Clark and Skamania counties are asking Gov. Jay Inslee for funding to build a new behavioral health crisis triage and stabilization center in Vancouver. The center would increase capacity for crisis stabilization and treatment and evaluation beds and bring a new, much needed service to Southwest Washington — a secure detox facility.
Local stakeholders say the proposal would increase capacity and address critical gaps in behavioral health services in Southwest Washington.
“We need to start addressing the gaps faster so people don’t keep falling through the cracks,” said Vanessa Gaston, director of Clark County Community Services.
Several community groups and behavioral health service providers teamed up with the counties to develop the capital budget request, which was submitted to Inslee’s office Thursday morning. The proposal requests $750,000 for planning and preliminary design and an additional $18 million for construction of the facility.
The proposal also included 27 letters of support from individuals and organizations, including the Clark County Sheriff’s Office, PeaceHealth Southwest Medical Center, Cowlitz Indian Tribe, city of Battle Ground, Columbia River Mental Health, NAMI Southwest Washington, Lifeline Connections and Council for the Homeless.
Representatives from the local group that drafted the proposal will meet with the governor’s office next month to discuss the project, with hopes of the facility making it into the governor’s capital budget for the next legislative session. They’ll also turn to local legislators for support.
The facility would include a drop-in center designed to resemble a living room rather than a medical setting. People would be greeted by certified peer staff and could talk while sitting on sofas and eating snacks. From there, staff could direct people to nurses and mental health professionals who would triage the person and determine their needs.
The facility also would feature three separate adult units: crisis stabilization; evaluation and treatment; and secure detox.
Currently, Columbia River Mental Health manages the only three crisis stabilization beds in the county at its Elahan Place residential center in Orchards. The beds provide a setting that’s less intensive than inpatient care but offers more assistance than outpatient care. The proposed project would relocate those beds to the center and add five more beds to the unit.
Telecare currently operates 11 treatment and evaluation beds at the Clark County Center for Community Health. The space is cramped, often requiring people in crisis to share rooms, said Dr. Lisa Clayton, administrator for the Telecare program. The proposal would relocate those beds to the center and add five beds to that unit, which would provide both voluntary and involuntary acute psychiatric care.
Finally, the center would include a 16-bed secure detox facility — a new service for Clark County. Lifeline Connections currently offers a 16-bed detox unit and a 16-bed sobering unit, but neither are secure facilities, Gaston said. The secure unit would be used for 14-day commitments for involuntary chemical dependency treatment.
This project would complement other efforts to expand behavioral health services locally — such as the Daybreak Youth Services expansion in Brush Prairie and the 72-bed Rainier Springs Hospital planned for Salmon Creek — and provide much needed services for Clark County residents, Gaston said.
Long-term savings
Whenever behavioral health services aren’t available locally, patients are sent to Western State Hospital, placed in facilities outside of the region or left to fend for themselves, Gaston said. For many, hospital emergency rooms and the Clark County Jail are fall-back plans when they have nowhere else to go.
“For far too long we’ve relied on the emergency department and the jail for crisis care,” said Jeff Hite, program manager for Clark County Crisis Services. “We can’t continue to rely on the emergency department to provide this care, and it’s a burden on the jail.”
Not only are emergency departments and jails inappropriate places for people experiencing behavioral health needs to receive treatment, they’re also expensive, Gaston said.
As part of the proposal, the Clark County Sheriff’s Office and PeaceHealth Southwest Medical Center provided savings estimates should a crisis triage and stabilization center be constructed locally.
At PeaceHealth Southwest, up to 40 percent of emergency department visits from March through August could have been diverted to a triage and stabilization center. Based on an average emergency department cost of $700 per visit, the hospital could save nearly $1.4 million per year, according to the hospital.
The sheriff’s office reports an estimated 17 percent of total bookings in 2015 were misdemeanor or gross misdemeanor bookings, which are most likely to originate with behavioral health or crisis-related issues. Those crimes might include urinating in public or having a campfire in a park and are instances where a patrol officer has discretion whether to arrest a person or not, said Randy Tangen, Clark County Jail operations commander.
Oftentimes, the root cause of why the person is committing those crimes is substance abuse or mental illness. Putting the person in jail doesn’t address that root cause, but if the officer has safety concerns, the person may end up in jail simply because the officer doesn’t have any other options, Tangen said. Using the 17 percent of booking estimate, diverting those people to the center could result in $712,000 in annual cost savings, according to the sheriff’s office.
“Providing behavioral health services is unavoidable,” Tangen said of the jail. “It’s a service we provide, but we know many people could be better served in another setting.”
Project organizers hope the new crisis triage and stabilization center will offer that alternative setting.
“Let’s let the jail do what the jail does, let the (emergency department) do what the (emergency department) does and let this facility do what mental health can do for the community,” Hite said.
