Austin EMCOT — Dispatch-Embedded Clinicians
Program: Expanded Mobile Crisis Outreach Team (EMCOT) — call center function Operational since: 2019 (dispatch-embedded component); 24/7 since 2023 Institutional home: Integral Care (Travis County’s local mental health authority), under contract with the City of Austin Location: Inside Austin’s 911 call center Coverage: 24 hours a day, 7 days a week Staff: 24 licensed mental health clinicians embedded in the call center
This profile covers only the dispatch-embedded component of EMCOT — the clinicians who work inside Austin’s 911 call center and handle calls by phone. EMCOT also operates field response teams that travel to scenes; that work is a separate program not covered here.
What Austin Built at the Call Center
In 2019, Austin embedded licensed mental health clinicians from Integral Care inside the city’s 911 call center. When a caller dials 911 and the presenting issue is behavioral health, the dispatcher asks: “Do you need fire, EMS, police, or mental health?” If the answer is mental health — or if the dispatcher identifies a behavioral health component — the call transfers to an EMCOT clinician in the call center.[0]
The clinician handles the call entirely by phone. Their documented functions at the call level: providing emotional support and guidance, facilitating access to community resources, checking records to determine whether the person is already connected to services through Integral Care’s system, and scheduling a same-day follow-up call to check back with the person after the initial contact.[1]
The same-day follow-up call is a specific design choice that differentiates Austin’s model from programs that resolve calls and close them without continuity. The follow-up call serves a clinical function — confirming the person is stable and connected — and a data function, producing information about what happened to callers after the initial contact.
When the embedded clinician determines that in-person response is needed, they dispatch the appropriate resource: an EMCOT field team if the situation is behavioral health, EMS if the situation is medical, or police if the situation requires law enforcement. The dispatch decision is the clinical staff’s to make, not the dispatcher’s. The routing decision happens inside the call, with clinical expertise applied to it. This profile ends at that dispatch decision — what happens in the field is outside the scope of this program’s dispatch function.
What Clinicians Can Access
EMCOT’s dispatch-embedded clinicians operate within Integral Care’s clinical records system. When a call comes in, the clinician can look up whether the caller or the person being reported about has an existing relationship with Integral Care — an active case manager, a recent crisis contact, a scheduled appointment. This records access is a direct function of Integral Care’s role as the designated local mental health authority, which serves a large portion of Travis County’s public mental health population.
Kedra Priest, Practice Administrator of Crisis Services at Integral Care, described the clinical demand of the role: dispatch clinicians must be comfortable handling crises at the phone level without the full information a field visit provides.[2] The role is professionally distinct from field clinical work — it requires rapid phone-based assessment, comfort with incomplete information, and the judgment to make routing decisions that cannot be reversed once made.
Clinicians also train 911 dispatchers continuously: reviewing recorded calls together, “like a coach dissecting game film,” in EMCOT’s program description.[3] This feedback loop builds dispatcher capacity to recognize behavioral health calls and improves the quality of the warm handoffs to clinical staff.
Outcomes: Dispatch Layer Specifically
In FY2025, EMCOT’s dispatch-embedded clinicians handled more than 3,800 calls and diverted more than 90% from police response, according to program data reported to KVUE.[4] The U.S. Department of Health and Human Services designated the EMCOT program as a “national role model.”[5]
Approximately 80% of calls reaching the dispatch clinicians are resolved entirely by phone — no field dispatch of any kind.[6] The remaining calls either receive EMCOT field dispatch (if the clinician determines in-person behavioral health response is needed) or are routed to EMS or police (if the situation requires it).
All outcome figures are program-reported. No independent evaluation of EMCOT’s dispatch-embedded component has been published.
The Funding Vulnerability
EMCOT operates under a city contract with Integral Care. In November 2024, Austin voters rejected Proposition Q, a property tax measure that would have funded expanded homelessness, public safety, and health initiatives. The vote reduced the city’s annual contribution to EMCOT from $3 million to $2 million for FY2026 — a 33% cut to a program designated a national role model.[7]
EMCOT maintained 24/7 operations after the cut, with staffing adjustments. The Prop Q failure illustrates the single-source vulnerability that affects programs funded primarily through a city contract subject to voter approval: strong operational outcomes are not a guarantee of political protection when the funding mechanism is exposed to a ballot measure.
Dominick Nutter, Austin Emergency Communications Director, described the operational value that the funding decision affected: “As we divert calls over to the clinicians, it helps with our improved response time. If responders aren’t going to those calls, they can focus on other calls where the public needs them.”[8]
The Path to 24/7
EMCOT’s dispatch-embedded component achieved 24/7 coverage in 2023 — four years after the initial dispatch integration in 2019. The ramp required building a pool of 24 licensed clinicians dedicated to call-center work before overnight staffing was achievable.[9] Each budget cycle added staff capacity; 24/7 was the result of sustained, incremental investment rather than a single decision.
The four-year path from partial to full coverage documents how long 24/7 embedded dispatch takes to build under workforce constraints. Programs planning to achieve full 24/7 coverage should budget for a multi-year build, not a year-one launch milestone.
Significance in the Documented Landscape
Austin’s dispatch-embedded EMCOT function is significant in the documented landscape for four reasons: it has been operational since 2019, longer than most embedded programs; it achieved 24/7 coverage in 2023, making it one of a small number of programs running around the clock; its records access through Integral Care’s clinical system adds a clinical capability most programs lack; and its public data reporting — KVUE coverage, CSG Justice Center profile, city budget documentation — makes it the most granularly documented embedded dispatch program in available sources.
The Prop Q funding cut also makes Austin a documented case study in program funding fragility: a nationally recognized program with strong outcomes facing a material budget reduction because its primary funding source was a city contract subject to a ballot vote.
Sources
[1] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/
[2] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/
[3] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/
[4] Austin EMCOT FY2025 diversion rate (90%+, 3,800+ calls): KVUE, 2025.
[5] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/
[6] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/
[7] Austin Prop Q failure; $3M → $2M funding cut: Austin Monitor, March 2025; KVUE, 2025.
[8] Dominick Nutter, Austin Emergency Communications Director: Safer Cities dispatch integration newsletter.
[9] Austin EMCOT dispatch functions; Kedra Priest; coach-reviewing-game-film training model; HHS national role model designation: CSG Justice Center, “Expanding First Response: Austin, TX,” updated December 2024, https://csgjusticecenter.org/publications/expanding-first-response/program-highlights/austin-tx/