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seek help via local medical and social service entities—which can be especially problematic for issues that arise outside of standard business hours. Families are often left with the difficult choice of having their loved one sent to John George Hospital in San Leandro for a 72-hour hold or trying to manage the situation on their own. This type of situation is especially concerning for youth that are experiencing a psychiatric emergency, as parents must choose to have their child placed on a psychiatric hold at a site in Oakland — which can be additional trauma for the child—or they must try to handle the situation with little or no professional assistance. As these scenarios demonstrate, the behavioral health care system is fragmented and siloed, and services are not interconnected. Patients arrive at care entry points that may not have the capability of coordinating with other available resources. This makes transitions from provider-to-provider and/or care level-to-care level difficult for patients and their families. This is especially challenging when patients are released from 72-hour holds and are not given resources for continuing care. Additionally, there is not an effective system for connecting patients and their families to resources to help guide and support them in achieving wellness. Current resources in the Tri-Valley include an array of private providers who are affiliated with local hospitals and health plans. Axis Community Health is the predominant provider of counseling services for low income and uninsured Tri-Valley residents. There are also several smaller nonprofit agencies that provide limited services. Most providers—both private as well as nonprofit—have full caseloads. There are three additional nonprofit organizations that provide some support services, however, they are not providers of direct services. Proposal: Establishment of a Mental Health Urgent Care Center In response to these substantial gaps in access to care and coordinated support, Axis proposes an innovative solution: the creation of a Mental Health Urgent Care Center. This center will be available to all members of the community, regardless of income or insurance status. Individuals and families with urgent mental health needs will be able to call for same-day appointments. During the COVID pandemic, services will be provided via telehealth; long term plans would include a walk-in access point as well. The center will serve as a central entry point for assessment, triage, treatment, and care coordination for anyone seeking mental health treatment, regardless of insurance type or status. Like a medical urgent care setting, Axis MH Urgent Care will provide assessment and timely connection to services--in a setting that is less costly than an emergency department. The MH Urgent Care staff will include a care coordinator, a licensed therapist, and an on-call psychiatrist. The service will be under the direction of Axis's Chief of Behavioral Health Services, who is a licensed psychologist. Staff will utilize mental health screening tools, conduct bio-psychosocial diagnostic assessments and provide brief counseling and trauma treatment. Psychiatric care will be provided via telehealth for patients that require medication management, and patients will be connected to an ongoing treatment provider that is appropriate to their needs. Like medical urgent care, staff will see patients with an immediate need, and assist in coordinating care that connects patients (and families) to ongoing care with a provider and behavioral health support resources. Patients visiting the MH Urgent Care Center will be assessed to determine where their condition falls in the diagnostic range that includes: 1) mild to moderate, 2) moderate, or 3) severe. Typically, the majority of patients in a community setting are in the mild to moderate range. We anticipate that the majority of the Consulting Services Agreement between City of Dublin and April 1, 2021 Axis Community Health for Mental Health Urgent Care Services Pilot Program Exhibit A—Page 2 of 6