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News / Northwest

King County Council approves crisis care centers plan, mental health funding

By Taylor Blatchford, The Seattle Times
Published: June 19, 2024, 10:02am

King County will soon begin the biggest expansion of its mental health system in decades, creating five centers meant to support people in a crisis.

The Metropolitan King County Council voted unanimously Tuesday to finalize rules determining who can run a crisis care center and how to evaluate them. This plan is the final step before the county begins selecting cities to host a center and the organizations that will run them.

All of this work is geared toward building something that doesn’t exist in King County today: mental health-focused centers where anyone can walk in and receive urgent mental health care. County officials believe the centers could serve as many as 70,000 people annually.

“There’s an opportunity here to make King County a national model for crisis care,” Councilmember Reagan Dunn said in Tuesday’s meeting. “As we know, behavioral health challenges of all kinds are hitting our community harder than ever.”

The funding comes from a $1.25 billion property tax levy voters approved last year to fund mental and behavioral health services. The first center is planned to open in 2026, with more opening in following years. All five centers are expected to be open and operating by 2030.

It took five months of discussion and amendments for the council to approve the implementation plan, a detailed 150-page document outlining how centers will be placed, funded and evaluated.

The county doesn’t have these types of centers right now. People in crisis often end up in hospital emergency rooms, jail, or don’t get help at all. County officials and mental health advocates hope the centers can be an important link in building a stronger mental health system that also includes mobile teams and more beds at psychiatric facilities.

Each crisis center will contain a behavioral health urgent care clinic that could screen people and triage them to appropriate services, an observation unit where people could stay for up to 23 hours, and a short-term stabilization unit where people could stay for up to 14 days before being discharged or referred elsewhere. People will be admitted to the crisis centers voluntarily, regardless of their health insurance coverage or ability to pay.

“We’ve thrown spaghetti at the wall many times hoping it’ll stick,” Councilmember Pete von Reichbauer, a co-sponsor of the initiative, said Tuesday. “I think this will stick.”

Months of discussion

Transportation to and from the centers came up repeatedly in the council’s discussions. The plan requires sites to have “meaningful access to public transportation” and proximity to major arterial roads. Councilmembers were concerned about where people would be released from the centers and how they would access transportation back to their homes.

The council added language requiring the centers to work with community health providers, mobile crisis teams, emergency responders or law enforcement to facilitate transportation to the centers. The county will also collect and report data on how people in crisis arrive at the centers.

A proposed amendment would have required the Department of Community and Human Services to coordinate with King County Metro to help people on transit or at a transit center access the centers. Councilmember Sarah Perry withdrew the amendment after other members of the Regional Policy Committee were concerned about giving transit operators additional responsibilities.

The council also removed language that would cap one operator at managing three centers. Earlier this year, seven providers expressed interest in operating centers.

“We want to make sure the best organization is managing the center in their zone, and they don’t want to be precluded from that happening just because we have three others,” Redmond Mayor Angela Birney said at the May 8 committee meeting.

New language also allows the county to purchase a property directly “in exceptional circumstances” with approval from the county council and support from the host jurisdiction.

The county’s vision

The centers are a key part of King County’s vision for a more robust mental health system. Susan McLaughlin, the director of the county’s Behavioral Health and Recovery Division, wants to use funds from the levy to build “the behavioral health system of the future.”

“Even as we’re thinking about the mental health residential beds and building those back, we’re not going to build back the same thing we had,” McLaughlin said in an interview ahead of the plan’s passage. “We’re going to build what the system needs and what the future of behavioral health looks like.”

The crisis care centers implementation plan lays out three components of a robust behavioral health crisis system: The centers are “somewhere to go.” Mobile crisis teams throughout the county are “someone to respond.” 988 and crisis hotlines are “someone to call.”

Before the centers are built, other funds from the levy will expand mobile crisis services: teams of mental health workers and peers who travel across the county to de-escalate crises and provide initial assessments, then help the person in crisis find further care. The county said $3 million in initial funds would allow it to expand the number of mobile response teams in the county from 20 to 32.

The county sought proposals this spring from organizations interested in providing mobile crisis services and is expected to announce its new contracts this summer. The county currently contracts with the Downtown Emergency Service Center.

The county will also add teams to its contract with the YMCA of Greater Seattle, which operates the Children’s Crisis Outreach Response System.

What comes next

The county can now begin finding locations and operators for the centers. A request for proposals will open this fall, seeking behavioral health organizations interested in operating the centers.

The levy divides King County into four geographic crisis response zones, which will each host one center. A fifth center will specialize in serving youth.

Earlier this year, the county gauged interest from cities and providers. The following cities expressed interest to the county, according to King County documents obtained by a public records request:

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* Bothell

* Lake Forest Park

* Burien

* Kirkland

* Kent, Renton and Auburn

* Kenmore

* Redmond

* Bellevue

* Seattle

The following providers expressed interest:

* RI International, an international nonprofit organization providing crisis response in Pierce and Thurston counties.

* Highline United Methodist Church, a church that operates the Burien Day Center & Severe Weather Shelter.

* Sound, a nonprofit mental health and addiction treatment provider in King County.

* Pioneer Human Services, a Seattle-based nonprofit assisting people with mental health problems or substance use disorders, and people reentering society after incarceration.

* Connections Health Solutions, an Arizona-based for-profit operator of behavioral health crisis care centers.

* Fairfax Behavioral Health, a for-profit subsidiary of national health care company Universal Health Services.

* Downtown Emergency Service Center, a Seattle-based nonprofit providing homelessness, substance-use disorders and mental health services. DESC operates the Crisis Solutions Center, which offers similar services but requires a referral from police, a mobile crisis team or mental health professional.

A separate center in Kirkland is slated to open this summer, operated by Arizona-based Connections Health Solutions. Before the levy was approved, the city announced plans to build its own mental health crisis center in partnership with Bothell, Kenmore, Lake Forest Park and Shoreline.

If the county selects the center as one of its sites, it could speed up the goal of opening the first center in 2026.

“Kirkland’s interest is that the benefits from the levy are felt in this part of the county, and we’re open to the Connections facility being designated as one of the county’s five clinics, if that’s the case,” Deputy City Manager Julie Underwood said in an email.