CM Restler on B-Heard funding flow and operational model

Thank you so much.

I am sorry, Councilman Brewer.

My wife will be considerably mad if I don't get there, so I apologize.

Thank you for giving me an opportunity.

I do have to say let's go Knicks.

That's really important.

And...

Wait, one second.

You have a very well-known fear of flying.

What are we talking about here?

No, I just said I'm picking up my wife.

Oh, okay.

Yes, I made that very clear, yes.

And she'll be pretty upset.

I'm going to be late anyway, so she'll probably be upset.

I may have to call you all for some help.

But thank you, Commissioners.

So really quick, I know I had a question about Be Heard.

I think you said you're not prepared to answer questions on Be Heard?

No, just that we don't do the operations of Be Heard.

So our role is to train the social workers, hire them, but the operations of Be Heard is right now in the fire department.

Okay, so the $6 million for BHA,

Going to you?

It's going to the fire department?

Fire department.

Okay.

And so I have, you know, I've been concerned about some of the things I've heard.

The commissioner basically said there's not been much conversation done with OCS coordination.

The fire department's kind of said similar.

Is it ultimately going to OCS?

Do we know?

We don't.

I don't think that decision has been made.

I think that there's, I think everybody agrees that the goal is to send Be Heard to more calls.

I think that's well established.

But how to do that?

Is the city does not seem to have come.

There was a proposal in the fall that it would come to health and hospitals and we would do it.

That proposal is no longer part of the city's idea, but I don't think anybody has articulated yet what it's going to be.

Okay, because I know there was a...

A report that's something that discussed the bottleneck, because NYPD answers are called FDNY handles EMS, but H&H employs the social workers.

And so that coordination can be difficult.

It sounds like it's something that could be difficult.

I don't think anybody objects to us hiring and training the social workers.

No.

I think everybody's good with that part.

Yes.

But I think there is an issue that right now many of these calls the police are...

Prioritize them and go rapidly to them.

and the fire department because of shortages of paramedics take longer to get there.

And so then in general, you're not achieving the goal of getting the mental health professional in the lead.

So the police are there first.

You probably can't answer this, but I'm going to ask anyway.

What do you think should happen?

I don't think the issue is the department.

I think this could run in a variety of ways.

I think the issue is the staffing and that the current model of staffing is not sustainable.

The current model is that two paramedics or EMTs go out with a social worker in a non-transporting ambulance.

And then if the person needs transport, they have to send two more EMTs in a different ambulance.

So on a crowded New York City street, you have two ambulances, four EMTs, one social worker.

And meanwhile, we have an EMT paramedic shortage.

So then the calls with medical illness don't get handled as quickly.

Also, these calls take a long time.

You don't de-escalate somebody by tossing them into the back of your ambulance and driving them to the hospital.

So I think that the model, whether it's by us, by the fire department, by the office, community safety, has to come up with a staffing model that there are enough.

of them.

Right now there are not enough paramedics or EMTs to respond to the number of calls people want.

Okay, I'd like to offline talk about this a lot further.