Marcus Alert - DBHDS Vision: A life of possibilities for all Virginians
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Marcus Alert DBHDS Vision: A life of possibilities for all Virginians
These Initiatives Complement One Another
Slide 2Initial Areas
• We are honored to have the following partnerships for initial
implementation:
– Region 1: Orange, Madison, Culpeper, Fauquier and
Rappahannock Counties (Rappahannock-Rapidan Community
Services)
– Region 2: Prince William County (Prince William County
Community Services)
– Region 3: City of Bristol and Washington County including the
Towns of Abingdon, Damascus, and Glade Spring (Highlands
CSB)
– Region 4: City of Richmond (Richmond Behavioral Health
Authority)
– Region 5: City of Virginia Beach (Virginia Beach Human
Services)
Slide 3July 1, 2021 Plan
• Report focuses on the state framework (i.e., not each local
implementation)
• Collaborative report between DBHDS, DCJS, and
stakeholders
• Has 10 components:
5 components (“catalog”) 5 components (“protocols and process”)
Past and current crisis intervention teams Protocol/framework for 9-1-1 diversion to
behavioral health system
Current mobile crisis teams and crisis Protocol/framework for relation between
stabilization units mobile crisis hubs (regional) and local law
enforcement
Other cooperative arrangements between Minimum standards/best practices for law
mental health and law enforcement enforcement engagement in system
Prevalence of crisis situations and any Assignment of duties, responsibilities, and
Virginia data authorities across state and local entities
Catalog state and local funding of crisis and Process for review and approval and
Slide 4
emergency services evaluation of localities’ plansVoluntary Database
F. By July 1, 2021, every locality shall establish a voluntary
database to be made available to the 9-1-1 alert system and
the Marcus alert system to provide relevant mental health
information and emergency contact information for
appropriate response to an emergency or crisis. Identifying
and health information concerning behavioral health illness,
mental health illness, developmental or intellectual disability,
or brain injury may be voluntarily provided to the database by
the individual with the behavioral health illness, mental health
illness, developmental or intellectual disability, or brain
injury; the parent or legal guardian of such individual if the
individual is under the age of 18; or a person appointed the
guardian of such person as defined in § 64.2-2000. An
individual shall be removed from the database when he
reaches the age of 18, unless he or his guardian, as defined in Slide
§ 5We Broke into 6 Workstreams
Triage: focuses on PSAP/911 Community Input: focuses on
dispatch and state requirements for gathering input from impacted
relationship between 911 dispatch communities at the state level to
and mobile crisis hub crisis call inform the plan and develop
Oversight and Accountability
Conceptualizations of Safety
center guidance for local community input
Authority and Power
Equity at Intercept 0: focuses on
building crisis services at intercept Local Roadmap: focuses on
Ethics
0 and incentivizing the creating resources and a process
development of services that are for local governments to plan and
peer led, Black led, and/or have a submit plans for their Marcus Alert
disability justice focus
Co-responder models, CITAC: Data and Reporting: focuses on
focuses on frameworks and models selection of key outcomes and
for the development of co- identification of data sources,
response teams cadence, and responsibilities
Slide 6Plan thus Far (Background and Values)
• Working together as a system to shift to a behavioral
health response to behavioral health crises
• Shifting role of law enforcement to be:
– Behaviorally health trained professionals who have the
skills necessary to triage people in behavioral health crisis
to the behavioral health system
– Supportive role to community based behavioral health
crisis response when there are safety concerns
• Building a robust system of community based crisis
services with equity as a key design principle
Slide 7Plan Thus Far (State Level Components)
• Statewide and cross-sector “language” to track how
situations are classified and what response is sent
• Minimum standards for diverting calls to 9-8-8 and STEP-
VA/BRAVO mobile crisis
• Specialty models, including protocols/process as well as
teams that can be developed, for localities to evaluate based
on their needs and define their plans at the different levels
– Poison control
– Telehealth
– Three community care team models
• An equity at Intercept 0 Initiative to build equity into the
crisis system from the start
• Training requirements within and across sectors
Slide 8Proposed Four Level
Framework
LEVEL 1 ROUTINE LEVEL 2 URGENT LEVEL 3 URGENT LEVEL 4 EMERGENT
Minimal Risk Low Risk Considerable Risk High Risk
• The framework provides a statewide way to communicate across sectors and across
communities about the different types of situations and how responsibility and
decision making are shared
• Four levels provides the breadth for communities to place resources at lower or
higher acuity levels based on their needs and communicate their plans to others (e.g.,
local leaders)
• NOT because there are inherently 4 levels of crisis or because there are hard rules
about when LE should be involved (i.e., you can have level 1 & 2 both diversion)
• A behavioral health focused response is the goal at all acuity levels, even if law
enforcement involvement is expected at level 4 and may be present at level 3
Slide 9Three Protocols Required by July, 2022
• Protocols are required for all localities by this date
(whether or not you have any new teams developed)
• Working within CSB catchment areas and regionally is
recommended
• Can be a shared protocol across areas even if there are
technical differences across PSAPs, as long as the plans
are equivalent
Slide 10Three Required Protocols
Protocol #1 Protocol #2 Protocol #3
• This protocol • MOU between the • Specialized response
demonstrates how regional call center by law enforcement
you will transfer calls and law enforcement • System/layered
from 9-1-1 to the 9-8- agencies that could approach to the
8 call center be called as back up requirements, based
• Required for level 1 to mobile crisis on a specific model
• Recommended for • Assumed standard (next slide)
level 2 language for the call
• Includes any center with each
provisions for participating agency
“poison control • Includes training
model” at level 2 agreement regarding
CIT trained officers
and advanced Marcus
Alert training
Slide 11Protocol #3
• Model for protocol 3:
Slide 12Community Coverage
• Required in a phased approach
• It is not required that you build your own local teams; the
requirements can be met with additional coordination
with STEP-VA/BRAVO teams, including telehealth
• Local teams do not replace utilization of STEP-VA/BRAVO
teams, instead they:
• Provide triage function to link people to the crisis
continuum (whereas mobile crisis is part of the crisis
continuum)
• Responses to emergent situations that mobile crisis
would have transferred to 9-1-1/involved LE
Slide 13Team Types
• STEP-VA/BRAVO mobile crisis teams (part of Intercept 0)
• Community care without LE (“CAHOOTS” style; a local link
to Intercept 0)
• Community care with LE (Henrico STAR style; a local link to
Intercept 0)
• Co-response teams (a local link to Intercept 0)
Slide 14Timeline
January –July, July- December, December 2021- Beyond July
2021 2021 July 2022 2022
•State Marcus Alert •Communities begin •Public service •Continued phasing in
workgroup launch Marcus Alert planning campaign continue, of community
•Virtual Community process community outreach coverage, until
Listening Sessions •DBHDS and DCJS to post •Select 2nd round of statewide coverage is
instructions for areas for full achieved by 2026
•RFP for Call
Center/Dispatch submitting plans and implementation •Ongoing data,
Software proposals •All communities reporting, and quality
•Statewide mobile crisis implement protocols improvement,
•State Plan due to
dispatch launch by July 1, 2022 including health
General Assembly,
(infrastructure) disparities
July 1, 2021 •July 16, 2022 all
•Adult mobile crisis states federally •Yearly reporting to
•Localities to
teams funded required to have 9-8- General Assembly
implement voluntary
databases, July 1, •Initial areas launch 8 link to National
2021 community coverage Suicide Prevention
•Ongoing children’s and protocols Lifeline and crisis
mobile crisis teams •Medicaid services
(STEP-VA) reimbursement for 4
new crisis services: Dec
1, 2021
Slide 15Thank you!
Slide 16You can also read
