SHAKER HEIGHTS, Ohio — A promising community mental health crisis response program is expected to expand, with the city of Shaker Heights taking over management duties, at least temporarily.
Just over two years ago, the First CALL (Crisis Assistance and Community Engagement) initiative expanded from a successful local pilot to the five cities served by the Heights-Hillcrest Regional Command Center.
The program sends a social worker or other qualified professional to the police or fire department and may only provide follow-up mental health counseling.
Shaker Heights, Cleveland Heights, Richmond Heights, South Euclid and University Heights are already participating, and First CALL initially contracted with Recovery Resources to provide five on-site staff.
The program continues to be funded primarily by grants, but reached an impasse last fall when Recovery Resources announced it would be disbanding as a nonprofit organization.
“This puts us in a situation where we have to find a new partner to hire these employees,” Shaker Heights Chief Administrative Officer Matt Carroll told the City Council during a May 11 work session.
First CALL program coordinator Annette Wallace already works in Shaker Heights, and the city continues to play a key role in operating the Alternative Crisis Response Team.
“We have pursued a number of avenues, but in the short term we will need to employ the remaining people as Shaker City employees,” Carroll said.
There is no additional cost to the City, and no administrative fees apply to anyone else at this time.
Grants are still available, so charter members of the First CALL program will continue to be funded through next April.
Meanwhile, at least four cities have expressed interest in participating: Beachwood, Orange, Pepper Pike and Solon.
That will require additional funding.
Cuyahoga County officials may already have identified about $3 million in funding to “encourage other communities to take this initiative,” Carroll said.
Shaker City has already submitted grant applications for all nine municipalities, but additional funding will continue to be sought, as the city has done for years.
“This is a throwback to Mr. Shaker’s hat for developing a successful program and the county is seeing the results,” Carroll said.
A smaller number of communities have expressed interest in signing on. They haven’t fully committed yet, but some are closer than others.
In response to a question from Vice Mayor Kim Vixenstine, Carroll said the city’s insurance company should be able to receive liability coverage for First CALL employees without increasing Shaker’s premiums.
Mr. Bixenstein also suggested checking with the county about the possibility of receiving insurance there.
Carroll said details such as personal liability insurance coverage could be among the terms of the agreement that county grant recipients would handle mutually.
Councilor Carmela Williams asked about the need for additional staff due to the expansion.
Based on population and call volume growth, First CALL currently has three teams covering five current cities, with one dedicated solely to Cleveland Heights.
As it stands, one team is typically assigned to Shaker Heights and University Heights, while the other team handles potential mental health crisis calls in South Euclid and Richmond Heights.
At least one team of three members must be added to cover the four new members.
With the exception of Cleveland Heights maintaining its own unit, the remaining three teams will be assigned jurisdictions based on location and call flow.
Councilor Tennille Kaus asked about maintaining the management contract temporarily and charging management fees.
Carroll said Shaker could take a nominal fee for handling the program, as Recovery Resources did, but it doesn’t actually do so.
City Councilor Nancy Moore pointed out that there would be additional costs for Shaker in terms of not only Carroll’s time but also directing the program and taking on potential responsibilities.
“At what point do you think it will cost more? And when do you think it’s appropriate to start looking at overhead costs to the city?” Moore asked.
Carroll said it’s a personal effort from John Potts, the city’s finance director, and William Ondry Gruber, the city’s law director.
“And to be clear, all costs are currently covered by grants, so there are no direct resources for the city other than some ‘in-kind services,’” Carroll said.
Councilman Peter Chengelis questioned a previous proposed agreement with Chagrin Valley Dispatch regarding possible oversight of the First Call program.
“We had a contract that Congress gave us the power to do, but ultimately we couldn’t get it done,” Carroll said.
Councilman Sean Malone asked if Chagrin Valley Dispatch would be prepared to take on the role of First CALL at a later date.
“We couldn’t get the insurance policy right,” Carroll said.
“I don’t know if we’ve given up on that idea forever, but we have to take action because our recovery resources are gone.”
Other candidates could include “federally qualified health centers” and mental health providers operating throughout the city.
While it seemed easy enough for Recovery Resources in terms of liability, Mayor David Weiss said some of the later suitors didn’t seem to know much about First Call.
“I think we’ll get there. It’s just going to take a little bit more time to educate them,” Weiss said.
Expressing concerns about First CALL’s potential for “mission creep,” City Councilman Orlando Alvarez called for a future work session to delve deeper into the program’s original intent.
“Obviously, this is a flagship and a beacon for the community, as best illustrated by the desire of other municipalities to participate and be involved,” Alvarez said.
At the same time, he expressed concern about “what the big picture and strategy is beyond services to our city” and the financial burden beyond that.
Carroll said the main objective remains to find a permanent partner to operate it.
If that doesn’t work, Malone asked about creating a Council of Governments (COG), as was done at the former Heights-Hillcrest and Chagrin Valley dispatch centers.
Gruber did not rule out that possibility, but noted that the process would be more complex and add cost.
Weiss said the goal remains to hand over management of the program to a nonprofit or other third party if it reaches a point of “critical mass.”
“We always needed to raise money,” Weiss said. “And all cities know that if there is a shortfall, the cost share will be guided through a formula.”
While Weiss called the transition purely a “stopgap measure,” Alvarez noted that hiring more city employees would increase potential liability risks.
Bixenstein said he hopes the liability issue will be resolved within the next few months.
“I think we all agree that this is a very important and valuable program that we want to continue,” Bixenstein said.
“We have a great need and a great interest.”
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