Puerto Rico 988 Local Capacity Building - The Puerto Rico Mental Health and Anti-Addiction Services Administration (MHAASA), the State Mental Health Agency (SMHA) and Single State Agency (SSA) for substance use services, submits this application for the Puerto Rico 988 Local Capacity Building (FG-26-002) . MHAASA operates PAS Line/988, Puerto Rico's only statewide 24/7 Suicide & Crisis Lifeline Contact Center, providing crisis intervention, suicide prevention, substance use crisis response, referral, care coordination, and follow-up services across all 78 municipalities. The purpose of this three-year project is to strengthen Puerto Rico's 988 crisis system by (1) strengthening 988 operational capacity; (2) implementing statewide quality assurance, clinical monitoring, standardized follow-up, and real-time referral protocols to improve continuity of care; (3) strengthening coordination among 988, Mobile Crisis Teams, the Puerto Rico 911 Emergency System, hospitals, and community partners through standardized coordination protocols, Sentinel Event reviews, and a long-term sustainability plan; (4) enhancing data reporting, cybersecurity, and continuous quality improvement; and (5) implementing standardized statewide substance use and overdose response protocols. Objectives include: 1.1. Achieve and maintain a ≥90% answer rate; 1.2. Ensure 100% acceptance of National Backup and applicable warm transfers; 1.3. Answer 95% of all contacts within 20 seconds; 1.4. Maintain workforce capacity and implement workforce wellbeing and retention strategies; 2.1. Implement a statewide quality assurance and clinical monitoring system; 2.2. Provide follow-up to 100% of individuals with suicidal ideation; 2.3. Implement standardized real-time referral protocols; 3.1. Implement statewide 988/911 coordination protocols; 3.2. Implement local PAS Line/988 Sentinel Event protocols; 3.3. Submit a 988 Sustainability Plan; 4.1. Participate in 100% of SAMHSA National Cross-Site Evaluation activities; 4.2. Report 100% of cybersecurity incidents and vulnerabilities; and 5.1. Implement standardized statewide substance use and overdose response protocols. Leveraging MHAASA’s established statewide behavioral health infrastructure, experienced federal grants management capacity, integrated crisis response network, and strong public-private partnerships, the project will improve timely access to evidence-based crisis services, strengthen coordination across Puerto Rico’s behavioral health crisis continuum, reduce reliance on emergency departments and law enforcement when clinically appropriate, and ensure the long-term sustainability of an integrated, recovery-oriented, and person-centered 988 crisis response system for all residents of Puerto Rico.
