Consideration and Approval of Contract:  Approval the contract amendment to the Professional Services Contract with Terros Health to include Emergency Medical Care Technicians in the operations of the Community Alliance, Response & Engagement (CARE) Unit
 

1. Approve the contract amendment to Terros Health for the inclusion of Emergency Medical Care Technicians in the CARE Unit contract.
2. Authorize the City Manager to execute all necessary documents.

The initial three-year term of the City's contract with Terros Health to staff a mobile alternate response team is expiring in October 2024. The initial term may be extended for up to two successive one-year terms upon mutual consent of both the City and Terros. The focus of the discussions revolved around ways to improve the program. The proposed amendment would change the contract between the City and Terros Health to allow Terros Health to provide a certified Emergency Medical Care Technician (EMCT) to staff the CARE Unit instead of the Flagstaff Fire Department Emergency Medical Care Technicians. Terros Health staff members believe this staffing recommendation will positively impact the interactions with the clients, significantly improving the effectiveness of the CARE Unit.  

The professional services contract includes the following proposed amendments:

• Update the Mobile Alternative Response Team to reflect the official name identified; Community Alliance, Response & Engagement or CARE
• Replace Emergency Medical Technician (EMT) with Emergency Medical Care Technician to reflect the certification title given by the Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System
• Staff Emergency Medical Care Technicians through Terros Health instead of Flagstaff Fire Department
• Add Cybersecurity and Privacy Breach Indemnification, Cybersecurity Liability coverage, Sexual Liability Insurance coverage, and Confidentiality expectations
• Describe service level expectations and communication needed to determine availability of unit
• Explain oversight by Flagstaff Fire Department Emergency Medical Services (EMS) Battalion Chief
• Create flexibility where CARE Unit is housed in a Fire Station or City facility
• Clarify what City equipment the City will continue to provide
• Include a 6-month check in following the date of the amended contract
• Provide a timeline for hiring and onboarding of Terros Health Emergency Medical Care Technicians
• Update the compensation schedule to reflect the change in personnel and related charges
• Remove items that were specific to the first few years of the contract that have been completed

The proposed amendment would include the addition of certified Emergency Medical Care Technicians to Terros Health staffing.  Terros Health has evaluated their staffing expenses related to the current contract and indicated the addition of the Emergency Medical Technicians would be $19,764 for year four of the contract and $22,488 for year five.  The City has a budget allocation available for the CARE Unit to cover these additional expenses. Terros Health was able to absorb the rest of the cost by adjusting what is charged for the Flagstaff Clinical Manager, Director of Northern Arizona Crisis Services, and Senior Director of Crisis Services. 

Account Number Budgeted: 001-03-051-0206-2-4290
FY2024-25 Budgeted Amount: $829,692.00 for the Terros contract
Funding Source: General Fund

City staff discussed proposed contract amendments with City Council on August 26, 2024, and there was direction to move forward with contract amendments. 

Direct City staff to consider other contract amendments. 
Maintain current Flagstaff Fire Department Firefighter/EMT staffing and program oversight. 

The City has been interested in providing an alternate response model for the past 8–10 years. The Flagstaff Fire Department has tried various models and the Criminal Justice Coordinating Council has also considered diversion programs. The City continued to pursue the vision to provide the community with crisis intervention and mental health stabilization services through a mobile response unit and implemented the Community Alliance, Response & Engagement (CARE) Unit in 2021. The CARE Unit began operations in 2022 and provides proactive outreach to the community and responds to public safety calls, such as, public intoxication, substance abuse, trauma informed, and mental or behavioral health related events received through the 9-1-1 Dispatch center. This CARE Unit is staffed with a Behavior Health Crisis Specialist and an Emergency Medical Care Technician. 

Safe and Healthy Community-Provide and build upon the alternative response model and other community partnerships to best serve the mental and behavioral health needs of the community. 
Inclusive and Engaged Community-Advance social equity and social justice in Flagstaff by supporting social services. 
High Performing Governance-Serve the public by providing high quality customer service. Implement and communicate innovative and efficient local government programs, new ideas, and best practices. 

Regional Plan
Public Buildings, Service, Facilities and Safety (Goal PF.3): Provide high-quality emergency response and publice safety services, including law enforcement, fire, medical, and ambulance transport services.
Public Buildings, Service, Facilities and Safety (Policy PF.3.1): Maintain high-quality effectiveness and efficiency in law enforcement, fire and emergency services to the extent that it is consistent with governmental operations, plans, public policies, population served, and monies available. 

NA

NA

Supports most appropriate utilization of qualified and trained employees, while ensuring non-emergent call types are being met.