Cascade Community Healthcare will soon open the doors to a new 23-hour crisis relief center in Centralia.
It’s the fourth facility of its kind to pop up in the state after a push for the new treatment model in 2023. The move represents an effort to catch up to the demand for mental health treatment.
Cascade Community Healthcare Chief of Inpatient Services Mindy Greenwood and the company’s Chief of Facilities Todd Morrison led state Rep. Peter Abbarno, R-Chehalis, on a tour of the mental health clinic’s new crisis center facility Monday morning, Nov. 10.
Greenwood expects to open the doors to the new facility in early January. She also hopes that the state Legislature will address some small funding concerns during next year's legislative session.
The Centralia Crisis Relief Center is not a new building. The center is in a recently renovated portion of Cascade's current Centralia clinic off of Reynolds Avenue. The facility is centered around a single large room with comfortable chairs and a couple televisions, one that will play familiar films and another that will list resources patients can access in the area, Greenwood said.
Attached to the main room are small medical rooms for wound care and other treatment as well as two rooms for isolating anyone who becomes violent or unruly. The renovation also included the construction of a commercial kitchen, meaning staff will be able to feed people that come to the facility.
“This room is unrecognizable from when we did the pre-tour,” Abbarno said. “This was all cubicles.”
The new facility is part of a new treatment model in the state meant to provide behavioral health treatment for adults for up to 23 hours and 59 minutes at a time. Because the facilities will only accommodate patients for less than 24 hours, they don't have to provide beds or private rooms and instead put their patients in cushioned recliners in a large, open room.
The new model was first put in motion in 2023 when the Washington state Legislature passed Senate Bill 5120 unanimously. The bill directed the state's Department of Health to begin licensing such centers.
While progress is being made, both Greenwood and Abbarno, who has been working with Cascade since he first took office roughly six years ago, say the development of the crisis centers is still a work in progress. As such, the clinics themselves and the state are still ironing out all of the details.
“The important thing to always realize, especially when we're dealing with whether it's crisis, stabilization, mental health, drug addiction, is that the state is woefully behind in their infrastructure to deal with these types of issues,” Abbarno said. “Whether it's the prison system and corrections or whether it's the hospital and emergency room … We've recognized kind of one of the pathways to do this, but there's got to be tweaks throughout this.”
According to the bill, the purpose of the facilities is to divert people with mental health conditions to a facility equipped to treat them and away from emergency rooms, involuntary treatment and jail — places that often struggle to address mental health conditions.
Crisis relief centers are designed to receive most of their patients from law enforcement and other first responders or voluntary dropoffs. Facilities are expected to accept any and all individuals. By law, the facility must accept a minimum of 90% of clients seeking to enter. They must also provide explanations for each patient they turn away.
The Centralia facility is uniquely well-equipped to hit the ground running for this type of facility as it already operates similar facilities in the same building and has a relationship with local law enforcement.
Cascade Community Healthcare operates a six-bed voluntary mental health clinic at its Centralia location as well as a 16-bed involuntary clinic.
Additionally, those clinics already accept patients brought in by law enforcement and ambulances. As of Monday, Greenwood said the facility had accepted 200 clients brought in by local law enforcement since the beginning of 2024. She added that many of those clients came to the clinic instead of the local emergency room, saving space for the ER and saving officers time. Officers often have to monitor patients they bring to the ER.
“January 1 of 2024, I started working with Centralia PD to do law enforcement dropoffs into our crisis stabilization unit, and that very quickly involved the whole county,” Greenwood said. “We took them, and they could get back out on the street. And now we're also doing ambulance diversion dropoffs.”
The agreement with law enforcement will continue, and the new facility that will accept a wide range of individuals might mean law enforcement can lean on the facility even more. The clinic is also hoping to become a resource for county ambulance services and for other services, such as local shelters.
Those admitted to the clinic will also still be able to access longer term treatment if they need it. In that case, they would simply move into an open slot of the six-bed mental health clinic that at one point was actually struggling to find enough patients.
Cascade Community Healthcare first began the journey to open the new clinic in 2023 after the state passed Senate Bill 5120, which directed the state's Department of Health to begin licensing crisis relief centers.
According to Greenwood, not long ago the facility's six-bed clinic was rarely used. In the early years, it had around 13% occupancy. In 2023, Greenwood began to look for ways to treat more patients and began working with law enforcement before discovering the crisis relief center model. She knew the local clinic would be a perfect candidate.
“I went to Richard Stride, who's our CEO, and I said, ‘this is what I want to do.’ And he gave me his blessing,” Greenwood said. “So in August of that year, I put in the application, and in November of 2023, we got granted.”
Cascade Community Healthcare was granted $1.83 million by the state in November 2023 to fund the renovations and other changes needed to open a crisis relief center.
Now that the center is close to opening, Greenwood said the biggest challenge will be funding for the first few months. The center is plenty prepared. Greenwood has already secured contracts with major insurance providers, including those through Medicaid.
However, until the clinic sees enough patients to begin billing, and through service contracts, it will rely on the state and the Great Rivers Behavioral Health Administrative Services Organization to provide operational funds.
“You know, it's going to be four to six months before we really see money rolling in from the billing part of it,” Greenwood said. “And this is a high paid program, because you have doctors, you have nursing, you have professionals.”
Greenwood said the crisis relief centers will also need a more long-term funding fix soon to help them continue operating. While the centers are set to receive some amount of grant funding and state dollars, that funding is limited to paying for mental health treatment.
That money cannot be used to fund wound care and minor medical treatment, even though the crisis centers are required by law to provide that treatment. The issue won't bankrupt the program immediately as the simple medical services will still be billed to insurances, but as clients that don't have insurance pile up over time, the cost the clinic has to absorb will increase if something doesn't change.
