County Counsel

The limited communication and coordination between Mono County Behavioral Health and MLPD may result in the improper handling of arrestees leading to increased risks to the officers and public. Response to F3: The Mono County Board of Supervisors (the “Board”) agrees and disagrees with this finding. The Board acknowledges that the privacy concerns and inability to share protected medical information pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”) may reduce MLPD’s understanding of the resolution of a call, the Board disagrees that a lack of communication results in the mishandling of arrestees. Mono County Behavioral Health (“MCBH”) staff are not trained or able to serve as first responders or act in the same capacity as armed law enforcement when there has been a crime or there are weapons present. When someone with a mental health condition commits a crime or is presenting a public safety threat, that is first and foremost a law enforcement issue. MCBH staff cannot intervene in such a situation to deescalate or otherwise resolve a criminal situation in the way that armed and trained law enforcement can. When someone who is committing or has committed a crime is arrested appears to be in mental distress, MLPD notifies MCBH to perform an evaluation of that individual. A 5150 evaluation may be completed at the jail in a safe and secure location, or is more often performed at the hospital if the arrestee has been transported there for medical care. MCBH staff are not on-scene first responders with the same role or responsibilities of armed law enforcement when it comes to addressing a crime or public safety threat. Currently, there is a Memorandum of Understanding in place for Mobile Crisis Response and communication, and there are established procedures for how the different agencies that may make contact with an individual experiencing mental distress will transport or refer individuals for 5150 assessment. If an emergency call is received for an individual who is not committing or who has not committed a crime and is not experiencing a medical emergency, MCBH can be connected to the individual by dispatch for a warm hand off to service. Law enforcement or emergency medical service respond to the individual’s location and MCBH can provide participating law enforcement agencies with mobile tablets for remote MCBH assessment. Law enforcement or emergency medical services will remain on site during the assessment unless another urgent situation or emergency presents. The assessment will determine if placement in the hospital is warranted. If not warranted, MCBH will coordinate follow-up care with the individual. If transportation to the hospital emergency department is warranted, MBCH works with the agency on scene to coordinate transportation to the hospital. No follow up communication with MLP regarding the results of any assessment is allowed under HIPAA. If law enforcement or emergency medical services encounters an individual experiencing a medical emergency or a substance use disorder-related need and that individual is transferred to the hospital, Mammoth Hospital will contact MCBH to conduct a 5150 assessment. Implementation of F3: The Board will direct MCBH to review and revise, if needed, the procedures for communication around 5150 referrals and holds with MLPD and other interested agencies. Implementation Timeline for F3: in Fiscal Year 25-26.

Due to the requirements of HIPAA Compliance, there is no mechanism for the Department of Behavioral Health to “close the loop” with MLPD after a potential 5150 hold incident is vacated. The police are not notified of the cause which hinders their ability to understand the outcomes and be better able to serve the public. Response to F4: The Board agrees with this finding. HIPAA prevents “closing the loop” with MLPD to inform them if any particular case they referred or transported for a 5150 assessment ultimately resulted in a 5150 hold. Implementation of F4: MCBH can provide aggregate annual data to MLPD on the “results” of 5150 referrals, i.e., how many of the referrals made by MLPD resulted in a 5150 hold, to help MLPD better understand their overall match from their own evaluation of when an individual may need a 5150 hold and how often that hold is actually warranted. MCBH cannot provide case-by-case data, which though would be more helpful, would violate HIPAA. MCBH is also available to coordinate with MLPD on a monthly basis or at another desired frequency to discuss coordination issues and review concerns. Implementation Timeline for F4: In January of 2026, MCBH will compile and arrange for aggregate data for 2025 to be sent to MLPD.