Police-free response created conflict

Shortly after the Minneapolis City Council diverted funds from the police budget to alternative violence prevention, the city's Office of Performance and Innovation was tasked with getting a new emergency response program off the ground — one that relied on unarmed mental health professionals rather than police.

Months later, in July, the city awarded Canopy Mental Health & Consulting a two-year, $6 million contract to provide the professionals who would respond to mental or behavioral health-related emergencies 24 hours a day. The Hennepin County Association of Paramedics and EMTs — the union that represents Hennepin County's paramedics, emergency medical technicians and emergency medical dispatchers — then accused city officials of pursuing the new program with little or no input from the union's health care first responders.

But internal e-mails obtained by the Star Tribune through a records request show that OPI staff initially welcomed input from Hennepin Healthcare's highest ranks of leadership, although none were union members.

The sometimes-tense conversations also clarify fundamental reasons the new program will not partner with the county like the now dormant co-responder program, which used to pair mental health professionals with Minneapolis police officers. The new program, initially scheduled to be underway by August, has yet to launch.

"I personally feel like there are a lot of silos in this arena [of mental health response] and hope that we can all work together to break some of those," wrote Dr. Nicholas Simpson, chief medical director of Hennepin Healthcare Emergency Medical Services, in a December e-mail to the director of OPI, Brian Smith. "I'd love to chat with you more about the work you're doing and how the work we're both doing can be synergistic."

The two were connected through a mutual contact, Dr. Stamatis Zeris, associate director of the Hennepin Healthcare Regions Psychiatry Residency Program.

By February, Smith and Simpson moved from e-mails to a conference call with other members from their respective teams, including Hennepin EMS Chief Martin Scheerer and Assistant Chief Thomas Mayfield. From that call, an important question emerged, according to an e-mail sent afterward: "What does Hennepin EMS need to become a partner in this pilot program?"

Though the city's co-responder initiative with Hennepin County's Community Outreach for Psychiatric Emergencies program, or COPE, has been inactive since fall 2020, e-mails make clear that city officials were interested in maintaining a partnership with the county by having EMS respond to calls along with the new mental health provider. EMS was already responding to such calls, referred to by dispatchers as "emotionally disturbed persons" (EDP) calls, alongside Minneapolis Police Department officers, but OPI wanted to know whether the removal of police would prove a problem for EMS.

It did.

If officers weren't going to be present, Simpson asked OPI to clarify which types of calls EMS staff would be requested on once the new program launched.

"I think we could consider starting to establish some of these criteria to break up the large EDP category into those situations in which police need to respond, and those in which they don't," the director of city strategic management, Andrea Larson, wrote to EMS leaders in February. "For the latter, we would need to hear from you when you would be comfortable responding without police."

Scheerer echoed Simpson's concerns, writing to OPI, "We would have to see the differentiating criteria for response with and without law enforcement responding. We do not want to put our staff into dangerous situations."

Two weeks later, Simpson e-mailed OPI with an idea of how to "triage" 911 calls and incorporate a telehealth option for mental health calls in addition to the civilian responders. "This would allow us to figure out who is safe and doesn't present such a concern about imminent safety that law enforcement might be removed safely from the equation," he wrote.

Over the next couple months, Simpson continued to send thoughts on what the new program could look like. In March, the city released its request for proposals from vendors interested in providing the mental health response teams. A panel — which included Simpson, Scheerer and Zeris as well as city staff — reviewed the proposals the next month. On Friday, April 23, OPI informed the panelists that it would "move forward discussions with Canopy Roots."

From then, conversations between OPI and Hennepin Healthcare leaders grew tense.

"I've been fairly vocal about my thoughts and concerns to make something like this work," Simpson wrote to Smith on April 26, the day before the city informed Canopy it was selected. "I worry that if I'm any more vocal about these things that I will be considered arrogant or thought dissenting in a way that's not compatible with what people want."

Simpson went on to send additional e-mails with examples of similar mental health programs elsewhere.

"I appreciate you sending the three examples of Mobile Behavioral Health models with [Emergency Medical Technicians] embedded in them, along with the training you attended online," Smith responded to an e-mail from Simpson in May. "Always good to have additional information to add to the almost two years of research that we have been doing on such models."

"With that said, I have to remind you that we attempted to embed EMT in this process and Hennepin County EMT did not want to be a part of our pilot model," Smith added. "Therefore I'm confused about why you keep sharing a model that you declined to be a part of."

At the end of July, Simpson again reached out to Smith, asking him for an update on how the new mental health program would be structured. Simpson said he had learned about the city selecting Canopy through the media, despite having been sent an e-mail about the decision in April.

"It is baffling to me that you are feigning ignorance," Smith replied. "You have the answers to these questions because you were involved in the process […]"

The details about the program weren't clear at the time he was involved, Simpson replied, "including things like the budget (which per the media is much larger than was expected)."

Two days later, Simpson received an e-mail from Larson, expressing the staff's disappointment in seeing a Star Tribune article about the union's stance that the city rushed the civilian mental health plan with no input from paramedics and dispatchers.

"You have been clear about your support of this effort since the beginning, and you have also made clear that EMS will not, at this time, respond without police," she said. "Because the core of this program is to provide a non-police response, we had no other choice but to move forward without Hennepin EMS as a staff person in the van."

Simpson was apologetic, responding that he was surprised to see his name in the article. "As this project moves forward, I hope that Hennepin EMS can help as a partner even if we're not able to staff the response ourselves," he said.

In an interview Tuesday, Simpson contested the idea that EMS declined to be a part of the mental health response teams because police would not be involved. "I think this was probably maybe a bit of a misunderstanding in the e-mail correspondence and maybe some of even the in-person correspondence," he said. EMS is unable to physically staff the response teams due to a staffing shortage, he said. "I think maybe that was misinterpreted as we don't want to be a part of this."

"I very much want the program to succeed," he added.

The city did not make Smith, the OPI director, available for an interview.

Sam Erickson, vice president of the union that represents Hennepin EMS paramedics, said the union initially had some concerns, mostly around security issues, but is generally "very supportive of this idea."

"This will be a huge load off a system that really has depended on police for a long time, and they're not always the right tool in the toolbox," he said, while adding that there are still "going to be times where they're going to need an ambulance transport, and we're just going to work collaboratively with them to get that done."

According to a recent update OPI provided to the Public Health & Safety Committee, the office and Canopy are in the process of interviewing potential crisis responders and conducting their background checks. The teams are expected to launch in late November.

Christina Saint Louis • 612-673-4668

Libor Jany • 612-673-4064