People in mental health crisis have nowhere to go in parts of Pierce County. Here’s why
It’s only been a couple years since Pierce County officials opened a behavioral health crisis center in Parkland, designed to support people in need of immediate help with their mental health or substance use.
Now officials are sounding the alarm because those services have been stopped in Fife and Parkland since March, leaving people in mental health crisis with nowhere to go except the emergency room or jail.
In letters addressed to the state Health Care Authority director late last month, Pierce County Executive Bruce Dammeier and Pierce County Council Chair Ryan Mello pressured HCA to take action to fund vital behavioral health care in the county, calling the situation “critical,” “unacceptable” and “entirely avoidable.”
HCA purchases health care for nearly a third of Washington residents through the Washington Apple Health or Medicaid program and the Public Employees Benefits Board Program.
Recovery Innovations operated crisis services at the Regional Crisis Center in Fife and the Crisis Recovery Center in Parkland-Spanaway. After struggling financially during COVID and a reduction of services late last year, Recovery Innovations abruptly ceased providing crisis-stabilization services in March, Steve O’Ban, senior counsel to Dammeier’s office, told The News Tribune on Aug. 8.
Both centers treated up to 16 patients at a time, patients stayed an average of 48 hours and Recovery Innovations cared for more than 20,000 patients over eight years in Pierce County, according to an FAQ about the Crisis Recovery Center on Pierce County’s website.
According to the letter Dammeier wrote to HCA, after Recovery Innovations gave notice it would cease to operate, Carelon Behavioral Health services issued a Request for Information as an agent of HCA to find its successor.
After a careful scoring process that involved five private managed-care organizations that deliver Medicaid services for patients in Washington (MCOs), Connections Health Services was selected as the successful bidder to provide urgent care and 23-hour services at the Parkland facility, Dammeier said.
Despite being chosen, a “fundamental barrier” to Connections Health Services reopening the Parkland clinic this year is that the HCA and the MCOs have been unable to negotiate adequate rates for services provided, Dammeier wrote.
“Some MCOs have hinted that they do not want to begin negotiating rates for these services until HCA completes the actuarial rate‐setting process for the 23‐hour crisis relief center service” next spring, he wrote.
The situation has hindered Pierce County’s ability to address its behavioral health goals, Mello told The News Tribune on Aug. 9. It also has put a burden on first responders and police, who have no choice but to take people in crisis to local emergency rooms or jail, where they are not receiving timely and adequate care, he said.
“That has an effect on everyone, not just the individual experiencing the behavioral health crisis, but the backlog that creates for others … who are at the emergency department for a heart [attack], a stroke or a broken leg or some other acute emergency that’s not a behavioral health crisis,” Mello said. “If something spirals and the behavioral health crisis turns into violence or something else, their alternatives are jail, which is not a therapeutic environment at all and doesn’t rectify any issues, or the emergency department.”
A crisis facility’s focus is getting to the root of the mental health or addiction issue that brought the patient to them and then connecting patients to the treatment needed, O’Ban said.
“If you don’t have a crisis facility that’s the front door to get folks in on their journey to better mental health and addiction treatment, then you’re going to see the wrong parts of the system get over utilized,” he said. “Whether it’s that a first responder who has to sit there in the emergency room waiting when they should be out catching bad guys, or you got emergency room personnel having to deal with somebody who’s having a serious mental episode and they’re not trained for it.”
A representative with Carelon Behavioral Health could not be immediately reached by The News Tribune on Aug. 9.
In response to an inquiry from The News Tribune, HCA deputy chief communications officer Katie Pope said in an email that the situation is ongoing, and HCA is actively working with managed-care organizations and Carelon Behavioral Health to explore potential solutions.
“To date, we have requested summaries from managed care organizations regarding outreach and the status of contract negotiations with this provider. In our communication with the MCOs, we have provided the information that is currently available related to funding and costs, and we will be meeting MCO leadership to further emphasi[ze] the need to follow up on the information we have requested,” Pope wrote. “In preparation for these conversations, our team is conducting program assessment and financial modeling for this new facility model.”
Mello told The News Tribune he addressed his letter on behalf of the County Council to members of the Pierce County Legislative Delegation in addition to HCA director Susan Birch to put additional pressure on negotiations.
Both O’Ban and Mello said there’s an argument to be made that Pierce County needs two or three crisis centers, but the focus now is getting one back up and running as soon as possible.
“We think Connections [Health Services] is the top provider. So [MCOs] have no excuse not to contract with Connections,” O’Ban said. “Connections clearly has the competency to do it. They’ve been licensed to provide those services in King County, those services are up and running. And there’s an approved facility to provide those services in Parkland. So step up, because you have [a] network adequacy requirement to provide those services.”
This story was originally published August 12, 2024 at 5:30 AM.
