The 32-year-old CAHOOTS (Crisis Assistance Helping Out On the Streets) program in Eugene, Oregon, is often looked to by those interested in police reform, since it responds to crisis calls deemed inappropriate for armed police officers. On June 4, 2021, the Civic Caucus interviewed Tim Black, director of consulting at White Bird Clinic in Eugene, which operates CAHOOTS.
Black says CAHOOTS diverts about 18 percent of 911 calls from police in both Eugene and Springfield, Oregon. Both cities and Lane County Health and Human Services contribute funds to CAHOOTS. The City of Eugene contributes $1 million, compared with the $60 million budget of the city's Police Department.
Black traces the history of the CAHOOTS program and makes clear that the city has still suffered police violence, despite CAHOOTS, which he says was not designed to resolve police violence. He says the program is not a one-size-fits-all solution for every city.
For more background on the CAHOOTS program, click on the following links:
Notes of the Discussion
(Remarks, questions and responses are edited.)
00:00 - Introduction of the Civic Caucus and Tim Black (Janis Clay)
Tim Black is director of consulting at the White Bird Clinic in Eugene, Oregon. With a background in work with runaway and homeless youth, harm reduction and street outreach, he began working with the CAHOOTS program as a crisis intervention worker in 2010.
A complete biography of Tim Black follows the discussion section below.
00:50 - Opening Remarks (Tim Black)
Black: In the late 1960s, medical and mental health providers in Eugene, Oregon, were seeing the "summer of love" affecting the community. Also, the community was not ready to support people following the deinstitutionalization of people with mental illnesses. Providers believed that people were not getting adequate care.
So, some providers from Eugene went to the Haight-Ashbury Free Clinic in San Francisco-founded in 1967-and to the Outside In medical clinic in Portland, Oregon-founded in 1968-to learn from both programs.
They came back to Eugene and, in 1970, created the White Bird Socio-Medical Aid Station and the White Bird Clinic Crisis Line. But after awhile, the organization decided the phone wasn't the right medium for providing crisis intervention. So the clinic started the Bummer Squad, through which volunteers from the White Bird Clinic would come out if someone was having a bad drug trip and provide support to the person in crisis. The responders would try to keep people out of the hospital and perhaps bring them to the White Bird Clinic. The clinic was providing a community-based crisis response program.
Even back in the 1970s, some police officers would respond to crisis situations by bringing people to White Bird rather than to the hospital or jail. The community came to depend on the Bummer Squad for 20 years. The public safety agencies in Eugene saw White Bird and the squad as a partner.
Under a Community Policing federal grant in 1988, the clinic, the Eugene Police Department and the city manager started formalizing the structure, based on the Bummer Squad. On July 4, 1989, CAHOOTS (Crisis Assistance Helping Out On the Streets) had its first official shift to provide mental health first response for crises involving mental illness, homelessness and addiction.
At first, CAHOOTS operated only 40 hours per week, from Tuesday through Saturday. Since then, the program has increased its hours of operation, put more CAHOOTS vans on the street and expanded into the community of Springfield, right across the Willamette River from Eugene.
It's important to understand the climate of Eugene. Several other grassroots organizations that got started the same year as the White Bird Clinic, such as a performing arts organization and the annual Oregon Country Fair, are the pillars of what people think about when they think about Eugene.
07:20 - What were the barriers when we transitioned from the Bummer Squad to the CAHOOTS program? (Tim Black)
Black: The barriers included White Bird's limited resources and the novelty of the idea that hippies would be in partnership with the police. Law enforcement officials worried about working with people they'd seen previously protesting the Vietnam War.
It turned out to be a perfect fit. Police officers were glad they weren't being asked to respond to noncriminal situations. The Fire Department was able to reduce the number of times its firefighters were going out for noncrisis medical situations. We had a medic and a mental health worker respond to crisis calls, because we wanted to respond to the whole person in a humanistic way. There's no clear delineation between mental health and physical health. We really had a direct impact right away on the public safety system.
09:04 - We needed to decide whether CAHOOTS should keep its separate phone number or be within the public safety system. (Tim Black)
We recognized we would have larger impact if police, fire and EMS could call for CAHOOTS directly. We'd be able to collaborate better with them and people wouldn't have to look up a separate number, but could, instead, dial 911. Being accessible through 911 has really made the difference. The 911 dispatchers, sometimes with help from CAHOOTS staff, determine the proper response for various situations. We've been really fortunate to have a good relationship with the dispatch department.
It requires a lot of privilege to call 911 or the nonemergency public safety number to ask for CAHOOTS. Some people aren't comfortable doing that because of its association with traditional public safety. But sometime in the next year, 988 will roll out as a federal crisis-line number and we will likely use that for people to request CAHOOTS services. We'd still have a way to respond to 911 calls and the public safety nonemergency number. We're in a state of flux right now as to which number people will use to call for CAHOOTS.
All our response teams are always unarmed. We've never had a serious injury as a result of CAHOOTS staff responses to crisis situations. There have been a few scuffles, though. CAHOOTS responders call police on average once a day for support in situations where there is physical aggression or where someone is so heavily intoxicated that the person is not safe to be out in the community and needs to be committed or taken to detox.
In 2019, CAHOOTS responded to 18,000 calls for service in the city of Eugene. We did 15,000 of those without other public safety on the scene and only called for police support 311 times. We did 3,000 calls where other public safety personnel-police, fire or EMS-were on the scene first and decided that CAHOOTS should be called in instead.
We've never had a serious injury as a result
of CAHOOTS staff responses to crisis situations.
For unhoused people, it's understandable that when they've been disempowered daily and weekly and they encounter someone in a position of power and authority, they might react physically. We try to verbally de-escalate the situation, so we can work together. Our vans are not the traditional public-safety vehicles and our responders all have a big White Bird Clinic logo on their shirts. We want to signal that this will be a safe interaction.
14:58 - Where does CAHOOTS fit in the overall public safety system? (Tim Black)
Black: In 2019, CAHOOTS responded to 18,000 calls for service out of 105,000 calls for a public-safety response in Eugene. So, almost 18 percent of those calls ultimately went to CAHOOTS. In the city of Springfield, we respond to about 2,000 to 4,000 calls annually. So, with a metro area population of 235,000 people in Eugene and Springfield, about one in 10 people have had an interaction with CAHOOTS in any given year.
CAHOOTS is a front door for accessing other services.
CAHOOTS is a first responder and doesn't have case management on the scene to follow up, if needed. White Bird Clinic handles issues related to housing, mental health, addiction, and dental and health services. While CAHOOTS is at the scene, the responders can call White Bird and ask for case management and the clinic will send a case support person. We can do those direct references for extra support with ease. CAHOOTS is a front door for accessing other services.
18:26 - What have we done to reduce the crime rate and police violence? (Tim Black)
Black: CAHOOTShas been operating for 32 years, many of those years with no digital records, so it's impossible to compare crime rates before and after CAHOOTS. Our population was drastically smaller when the program started. But every time CAHOOTS goes out to talk to somebody, it's one fewer interaction with the police. The person in crisis is much less likely to end up with a misdemeanor charge, a ticket or a court date. CAHOOTS is working to identify an evaluator to try to quantify its impact.
We're still seeing folks in crisis killed by police
in our own community. Our work is not done.
There have been profound incidents of police violence in Eugene. Four people were killed by police in the past six years. One family had been reaching out to the Springfield police with concerns about their adult daughter for over a year. Yet, when the police pulled her car over, she was dead within one minute. At first, the police officer who killed her was awarded a Purple Heart for some injuries to his wrist when he broke a window in her car to reach in and shoot her. A year later, the family received a $4.5 million civil settlement for her death.
We're still seeing folks in crisis killed by police in our own community. Our work is not done.
23:01 - How might your experience from CAHOOTS in Eugene, Oregon, apply to Minnesota, and specifically Minneapolis, where many different alternatives are being proposed to policing and public safety? It sounds like a large part of CAHOOTS' success is in collaboration with the police department. Was there initial resistance to the CAHOOTS program, and how did you gain police support? (Lee Munnich)
Black: We had the right kind of mix of public-safety personnel at the time. They were positive about CAHOOTS. We were getting our initial support from a federal grant, so no money was diverted from the police department for our program. It was this additive thing.
But when we were expanding to the city of Springfield in 2015, it was really challenging. Police there refused to recognize that there were homeless people in Springfield or that any of them might be going hungry.
26:32 - How is CAHOOTS funded, and where does the funding come from? Does this come out of the Eugene police budget or a separate public-safety budget? (Walt McClure)
Black: The short answer is it's funded inadequately. CAHOOTS runs at a deficit to provide the services we need to provide. The City of Eugene funds 100 percent of the services we provide that are identified within our contract, which amounts to $1 million. The City of Springfield and Lane County Health and Human Services jointly supply another $1 million in funding. The program also receives some funds from Medicaid. We have to do fundraising for an additional $500,000.
CAHOOTS is funded inadequately and runs at a deficit
to provide the services we need to provide.
The Eugene Police Department budget is $60 million. We need to recognize that the funding for CAHOOTS is not enough. The cost savings from the program in public-safety labor alone is $1.5 million beyond the $1 million in funding that Eugene provides.
We pay our responders $18 an hour, so they're not going to make a career out of CAHOOTS. And we can't afford to offer health-insurance coverage to families of our staff. Eugene gets lots of praise for the CAHOOTS program, but the city is not giving it enough support.
30:15 - How does CAHOOTS save resources as compared to traditional law enforcement? What kinds of calls are you handling at CAHOOTS that might not have come in had there been no CAHOOTS program? (Helen Baer)
Black: We're handling lower acuity mental health stuff. We talk with people before things have really escalated. We reach out when someone first experiences shelter insecurity. We get in there early, getting folks connected with services. A police officer can take someone to the hospital or to jail.
The city needs to recognize that CAHOOTS fills in lot of gaps in public safety. We can be the eyes for the police to see if a situation needs them. And we have the ability to respond before things get out of control. We've gotten to where folks really trust us.
33:47 - Your program seems central to the mental health activities of the community, since it grew out of deinstitutionalization and an increase in drug consumption. Who do you envision being the community entity that truly bears responsibility for responding to mental health and drug-related crises? (Clarence Shallbetter)
Black: We're operating in the public health sphere. A lot of local initiatives are being driven by the funders. Lane County Health and Human Services makes its own grants and is the facilitator of state and federal funding. We have a really strong coalition within our service providers who are addressing mental health together on an ongoing basis. But there are still inadequate resources.
36:59 - Health and Human Services already receive significant funding. How much more would be required to support a CAHOOTS-style program? Would this money come from municipal, county, state or federal budgets? (Clarence Shallbetter)
Black: There is a CAHOOTS Act in Congress now that would use some money set aside in the America Recovery Act. That's one funding stream. We need to really look at how that will work in different communities.
Clarence Shallbetter comment: Don't forget the role of the counties in all of this.
Black: CAHOOTS stands for Crisis Assistance Helping Out On the Streets. The CAHOOTS Act allows the use of Medicaid funds-supplemented by extra Medicaid funding from the American Recovery Act for the CAHOOTS Act-to get new CAHOOTS-type programs through the pilot phase. The funds would pay for up to 85 percent of the costs for the first three years of new crisis-response team programs. It's to kickstart programs and to help communities realize they can start high-quality programs like CAHOOTS. The federal government would provide the funds and then get out of the way to let communities run their own programs, based on the needs in each individual community.
40:54 - There is some tension between the Minneapolis Police Department and the University of Minnesota police. What kind of parallel situation might exist in Eugene with regard to policing, human services and crisis intervention, considering that the University of Oregon forms a significant share of Eugene's population and economy? (John Adams)
Black: It's been hard to break through to develop a relationship with the University of Oregon. The University police say they can handle their students and that they have their own crisis line. It's challenging for CAHOOTS to get in and respond to situations on campus. Students who live off campus call us a lot. We'd like to see the University police as a funding partner.
43:17 - In today's public discourse around the growing concern over police misconduct, do you see a false narrative in terms of the role CAHOOTS plays in the community? It sounds like the primary goal of CAHOOTS has been to help better serve people in need to access the right kinds of services and that this helps free up law enforcement to do those things they should be doing. However, it sounds like the initial CAHOOTS program intent was not to reduce violent police-citizen confrontations and that the program has not fundamentally changed the approach of the Eugene police. Maybe we need to focus on police themselves. Can you say more about this? (Paul Ostrow)
Black: CAHOOTS wasn't founded to reduce police violence, but rather to reduce jail time and hospital admissions by including this response. The program wouldn't have saved George Floyd or Breonna Taylor, because those aren't the kinds of situations that would involve CAHOOTS. But those situations opened a lot of eyes in the country.
People wondered what other situations police are responding to that might be better served by a different response. People with mental illness are 16 times more likely to be killed by law enforcement than people without mental illness. We can't separate the issue of police violence from the issue of mental illness.
If people are going to talk about reducing or getting rid of the police, they have to think about what would be there instead. There's a need for another type of responder that doesn't exist on the type of scale we need it.
48:25 - Does the University of Oregon have a criminal justice department? Do you work in collaboration with that department? (Walt McClure)
Black: Yes, there is a department, but they don't talk to us.
49:16 - How might we intentionally establish a CAHOOTS-style crisis response program in Minnesota, as opposed to yours in Eugene that developed more organically? (Walt McClure)
Black: What has worked has been continuing to show up. Reform only happens where there are people who are willing to go in and make change. We went in every few weeks and told the police we needed to respond to certain calls without the police. Citizens need to be involved, with a majority of them people who've lived the experience of homelessness, police violence, addiction, poverty and mental health.
Reform only happens where there are people
who are willing to go in and make change.
52:05 - When creating CAHOOTS, what kinds of information did you gather about the problem you were facing and to what extent did you look to what others were doing? Did you have an opportunity to look back at your community's past experiences to inform your programming choices? Today, people often don't look back on lessons learned from past community experiences, acting as if we are starting from scratch. (T Williams)
Black: When CAHOOTS was getting started, the founders looked at what times of day these quality-of-life calls were coming in. They determined that the latter half of the week and evenings would have the highest number of potential CAHOOTS responses.
If we did that today, we'd prioritize community engagement. We didn't do a good job of creating opportunities for large-scale community engagement. Other cities should look at doing that.
Comment by T Williams: In the late 1990s and early 2000s, Minneapolis had an experiment in a community-policing program. No one looks at what that experience was like and what happened to it. What came out of that could be helpful to us today.
Black: Community policing is still part of the Eugene Police Department today. It's helpful for people in the community to know the names of police officers.
57:55 - Since CAHOOTS programming is centered in the community, could you comment on the cultural distinctions between individuals in the health care industry, in the public sector and those who are community organizers? It seems that much discussion today is stimulated by professional community organizers who engage in a specific set of theories and activities and have a certain philosophical disposition. This is a very different paradigm from what is present in the health care industry and in the public sector. (Clarence Shallbetter)
Black: There's a difference in the way we talk about this and the way some organizations would like it to happen. It's hard to be an elected official and to know what your community thinks. It puts a lot of external pressure on the officials. There's always going to be disagreement and tension.
Some people in the community organized an online petition, which got 15,000 signatures, to have one-third of Eugene's police funding go to CAHOOTS. That would amount to $20 million to CAHOOTS out of the Police Department's current $60 million budget.
Community organizers should reflect on whether they celebrate successes in the community. They should use their voices for something productive.
1:02:34 - Closing Remarks (Tim Black).
Black: CAHOOTS isn't a cookie-cutter program. This is not a one-size-fits-all program. We have something that's been shaped by the communities of Eugene and Springfield. It needs to be designed, informed and kept accountable in each community according to that community's needs.
CAHOOTS alone won't save Eugene or any other community. It's just part of a larger systems reform that needs to happen. Communities must look at other things that need to happen.
CAHOOTS alone won't save Eugene
or any other community. It's just part
of a larger systems reform that needs to happen.
There's little recognition that CAHOOTS saves the community $15 million for emergency rooms and through reduced ambulance rides.
Maybe other communities need to focus on building up a crisis center first, before starting a mobile-response program.
CAHOOTS has been running an eight-week course with 13 cities across the U.S. on preparation work for CAHOOTS-type programs. Some of the resources used in that course are linked below:
Jessica Gilooly, PhD, " The Missing Link in Police Reform: 911 Call-Takers "
Street Roots, " Portland Street Response: A Street Roots special report "
National Association of Social Workers, Reimagining Policing: Strategies for Community Reinvestment .
Center for American Progress, " The Community Responder Model "
Black Brilliance Research Project Preliminary Research Report .
Tim Black is director of consulting for White Bird Clinic in Eugene, Oregon. He has held that position since July 2020. His primary focus is on development and support of behavioral health first-response programming in North America, based on the CAHOOTS (Crisis Assistance Helping Out On the Streets) model run by the clinic. He is an experienced professional with extensive background in direct service, harm reduction and mobile crisis intervention.
Black began working with White Bird Clinic in 2010 as a crisis intervention worker. He served as CAHOOTS operations coordinator from 2014 to 2020, overseeing the day-to-day operations of CAHOOTS, as well as relationships with local and national media, consultation, program development and expansion, fundraising, and communication and coordination with local and state government agencies.
Prior to his work with CAHOOTS, Black worked with Looking Glass Community Services; with SageWalk, The Wilderness School; with the Northwest Youth Corps; as an Americorps volunteer; and with a youth environmental conservation program. As a volunteer, he serves on the board of Community Supported Shelters and as a Rock Medicine crisis counselor and shift supervisor.
His postsecondary education was at Lane Community College.
Present for Zoom interview
John Adams, Helen Baer, Tim Black, Janis Clay (chair), Paul Gilje, Walt McClure, Lee Munnich, Paul Ostrow, Dana Schroeder (associate director), Clarence Shallbetter, T Williams.