Tompkins County
New York


Authorization to Execute Agreement - Development of a Mobile Crisis Team - Tompkins County Mental Health Department


Department:Mental Health DepartmentSponsors:
Category:Agreements, Bids, ContractsFunctions:Mental Health

Resolution/Document Body

              WHEREAS, the Tompkins County Mental Health Department (Department) has recognized the community need for behavioral-health crisis assessment, intervention, and stabilization services 24 hours per day, seven days per week, and 365 days per year, and


WHEREAS, the Department is proposing the development of a Mobile Crisis Team (Team) in order to serve individuals and families who are experiencing urgent concerns related to mental health and/or substance abuse issues, and


WHEREAS, the development of this Team will increase public safety, decrease unnecessary hospitalizations for those experiencing behavioral-health crises, and decrease unnecessary legal involvement or incarcerations for those experiencing behavioral-health crises, and


WHEREAS, the Delivery System Reform Incentive Payment (DSRIP) program will help fund this Team via the regional Performance Provider System (PPS) - Care Compass Network. The DSRIP program promotes community-level collaborations and restructures the health care delivery system by reinvesting in the Medicaid program to reduce avoidable hospitalizations, and


WHEREAS, the Care Compass Network is a not-for-profit, community organization created to champion new models of providing Medicaid beneficiaries with higher quality care, while reducing expenses through care coordination and community-focused care and education, and


              WHEREAS, the Department wishes to enter into a professional services agreement with the Care Compass Network to be eligible for and to receive the financial support for those individuals who are unable to pay for services through conventional means, and


              WHEREAS, the Care Compass Network will provide startup funds for the first two years of participation in this DSRIP (Delivery System Reform Incentive Payment)-supported project, and


WHEREAS, this request will result in no change in the target funding from the County since this project is designed to support any additional expense sustained by the Department as one of the goals of the project is to be self-sustaining, that is, that any additional expenses will be covered by the revenue generated by this project, now therefore be it


RESOLVED, on recommendation of the Health and Human Services Committee, That the County Administrator or his designee is hereby directed and authorized to execute any and all agreements necessary to complete the requirements of this Mobile Crisis Team project.



Meeting History

Dec 19, 2016 3:30 PM  Health and Human Services Committee Regular Meeting

Mr. Kruppa provided a brief description of the proposed Mobile Crisis Team to deal with behavioral health issues that may occur in the County. The main goal of the team is to provide a social worker and case worker in a situation to avoid unnecessary involvement of law enforcement or hospitalization. The service provided by this team would be available 24 hours a day, which is an expansion of the current emergency outreach services that is currently only available during normal working hours of 8:30 a.m. to 4:30 p.m.

Mr. Kruppa said he is hoping to work with the crisis suicide line where referrals would be made and the calls would be triaged. A determination would then be made if the crisis line could support the person or if there is an additional need to call in the crisis team. A further phone triage would be conducted to determine if there was need for the crisis team to go to the site. The social worker and case worker would work in tandem to assist in following through with necessary additional services beyond the crisis itself.

Mr. Kruppa explained there is an attempt to access funding from the Delivery System Reform Incentive Program (DSRIP) and Care Compass Network is looking to contract for crisis intervention. There have been discussions with Care Compass Network and he believes it will assist in allowing for this service to be provided.

Mr. Kruppa stated billing would be done for Medicaid and/or private insurance and Care Compass Network would be paying for those that cannot be billed. Care Compass Network will also be providing some startup funding.

Mr. Kruppa said this proposal would create the Mobile Crisis Team and authorize a contract with Care Compass Network. There is a team within the Department working to operationalize this service. He would like to have this team ready by March 2017 and be able to maximize the available funding.

Ms. Kelles inquired about billing. Ms. McDougal stated it was difficult to estimate what percentage would be able to be billed but Care Compass Network would reimburse the Department for any cases they were unable to bill for. Ms. Kelles further inquired that since the plan is for the program to be self-sufficient and pay for itself she is concerned with the unknowns regarding the future of Medicaid, the Affordable Care Act, and the changes involving the recent election and asked if there are the same concerns within the Department. Ms. McDougal stated she does not have any information regarding that funding but has been told that DSRIP has already been funded.

Mr. Kruppa clarified there was $8 billion received by the State through DSRIP for allocation to put programs in place that will reduce unnecessary emergency room visits and hospitalizations. This region received $250 million of that funding and Care Compass Network is responsible for administration of those dollars.

Ms. Kelles requested the resolution have an additional whereas statement to explain the DSRIP and Care Compass Network. Mr. Kruppa agreed to make the amendment to the resolution as requested.

Ms. Robertson inquired about the mentioning of housing and Drop-in Center in the back-up information to the resolution. Ms. McDougal said Care Compass Network has recognized crisis interventions also needs some additional housing support and there are some residential providers in the community that are interested in providing mental health crisis housing and are looking into funding for that. Also, some addiction treatment providers in the area are also looking into crisis stabilization and detoxification centers.

Ms. Chock asked if when the Mobile Crisis Team shows up to a call, if an individual has a choice to refuse services due to their inability to pay. Ms. McDougal explained how the cases would involve crisis and urgent issues in the community. She also stated that under Mental Hygiene Law, if a person is in immediate danger to themselves or others, that individual can be taken to a facility for observation.

Ms. Chock stated she is supportive of this in concept but is unsure of the insurance and payment issues as they relate to this.

Mr. Kruppa stated if the team is going out it is due to a person in crisis and the copay will be the least of their concerns if intervention is not done in an effective manner.

Ms. Kelles spoke of a program in which police officers and mental health care workers work together and communicated well to reduce risks and crisis situations and asked what mechanisms are in place to ensure there is consistent communication of cases so that there is follow-up care after a crisis situation. Ms. McDougal stated all of the stakeholders, as part of the planning that is currently taking place, are involved in making sure that happens when this program is operationalized. She also stated that if the intervention can be accomplished without the assistance of law enforcement, then that is done. Ms. McDougal further explained how the communication portion of the follow-up will be done by the use of electronic medical records and the sharing of information.

Ms. McDougal spoke of Health Insurance Portability and Accountability (HIPPA) Act protections and how patient/client information cannot be shared unless there is a crisis situation taking place.

MOVER:Martha Robertson, Member
SECONDER:Anna Kelles, Member
AYES:Leslyn McBean-Clairborne, Carol Chock, Will Burbank, Martha Robertson, Anna Kelles
Dec 20, 2016 5:30 PM Media Tompkins County Legislature Regular Meeting

Mr. Klein asked if the Community Outreach Worker would be included in the list of stakeholders. Mr. Kruppa believes that was an oversight and that all appropriate stakeholders will be engaged in the process.

Mr. Kruppa explained the proposal and said the Mobile Crisis Team will be available 24/7 to respond to behavioral-health crisis assessment, intervention, and stabilization services. He noted they are not requesting County funds at this time and expects that after the initial two years the program will be self-sustainable.

MOVER:Leslyn McBean-Clairborne, Member
SECONDER:Anna Kelles, Member
AYES:Will Burbank, Carol Chock, James Dennis, Rich John, Anna Kelles, Dooley Kiefer, Daniel Klein, Michael Lane, Leslyn McBean-Clairborne, Martha Robertson, David McKenna, Glenn Morey, Michael Sigler, Peter Stein