Alameda CARE Team

The Alameda CARE Team (Community Assessment Response & Engagement), led by the Alameda Fire Department (AFD), provides a 24/7 alternative response to nonviolent, noncriminal individuals facing a mental health crisis.

CONTACT THE ALAMEDA CARE TEAMcare-team-vehicle.jpg

  • If you are experiencing an emergency, always call 911.
  • If you are in crisis or see someone who may be in crisis, call 911 or call 510-337-8340, the police non-emergency line, and explain the current situation so our dispatchers can determine if the CARE Team is the appropriate resource to send.

When the CARE Team is dispatched, first responders will arrive in a low-profile program-branded vehicle outfitted for this work. The CARE Team will triage and assess clients in order to assist them with navigating the best path forward in obtaining needed services.

Frequently Asked Questions (FAQ) -- Updated January 3, 2022

1) What is the Alameda CARE Team?

The CARE Team is a pilot program approved by the Alameda City Council that utilizes a mobile crisis team staffed by a licensed Paramedic and an Emergency Medical Technician (EMT). Paramedic personnel have received additional training regarding de-escalation and behavioral health. Alameda Fire Department operates the pilot program in conjunction with 24/7 support from Alameda Family Services (AFS) (https://alamedafs.org/). The CARE Team is designed to provide mental health assessments and medical clearances in the field for community members experiencing a crisis within the city of Alameda. They can provide diagnostic assessments, identify the most appropriate interventions, and provide transportation. Their primary goal is to reduce unnecessary hospitalizations and visits to emergency rooms, including psychiatric emergency services. The CARE Team will divert community members to voluntary alternatives to hospitalization but can initiate involuntary holds (5150/5585) when necessary and appropriate.

2) Is Alameda CARE Team an alternative to the Alameda Police Department (APD)?

The CARE Team is an alternative to police responses in certain instances. The CARE Team will be dispatched to calls when the community member in crisis leans towards voluntary mental health services and is not demonstrating any violent behaviors. However, the CARE Team is not an alternative to police responses in every situation. If there is any indication that the community member may be violent, APD will arrive first to secure the scene before utilizing the CARE Team. In addition, the CARE Team will not enforce an involuntary psychiatric hold for a community member who is not cooperative. The CARE Team will utilize APD and a transport ambulance in those cases. To ensure the safety of CARE Team personnel, APD will respond to all calls that the CARE Team is dispatched to. One of the CARE Team priorities on the scene is to release APD from a call as soon as possible to make them available for other calls for service if needed. All CARE Team Paramedics are certified to initiate involuntary holds in Alameda County, but generally will only do so with APD assistance. However, CARE Team Paramedics will offer voluntary treatment via various diversion programs when clinically appropriate and in coordination with AFS. The CARE Team works in partnership with APD. Due to safety concerns, requests to respond without law enforcement cannot be guaranteed.

3) How does the Alameda CARE Team ensure clients get the assistance they need?

Although the Alameda Fire Department operates the CARE Team, its close partnership with AFS will be the essential link to ensuring an integrated system of care that guides and tracks client care over time; this is also referred to as a continuum of care. The Crisis Continuum of Care has two significant components. The first one is 24/7 licensed clinician support for the CARE Team personnel working in the field. The unit can, anytime day or night, speak with a licensed clinician to assist the CARE Team or the client in finding the best solution for navigating the current situation. The second component is that AFS provides case management follow-up as required for all clients that require it. The case management services will also include a 30- and 60-day follow-up for the client.

4) What do the numbers 5150 or 5585 mean?

5150 is the number of the section of the California Welfare and Institutions Code, which allows a person with a mental disorder and who is a danger to others or themselves or who is gravely disabled to be involuntarily detained for psychiatric hospitalization. A person on a 5150 can be held in the psychiatric hospital against their will for up to 72 hours. This does not mean that they will necessarily be held the entire 72 hours; it means that psychiatric hospitals have the legal right to do so if determined to be necessary. California Welfare and Institutions Code Sections 5585.10 to 5585.25 provide for psychiatric holds for minors for up to 72 hours. A person can be held against their will in a psychiatric facility only if they meet at least one of the three basic criteria listed: They are a danger to self, they are a danger to others, or they are gravely disabled.

5) What is the difference between the Alameda CARE Team and other mobile crisis teams in Alameda County?

Each mobile crisis team has a unique function within the system of care. The CARE Team is the only mobile crisis team staffed by a Paramedic and EMT in Alameda County. The Paramedic and EMT can provide a comprehensive medical evaluation and clearance to bypass medical emergency rooms when transporting clients to an alternative facility. The CARE Team is fully equipped to handle any call requiring Advanced Life Support if the need arises. The CARE Team cannot use force or otherwise enforce an involuntary hospitalization for a community member who is not cooperative. Therefore, CARE Team can be more appropriate for individuals who cooperate voluntarily and are willing to be transported to the appropriate locations. The CARE Team is currently the only crisis response resource operating 24 hours a day, seven days a week in Alameda County. They are also the first resource in Alameda County that has firefighters trained and authorized to initiate involuntary psychiatric holds (5150/5585 holds) as part of the pilot program. Alameda County Emergency Medical Services Agency and Alameda County Behavioral Health Care Services are closely monitoring the pilot program to evaluate the effectiveness of this expanded scope of services for the firefighters. The CARE Team is dedicated to the City of Alameda community and is the only resource that incorporates intensive case management follow-up services.

6) How do I access services from the Alameda CARE Team?

CARE Team services are accessed by placing a call to the Public Safety Answering Point (PSAP) for the city of Alameda. The PSAP is the Alameda Police Department Dispatch Center. If a person in the city of Alameda is experiencing or observes someone they suspect is experiencing a mental health situation, they should call 911 or 510-337-8340 (APD non-emergency). The APD call taker will triage the call and route it accordingly. If it is determined that the call falls into a potential incident that will benefit from the engagement of the CARE Team, they will be dispatched with an APD resource. Utilizing the information received from the reporting party, the call will be coded as either the CARE Team as the primary responder (the situation is confirmed stable and has no potential for weapons or violence) or APD as the primary responder to ensure the scene is safe for the CARE Team. The goal will be to release APD as soon as possible to allow for them to return to service to respond to other calls as needed.

7) What is the training of the Alameda CARE Team Paramedics that will assist them in the delivery of these new services?

CARE Team Paramedics have completed the following required enhanced training before being allowed by Alameda County to function on the CARE Team Unit:

  • 40 hours of Alameda County Mental Health Clinician Response curriculum provided by the Bonita House.
  • 8-hours of 5150/5585 training and accreditation to issue psychiatric holds provided by the Alameda County Behavioral Health Care Services.    
  • Although not mandated by the county, 32 hours Critical Incident De-escalation Training (CIT), all CARE Team Paramedics are scheduled to complete the training.

8) What type of vehicle does Alameda CARE Team use?

The CARE Team responds with an AFD Paramedic and EMT in a low-profile mid-size SUV. The vehicle is equipped with emergency lighting to have the ability to respond to other calls for emergency services as needed. The rear seating area of the vehicle is separated from the CARE Team personnel to provide an extra level of safety for the employees. The vehicle is equipped with a full complement of Advanced Life Saving (ALS) equipment and required technology for report writing and radio communications.

9) Where is the Alameda CARE Team unit stationed?

The CARE Team response unit is currently housed at Fire Station 3, located at 1625 Buena Vista Ave, Alameda, CA. The AFS Case Manager is co-located with the Fire Department's Emergency Medical Services Division located at City Hall West. The AFS Case Manager and the on-duty CARE Team staff meet every morning M-F to debrief on client contacts with the CARE Teams over the previous shifts.

10) What is the plan for data collection and record-keeping?

The AFD utilizes an enhanced module of the department's existing Electronic Health Care Record software. AFS utilizes its existing software to track the client contacts with the CARE Team and chart short-term outcomes for all clients referred to them through the CARE Team pilot program.

11) What alternative support service provider destinations are available for the Alameda CARE Team?

Every call is handled as a unique engagement to determine the best plan for the client. In consultation with the on-call AFS licensed clinician, the CARE Team can navigate to multiple destinations or client resolutions. The unit can transport a client to a family/friend's home if local, sobering facility (based on availability), temporary shelter (based on availability), and a public transit hub and psychiatric facility. The CARE Team also can develop a care/safety plan on the scene for the client with AFS Case Manager follow-up the following business day.

12) How long will the pilot program last?

The pilot program is scheduled to last for at least one year. The roll-out of the CARE Team was December 16th, 2021. After the first year, a report will be completed, and City Council will determine a path forward with staff recommendations.

13) Does the Alameda CARE Team have a system in place to ensure clinical quality improvement?

The CARE Team Program will engage in continuous quality improvement (CQI), as overseen by a quality management team (QMT) comprised of:

  • AFD Deputy Chief of Operations
  • AFD Deputy Chief of Support Services
  • AFS Behavior Health Director (or designee)
  • AFS Assigned Program Case Manager
  • AFD Education Coordinator
  • AFD Medical Director
  • AFD Paramedic CMU Representative(s)

Priorities of the QMT will involve:

  • Determination of program objectives and CQI process and outcome metrics
  • Individual case review
  • Performance metric review
  • Policy and procedure revisions based on CQI outcomes and best practices for crisis response

14) Does the Alameda CARE Team have any community oversight during the pilot program?

The CARE Team Stakeholder Advisory Committee will be responsible for reviewing outcomes, the progress of the program, and advising related to all components of the CARE Team program. It will include discussion and input on dispatch, on-scene interaction, client assessment, disposition, documentation, consultation, destination interactions, and the CARE Team referral process. The CARE Team Advisory Committee will include, but not be limited to the following individuals:    

  • City Manager's Office Representative
  • AFD Fire Chief
  • AFD Deputy Chief of Support Services
  • AFD Education Coordinator
  • AFD Medical Director
  • Alameda County Public Health Behavior Health Representative
  • Alameda County Emergency Medical Services Representative
  • Alameda Family Services Representative
  • Alameda Police Department (APD) Representative
  • ACRECC Representative
  • Community Representative

 The CMU Stakeholder Advisory Committee will meet quarterly.

15) Will the Alameda CARE Team respond to other calls for service in addition to mental health responses?

If the CARE Team is available, it will also respond to emergency calls such as structure fires, water rescues, vehicle accidents to supplement other AFD resources on the scene and provide additional personnel to these high-risk calls. If assigned to these calls and a CARE Team call is received, Incident Commanders will be notified by the Fire Dispatch Center, and the CARE Team unit will be released if feasible to respond to the mental health call.

16) What agencies are involved in ensuring the success of the CARE Team?

The CARE Team is a collaborative effort between the Alameda Police Department, City Manager's Office, Alameda County Regional Emergency Communications Center (Fire Dispatch), Alameda County Emergency Medical Services Agency, Alameda County Behavioral Health Care Services, Alameda Family Services, and the Alameda Fire Department.

Background

Prior to launching, nine AFD staff received program-specific mental health responder training and crisis intervention behavioral health training. These initial nine AFD personnel have been assigned to this pilot program and will be serving in the role of CARE Team paramedic. They will be partnered with firefighter emergency medical technicians (EMTs) when serving the community. During this pilot, the CARE Team will provide mental health response coverage 24-hours a day, 7-days a week. Alameda Family Services has been contracted by the City to provide case consultation for the field units, clinical field response when needed, and case management/follow-up support for Care Team clients.

Developing options to shift certain responsibility for managing mental health crises from the Police Department to non-police agencies is a recommendation of the community-led committees on police reform and racial equity. At its March 16, 2021 meeting, the Alameda City Council unanimously approved moving forward with this program and a series of recommendations. The Alameda CARE Team is also supported by Alameda County Behavioral Health Care Services and the Alameda County Emergency Medical Services Agency.