Biden includes more than $1 billion over 10 years to fund non-police crisis response in his American Rescue Plan
In the year since Sen. Ron Wyden (D-Oregon) first introduced the CAHOOTS Act, much has changed to suggest that this nationwide incentive for non-police crisis response could become a reality.
The bill was first proposed in 2020 amid the condemnation of George Floyd’s murder at the hands of former Minneapolis police Officer Derek Chauvin. At the time, Donald Trump was in the White House, the GOP controlled the Senate, and gridlock was business as usual.
But this year, a new administration was sworn in for both the White House and the Senate, leading to the passage of the $1.9 trillion American Rescue Plan, signed into law March 11 by President Joe Biden. In addition to aid for pandemic-related needs, the plan includes a new silo of funding — an estimated $1.1 billion over 10 years through Medicaid — for local crisis response programs similar to Eugene’s gold standard, CAHOOTS.
On April 20, Chauvin was convicted of manslaughter, unintentional second-degree murder and third- degree murder for killing Floyd, creating a catalytic moment for the nationwide push to rethink the role of police in public safety.
“I believe that right now there exists a sweet spot for this sort of reform to happen — paying attention to the mental health needs of people in need of urgent help,” Wyden told Street Roots. “There is a renewed urgency to reimagine public safety.”
Wyden is championing the bill in the Senate, while U.S. Rep. Peter DeFazio (D-Eugene) has introduced a corresponding bill in the House.
The bill’s moniker comes from the model adapted from Eugene’s 30-year old CAHOOTS program, which is an acronym for Crisis Assistance Helping Out On The Streets. Operated by White Bird Clinic, a nonprofit that provides free and reduced-cost health care, the CAHOOTS mobile crisis team has become a template for similar programs in other cities. It is the model that inspired the Portland Street Response pilot in Portland, created in 2020 to address mental health crises on the streets and to avoid unnecessary police involvement.
DIRECTOR’S DESK: Go big, Mayor Wheeler. Our city needs Portland Street Response.
The act sets aside $25 million for states to help communities establish mobile crisis response teams for people experiencing mental health or drug-induced crises. It then allows for a 95% federal match from Medicaid to cover three years of operational costs. Wyden calls the 85% already included in the American Rescue Plan act a “down payment” on the larger match in the CAHOOTS Act.
These mobile units would be trained in trauma-informed care, de-escalation and harm reduction, and provide voluntary assessment and stabilization services for individuals in crisis. The crisis response teams would be required to partner with community resources for referrals and coordinated care, including behavioral health providers and housing assistance providers.
CAHOOTS and White Bird Clinic staff were consultants on the bill. White Bird’s director of consulting, Tim Black, said collaborating with other services providers is a critical component for any similar program looking to take hold.
“When we engage in conversation with communities about developing a mobile crisis program like CAHOOTS, two critical areas to consider are the resources needed to ensure diversion from the hospital or jail, and centering both system design and program implementation in lived experience,” he said.
“If this act passes, we will have an opportunity to make a profound impact on both the lives of our neighbors experiencing crisis and continue the work of necessary reforms to our nation’s public safety system,” Black said.
Another key component of the CAHOOTS Act is distinguishing these types of programs from police authority. The mobile crisis teams qualifying for this funding “must not be operated by or affiliated with state or local law enforcement agencies,” according to the act; however, teams may coordinate with law enforcement if appropriate.
“Police officials tell me they know there’s a better response than simply sending a uniformed officer without specific training when a call comes in about somebody in a serious mental illness crisis,” Wyden told Street Roots. “And that better alternative isn’t theoretical. The long-standing CAHOOTS model in Eugene has blazed a proven trail to follow for how communities like Portland and others can use health care, rather than law enforcement, to help people experiencing a mental health crisis.”
The CAHOOTS program is lauded for both alleviating crisis situations on the streets and reducing the need for police intervention. Olympia, Washington, and Denver, Colorado, have enacted similar programs, and White Bird regularly consults with other cities interested in doing the same. Portland’s version, Portland Street Response, began taking calls in the Lents neighborhood earlier this year.
Police departments often have crisis intervention teams as part of the force, but the CAHOOTS model creates autonomous response teams composed of a medic and an experienced mental health crisis worker. They are not members of law enforcement and do not carry weapons.
That defining difference was in stark contrast on April 16 when police responded to a call of a subject in Lents Park with a gun in his hand, “acting like James Bond or like a cowboy doing like quick-draws with it. He’s not pointing it at anybody,” according to transcripts of the 911 call first published by Willamette Week.
Police were the first responders, not Portland Street Response, because of the reported presence of a gun. Within minutes of arriving, police shot Robert Delgado and killed him. The gun was fake, with an identifying orange tip. Delgado’s family members said he had history of mental health problems and was afraid of the police, according to published reports. People who knew Delgado say his death was preventable, and the case is under investigation by the Oregon attorney general and the Multnomah County district attorney.
DIRECTOR’S DESK: Delgado’s sister: ‘Why are they shooting people?’
Oregon’s Deschutes County is also in the process of expanding its existing crisis response team to non-police response needs, such as suicidal ideation, mental health crisis or related disturbances — calls the police were never designed to respond to in the first place, said Deschutes County’s Holly Harris.
“What I hear from both the community and law enforcement is that police are not intended to be serving this population like this,” said Harris, the county’s mental health program manager for crisis services. “It’s been put upon them because of a variety of factors that happened over the course of time. And now they’ve suddenly become mental health workers on the field. And that’s not what they want to be doing. It’s not what the community wants them to be doing. This is an effort to support law enforcement and take these kinds of calls off their plate. It’s an effort to support client and individuals experiencing mental health crises so they can actually be talking to the mental health workers that they need to be talking to.”
As Harris suggests, a crisis response team is ultimately a health care provider offering a crisis resolution, which is the view of the National Health Care for the Homeless Council. The NHCHC strongly supports the CAHOOTS model and sees the need for similar health care responses in cities across the country to stop the criminalization of behavioral health and homelessness.
“It is a crisis in every community in which there is homelessness,” said Michael Durham, community engagement manager for NHCHC. “Police are used — as they are for so many activities — outside what we might think of as public safety. And primarily used to clear (homeless) camps.”
There’s also racial justice component to a non-police response, Durham said. “A majority of people who are homeless across the country are people of color. Forty percent of people who are homeless are Black. And of course, the intersection of policing and racism is well documented.”
Durham noted that delivering appropriate mental health response from the beginning is not just part of a crisis response, but a longer-term solution, by stabilizing people’s lives and alleviating homelessness and poverty.
“This is an opportunity for them specifically, in any other community that’s doing this, to get folks who are really vulnerable, who are struggling with trauma, histories of violence, more than likely, and certainly in poverty, into primary care services and other supportive services,” Durham said. “And that has life-changing possibilities — to get folks into a trusted relationship with a primary care provider, with a case manager and avoid them entering the carceral system, which just makes it worse for everybody.”
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