Programming Planning Form
This tool is designed to help jurisdictions plan specialized responses to 911 calls involving behavioral health crises. The intent is to alleviate law enforcement demand, connect individuals in crisis to services, reduce repeat crisis events, and reduce inadvertent criminal justice outcomes. If you have any questions or would like assistance completing this survey please contact us at director@co911rc.org. The survey will suggest planning participants, inventory your existing resources and take you through a decision tree to identify the specialized responses you would like to develop in your jurisdiction. At the end, you will be given your own responses as well as links to resources to develop the specialized responses your planning committee selects.
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What problems are you trying to solve?
What is/are your intended outcome(s) ?
Target population for program (Check all that apply) *
Lead Agency Contact Information
This is generally the lead/primary agency involved in administering the specialized response program for 911 calls involving behavioral health crises. If there is not a lead agency, please enter information on the agency that is willing to be the contact agency for program information. Contact email and phone number will not be published on the web page. If you have more than one program please submit a separate response for each program. There is an option to submit another response at the end of this survey - thank you.
Lead agency name * ( Do not use abbreviations)
Agency contact *
Title*
Phone Number
Type of Agency *
Select the primary agency function that is involved in the specialized response. For example, if you are an EMS that operates out of a fire department, select EMS if that is the primary function involved in the response.
What is/are the primary type(s) of jurisdiction? (Check all that apply) *
Jurisdiction Planning Committee
Most specialized responses for 911 calls involving behavioral health crises involve collaboration of several agencies. In order to plan specialized responses, it is beneficial to identify the following agency representatives in the Public Safety Answering Point jurisdiction. These agencies include the law enforcement agencies, fire departments, emergency medical services, community mental health agencies, crisis services administrative services organization, substance use disorder managed service organizations, regional accountable entities, and emergency rooms.
The following planning committee questions apply to all the agencies in the listed categories that provide coverage in the same area that the PSAP covers.
Will the following entities be collaborating on this program? Please note, there are many reasons why one of the entities listed here may or may not be included in your program. The goal here is to think about who you may want to consider collaborating with in developing the program.
| Currently involved in planning process | Anticipate including in planning process | Do not plan to include at this time | |
|---|---|---|---|
| 988/Crisis Support Line | |||
| Community Mental Health Center | |||
| Crisis Services Agency | |||
| Emergency Medical Provider | |||
| Federally Qualified Health Center | |||
| Fire and Rescue Agency | |||
| Law Enforcement Agency | |||
| Local Hospital/Emergency Department | |||
| Local Public Safety Agency | |||
| Local Task Force Advisory Board | |||
| Native American Tribal Community | |||
| Peer Specialist Program | |||
| Public Safety Answering Point (PSAP) | |||
| Regional Accountability Entity | |||
| Substance Use Disorder Treatment Agency |
County where services are located
Select county/counties where program services are provided. Submit additional surveys for each county where services are offered.
Specialized Response Services for 911 Calls Involving Behavioral Health Crises
This section asks about the specialized response components that currently exist in the jurisdiction and asks about the new services that jurisdiction would like to develop.
| Already exist in our area | Part of current planning efforts | Maybe in the future | |
|---|---|---|---|
| Alternate Non-Secure Transport Option | |||
| Alternate Secure Transport Option | |||
| Co-located mental health professional in PSAP | |||
| Co-located Peer Specialist in Public Safety Answering Point | |||
| Drop off locations for detox or substance use crisis | |||
| Drop off locations for mental health crisis | |||
| EMS Community Paramedic/Psychiatric EMT | |||
| EMS Co-Responder | |||
| Fire & Rescue Co-responder | |||
| Law Enforcement Co-Responder | |||
| Law Enforcement Trained Crisis Intervention Team (CIT) | |||
| Mobile Crisis Response (MCR) or Mobile Crisis Team | |||
| Post-911 call Referral/Navigation to Services/Follow up Services | |||
| PSAP call triage and direct dispatch to a specialized response | |||
| PSAP call triage and direct transfer to the Colorado Crisis Line/988 |
