CAHOOTS Act could help US cities create mobile crisis response programs

Eugene’s Crisis Assistance Helping Out On The Streets program has caught the attention of city planners across the nation in recent years, and the model could be expanding nationwide soon. Oregon’s U.S. Senators Ron Wyden and Jeff Merkley are co-sponsoring a bill with seven other democratic senators which would allocate funds to cities that want to start similar programs. 

U.S. Rep. Peter DeFazio introduced the CAHOOTS Act in August 2020, which Wyden reintroduced to Congress last week. It will provide around $1 billion in Medicaid funds through the recently passed American Rescue Plan to help other cities get started in implementing mobile crisis response teams. In the proposed bill, cities would have their budget matched by 95%. 

The bill’s co-sponsors include Sens. Dianne Feinstein, Calif.; Bernie Sanders, Vt.; Sheldon Whitehouse, R.I.; Tina Smith, Minn.; and Bob Casey, Pa. 

Eugene’s White Bird Clinic runs the CAHOOTS program, providing an alternative to the traditional method of dealing with non-criminal situations like mental health crisis, housing-related issues or substance abuse. They’re on call 24/7 in the Eugene-Springfield area.

“Each CAHOOTS team consists of a medic, being either a nurse or an EMT and a crisis worker with several years experience in the mental health field,” Abbey Carlstrom, a consulting and outreach coordinator at White Bird, said. 

The team can provide immediate medical care, psychological care and — in some cases — transportation to medical or treatment centers. They’re dispatched through either the Eugene police-fire-ambulance number or Springfield non-emergency number, so when someone calls to report an applicable situation, CAHOOTS might arrive rather than police. This allows those who need help to avoid an encounter with the police or a costly trip to the emergency room if that’s not what they really need, Silver said. 

“Our ability to transport clients to staffed services also saves our city and county millions in ER and jail diversion,” Arlo Silver, White Bird’s CAHOOTS office manager, said. 

Silver said that some city planners have begun reaching out for guidance on starting their own program. 

“We currently are busy responding to requests we receive from communities and do not often reach out to introduce the model without being asked first,” he said. 

Portland and Denver have both recently implemented mental health response teams. The Portland Street Response and Denver’s Support Team Assistance Response programs both cite CAHOOTS as the model for their programs.PSR is still a pilot program having launched this past February, but STAR has shown promising results since it started last June. 

The influx of interest in CAHOOTS comes after widely publicized incidents of police brutality over the past year, Silver said. By giving an alternative to the traditional method, the program is applicable to the discussion of changing the system of policing. The CAHOOTS Act would not take any money from police department budgets, only allocating federal Medicaid funds. 

Since its inception in 1969, the White Bird Clinic has been committed to serving underrepresented members of the community. They are eager to help other cities build their own programs that will help them in their own unique ways, Silver said. 

“When thinking about how CAHOOTS-modeled programs can improve other cities, that really depends on the community,” Silver said. “Our model provides an option in times of crisis that looks different than the traditional police response and centers on the client’s needs, and we hope to see some other communities go in the same direction.