Toiyabe mobile crisis team (tmct) project - toiyabe indian health project (tihp), a consortium-governed, tribally controlled health organization serving nine tribal communities across inyo and mono…

The Substance Abuse and Mental Health Services Administration awarded Toiyabe Indian Health Project, Inc. $746,639 on September 30, 2026, under the Center for Mental Health Services Projects of Regional and National Significance program (CFDA 93.532) to establish the Toiyabe Mobile Crisis Team (TMCT), the region's first mobile crisis response serving American Indian and Alaska Native people across Inyo and Mono Counties, California.

TMCT will deliver clinician-led, culturally grounded crisis care through a four-vehicle, telehealth-equipped fleet stationed across the two-county area. The team will achieve 24/7/365 coverage by the end of year four, diverting tribal community members from law-enforcement-only responses, emergency departments, and other restrictive settings. Service delivery begins by month six and expands in annual phases. The project serves all American Indian and Alaska Native children, youth, and adults in the two-county region who are members of seven federally recognized tribes and two additional tribal communities for whom Toiyabe is the health care home.

Required activities include an implementation plan by month four; written partnership agreements across all three required tiers within twelve months; continuous quality improvement through the standing Tribal 988 Task Force; crisis system planning; evidence-based training for partner personnel; and financial sustainability planning. Performance occurs in Bishop, California, with the period of performance running through September 29, 2030.

Toiyabe mobile crisis team (tmct) project - toiyabe indian health project (tihp), a consortium-governed, tribally controlled health organization serving nine tribal communities across inyo and mono counties, california, will establish the toiyabe mobile crisis team (tmct), the region's first mobile crisis response for american indian and alaska native (AI/an) people, delivering clinician-led, culturally grounded crisis care that reaches 24/7/365 coverage by the end of year 4 and diverts tribal community members from law-enforcement-only responses, emergency departments, and other restrictive settings. Geographic area and capacity need. Inyo and mono counties, in california's rural eastern sierra, where county mobile crisis coverage is limited to a single bishop-based unit, mono county has no team, and remote communities such as those near death valley face some of the longest response distances in the state. The project builds the capacity samhsa's crisis continuum calls someone to respond: a behavioral health practitioner-only mobile crisis team operating a four-vehicle, telehealth-equipped fleet stationed across the region. Population of focus. All AI/an children, youth, and adults in the two-county area, members of seven federally recognized tribes and two additional tribal communities, for whom tihp is the health care home. AI/an suicide mortality is 91% higher than the general population, AI/an overdose mortality is the highest of any group, and local crisis episodes are most often resolved today through law enforcement or emergency departments. Strategies and interventions. All seven required activities: an implementation plan by month 4; service delivery beginning by month 6, expanding in annual phases to 24/7/365; written partnership agreements across all three required tiers within 12 months; CQI through the standing tribal 988 task force; crisis system planning; evidence-based training for partner personnel; and financial sustainability anchored in calaim medi-CAL mobile crisis reimbursement. Allowable activities add field technology suited to a frontier service area, a youth-focused response option, community outreach team activities, and continued community engagement. Project goals. (1) establish and operate a culturally grounded mobile crisis team; (2) formalize cross-system partnerships through which crisis diversion is achieved; (3) divert tribal community members in crisis from restrictive settings; (4) build a distributed, certified crisis workforce suited to the service area; and (5) institutionalize quality improvement and financial sustainability. Measurable objectives. Face-to-face response within two hours for at least 80% of rural responses by year 2; at least 70% of episodes resolved in the community without emergency department transport, arrest, or involuntary hold; 100% of individuals screened for suicide risk with validated tools and 72-hour follow-up for at least 90%; at least 12 partner agreements by month 12; a certified six-member per diem responder network in outlying communities by year 2; at least 100 partner personnel trained annually; and a 15% reduction in law-enforcement-only or emergency department dispositions by the end of year 4, advancing samhsa's priorities for crisis intervention, suicide prevention, overdose prevention, and access to evidence-based treatment.