Listen to and engage in a dialogue with staff, presenters and agencies making public comment to provide direction to the city administrator on next steps.  I will provide a brief update and introduction and will be followed by a presentation on Nurse-Family Partnership (NFP) by RiverStone Health.  Additionally, representatives from School District 2 (SD2), Continuum of Care (CoC), Montana Rescue Mission (MRM) and Substance Abuse Connect (SAC) will be present to make public comment and answer questions.

Improving the safety of Billings remains the city’s #1 priority.  Our September 6 work session conversations will focus on crime prevention.  When discussing the 2021 PSML (public safety mill levy) we included two additional mills to invest in mental health and substance abuse.  The conversations where broad, consistently including, what causes crime and crime prevention.  Many in the community insisted we invest some PSML dollars into crime prevention since it is well understood that millions are spent annually dealing with the consequences of crime.

The following strategies to reduce crime were presented throughout 2020 and 2021:

1. Collaboration with Federal, State and County officials.
2. Improve safety of neighborhoods and crime prevention, building stronger community relationships, efficient code enforcement and proactive law enforcement.
3. Invest in mental health and substance abuse through our partnership with Substance Abuse Connect.
4. Hold criminals accountable and help break the cycle of crime and abuse.
5. Help victims recover from the trauma of crime.
6. Efficiently respond to emergency calls for aid from our Fire Department.
    

Stated more broadly, nearly every PSML presentation included a commitment to reduce violent crime, improve downtown safety, improve traffic safety, and support mental health, substance abuse and prevention partners.

Improving the safety of a city of 120,000 is extremely complex.  The city’s crime rates have steadily increased over the past decade.  In 2019, 2020 and 2021, Billings experienced 2,123 aggravated assaults (116 FMA strangulations 2021 alone), 36 homicides, 319 sexual assaults and 388 robberies.  Each crime impacts a victim, their family, and friends.  These individuals, the occurrences of domestic violence and prevalence of drugs are subjecting many of our children to an epidemic of trauma.  Trauma ignored, results in way too many children witnessing and then repeating cycles of violence later in life.
Data throughout the country provides strong evidence that most of today’s criminals are coming from homes where the parents had trauma.  Arguably the greatest injustice is that their children are too often destined to enter the criminal justice system if we don’t make significant investments into preventing and addressing childhood trauma.  Therefore, I have been focusing my attention on learning about strategies and programs that break this cycle.  The Deepest Well by Nadine Burke Harris, MD and Hope Rising by Casey Gwinn, JD & Chan Hellman, PHD are resources I used and recommend gaining important knowledge on the impacts of childhood trauma.  By no means is this exhaustive, but they are research based and extremely informative for those of us who don’t regularly work in this area.

It was excited to learn that one of the most respected, heavily analyzed, and effective programs, strongly supported by the US Justice Department, is operating out of Riverstone Health.  However, the programs capacity is nowhere close to meeting the growing need for such a service.  This evidence-based program is Nurse Family Partnership (NFP).

RiverStone will be presenting their NFP program to the Council and sharing its findings.  Over the last 10 years, NFP has served more than 400 Yellowstone County families.  This voluntary program with home visits from RiverStone Health nurses has improved the lives of pregnant women, new moms and dads, and their babies. Among participants, smoking decreased 25%, alcohol use dropped 56%, reports of domestic violence dropped 63% and the number of mothers who were back in the workforce 12 weeks after delivery increased 31%. (see attachments)

Additionally, community data indicates that we have ~360 births annually, to moms who had inadequate prenatal care.  This data along with the skyrocketing levels of foster care indicate childhood trauma is becoming all too common.  NFP’s critically important standards, require nurses’ caseloads remain under 30.  Therefore, the current program needs to grow from serving 62 families with 2.5 nurses to between 12 – 15 nurses building trusting life changing relationships with several hundred Billings families annually.  The great news is we are helping 62 families break this cycle.  Unfortunately, to lower crime across our city we need to significantly increase the number of families who have access to this effective program.

I recommend the city set aside a minimum of $200,000 year one and $300,000 for years two and three.  For the program to meet our community’s need we will need to partner with other agencies.  School District 2 (SD2) is also considering providing financial support.  The goal is to allow every expecting mother in Billings to participate in NFP.  Why, the hard data in this programs history over the past 40 years throughout the US and for its shorter history in Montana show an $8 to $1 return of investment (ROI).  This ROI is primarily connected to the high numbers of NFP families who stay out of the criminal justice system, achieve educational goals, and remain in the workforce (several reports have been provided to the council on the impacts of NFP over the past few months). 

I recommend the Council consider committing all revenue generated from the marijuana local option tax to crime prevention.  In addition to NFP, I will be looking to our community stakeholder to help make recommendations on other evidence-based prevention programs. 

In addition to prevention, we will also discuss the fiscal year 2023 budget adoption amendment that passed:

1) As recommended by staff, the FY23 budget should reflect the assessment of the 2 mills from the Public Safety Mill Levy. The revenue generated from those mills, plus $400k of the anticipated cannabis tax revenues should be placed in an accounting fund explicitly designated for improving public safety and reducing crime in our community through programs addressing substance abuse, mental and behavioral health, housing essential to public safety, and related support services.

Per the adopted budget, $864,952 dollars are anticipated (2 mills = $432,452 + 3% marijuana local option tax $432,500) and will be placed in a fund to improve public safety and reduce crime in our community through programs addressing substance abuse, mental and behavioral health, housing essential to public safety, and related support services.  Additionally, the city collected $83,000 from last fiscal year’s local option marijuana tax.

2) The City Administrator should designate a staff member, or contract with an external resource using the funds allocated in item #1, whose role it will be to engage with service agencies working on the issues of mental and behavioral health, housing security and homelessness, and related public safety issues in our community and to advance solutions through public-private partnerships.

I have not signed a contract or designated a staff member to guide our decisioning yet.  I have been working in this area to learn enough to make more informed decisions and recommendations.  I also believe the scope of work for these responsibilities will be significantly impacted by decisions Substance Abuse Connect (SAB) is making over the next several months.  The Executive Committee of SAB, of which I am a member, is in the process of determining the structure of SAB moving forward.  Additionally, the board will also hire a new executive director since Kristin Lundgren has accepted another position.  Rimrock, has also asked to step away from providing “backbone” services to SAB since their staff support is being incorrectly perceived as controlling SAB.  Both United Way and Riverstone are being considered as a better fit to provide administrative and financial services.  I am also learning from our criminal justice professionals of the impacts of a Family Justice Center.  Once these decisions are made, I will decide how the city should move forward in this area.  Please understand that I see and agree with the sense of urgency to solve these problems, but I also want to make sure we don’t lock into long term contracts or hire additional staff before we have fully committed to our path forward. 

3) The City Administrator should solicit input or proposals from agencies or firms that desire to provide behavioral health co-responder services for the Crisis Response Units beginning in FY23. Input should include, but not be limited to, costs, implementation plan, and success metrics. Responders should operate under the assumption that City funding will include at least the EMT/paramedic resources required as part of a best-practice solution.

The RFP is now complete.  Proposals will be due in mid-October.  We anticipate needing to invest between $250,000 and $350,000 to implement and operate a CRU (crisis response unit) in the first year.  However, if we find the right partner and if the state and federal government support crisis response through eligible reimbursable expenses, the net cost to the city should go down.  Mobile crisis response, is quickly being recognized as a best practice for effectively and more efficiently meeting the needs of citizens in crisis while lowering costs and risks to first responders.  Once the proposals are reviewed, a staff recommendation will be made for Council’s consideration.

4) The City Administrator should solicit input or proposals from agencies or firms that desire to provide seasonal low-barrier shelter and/or sobering center services for all or part of the period from October 1, 2022 through March 31, 2023. Input should include, but not be limited to, location, costs, implementation plan, and success metrics. Case management services would ideally be included as a factor of success for the program.

The city has not issued an RFP.  We have received written proposals from CoC (Continuum of Care) and MRM (Montana Rescue Mission).  I have also spoken to OtS (Off the Streets).  OtS supports the CoC 6-month shelter option for this winter, while they work towards a long-term low barrier shelter.  (see attachments from CoC and MRM)

The final CoC project budget was included in a Progress Update that Kari Boiter sent to the Mayor, City Council, and city on July 30th. The total for both program components is $410,000. This includes seasonal sheltering and case management services. The year-round Care Coordination component (aka case management) would be designed to augment the CoC’s Coordinated Entry System (CES), which is presently utilized by 17 service providers in our community. 

MRM's proposal is also attached.  The following is abbreviated:

Proposed Budget: Addressing Public Safety Community Needs Through Emergency Sheltering Services
 

Category	Annual Cost
Staffing:	$373,300
Sheltering:	$ 60,000
Data/Adm in/Overhead:	$ 76,700
Total Annual Budget/ Request	$510,000

Terms and Conditions:
· 24 Month Contract.
· Payable in quarterly installments, net 30 days from invoice.
· We will operate our emergency shelter 365 days per year.
· We will accept those who are not a danger to themselves or others.
· We will accept qualifying referrals from Law Enforcement, Mobile Crisis Team, and Crisis Center, as well as walk ins.
· We will file quarterly reports with numbers served, numbers moved to our regular shelter, number of law enforcement, crisis center or mobile crisis unit referrals/hand offs as well as walk ins.
· We will meet with the City Administrator to deliver this data and provide quarterly updates.

5)    The City Administrator should provide regular progress updates and the results of #2 and #3 above to Council with all due haste, especially prioritizing #2 as seasonal low-barrier shelter services will be required in just over 3 months.

Candidly, this timeline has been difficult to adhere to while assessing how best to invest this new fund designated for improving public safety and reducing crime in our community through programs addressing substance abuse, mental and behavioral health, housing essential to public safety, and related support services.  When you consider the CRU and the proposals from CoC and MRM, nearly all of the funds will be allocated.  This leaves no meaningful investment into prevention. 

As I gain knowledge in this area, I’m becoming more convinced that to make a meaningful and lasting impact on our community, most, if not all new dollars should be invested into proven, evidence-based prevention programs.  Particularly, programs that are not or cannot be provided by our for profit, non-profit and or faith-based partners.  We expect to be held fully accountable for how all public dollars are spent and I am not willing to recommend spending $410k or $521k annually for sheltering and related services without better understanding our most impactful and probable options.  I realize this is frustrating for our partners, particularly at the CoC but this is new territory for the city, and we have yet to collect $1 dollar from the 2021 PSML.  Somewhere, somebody once said “patience is the key to success and the companion of wisdom.”    

I expect to have a productive and educational dialogue between all of us.  I know that several partners of SAC and CoC will be in attendance.  They will be making public comments, and all are willing to share there perspective and expertise to address this extremely complex issue as a community.



 

These challenges can only be overcome by working collaboratively with our community.  No-one within our community is immune from the effects of crime, addiction and trauma.  Implementing plans and strategies developed by our stakeholders in SAC and CoC along with all those who work in the criminal justice system, crime and addiction prevention, intervention and treatment all contribute to long term solutions.  

N/A

Per the adopted budget, $864,952 dollars are anticipated (2 mills = $432,452 + 3% marijuana local option tax $432,500) and will be placed in a fund to improve public safety and reduce crime in our community through programs addressing substance abuse, mental and behavioral health, housing essential to public safety, and related support services.  Additionally, the city collected $83,000 from last fiscal year’s local option marijuana tax.

Difficult decisions will need to be made sense there is not enough revenue to meet this growing need and problem.  This is one of the reasons that partnerships are so critical.  It is also important that we remain engaged with our state and federal partners to ensure appropriate reimbursements are available to the City and our partners who are providing medical services. 

As a reminder - The Council appropriated $200,000 in last years budget to help the YWCA build their new facility for victims of domestic violence.  Reducing domestic violence and breaking the cycle of DV must be one of our critical strategies.  When you research DV, (Hope Rising Chapter 13) you will learn that men who strangle women have a strong propensity to commit homicide of their partners and police officers. 

Background information is being shared with the council and public to provide informed guidance on future appropriations of funds for the purpose of  improving public safety and reducing crime in our community through programs addressing substance abuse, mental and behavioral health, housing essential to public safety, and related support services.