Behavioral Health Commission staff briefed members on September 9 on the results of a Commission-directed study on the implementation of the Marcus Alert system. This initiative, enacted during the 2020 legislative session and refined in several subsequent sessions, aims to ensure that a behavioral health crisis is met with a behavioral health response by requiring the implementation of a set of protocols for transferring certain calls from 911 to 988 call centers, collaboration between local law enforcement and regional mobile crisis hubs, and law enforcement training on responding to mental health crises. Implementation is phased over several years, with all localities required to implement a Marcus Alert system by July 2028. Smaller localities with populations below 40,000 must implement Protocol One (establishing 911-988 interoperability and determining the responses to behavioral health crises with varying levels of urgency and risk, based on the state’s framework for triaging such calls) but are not required to implement Protocol 2 (establishing a memorandum of understanding between local law enforcement and the regional mobile crisis teams that are dispatched through the 988 system) or Protocol 3 (training requirements for law enforcement and the establishment of certain departmental policies), although some localities have voluntarily met these requirements.
Staff reported that 17 of the 40 Community Services Boards (CSBs) have implemented Marcus Alert systems in their coverage areas, representing 48 localities; another ten CSBs, representing 36 localities, will implement the program in 2026. In localities that have implemented Marcus Alert systems, 911 calls with individuals in crisis still largely receive a response from law enforcement, but behavioral health responses to these calls are increasing (from 10 percent of calls in 2022 to 22 percent in 2024). When law enforcement does respond to behavioral health calls, Crisis Intervention Team-trained officers are increasingly deployed to those calls (responding to 69 percent of these calls in 2024, up from 56 percent in 2022).
Commission staff outlined several barriers to full implementation of the Marcus Alert system as originally envisioned, including funding, staffing, and organizational challenges. State funding for local implementation has been fixed at $600,000 per CSB since the beginning of the program, regardless of the size of the CSB or whether the CSB uses community care teams to respond to behavioral health calls, and Public Safety Answering Points (PSAPs) often do not receive additional funds for necessary equipment or software modifications. Less-urgent calls, which could be transferred to 988, frequently remain with 911 call takers for a variety of reasons (including dispatchers’ concerns about 988 or callers’ insistence on remaining with the 911 call taker), and co-response teams of law enforcement and clinicians are often sent to respond to less-urgent calls, limiting their availability to respond to more urgent situations.
Staff also noted that although state law requires each locality to have a database where individuals could voluntarily make mental health information available to first responders, approximately 25 percent of localities do not have such a database, and there are concerns about localities’ ability to comply with a statutory provision requiring removal of information when an individual reaches the age of 18, if localities are using software that restricts the ability to remove a profile to the individual who created the profile. Staff also pointed out that although the Department of Behavioral Health and Developmental Services (DBHDS) requires significant local data collection, there are no agreed-upon outcome measures for tracking whether the Marcus Alert system is meeting its goals, and the state’s designated evaluation task force has never met.
Staff offered a series of recommendations and policy options for General Assembly consideration, among which are the following:
- Encourage CSBs to hire local Marcus Alert Coordinators with implementation funds.
- Include funding in the 2026 Appropriation Act for the remaining 13 CSBs that have yet to begin the planning process for implementation.
- Revise the current fixed allocation of $600,000 per CSB and allow DBHDS to allocate funds based on the needs of each community; require funds to be provided to PSAPs for system updates and training.
- Allow the establishment of co-response teams with jurisdiction in multiple localities to improve coverage in areas with limited resources.
A full list of recommendations is included in staff’s report, which is available at this link. Staff’s briefing to the Commission is available at this link. Commission members expressed interest in revising the funding model, but several members cautioned that state budget pressures in the upcoming session may limit the state’s ability to make additional investments in the program. Several members also expressed interest in revisiting the opt-out provisions for smaller jurisdictions.
VACo Contact: Katie Boyle