WEBINAR

Connecting to Serve: Promising Practices for 988 

& 911 Collaboration Webinar Series Session 3: 

Rural, Urban, and Tribal Communities Approaches to Collaboration

February 15, 2024
Disclaimer

The views expressed in written conference 

materials or publications and by speakers and 

moderators do not necessarily reflect the official 

policies of the Department of Health and Human 

Services, nor does the mention of trade names, 

commercial practices, or organizations imply 

endorsements by the U.S. government.
Crisis Systems Response TTAC

The Substance Abuse and Mental Health Services Administration (SAMHSA) 

has selected Altarum to provide training and technical assistance support 

to states, territories, tribal organizations, and community partners across the 

988 Suicide and Crisis Lifeline and crisis continuum of care. Along with our 

partners, W2 Consulting Corporation and Change Matrix, LLC, who have 

extensive experience with crisis services, technical assistance, and health 

equity, the Crisis Systems Response Training and Technical Assistance 

Center (TTAC) was formed to support the continued growth of 988 Lifeline 

and build a more robust crisis care system.
Learning Objectives

• Utilize promising practices to engage with 

collaborative 988 and 911 partners such as

• Local Public Safety Answering Points 

(PSAPs), Mental Health Providers, State 

Mental Health and Substance Abuse 

Authorities, and Emergency Responders

• Conceptualize challenges and identify 

solutions around the implementation of 988 

and 911 collaborative efforts

• Identify resources available for establishing 

collaborative partnerships
SAMHSA’s 988 and Behavioral Health Crisis Coordinating Office

Tiffany M. Russell, MBA

Chief of Crisis and 

Justice Initiatives

• As the Chief of Crisis and Justice Initiatives with SAMHSA’s 988 and Behavioral Health Crisis 

Coordinating Office, Tiffany serves as an advisor to the 988 director and other members of SAMHSA’s 

senior leadership in planning and determining policy, programs, and activities that address complex 

challenges in coordination of 988 crisis centers with law enforcement, 911 call centers, and 

emergency medical service providers. She also develops, recommends, and implements programs 

and provisions of guidance related to improving crisis response and equitable access to services for 

individuals with behavioral health needs that minimize unnecessary law enforcement involvement and 

promotes diversion from the justice system.

• Before joining SAMHSA, Tiffany directed the Mental Health and Justice Project which focused on 

improving behavioral health crisis responses in state and local governments for Pew Charitable 

Trusts. Prior to Pew, she served as the Director of Strategic Planning and Research Development in 

the District Court Administration for the Superior Court of Fulton County, Georgia, where she was 

responsible for building the court’s capacity by developing policies, programs, and processes to 

enhance the administration of justice and increase access to justice for all. Tiffany also held several 

positions in grant management, research, strategic planning, public relations, and communications in 

nonprofit, government, and education organizations.

• Tiffany also holds a bachelor’s degree in organizational leadership and a Master of Business 

Administration in Innovation from Mercer University.
GUEST SPEAKER – Betsy Schuster

Betsy Schuster

Vice President of 

Program Development

Helpline Center

• Betsy Schuster serves as the Vice President of Program Development at the 

Helpline Center. Betsy's passion lies in driving system change and fostering 

increased collaboration between agencies to ensure more coordinated 

services for individuals across South Dakota. She collaborates closely with 

community partners and funding agencies to secure the necessary 

resources and support for these initiatives. 

• Betsy holds a Bachelor of Arts degree in Government/International Affairs 

from Augustana University and a Master of Science in Administration 

Services with a focus on Organizational Leadership from USD. Betsy's 

professional credentials include being a Certified Resource Specialist (CRS) 

from the Alliance of Information and Referral (AIRS) and holding the Crisis 

Worker Certification from the American Association of Suicidology (AAS). 
GUEST SPEAKER – Caroline Crehan Neumann

Caroline Crehan Neumann

Crisis Services Coordinator

Mental Health Services Section, 

Department of Health Services

• Caroline Crehan Neumann is a Crisis Services Coordinator in the 

Mental Health Services Section at the Department of Health Services. 

She works to support the 988 Suicide and Crisis Lifeline and other crisis 

services in Wisconsin.

• Outside of her work at DHS, she sees clients for therapy in private 

practice and volunteers with Madison Street Medicine, providing 

behavioral health care to individuals who are homeless. 
GUEST SPEAKER – Joshua DeBartolo

Joshua DeBartolo

Senior Manager of 

Community Integration

Oklahoma Dept. of Mental Health 

and Substance Abuse Services

• Joshua DeBartolo serves as the Senior Manager of Community Integration 

for the Oklahoma Department of Mental Health and Substance Abuse 

Services. In his current role he overseas Public Partnerships & Advocacy 

Relationships, Oklahoma Tobacco Settlement Endowment Trust HSI Grant, 

and Liaison to Oklahoma Tribal Nations. 

• Josh has worked in several roles in the behavioral health field since 

2016: starting out as an intern and has direct care experience. Josh attended 

the University of Oklahoma where he received both his bachelor's and 

master's degree in human relations. 

• Josh is also a Tribal Citizen of the Comanche Nation, and in his personal 

time is actively engaged in the local Tribal Community.
GUEST SPEAKER – Tony Stelter

Tony Stelter, LPC

Chief, Statewide Crisis Services

Oklahoma Dept. of Mental Health 

and Substance Abuse Services

• Tony Stelter is a Licensed Professional Counselor and recently (this week) 

began his role as the Chief of Statewide Crisis Services for the Oklahoma 

Department of Mental Health and Substance Abuse Services. Prior to this 

role Tony worked for Solari Crisis and Human services serving as the 

Director of Oklahoma's 988 Contact Center for the state of Oklahoma. 

• Tony has 13 years of experience in behavioral health in inpatient, outpatient, 

advocacy, and crisis services. 

The Helpline Center

The Helpline Center has been helping South Dakotans 

in need since 1974.

• 211 Helpline including responding to disasters

• 988 Lifeline

• Volunteer Connections

• Suicide Prevention and Aftercare Services

• Family Support Program

Mission: making lives better by giving support, offering hope and creating 

connections all day, every day.
South Dakota — Laying the Foundation

• 66 counties

• Population: 900,000ish

• Rural areas with growing 

urban areas
South Dakota — 33 Independent PSAPs
988 in South Dakota

• 988 is answered by the Helpline Center and staffed by individuals with 

advanced degrees and experience in behavioral health. 

• 988 provides supportive follow-up calls to callers and can include follow-up 

calls from mobile crisis team referrals, discharges from inpatient units or 

other programs to support care coordination.

• Partner with 911 Public Safety Access Points, outpatient behavioral health 

providers, psychiatric inpatient units, stabilization units and appropriate 

regional facilities. 

• On average, 97% of calls received by trained crisis counselors in a 988 

setting can be de-escalated on the phone, reducing the need to dispatch law 

enforcement in situations that do not have safety concerns.
Title: Help is 3 Numbers 

Away

(top circle)

Call for Information and 

Community Resources

211

• 211 maintains a 

comprehensive 

database of 

community 

resources and 

provides 

information and 

referrals for 

essential needs like:

 Food

 Housing and 

Shelter

 Utility Assistance

 Healthcare 

Services

 Government 

Services

• 211 also can 

connect people 

with information 

and referrals for:

 Transportation

 Legal Services

 Support 

Groups

 Disaster 

Aftercare

(bottom left circle)

Call for Suicide 

Intervention and Crisis 

Support 988

• 988 provides crisis 

support for:

• Thoughts of 

Suicide

• Mental Health 

Crisis

• Substance Use 

Crisis

• Emotional 

Distress

(bottom right circle)

Call for Emergencies 

911

• 911 provides first 

responder dispatch 

for:

• Medical 

Emergency

• Fire

• Reporting a 

Crime

• Disaster 

Response

• Life 

Threatening 

Situation
988 and 911 Partnership – Lessons Learned 1

1. TRUST – the Helpline Center was a known name with our work in 211, 

disasters, and the NSPL

2. TIME – lots of explaining and asking questions to understand both 

sides of operations

3. TRAINING – training of both 988 and 911 staff to build trust

• Our team had the opportunity to do a ride along with PD to see how they see 911 

dispatches

• We got to every new 911 Dispatcher Certification course – this is a required course for 

every 911 dispatcher within the first year of dispatching

4. TANGIBLE – show data that warm transfers from 911 to 988 work
Public Dashboard
Internal Only Report
988 and 911 Partnership – Lessons Learned 2

• 18 of 33 have signed an office MOU with us

• Started with 1 PSAP

• met monthly for over a year reviewing transfers and breaking

down barriers

• We provide the base MOU, but allow each PSAP to slightly

modify

• Example: One of the PSAPs wants an outcome from us; the other

one does not need outcomes
Contact 1

Betsy Schuster

Vice President of Program Development

605-274-1412

betsy@helplinecenter.org
988 and 911 in Wisconsin 

Caroline Crehan Neumann, MSW, APSW
Wisconsin Landscape

• 1 statewide 988 center – 988 Wisconsin Lifeline

• 112 Public Safety Answering Points (PSAPs)

• 400+ Law Enforcement Agencies

• 100+ Emergency Medical Services companies
Overview: Our Learning Experience

• 2021 – Realized the importance of 911/988 collaboration

• 2022 – Created 911-988 Workgroup and joined NENA workgroup

• 2023 – Denial and then acceptance of the challenges surrounding

911-988 collaboration

• 2024 – New approach: slow and easy outreach and education
2021: Realizing the Importance

• Nearly all discussions regarding 988 implementation would lead to a

discussion on coordinating with Public Safety Answering Points

(PSAPs) and Emergency Coordination Centers (ECCs).

• Learning the very basics of PSAP/ECC/Sheriff’s offices/Police

Departments, etc.
2022: Wisconsin and National Workgroups

• Our goal was to create non-mandatory, general guidelines for how

PSAPs/ECCs should interact with the 988 Wisconsin Lifeline.

• National Emergency Number Association (NENA) assembled a 911-

988 Interoperability Standards Workgroup.
2023: Denial and Acceptance of 911-988 Challenges

• Wisconsin 911-988 workgroup continued to find obstacles in

implementing guidelines that would be accepted statewide, given

resistance from local government counsel.

• 911-988 Coordinator position was focused on an end result of

implementing standards in 112 PSAPs.
2024: Slow and Easy Outreach and Education

• Wisconsin 911-988 workgroup meets on as ad needed basis.

• 911-988 Coordinator position is now focused on relationship building,

gauging readiness, providing education, and offering guidelines and

standards for those agencies that express interest.

• Pivoting expectations and extending timeline
Contact 2

Caroline Crehan Neumann

Crisis Services Coordinator 

caroline.crehanneumann@dhs.wisconsin.gov
Oklahoma 988 

& Coordination 

with Tribal Nations
Oklahoma Map

oklahoma.gov/odmhsas
Oklahoma’s Largest Metro Areas

Oklahoma City, Oklahoma:

• Land Area in Square Miles (2020): 606.20

• Population Estimates (2020): 694,800

Tulsa, Oklahoma:

• Land Area in Square Miles (2020): 197.53

• Population Estimates (2020): 411,867

oklahoma.gov/odmhsas
Rural Oklahoma

Kiowa County, Oklahoma

• Land Area in Square Miles (2020): 1,015.08

• Population Estimates (2020): 8,345

Kay County, Oklahoma

• Land Area in Square Miles (2020):919.60

• Population Estimates (2020): 43,668

oklahoma.gov/odmhsas
Oklahoma Tribal Nations Today

Tribal Jurisdictions in Oklahoma

oklahoma.gov/odmhsas
988 Oklahoma

1. Call The Lifeline. It all starts when you call 988. You'll be connected to a

mental health professional to talk you through what's going on and get the

resources you need for either yourself or your loved one. About 80% of the

time, things can get sorted out with just a phone call. But if you need more

help, we got you.

2. If Needed, Connect with a Mobile Crisis Team. If you or your loved one

need more help after your initial phone call, the 988 call center will send a

mobile crisis team to assess things and intervene if necessary. About 7 in 10

crises can be resolved at this touchpoint.

3. If Even More Help Is Needed, Get Transportation. Some people need more

in-depth care. If this is the case, transportation will be provided to help

Oklahomans in need safely arrive at an Urgent Care and Crisis Center.

4. Check In at an Urgent Care and Crisis Center. For those of us that need

higher touch help, an Urgent Care and Crisis Center has your back. These

centers are staffed 24/7/365 with licensed local medical professionals,

nurses, and peers who have been through it themselves. Every center

accepts both drop-offs from first responders and walk-ins.

oklahoma.gov/odmhsas
ODMHSAS & Tribal 988 Monthly Meeting

Attendees:

• Oklahoma Department of Mental Health & Substance Abuse Services

• Solari (Call Center)

• Oklahoma Tribal Nations

Agenda:

• Monthly Updates

• Workgroups Update

oklahoma.gov/odmhsas
Solari & ODMHSAS Questionnaire

oklahoma.gov/odmhsas
Tribal 988 Response Workflow

Title: Iowa Tribe of Oklahoma 988 Tribal Response Workflow

(icon: female head) Crisis Contact. 988 staff identifies tribal affiliation and determines that 

individual would like to receive services at Perkins Family Clinic

Perkins Family Clinic serves all Native American and Non-Native American Individuals across 

Oklahoma

(icon: smartphone) Connecting. 988 staff refer callers to (405) 547-4388 a resource line that 

will guide individuals on their healing journey

(icon: male head) Needs Assessing. Individuals who leave a voicemail on the resource line will 

be called back within 48 business hours

Individuals who call during normal business hours can talk to someone immediately to make 

a same day or next day appointment

(icon: automobile) Receiving Services. Client will begin receiving therapeutic services and can 

receive referrals for other ITO or community-based services Takes all major insurances and 

offers a sliding scale for individuals without insurance

(icon: circle with heart inside) Client Safety Planning. Client and provider will develop a safety 

plan and will engage clients support system and continuously monitor together

oklahoma.gov/odmhsas
oklahoma.gov/odmhsas
Oklahoma 988 Dashboard

OK Public Dashboard | Tableau Public

oklahoma.gov/odmhsas
911 PSAP Diversion to 988

• Tony Stelter, Chief of Statewide Crisis Services, Oklahoma 

Department of Mental Health and Substance Abuse Services

• 911 PSAP Diversions to 988

• First Responders Line

• Law Enforcement

• Mobile Crisis Team Dispatch

• Procedure

• Warm Transfer Procedures and Pathways (Tribes, CCBHCs, 

911 and PSAPs)

oklahoma.gov/odmhsas
Thank You!

Josh DeBartolo

Senior Manager of Community Integration

Joshua.DeBartolo@odmhsas.org

LinkedIn Profile
Information Exchange

Tiffany Russell, Chief of Crisis & Justice Initiatives, SAMHSA’s 988 

Behavioral Health Coordinating Office

• Tiffany.Russell@samhsa.hhs.gov

SAMHSA’s 988 Crisis Systems Response, TTAC

• support@988crisisttac.org

• 844-464-8338 (toll free)

Crisis Systems Response Training and Technical Assistance | SAMHSA

This project is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), the agency within the U.S. Department of Health and Human Services that leads public 

health efforts to advance the behavioral health of the nation. The Crisis Systems Response Training & Technical Assistance Center works in conjunction with the 988 Suicide & Crisis Lifeline. In 2020, 

Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline. SAMHSA sees 988 as a first step towards a transformed crisis care system in 

America. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of SAMHSA or the 988 Suicide & Crisis Lifeline.
UPCOMING:

Webinar Series: “Connecting to Serve: Promising Practices for 988/911 Collaboration”

April 18 @ 1:00-3:00 PM EST: "Session 4"

Registration Link:

• Session 4 (Zoom)

Or use this QR code: