Committees advance pilot for 24/7 mobile street psychiatry, increase participant floor to at least 40

A joint hearing of the House Human Services and House Health committees advanced HB 1131 on Jan. 30, 2025, a bill to create an intensive mobile treatment (IMT) pilot within the Department of Health to provide ‘‘street psychiatry’’ services to chronically houseless people with serious brain disorders.

The measure would authorize multidisciplinary mobile teams to deliver intensive, 24/7 outreach and treatment modeled on New York City’s IMT program, focusing on people with diagnoses such as schizophrenia and schizoaffective disorder. The committees adopted the chair’s recommended amendments to set the effective date to a future placeholder and remove appropriation language.

The bill’s main Department of Health witness, Chad Koyanagi of the Adult Mental Health Division, summarized the program and expressed support. “We strongly support this bill. Stand on our written testimony. I'll be here for questions,” Koyanagi said.

Committee members discussed program scale and continuity. Chair Lisa Martin asked about the program’s participant cap and whether replacements would be found if enrollees left the program; Koyanagi said the model’s low caseload is a key feature and that patients typically remain on the team even if they cycle through jail or hospital. “One of the features that contributes to its success is the low case load... teams able to go out to the field 24/7, mobile psychiatrists,” he said.

Members amended the bill language to change the participant cap from a hard ceiling of 40 to language establishing “at least 40” participants to give the Department flexibility if some enrollees are unavailable because of incarceration or hospitalization. The chair said that ‘‘the ceiling be too high would dilute the second—of the ceiling’’ but supported language that allows some upward flexibility.

Committee members also asked how the IMT would coordinate with existing crisis and outreach services. Koyanagi said the team would collaborate with hospitals, police, CORE and other case management teams, while retaining primary responsibility for the care of enrolled individuals and seeking placements for treatment.

The Department signaled the pilot is part of the governor’s legislative package but not included as a standalone budget add. Joy Koyashi of the Department of Health clarified: “It is in the governor’s package, but it is not being added as a budget add in, like, the form a sense.”

After discussion, both committees voted to adopt the chair’s recommendation to pass HB 1131 with amendments, including the ‘‘at least 40’’ change and defecting the effective date and appropriations language for future action.

Votes at the committee were recorded in favor of the chair’s recommendation and the recommendation was adopted by both committees.