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Eugene, Ore.'s CAHOOTS inspires federal funding for non-police mental health response

The American Rescue Plan Act includes a funding incentive for communities that form similar mental health response programs

cahoots senator ron wyden stock image register guard

Eugene, Oregon’s CAHOOTS program, which sends behavioral health workers to mental health emergency calls instead of police, has inspired a push for federal funding for similar programs in other communities. Sen. Ron Wyden (left) is sponsoring the Cahoots Act in Congress.

Photo/Chris Pietsch, The Register-Guard

Nicole Hayden

EUGENE, Ore. — A provision of the latest federal coronavirus relief package will provide funding for communities across the country to launch programs like the widely admired one in Eugene that send behavioral health workers instead of police in response to mental health crisis.

Tucked into the $1.86 trillion American Rescue Plan Act, commonly known as the COVID relief bill, is a funding incentive meant to encourage communities to create programs that mirror the Eugene-area Crisis Assistance Helping Out On The Streets program, called Cahoots for short.

The provision allows communities to be reimbursed by Medicaid for up to 85% of their service costs, with an initial $1 billion for those reimbursements.

This paves the way for the Cahoots Act, proposed in February by Senate Finance Committee Chair Ron Wyden, D- Oregon, and seven other senators, and slated to be introduced to Congress soon. The Cahoots Act would increase the Medicaid reimbursement to 95%. The bill would also provide states grants to plan for and set up the new reimbursement option.

“This gives us a chance to showcase that once again Oregon is leading the nation,” Wyden said. “And for Oregon, this could mean money that might be used in Roseburg or Medford or along the Oregon coast to set up similar programs.”

For Wyden, the decision to work on the bill is far more complicated than wanting to showcase work being done in his home state. It is an issue that he contemplated long before his political career.

“My brother was schizophrenic and there were years when our family went to bed at night worried about my brother Jeff being on the streets,” Wyden said. “We worried about whether he would hurt himself or someone else…This is a deeply personal.”

The federal reimbursement is meant to catalyze new programs or expand those already operating.

“(We) are really excited and proud that the model we have been developing in our community for 31 years has an opportunity for being disseminated nationally so other communities might be able to develop public safety systems that are more in line with their community’s values,” said Chris Hecht, executive coordinator of the White Bird Clinic, which operates Cahoots.

The Eugene-area program acts as another arm of the city’s first response system. Police are sent to crimes, firefighters are sent to fires, and mental health workers are sent to behavioral health incidents.

“Whether suicidality, a really difficult relationship issue or a substance abuse crisis, we are talking about people who may be experiencing the worst day of their life,” Hecht said. “To be able to support them by sending out folks who are trained in mental health services is a really different experience than a patrol car with officers carrying weapons showing up in that moment.”

The funding will encourage communities to try a model that looks and feels different than what they are used to.

For some decision-makers, Hecht believes the potential to save money will be the allure. Eugene’s $2 million program saved the city around $14 million in 2019, he said. Those savings came from not having to provide ambulance rides and emergency room treatment and from the decrease in policing.

But the impact will reverberate far deeper than that, he predicted.

“I think we mostly hope that what we have learned here in our community can be of service to other communities … struggling with profound questions around systemic racism, policing and the social contract,” Hecht said. “Quite often, it is (people of color) that experience the brunt of violence from police and inappropriate interactions, and that can often be in the context of mental health or drug and alcohol related issues.”

One way that these non-police response programs lift up Black, Latino, Indigenous and other communities of color is by working with culturally relevant nonprofits that are already embedded within that community to host the program, he said. While the programs collaborate with police departments, running them out of a community organization rather than the police department creates a greater level of trust.

“As our country continues its racial justice reckoning, engaging mobile health crisis units that center the needs of (communities of color) that are disproportionately impacted by health and housing disparities is just one part of an equitable response,” said Caryn Brooks, the communications manager for the Portland program that is modeled off Cahoots.

While Wyden hopes the model ripples across the country, it has already gained traction in Portland. Portland Street Response launched last month in the Lents neighborhood, focusing on homeless individuals. Program officials hope to expand it city wide next year.

“We’re excited to see support on the federal level for programs like Portland Street Response and we are actively investigating ways this sort of legislation can help fund the expansion of (our program),” Brooks said. “We hope that our legislators see the immense value of these programs and support the Cahoots Act.”


(c)2021 The Oregonian (Portland, Ore.)