How Washington cities are forming new partnerships to better serve individuals in crisis.

By AWC Staff

Alternative response and behavioral health have not been traditional services provided by cities. However, Washington cities seeing the need for these services in their communities are stepping up collaborative efforts to provide resources and aid to residents in crisis.

Across the state, cities are taking the lead on this critical issue by forming partnerships with neighboring cities, counties, fire districts, nonprofits, and other organizations to make alternative response programs happen. What used to be siloed work between cities and outside groups is now a coordinated effort to provide services to individuals in need.

“As cities have explored how to do alternative response, it became clear that in order to be effective in this critical work, we needed to work together,” says Brook Buettner, Executive Director of the Regional Crisis Response (RCR) Agency—a regional partnership between the communities of Bothell, Kenmore, Kirkland, Lake Forest Park, and Shoreline. “The issues individuals in crisis face cross over between cities, city departments, and counties. Bouncing someone back and forth doesn’t work. We must have a coordinated system in place to make a difference.”

Since 2022, AWC in partnership with the Washington Health Care Authority (HCA) has managed the Alternative Response Team (ART) Grant Program. The program provides state funds to cities to create and maintain new alternative response programs. These programs help cities reduce the burden of calls to first responders that could be better handled by a mental health professional, community paramedic, social worker, or peer support specialist. Programs funded by ART grant funds are diverse and specifically envisioned by cities and their partners to meet the unique needs of the communities they serve.

To date, AWC has awarded close to $6 million to 21 alternative response programs across the state. Some programs follow the ‘Let Everyone Advance with Dignity’ (LEAD) model (formerly called ‘Law Enforcement Assisted Diversion’) that partners police officers with mental health professionals to help divert individuals away from the criminal justice system. Other programs fall under the ‘Community Assistance Referral and Education Services’ (CARES) model that brings mental health professionals and case managers into a fire department to proactively address medical conditions, mental health issues, and addiction challenges.

There are also programs that operate outside of traditional models to take on unique challenges and provide different approaches. Cities all over Washington are building collaborative partnerships tailored to their own communities. Here are two programs—of many—funded in part by the ART Grant Program, and which are setting a strong example of how cities can lead in helping people.

“What used to be siloed work between cities and outside groups is now a coordinated effort to provide services to individuals in need.”

Port Angeles | LEAD-Fire Program

LEAD has been a well-known program for years, but Port Angeles was the first jurisdiction to launch a LEAD-Fire program. Port Angeles’ LEAD-Fire program combines the efforts of the Port Angeles Fire Department, Port Angeles Police Department, and Olympic Peninsula Community Clinic.

The LEAD-Fire program differs from traditional LEAD programs as it focuses on the medical needs of individuals to help them address their immediate needs without needing to involve the criminal or legal system. LEAD-Fire engages participants in intensive case management including services offered by an advanced registered nurse practitioner for behavioral health medication management as a bridge program to support stabilization in social, medical, and mental health needs.

To date, the program has helped dozens of individuals with overdose response, connections to shelter programs, street medicine services or community paramedic referrals, and differing levels of case management.

Clarkston | CARES – Community paramedic

Located on the Washington-Idaho border along the banks of the Snake River, Clarkston is home to just over 7,000 individuals. With an aging population and a rising number of unhoused individuals in the community, ambulance call volumes have nearly doubled between 2010 and 2023, going from 1,378 to 2,598 despite the community’s population remaining about the same.

In 2023, the city launched a community paramedic program with the goal of identifying high utilizers of the 911 system and providing them direct support to solve their underlying conditions. The community paramedic can meet people where they are and provide resources including medication management, education, ramps and handrails, substance use referrals, transportation to and from doctor appointments, pharmacy medication pickup and delivery, post-discharge follow-up, and referrals for in-home care.

The community paramedic can provide services to about 26 individuals at any time, conducting between 50-60 visits per month. Since launching the program, the community paramedic has provided close to 700 responses, diverting over 100 calls from 911 or local emergency departments, saving emergency responders and medical providers over $300,000.

By investing in alternative response models, cities are providing lasting support to residents while allowing first responders the time and space to respond to the unique calls they are best suited to handle.

For more information: wacities.org/services/alternative-response-team-grant-program