degree in social work, counseling, or equivalent work experience
and are trained to respond to most community needs including behavioral crisis, mental health, non-
emergency transportation, substance abuse, victim advocacy, elder abuse, homelessness and much
more. The CRUs are response units and will also augment the Behavioral Health Units in performing
follow-up when available. The CRUs connect residents with existing community resources for short,
mid-range and long-term needs.

Behavioral Health Unit (BHU)
The BHUs are staffed with one full time Caseworker II from the City and one Behavioral Health
Navigator from a local Integrated Behavioral Healthcare provider. This public-private partnership
significantly enhances the program by connecting residents with existing community resources to get
them the help they need. This team will work a regular 40 hour per week schedule and will primarily
perform follow-up with customers who were contacted by the CRUs. The BHUs may also receive
referrals for clients from Police or Fire personnel in the field that have identified a resident in need.

The enhanced CAP will provide 24/7 crisis response services to the residents of Phoenix by
augmenting the existing 911 system. The concept is to eventually place licensed clinicians in the 911
communications center to triage calls where a CRU or BHU could be requested. If it is possible to
determine from the caller the incident will not require a public safety response then the CRU or BHU
will be deployed. However, due to the nature of calls this is not always easy to determine which will
require a co-response from both a CAP unit and public safety. The intent is to identify calls
immediately and determine the appropriate response so help can be provided right away to
individuals in need. Additionally, if sworn personnel are in the field they can request from dispatch a
CAP unit if needed and by expanding the number of units this will allow more calls to be serviced in a
reasonable response time. The program would utilize data analysis such as heat mapping, call
volume and response times to determine the most appropriate locations to deploy units. An
evaluation of those data points would continue as the program is expanded so any adjustments can
be made. The program will also provide short-term follow up for residents and work with the
behavioral health provider or other agencies to connect individuals with the county, state or private
resources they need to assist with resolving their crisis or mental health need.

Estimated Costs

In order to expand the number of CRUs from five to ten, add nine BHUs and ensure units are in
service 24 hours a day 7 days per week, significant resources will be required to add staff,
equipment, and to establish a public-private partnership contract with a behavioral health care
provider. To effectively service the Phoenix area and the level of demand for calls for service there
will be three 8-hour shifts for each unit, which will require adding a combination of Caseworker IIs,
IIIs, a Program Deputy Director and administrative staff. The addition of approximately 100 full-time
staff and 35 part-time FTE is proposed for consideration. This would bring the staffing level of the
CAP program from 17 FT to 108 FT positions and from 23.3 part-time FTE to 34.9 part-time FTE.
The estimated costs for staffing, equipment, vehicles, costs for a telemedicine on call platform of
licensed medical professionals and a public private contract with a behavioral healthcare provider is
a range of $13M - $15M and does not include costs for leasing facility space for the additional units.
It is recommended existing city facilities be used if possible to avoid additional costs for facility
space.


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RECOMMENDATIONS

1. Work with the City Manager’s Office for City Council approval to expand the CAP program.
2. Establish protocols for diversion of 911 calls for service to the program including how staff will
be trained, who will provide the training, how calls for service will be triaged, how information will
be collected and tracked for reporting purposes.
3. Develop performance metrics to identify program effectiveness including using the new
electronic patient care reporting system and existing records management system to: collect
data to identify the universe of crisis response and behavioral and mental health calls for service
by call type, geographical location, call duration, response times, follow-up and connectivity to
ongoing behavioral and mental health services, and conduct regular customer surveys.
4. Identify a strategy for how and where additional staff and units will be located based on heat
maps. Coordinate with the Finance Department Real Estate Division to identify if existing space
is available, including using other city facilities, prior to exploring leasing space to accommodate
staff and equipment.
5. Work with Human Resources Classification and Compensation Division to evaluate requested
position classifications based on job duties.
6. Consult with the Law Department on how services will be provided to determine if there are any
liability concerns or considerations prior to program expansion and use of any private-public
partnership to include appropriate information gathering, reporting and sharing of personally
identifying information.
7. Consult with the Finance Department Procurement Division to establish the public-private
partnership contract for City Council consideration with a behavioral health care provider for the
navigators to be used in the BHUs.
8. Consult with the Finance Department Procurement Division to explore amending the existing
IMD medical group contract to provide on call 24/7 telemedicine services.
9. Consult with the Human Resources Labor Negotiations Division to determine if union approval
is needed for desired shift changes from 8 hours to 12 hour shifts for certain positions.
10. Determine if opportunities exist and what will be required for cost reimbursement from AHCCCS,
Medicare, Medicaid and private insurance companies for behavioral and mental health services.
11. Collaborate with HSD, NSD, Housing and Municipal Court to identify and document how services
can be coordinated to maximize the benefit to residents in need where possible.

CONCLUSION

Community members, first responders and mental health professionals have all identified the need for
enhanced mental health and crisis response support in Phoenix. Vulnerable communities including
children and the elderly, individuals experiencing abuse, poverty and homelessness, residents with
behavioral and mental health disorders or people with alcohol and drug dependencies all require help
from the City of Phoenix that could be provided by expanding the CAP. Surveys of other cities
indicate local government is providing services in some capacity whether directly in police and fire
departments or through non-profit partners. It is clear, the current level of resources provided to the
Phoenix CAP program is not sufficient to meet demand or to provide a comprehensive service
delivery model. Increasing the number of staff, utilizing general funds rather than grant funds and
becoming less reliant on volunteers to operate the program will increase the number of calls units can
respond to as well as improve response times. The benefits of additional CAP units will result in more
residents receiving the behavioral and mental health crisis services they need to be healthier. It will
also allow sworn personnel to return to the field to respond to core public safety emergency calls, and
will help to improve the relationship between public safety and the community.




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References
1. "Mental Health Resources in Arizona | Resources to Recover". Rtor.Org, 2020,
https://www.rtor.org/directory/mental-health-arizona/
2. Mental Health in America ‐ Access to Care Data. (n.d.). Retrieved August 03, 2020,




Page 31
ATTACHMENT A

Below is a summary of the eight cities surveyed about their crisis response programs. The survey
focused on understanding the staffing, funding, and nature of each program. Common across all cites
was an effort to provide mental health services to those in need, particularly repeat 911 callers and
homeless individuals. To track their success, all programs use performance measures. Additionally,
mental health training is highly emphasized for everyone, especially first responders.

Albuquerque, NM
The Albuquerque Community Safety Department (ACSD) was created June 2020, designed to
restructure thousands of calls for issues relating to homelessness, addiction and mental health into the
care of trained professionals to keep officers focused on core police work and reform efforts. Staff
consist of social workers, housing and homelessness specialists, violence prevention and diversion
program experts, some of which are licensed. In addition to responding to calls, the program provides
case management services. The types of calls serviced include behavioral health, homelessness,
addiction, social issues, non-violent and noncriminal welfare checks. Staff work 24 hours a day, seven
days a week. ACSD personnel are dispatched through the 911 system. Emergency dispatchers
determine if a community safety response is more appropriate than dispatching a firefighter or police
officer. ACSD staff respond in teams with no sworn staff. The Albuquerque City Council is working with
experts and community members to reallocate millions of dollars and expand community investments
in violence intervention, diversion programs and behavioral health treatment initiatives. Currently the
program is funded through both general and special revenue funds.

Austin, TX
The Expanded Mobile Crisis Outreach Team (EMCOT) launched in 2013 to bring specialty health care
response to mental health emergencies. Positions are staffed by Integral Care, which is the Local
Mental Health Authority of Travis County. This program is a partnership between multiple agencies of
Travis County and the city of Austin. Staff consist of mental health professionals including registered
nurses. They provide case management services including counseling, medical provider assessments,
prescriptions for medications, and living skills trainings for 90 days after initial crisis. The types of calls
serviced include behavioral and psychiatric crises such as suicidal ideation, psychosis, substance
abuse, medical issues, and homicidal ideation. EMS and law enforcement agencies can request
EMCOT through the 911 call center for real time co-response; behavioral health clinicians are
embedded in the 911 dispatch center as primary triage for mental health calls and available to consult
with officers in route to a call; and clinicians are embedded at central booking to divert individuals from
incarceration. Hours vary depending on the day but are generally each day between 6 a.m. and
midnight. Staff respond in teams and first responders remain on site when EMCOT arrives on site until
safety concerns are addressed. The program is funded by both Travis County and the city of Austin.

Denver, CO
Denver has two programs, the co-responder Crisis Intervention Response Unit (CIRU) founded in 2016
and the Support Team Assisted Response (STAR) launched June 2020 as a six-month mobile crisis
unit pilot program. Both programs are grant funded and operated under a contract with the Mental
Health Center of Denver. CIRU is staffed by clinicians that ride with police officers, responding to both
mental health situations and calls that are not necessarily mental health related. Co-responders
research what is known about individuals involved, provide clinical assessments and identify the most
appropriate response or treatment for the individual. Co-responders provide short-term system
navigation and coordination services to ensure individuals are engaged with the appropriate resources
and services. The city plans to completely transition the CIRU to the Denver Department of Public
Safety over the next few years. STAR aims to send more appropriate responses to 911 calls that have
to do with substance abuse, mental health crises or people who need help connecting to social services.
The mobile crisis unit is staffed by licensed social workers and mental health clinicians from the Mental
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Health Center of Denver, and licensed paramedics from Denver Health. The program is designed to
offer follow-up case management and social services. Typical calls include substance abuse, mental
health, connecting people to social services, and non-violent calls for service. Teams consisting of one
clinician and one paramedic are dispatched through the 911 dispatch center weekdays between 10
a.m. and 6 p.m.

Eugene, OR
The Crisis Assistance Helping Out on The Streets (CAHOOTS) program began in 1989 to divert calls
from a sworn response and provide humane and restorative care to populations in need. Services are
provided by the White Bird Clinic on contract with the city. Staffing consists of emergency medical
technicians and crisis counselors. The program does not provide case management services but
responds to calls relating to homeless individuals and mental health service calls. Staff are available
24 hours, seven days a week and are dispatched by 911 operators who are trained to route calls to
CAHOOTS. Calls also come in directly to the White Bird Clinic. Teams of two respond alone unless
police assistance is requested. The program is funded by city general funds.

Redmond, WA
The city of Redmond program began in 2017 and consists of one mental health professional on staff
within the police department. The goal is to better respond to types of calls that don't necessarily require
a police response or can be better resolved with alternative means. The licensed professional responds
to calls focused on providing mental health services. Individuals are tracked for future reference and
referrals to social service non-profits are provided. Calls come in via the 911 system, but this position
is also sometimes contacted directly by staff and community members for assistance. This position
monitors radio traffic to see which calls make sense to respond to with a police officer. Calls are
responded to 40 hours per week on weekdays. The position is funded by the general fund and grants.

Salt Lake City, UT
The Community Connection Center opened in 2016 to provide a safe environment for people to access
individualized care, support, and appropriate community services. Staff consist of police officers and
social workers withing the police department. The staff respond to referrals from first responders and
the center offers in person case management. Type of calls include any individual in Salt Lake City that
needs a police response or is in crisis and in need of social services. Teams respond weekdays 6 a.m.
to 4 p.m. with one officer and one social worker. The teams are call responsive which means they listen
to the radio to identify calls. There may be specific requests through 911 operators asking for a team
to respond. They focus and track the top 20 highest utilizers of 911 to contact for services. The program
is funded by the general fund and grants.

San Antonio, TX
The San Antonio Mental Health Detail (MHD) began in 2008 to effectively respond to calls from people
experiencing a mental health crisis, de-escalate mental health emergencies, and coordinate treatment
with local behavioral health providers. Staff consist of police officers in partnership with contracted
licensed clinicians from Baptist Healthcare System. MHD officers are Certified Mental Health Officers,
credentialed by the Texas Commission on Law Enforcement and Education. MHD officers are crisis
intervention specialists in plain clothes, driving unmarked cars. Case management is provided by
clinicians working with individuals to address housing, employment, and other issues that may
negatively impact mental health. The MHD is staffed in two shifts from 10 a.m. to 4 a.m. and respond
to calls in teams of two officers. When a call is received by 911, patrol officers are initially dispatched.
If a situation appears to involve an individual experiencing a mental health crisis, the responding officer
will hand-off the case to MHD officers. The MHD also monitors radio calls, can be requested by other
officers or organizations, and may work in conjunction with another unit or Fire/EMS. The program is
funded by the general fund and grants.

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San Diego, CA
The Resource Access Program (RAP) began as a pilot program in 2008 to preserve public safety
resources by connecting the patients with proper systems of care. RAP primarily focuses on high 911
utilizers, who are known to be especially vulnerable and suffering from complex medical or social
difficulties. This is a joint program between the city and county with staff consisting of a program
manager, community paramedics, and mental health clinicians. Case management services are
provided by clinicians. Hours of operation are weekdays 7 a.m. to 5 p.m. Teams of one clinician and
one community paramedic respond to referrals in teams unless there is a prior established relationship
with the client. They do not respond to 911 calls, instead they receive referrals from first responders.
Funding is provided by the county and city, although the city provides capital equipment. This program
uses a unique software called Street Sense which was developed in house. It monitors the 911 call
system and matches names with their clients. Street Sense provides profiles for all their clients and it
has information regarding their call history, medical and mental issues, even vital signs. The software
allows you to create reports and dashboards.




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C
ARE
FRE
EHWY 3
0N
W
EST
LANDR
D 7
D
O V
EVA
LLEYR
D 3
0N
A
SHL
E RH
ILL
S

L
O N
EMO
UNT
A INR
D 3
0N
M
ONT
G O
M E
R Y

D
IXIL
E T
A D
R 2
0N
P
EAK
VIE
W R
D
D
YNA
M IT
EBL
VD 2
0N
P
INN
ICA
LEV
IST
A
J
O M
AXR
D 2
0N
Y
EARL
INGRD
H
APP
YVA
LLEYR
D 2
0N
A
LAME
D AR
D

P
INN
ACL
EPE
A KR
D 2
0N
W
IL
LIA
M SD
R
6 5
D
EERV
ALL
E YD
R 2
0N
R
O S
EGA
R D
EN 5
0 4
B
EAR
DSL
E YR
D 2
0N
Y
O R
KSHIR
EDR
U
NIO
NHIL
LSD
R 4
1 1
0N
G
ROV
ERSA
VE
B
ELLR
D 3
5 1
0N
P
ARA
D IS
ELN 4
G
REE
N W
AYR
D 1
0N
A
C O
M AD
R 3
T
H U
NDE
R B
IRDR
D 1
0N
S
W E
ETWA
TERR
D
C
ACT
U SR
D 1
0N
C
HOL
LAS
T

P
EOR
IAAV
E 1
0N
M
OUN
TAINV
IEW
D
UNL
A PR
D 9
000N
B
U T
LERD
R

N
O R
THE
R NAV
E 3
0 8
000N


0W 1
0W 1
0W 9
900W
O
RANGE
W O
OD 2
G
LEND
ALEA
VE 7
000N

100W 8
300W
M
ARY
LANDAV
E

B
ETHA
NYH
O M
ERD 1
7 6
000N
M
ISS
O U
RIA
VE 1
5 5
000N
C
AME
LBA
CKR
D 5
C
AMP
BEL
LAV
E
0 2
5 9 6
IN
DIA
NSCH
O O
LRD 4
100N
O
SBOR
NRD
4 1
0 5 1
T
H O
M A
SRD 2
900N
E
N C
ANT
O B
LVD
4 1
4 4
M
CDOWE
LLR
D 1
1 1
600N
R
O O
SEV
ELTS
T 1 8
V
ANB
URE
NST 3
00N
H
ARR
ISONS
T
9 2
B
UCK
EYER
D 6 1
D
URA
N G
O S
T

L
O W
ERB
UCK
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D 2
800S
E
LWO
ODS
T
B
ROA
DWA
YRD 2
2 4
400S
R
O E
SERR
D
S
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THE
R NAV
E 6
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V
INE
YARDD
R 2
8 3


9thA
VE 9
1stA
VE 8
3rdA
VE
07thA
VE
B
ASE
LIN
ERD 7
600S
S
O U
THM
OUN
TAIN 5
8 5

5thA
VE
D
O B
BIN
SRD 9
200S
M
INE
R A
LRD
In
ciden
t
7thA
VE
E
LLIO
TRD 1
0S
C
ARV
ERR
D
8 Volu
m e
9thA
VE
E
STRE
LLADR 1
0S

H
igh
K
N O
XDR




1stA
VE
R
AYR
D 1
0S
6 4
C
HAN
DLERB
LVD 1
0S
F
R Y
ERD

P
ECOSR
D 1
0S L
ow
4 V
rdAE 3
5thA
VE 2
7thA
VE 1
9thA
VE 7
thA
VE
C
ENT
R A
L
6thS
T 2
4thS
T 2
3n T
dS 4
0thS
T 8
4thS
T
thS
T
/27
/20

Page 35
Attachment B

CITY OF PHOENIX POLICE DEPARTMENT
Dispatched/Callback/Self-Initiated Calls for Servcice
For Specified Final Radio Codes^
Citywide
Date Range: 1/1/20 - 6/30/2020


RD
RIVE
R
NE
W
N




RD


N 27TH AVE
RIVER


N N EW

DENSITY
W DOVE VALLEY RD
Very Low

Low £
¤ 303 KR
EE
D




Moderately Low 200 CR
AV E
N BLAC
NC
Moderate

N TATUM BLVD
K CANY
E JOMAX RD
Moderately High

N 67TH AVE ON AC
W HAPPY VALLEY RD
High

N 43RD AVE
E PINNACLE PEAK RD
Very High
LLEY RD
E DEER VA
Freeways

N 56TH ST
W BEARDSLEY RD E BEARDSLEY RD
Precinct Boundaries 101
£
¤
N 7TH AVE N 7TH ST
E UNION HILLS DR

N 16TH ST
Main Streets 900
£
¤ E BELL RD
Canals W BELL RD



§
¨
¦ N 32ND ST
Railroads 17 E GREENWAY RD

N 19TH AVE
N 64TH ST
N 51ST AVE
ET




N BLACK CANYON AC
Mountains HU
ND

N 40TH ST
ER
BIR
W CACTUS RD DR
D



N 43RD AVE
W PEORIA AVE E SHEA BLVD


W DUNLAP AVE

W NORTHERN AVE E NORTHERN AVE


W GLENDALE AVE



N 7TH AVE N 32ND ST
W BETHANY HOME RD

N 24TH ST

N 107TH AVE N CENTRAL AVE
W CAMELBACK RD


N 99TH AVE E INDIAN SCHOOL RD 700

N 91ST AVE N 83RD AVE N 51ST AVE N 56TH ST

N 16TH ST N 44TH ST
E THOMAS RD


E MCDOWELL RD
N 75TH AVE §
¨
¦ 10 202
W VAN BUREN ST
E WASHINGTON ST £
¤
S 59TH AVE
500 143
W BUCKEYE RD 10
§
¦
¨ £
¤
S 67TH AVE
S 75TH AVE S 51ST AVE

S CENTRAL AVE
S 91ST AVE S 83RD AVE
E UNIVERSITY DR

S 99TH AVE
W LOWER BUCKEYE RD E UNIVERSITY DR



S 19TH AVE
E BROADWAY RD
S 27TH AVE
§
¨
¦
S 7TH AVE S 7TH ST S 16TH ST
S 91ST AVE
E SOUTHERN AVE



S 75TH AVE 202 S 43RD AVE
E BASELINE RD
£
¤ W BASELINE RD


W DOBBINS RD W DOBBINS RD
W ELLIOT RD E ELLIOT RD




E RAY RD



S 48TH ST
E CHANDLER BLVD


W PECOS RD E PECOS RD S 40TH ST



^Specified final radio codes include 415H*, 415I*, 415J*,418A*, 418B*, 418D*, 503*, 601T*, 651*, 901O*, 901U*, 901X*, 918* (but not 918T*).
Any calls for service that had missing or incorrect information may not be properly depicted in this map. Calls are based on the final call type as entered by Communications and/or Patrol. All
dispatched/callback/self-initiated calls are included regardless of the final disposition of the call (ie. report written, no action required, etc.). Precinct boundaries changed effective October 20, 2014.
Density created for specified area only with a cell size of 100 and a search radius of .75 miles. Any addresses or intersections that could not be geocoded are not included.




®
PHOENIX POLICE DEPARTMENT Miles
Crime Analysis and Research Unit 0 2 4 8 12 16
jaj 8/4/20 Source: ITBCDCv01, vIncident
U:\Ad-Hoc Requests\Internal\42239 nr CFS Cooper\mapping\42239map.mxd


Page 36
Attachment C



Phoenix Community Advocacy Program Overview




Page 37
Attachment B


Community Assistance Program Expansion Implementation Timeline
July 2021 • Hired CAP Program
Administrator
• Implemented
Multidisciplinary City
Team Meetings
• Opened CWSC Position
Recruitment
August 2021 • Issued 3rd Party
Telehealth Request for
Information (RFI)
• Opened CWIII
Recruitment
September 2021 • Ordered 23 Supplemental
Vehicles
• Received 10 Responses
to 3rd Party Telehealth RFI
• Conducted CWSC
Interviews
October 2021 • Conduct CWII Interview
Process
• Onboard New CWSC
Staff
• Finalize Scopes of Work
for Telehealth and
Behavioral Health RFPs
November 2021 • Conduct Community
Engagement Process with
Independent Consultant
• Onboard New CWII Staff
• Conduct CWIII Interviews
• Publish RFP for
Telehealth and Behavior
Health



Page 38
December 2021 • Onboard CWIII Staff
• Train New Staff
• Bids Due for Telehealth
and Behavioral Health
• Interviews and
Demonstrations for RFP’s
• Identify new locations
January 2022 • RFP negotiations and
best and final offer
• Continue recruitment for
open CWII and CWIII
positions
February 2022 • Seek City Council
Subcommittee approval of
Telehealth RFP Award
• Seek City Council
approval of Behavioral
Health Unit RFP Award(s)
March 2022 • Contract implementation
• Continue on-boarding and
training CWII and CWIII
April 2022 • Finalize new locations
May 2022 • Vendor ETA for Vehicles
*Five 15-passenger vans
due to arrive August 2022

June 2022 • Continue roll out of new
and expanded programs




Page 39