Chicago’s Mental Health Alternate Response Expansion

Clients: Chicago Office of The Mayor, Chicago Department of Public Health, Chicago Police Department, Chicago Fire Department, Chicago Office of Emergency Management & Communications

Partners: Kearney, Riley Safer Holmes & Cancila

Challenge: Chicago’s Crisis Assistance Response and Engagement (CARE) program responds to 911 calls involving individuals experiencing a mental health or substance use-related crisis. The City has continued to scale up operations since the first on-the-ground team was launched in September 2021. Early in his tenure, Mayor Brandon Johnson committed to expanding the CARE program for two reasons: alternate response directly supports his “Treatment Not Trauma” policy priority, and the work is an element of his “People’s Plan for Community Safety.” However, to expand CARE, crucial questions needed to be addressed: what resources would be needed (team composition, headcount, budget, etc.), and how could expansion be achieved most effectively? To answer these questions, the Chicago Department of Public Health would need to partner with multiple city departments and agencies, each with their own priorities, perspectives, and labor constraints.

Action: The Mayor’s Office needed a fact base to make a thoughtful budgeting decision about expanding the CARE program. Our pro bono partners provided technical expertise (legal analysis and labor modeling) that was not readily available to our government clients. Kearney and Riley Safer Holmes & Cancila provided a staffing model and expansion scenarios – including headcount projections, budget projections, and operational feasibility within the parameters of collective bargaining agreements – that the Mayor’s Office used to make a policy decision on how the model would scale in 2024 and beyond.

Based on the Mayor’s policy decisions, our pro bono partner Kearney then developed implementation plans, timelines, and a change management strategy that were heavily informed by stakeholder feedback. Because CARE program staff at CDPH would face changes in their day-to-day operations, Kearney took a listen-first approach with front-line CARE staff to inform the plan to double the footprint of the program in the coming 1-2 years.

Result: The Mayor’s Office was able to make informed budgeting decisions and expansion implementation plans as a direct result of this project. By developing plans to expand geographic reach and hours in the field, the City has made a significant step towards scaling CARE citywide. Our partner Kearney developed a demand-driven labor model by looking at where the greatest need is for services, then proposed those as the expansion districts.  As a result, this CARE expansion improves equitable access to compassionate care by prioritizing communities with the greatest need.