12. Creating a Community Responder Program

Prior to the advent of paramedics, police put injured people into squad cars and drove them to the hospital; in some cases, they still do. Paramedics developed as a profession relatively recently, in the 1970s and 1980s. Now, they are a permanent part of our local government and medical infrastructure. This development over the last fifty years demonstrates what’s possible: local governments can establish a new emergency response that provides a better answer to specific emergency calls for service.

Now, another new emergency response is taking root. Localities are establishing community responder programs for the same reason that paramedics took root fifty years ago: police officers are the default response to many calls for service that they are not trained or equipped to handle appropriately, including categories like mental health crises and homelessness. Multiple analyses of 911 call data from different jurisdictions show that the vast majority of calls are not life-threatening and do not merit an armed law enforcement response.

This trend has been exacerbated by disinvestment in public health and human services over multiple decades. In the absence of better upstream strategies, local governments are intervening. Community responder programs can:

• Provide a better, more effective response to several different types of calls for service that are more appropriately met by a social service intervention than a law enforcement intervention.
• Reduce exposure to armed police, potential use of force, and entanglement with the criminal legal system, thereby reducing harm for, in particular, low-income people and communities of color that are historically overpoliced and overexposed to these dangers. 
• Allow police to focus on responding to and investigating violence and other emergencies that more appropriately call for an armed response by freeing up time previously spent on these calls.
• Reduce reported crime – and thus criminalization – in the categories of calls that they respond to.
• Divert calls from Fire, EMS, and/or emergency rooms; and respond to calls in a more cost-effective manner.

When asked what the most important considerations are for elected officials in the development and launch of a community responder program, subject matter experts repeatedly bring up a few key roles that elected officials are best able to play: demonstrating political will, building consensus, and leading authentic community engagement.

As reflected in Local Progress’ strategic framework of collaborative governance, the best way to demonstrate political will is in partnership and collaboration with community organizations, community leaders, and activists pushing for change. With or without that active partnership,

affirmatively demonstrating support for the development of a community responder program in the form of a resolution or executive action is how several programs have begun in the last two years, and can be helpful (or even necessary) to give staff a clear directive to begin work on program development. 

Authentic community engagement is critical to developing a successful community response program if it is going to successfully meet community needs and be sustainable over time. As an elected official, you are uniquely positioned to play a leading role in this work due to your position within the community, your responsibility to all residents and other interested groups, and your need to consider and mediate different points of view.

Internal engagement of local government staff and external community engagement should, at a minimum, accomplish the following tasks:

• Establish a baseline understanding of current emergency responses, calls for service, and community experience with current responses.
• Establish a baseline understanding of what community responder programs are and what they are not. 
• Using accessible call data analysis and based on community experience with current responses, ask community members.
• Seek community input and consultation on key structural questions.
• Establish norms for long-term community engagement and set realistic program expectations.

The question of housing your program via internal hire vs. an outside contract is a key consideration.

If your program decides to contract for services, consider including a labor neutrality provision and/or minimum contract requirements for job quality to ensure that the contract does not undercut city labor standards.

Other important aspects of this decision include:

• Administrative needs – the speed with which a program may be able to launch with an external contract vs. internal city staff positions given the steps needed to develop new job classes, negotiate with existing city staff unions, etc.
• Community trust – depending on the community and political dynamics in your locality, this could cut both ways: municipal (or specific government departments) or a community-based mental health provider may be perceived by the community as more trustworthy than the alternative. If the program is internal to your locality, regardless of the department, there may be skepticism in the community among those who believe that the program is merely an extension of law enforcement. If the program is housed in the police department, there will undoubtedly be difficulty in establishing community trust, and concerns from the community that the program will be co-opted by police and their existing departmental culture.
• Departmental home – related to above, some localities may not have an existing department or structure that is a good fit for this program, and hiring internally without the right leadership and home can hinder its success.
• Recruiting and hiring a diverse workforce – a consensus best practice for community responder programs is to hire responders who reflect the communities they serve by hiring for skills and experience, not credentials. Community organizations in your locality may have an easier time hiring staff that reflect the communities the program will serve than government, and there may be rules in your locality that preclude or make it more difficult to hire people impacted by the criminal legal system.

It is worth noting that the question of internal hire or an external contract does not need to be all or nothing. Depending on the mix of skills you decide to include in your teams, your program could choose to contract for some services and not others. Similarly, a response program could begin as a contracted service and transition to being municipally run (as in the case of Olympia’s Crisis Response Unit).

Like any public service, the long-term success and sustainability of community responder programs will depend on how effectively the program meets community needs. In order to make that case, highlight program successes, and allow for continuous improvement, elected leaders should ensure that relevant data will be collected and evaluated from the start while maintaining the data privacy of individuals.

Key recommendations from city leaders and subject matter experts include the following:

• • Pursue a partnership with an academic research center or other evaluation partner to conduct (and seek outside financial support to fund) longitudinal research and evaluation. Engage them early in program development and engagement. 
  • Establish key metrics and performance indicators that clearly connect to identified program goals and program equity, such as: call volumes, response times, call diversion rate, “customer satisfaction,” cost per call, etc. Ensure that there are viable data sources for these metrics. 
  • Solicit feedback from partners and community members on these goals and metrics and regularly share results in an accessible dashboard to promote program transparency.

• Build data collection and analysis into program planning and budgeting.

Examples of program evaluations and dashboards that provide regular access to key data include:

• Albuquerque, NM Community Safety’s Transparency page publishes monthly informational reports
• Eugene, OR Police Department Analysis of CAHOOTS Program using 2019 data
• Portland, OR Street Response maintains a data dashboard updated at least weekly
• San Francisco, CA Street Crisis Response Team monthly updates include key performance indicators

Program Pilot

Whether your locality’s program pilot is more accurately a program launch phase or if it is a genuine pilot that will be evaluated before a determination is made regarding permanency and long-term funding, conducting a large pilot will better position your locality to collect useful data and expand into a permanent program if there is the will to do so. Therefore, it is helpful to plan for as large of a pilot as there is the political will to fund.

Multiple cities and subject matter experts underscored how challenging it can be to scale a program up to a citywide, 24/7 response – for both staffing and budgetary reasons. Whether intentionally or as a result of those challenges, several cities have started their program within one or more specific geographic areas where the identified call categories are most prevalent, and/or have started with the highest-volume shift of the day.

As a common model begins to emerge across the country for alternative response to behavioral health crisis calls, the prospect of national standards becomes increasingly likely. The inclusion of guidance on best practices in President Biden’s executive order, as noted in the previous section, indicates as much. Even as that happens, there will continue to be opportunity for local innovation and experimentation in community responder programs. A few key areas of opportunity include:

• Expanding call categories beyond behavioral health. Beyond the consensus on behavioral health, there are several additional call categories that many, though not all, community responder programs are taking, including calls arising from unhoused people, inebriation or addiction, welfare checks, “quality of life” calls like noise complaints, “suspicious person” or “suspicious vehicle” complaints, and other categories that call for community mediation.

Your program can be tailored to best meet local needs depending on your call volume in each of these areas.

• Experimenting with the skill sets that are included on each response team. Localities are making different choices regarding which skill sets, and especially which professions, their responder teams will have. As noted earlier, there are several different areas of professional and non-traditional expertise being included on community responder programs around the country: mental health clinicians, licensed social workers, emergency medical technicians, peer support specialists, community mediators, or other professionals (licensed or not) with a mix of these skills. Last year, CSG published this resource on the different types of workers and team structures in community responder programs.
• Exploring opportunities to integrate these programs into broader infrastructure. Community responder programs can and should coordinate with violence prevention programs, and with health and human services infrastructure in your county or state.
  • Community responder programs can do follow-up and some case management work if your locality chooses to do so in order to address underlying conditions that led to the incident. However, some localities are deliberately choosing not to offer this service in order to focus on the core mission of an emergency crisis response.
  • The long-term success of community responder programs may rely on, and at a minimum will be augmented by, success in helping community members navigate to needed in-patient and out-patient treatment, recovery housing (not only low-barrier shelters), and other resources. 
  • Community responders should be in relationship with Violence Interrupters and other violence prevention frontline staff, and can learn from and hire people who have lived experience. Since both of these programmatic areas are still emerging, so too are best practices in their collaboration and cross-pollination.

While many current community responder programs are still in their early phases of implementation and operation (with the exception of Eugene’s CAHOOTS), subject matter experts and city staff identified key considerations for long-term success and sustainability: 

• Staff leadership consistency. When compared to municipal departments that have historically existed for hundreds of years and are likely baked into your locality’s charter, community responder programs are on fragile political and budgetary ground. In addition to (or especially in the absence of) long-term political champions, these programs need long-term staff leadership to persistently work on and fight for growth, development, evaluation, and continuous improvement.
• Departmental infrastructure. Whether or not your program is housed in an existing department or a new one, it will need its own management and staff infrastructure in addition to the frontline staff teams. While it is likely more politically expedient and financially feasible to establish a program without a full structure built out, it is important to plan for the addition of positions that support needs like training, communications, data support, human resources support, and policy analysis in future budgets.

Related to both of the above, community responder programs need the political and administrative support to adjust their structure as they grow and as needs change. That could mean bringing contracted services in-house, moving from one department to another, or creating a new department or a new division.

• Client support. Client follow-up after the initial crisis is critical to connect people to the long-term support they need and will improve the effectiveness of the program at addressing chronic challenges. Some localities are building case management into their program and some are not; what is imperative is that some form of client follow-up happens.

Staff support. Community responder staff do physically, mentally, and emotionally challenging work with people in crisis. They need and deserve both day-to-day support to sustain that work in the form of structured debrief time and other supports, and career-level support in the form of pay equity, career tracks, and promotional opportunities.

Check out pages 31-37 of the full resource available here to see in-depth case studies on the community response programs in Albuquerque, New Mexico, Durham, North Carolina, and Oakland, California. Each case study includes an overview, key takeaways, a note about community engagement, and a program budget.