To: County of Sonoma Board of Supervisors
Department or Agency Name(s): Department of Health Services
Staff Name and Phone Number: Nolan Sullivan, 707-565-4774; Jan Cobaleda-Kegler, 707-565-5157
Vote Requirement: 4/5th
Supervisorial District(s): Countywide
Title:
Title
Specialized Assistance for Everyone Mobile Crisis Agreements
End
Recommended Action:
Recommended action
A) Authorize the Director of Health Services, or designee, to execute agreements for mobile crisis services via the Specialized Assistance for Everyone (SAFE) teams with jurisdictions listed below for three-year terms of July 1, 2026 through June 30, 2029 subject to review and approval by County Counsel:
i) City of Cotati for covering mobile crisis services in Cotati, Rohnert Park and on the campus of Sonoma State University for an amount not to exceed $3,200,000.00
ii) City of Petaluma for mobile crisis services in Petaluma for an amount not to exceed $3,200,000.00
B) Authorize the Director of Health Services, or designee, to execute modifications to the agreements in this Board Item which do not significantly change the scopes of service in order to address increased service needs, payment or reimbursement methodologies, subject to available funding and approval by County Counsel.
C) Adopt a Resolution authorizing budgetary adjustments to the Department of Health Services Fiscal Year 2026-2027 Adopted Budget, increasing appropriations in the amount of $815,813 to program available Measure O funds to finance agreements with the cities of Cotati and Petaluma.
(4/5th Vote Required)
end
Executive Summary:
In response to community interest in expanded mobile crisis services, several cities within Sonoma County have established mobile crisis services that utilize behavioral health and emergency medical service teams as first responders to service calls that do not require law enforcement resources. Along with the Department of Health Services’ Mobile Support Team, the City of Santa Rosa has the inRESPONSE team, and the Cities of Petaluma, Cotati, Rohnert Park and the campus of Sonoma State University have the Specialized Assistance for Everyone (SAFE) teams. This item requests authority to execute new three-year funding agreements that will continue these vital services with Sonoma State University, as well as the cities of Cotati, Rohnert Park, and Petaluma, (Santa Rosa’s contracts were approved in a previous item) for a total cumulative amount not-to-exceed $6,400,000 through June 30, 2029. The City of Cotati will serve as the fiscal agent and contract lead for the cities of Cotati and Rohnert Park, and Sonoma State University.
Discussion:
Since its launch in 2021, the Specialized Assistance for Everyone (SAFE) program has become a critical component of the South County behavioral health and public safety continuum, providing community-based, non-law-enforcement crisis response services across Petaluma, Rohnert Park, Cotati, and Sonoma State University. SAFE has demonstrated strong community impact through high utilization, diversion from emergency departments and law enforcement involvement, and proactive outreach to individuals experiencing behavioral health crises, homelessness, and substance use challenges.
Like other Mobile Crisis programs throughout Sonoma County and California, SAFE is now transitioning from a locally developed crisis response model into a State-mandated Medi-Cal Mobile Crisis framework. This transition requires substantial operational changes, including Medi-Cal certification, staff credentialing, implementation of standardized documentation and data systems, clinician supervision structures, and compliance with evolving State and federal requirements. The Department of Health Services (DHS), SAFE, and regional partners have worked collaboratively throughout this process to align local services with Medi-Cal standards while preserving the strengths of the existing South County response model and maintaining continuity of care for the communities served.
To support the continued operation and transition of South County Mobile Crisis services, DHS is proposing a time-limited funding approach that maximizes existing resources while advancing compliance with State Medi-Cal Mobile Crisis requirements. This approach reflects both the County’s fiscal constraints and its commitment to maintaining critical crisis response services in partnership with local jurisdictions.
Under this proposal, SAFE jurisdictions will be authorized to front-load their total three-year Measure O allocation of $4.6 million into the first two years of their three-year contract. This allows the program to stabilize operations and meet immediate service and staffing needs without increasing the County’s overall financial obligation. In addition, DHS will allocate $1.8 million in Behavioral Health Services Act (BHSA) funding over three years to support the recruitment and deployment of licensed clinicians through a sub-contracted provider, as required to meet Medi-Cal Mobile Crisis Benefit standards.
This combined funding strategy is intended to ensure SAFE can:
• Maintain service continuity during the transition to Medi-Cal compliance
• Establish a clinically appropriate staffing model aligned with State requirements
• Begin generating Medi-Cal reimbursement (Federal Financial Participation) to support long-term sustainability
• Create parity for in-kind contributions between mobile crisis contract providers
This proposal represents the full extent of funding available within existing Measure O and BHSA resources, and does not increase the County’s total financial commitment. Rather, it reconfigures the timing and use of those funds to address immediate operational and regulatory needs. Complete funding for the third year of services will need to be determined at a later date when a clearer picture of the federal Medi-Cal reimbursement is understood, as well as the true personnel costs under this new model.
This approach also reflects the County’s commitment to being a strong and collaborative partner with South County cities and providers, recognizing the significant local investment already made to establish Mobile Crisis services. While SAFE and inRESPONSE have developed under different models, DHS continues to work with all partners toward a more unified, countywide Mobile Crisis system that standardizes clinical practices, improves efficiency, and ensures equitable access to services across jurisdictions.
Over time, this transition is expected to:
• Reduce duplication across regional models
• Better align staffing and service delivery with Medi-Cal requirements
• Maximize available federal reimbursement
• Support a more sustainable and coordinated crisis response system
DHS will continue to work with SAFE, inRESPONSE, and other stakeholders to refine the service model and funding approach, with the goal of achieving long-term fiscal and operational stability within a unified system of care.
Strategic Plan:
This item directly supports the County’s Five-year Strategic Plan and is aligned with the following pillar, goal, and objective.
Pillar: Healthy and Safe Communities
Goal: Goal 1: Expand integrated system of care to address gaps in services to the County’s most vulnerable.
Objective: Objective 3: Create a “no wrong door” approach where clients who need services across multiple departments and programs are able to access the array of services needed regardless of where they enter the system.
Racial Equity:
Was this item identified as an opportunity to apply the Racial Equity Toolkit?
No
Prior Board Actions:
The Department of Health Services have brought numerous Board Items associated with the Mobile Crisis Program. The most recent items include:
March 24, 2026 - Received the Measure O annual Report for Fiscal Year 2024-2025
August 26, 2025 - Received an update on Mobile Support Team/Sonoma County Mobile Crisis Services Continuum
July 22, 2025 - Authorized execution of five (5) funding agreements for Mobile Crisis Programs for a combined total not-to-exceed $5,984,803 through June 30, 2026
Fiscal Summary
|
Expenditures |
FY 26-27 Adopted |
FY 27-28 Projected |
FY 28-29 Projected |
|
Budgeted Expenses |
$2,200,000 |
$2,784,187 |
$600,000 |
|
Additional Appropriation Requested |
$815,813 |
|
|
|
Total Expenditures |
$3,015,813 |
$2,784,187 |
$600,000 |
|
Funding Sources |
|
|
|
|
General Fund/WA GF |
|
|
|
|
State/Federal |
$600,000 |
$600,000 |
$600,000 |
|
Fees/Other |
$2,415,813 |
$2,184,187 |
|
|
Use of Fund Balance |
|
|
|
|
General Fund Contingencies |
|
|
|
|
Total Sources |
$3,015,813 |
$2,784,187 |
$600,000 |
Narrative Explanation of Fiscal Impacts:
Over the three-year term, this item authorizes a total of $6.4 million to support mobile crisis response agreements with the Cities of Cotati and Petaluma. Funding consists of $4.6 million in Measure O funds for FY 2026-2027 and FY 2027-2028, and $1.8 million in Behavioral Health Services Act (BHSA) funds distributed evenly across the three fiscal years at $600,000 annually.
For FY 2026-2027, the Recommended Budget included $2,200,000 to support the SAFE agreements. Subsequent to budget development, the Year one agreement amounts were finalized at $1,528,000 for the City of Petaluma and $1,487,813 for the City of Cotati, for a combined total of $3,015,813. Accordingly, adoption of this request will increase appropriations by $815,813 to fully fund the agreements. For FY 2027-2028, the City of Petaluma agreement will require $1,372,000 and the City of Cotati agreement will require $1,412,187, for a total of $2,784,187.
For FY 2028-2029, each agreement will require $300,000, for a total of $600,000, funded entirely through BHSA funds.
The requested revenue and expenditure appropriations for FY 2027-2028 and FY 2028-2029 will be included in the respective Recommended Budgets.
Narrative Explanation of Staffing Impacts (If Required):
None
Attachments:
Attachment 1 - Budget Resolution
Attachment 2 - Draft Agreement
Related Items “On File” with the Clerk of the Board:
None