Table 2.
Examples from the available resources and resource gaps identified by the working group under the Sequential Intercept Model’s Intercept 1 “Law Enforcement and Emergency Services” Intercept (COJENT Step 5)
| Resources Available | Gaps |
|---|---|
| Law enforcement training: Crisis Intervention Team (CIT) training includes a 2-hour geriatrics training (20% of police force must be trained based on California mandate) | Lack of general awareness of national suicide hotline for older adults: 1-800-273-8255 (TALK) |
| Older Offender Population (OOP) training for hospital security (not mandatory) | Less than 5% of 911 staff have had crisis intervention training |
| San Francisco Sheriff’s Department primary care dispatch | 911 does not have enough staff with knowledge about older adults |
| Shelter cell-phone app for law enforcement professionals: “Elder App 368” | There is no OOP training for the San Francisco Sheriff’s Department |
| EMS-6 Frequent User Service Enhancement (FUSE) for homeless (a pilot project) | Adult Protective Services is underutilized and over capacity |
| Senior mobile crisis (Department of Public Health), 9am-5pm | Older adults must be released without mandatory follow-up if they have not reached 5150 criteria following evaluation |
| Dore Urgent Care Clinic, open 24/7, offers detox, peer services, medical screening, and residential support | Lack of communication between jail and hospital concerning medical needs of older adults and whether behavior leading to police arrest could be medical in etiology |
| County Hospital Psychiatric Emergency Services: • social worker on staff for referrals • two-week hotel voucher with 6 beds • phone triage available for police department • 18 PED beds |
Mobile crisis has a long wait time (up to one hour), is not necessarily geared to meet the unique needs of older adults |
| One community hospital has 3 behavioral health safe rooms and 18 all-purpose beds in the ER | Lack of a one-stop drop-off center for older adults in crisis |
| VA urgent care services | The psychiatric emergency services in the community are over capacity and often divert to other emergency rooms with less expertise |
| Plans for OOP team to serve patients with dementia awaiting commitment hearings | Limited resources for post-emergency room referral and follow-up especially after hours |
| There can be an hour wait for para-transport |