Crisis Stabilization Facilities Progress Report

Summary

The Crisis Stabilization Facilities Progress Report, a report to the Legislature from the Washington State Department of Commerce Behavioral Health Facilities Program dated March 1, 2023, required by the 2022 Supplemental Capital Budget, Laws of 2022, Chapter 296. It reports 13 applications requesting $53,604,677 and five crisis stabilization facility grants totaling $20.5 million that will create 16 new beds and four outpatient treatment centers in Benton, King, Skagit and Whatcom counties. Key findings cite few viable applications, provider staff shortages and inflation affecting construction. A table lists the five awards, totaling $20,490,739 against total project costs of $21,636,027, with project summaries for each grantee.

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 Crisis Stabilization
 Facilities Progress Report



   Behavioral Health Facilities Program report to the Legislature
   pursuant to the 2022 Supplemental Capital Budget, Laws of 2022,
   Chapter 296 (SB 5561, Section 1025(5))




                                              March 1, 2023
       BEHAVIORAL HEALTH
       FACILITIES                             Report to the Legislature

                                              Interim Director Kendrick Stewart
V3.1
Acknowledgments

Washington State Department of Commerce
Mark Barkley, Local Government Division, Assistant
Director

Tony Hanson, Local Government Division, Deputy
Assistant Director

Addie Craig, Community Capital Facilities,
Managing Director

Megan LaPalm, Community Capital Facilities,
Community Facilities Manager

BEHAVIORAL HEALTH FACILITIES PROGRAM
COMMUNITY CAPITAL FACILITIES UNIT



1011 Plum St. SE
P.O. Box 42525
Olympia, WA 98504-2525

www.commerce.wa.gov

For people with disabilities, this report is available on
request in other formats. To submit a request, please
call 360-725-4000 (TTY 360-586-0772)




 BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT
Table of Contents
Executive Summary ..................................................................................................................................... 2

Introduction ................................................................................................................................................. 3

Key findings ................................................................................................................................................ 3

Funding report ............................................................................................................................................. 4




  BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT                                                                                                  1
Executive summary
Authorizing legislation
The Legislature directed the Department of Commerce (Commerce) to submit a progress report summarizing
grants made by the Behavioral Health Facilities Program for crisis stabilization facilities. The report, due March
2023, is required by Chapter 296, Laws of 2022 (SB 5651, section 1025) and must include:

    (a) The total number of applications and amount of funding requested

    (b) A list and description of the projects approved for funding including state funding, total project cost,
    services anticipated to be provided, bed capacity, and anticipated completion date

Highlights
   Commerce has awarded five crisis stabilization facility grants totaling $20.5 million.

   The awards to date will create 16 new beds and four outpatient treatment centers in Benton, King, Skagit
   and Whatcom counties.

   The Behavioral Health Facilities Program is planning another funding round in early spring of 2023 for the
   remaining funds.

   Number of applications received: 13

   Total funding requested: $53,604,677

Key findings
   Commerce received few viable applications for funding, leading to extended time to award and grant funds.
   Eligible facilities are facing staff shortages, which may limit provider interest in applying to expand services
   or operate new facilities. The steps the Legislature took in 2022 to raise reimbursement rates for providers,
   expand workforce training programs, and provide operating funding to facilities will alleviate the pressure
   on providers seeking to expand existing or open new facilities. Commerce is monitoring progress of this
   situation and acknowledge that improving the behavioral health workforce will aid fund distribution by
   increasing provider service capacity.

   Commerce, in concert with state partners and providers, identified that the ongoing inflationary
   environment compounded the ability of providers to construct new facilities within the current grant
   framework. We are exploring an increase to the maximum dollar amounts for Behavioral Health Facilities
   grants to address this concern and ensure facilities have the resources they need to complete construction
   and open on schedule.

   The crisis stabilization funds are a helpful complement to the work the Health Care Authority is doing to
   support new crisis services in Washington, such as Mobile Crisis Response Program and the 988 Suicide
   and Crisis Lifeline.




 BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT                                                          2
Introduction
Commerce’s Behavioral Health Facilities (BHF) Program funds community-based behavioral health facilities in
all parts of the state. The number of grants awarded has increased in recent biennia as the state works to
close the gap between the number of adults and children needing treatment for mental health and substance
use disorders and the availability of appropriate treatment options. Governor Jay Inslee’s behavioral health
plan calls for more community-based treatment options as the state works to transition civilly committed
individuals out of Western and Eastern State Hospitals.

Since the start of the program in the 2013-15 biennium, the BHF Program has made 220 awards to projects
across a variety of facility types statewide. Grouping these facility types into five categories, the BHF program
has funded:

      959 crisis behavioral health treatment beds
      885 long-term behavioral health treatment beds
      629 substance use disorder treatment beds
      523 beds in other behavioral health categories
      48 outpatient treatment facilities

This report provides details about the progress of creating new behavioral health facilities, highlighting those
funded by the 2022 State Supplemental Budget for crisis stabilization facilities. Specifically, the Legislature
requested:

    (a) The total number of applications and amount of funding requested

    (b) A list and description of the projects approved for funding including state funding, total project cost,
    services anticipated to be provided, bed capacity, and anticipated completion date


Key findings
   Commerce has received few viable applications for funding, leading to extended time to award and grant
   funds. Eligible facilities are facing staff shortages that may be limiting provider interest in applying to
   expand services or operate new facilities. This might improve in 2023 and beyond with the steps the
   Legislature took in 2022 to raise reimbursement rates for providers, expand workforce training programs,
   and provide operating funding to facilities. Monitoring progress made and maintaining momentum for
   improving the behavioral health workforce will aid fund distribution and increase provider service capacity.

   Commerce, in concert with our state partners and providers, identified that the ongoing inflationary
   environment compounded the ability of providers to construct new facilities within the current grant
   framework. We are exploring an increase to the maximum dollar amounts for Behavioral Health Facilities
   grants to address this concern and ensure facilities have the resources they need to complete construction
   and open on schedule.

   The crisis stabilization funds are a helpful complement to the work the Health Care Authority is doing to
   support new crisis services in Washington, such as Mobile Crisis Response Program and the 988 Suicide
   and Crisis Lifeline.




 BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT                                                          3
Funding report
Behavioral Health Facilities grant applications and funding requests
  Number of applications received: 13
  Total funding requested: $53,604,677


Funded projects
Table 1: 2021-2023 Behavioral Health Facilities Crisis Stabilization grant awards

                                                              Planned
                                                              Facility Commerce Total
Grantee           Project            Service                  Opening Grant     Project
Name              Name               availability        Beds Date     Amount   Cost                   County
                    Three Rivers
                      Behavioral           Outpatient
 Benton County            Health        Treatment, 20     N/A   04/01/25    $2,170,739    $2,170,739    Benton
                       Recovery             Recliners
                          Center
                      North King
                                           Outpatient
                   County Crisis
ConnectionsWA                           Treatment 20      N/A   10/01/23    $5,820,000    $5,820,000      King
                       Receiving
                                            Recliners
                          Center
                   Skagit County
                                                Crisis
                           Crisis
  Skagit County                          Stabilization     16   10/01/24    $5,800,000    $6,830,288     Skagit
                    Stabilization
                                             16 Beds
                          Center
                                           Outpatient
                      Adult Crisis
        SOUND                           Treatment 12      N/A   09/15/23    $5,800,000    $5,800,000      King
                   Triage Facility
                                            Recliners
                    Youth Crisis
                          Triage,
    TouchStone                             Outpatient
                    Stabilization
     Behavioral                            Treatment      N/A   08/01/23     $900,000     $1,015,000   Whatcom
                   and Intensive
        Health                             3 Recliners
                      Outpatient
                      Treatment
                                                           16
                                               Totals                      $20,490,739   $21,636,027
                                                         beds




 BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT                                                       4
Project summaries:
Benton County: Three Rivers Behavioral Health Recovery Center
This project will provide services for up to 52 people in crisis. Grant funds will contribute to building a 23-hour
observation unit with 20 recliners.1 This unit will be attached to a 16-bed crisis stabilization unit and a 16-bed
secure withdrawal management unit project, where appropriate referrals can be made.

Connections WA: North King County Crisis Receiving Center
This project aims to serve up to 13,650 individuals yearly and connect to community supports; 70% or 9,555
individuals yearly will be stabilized within 24 hours. The project creates walk-in access to 20 new 23-hour
recliners and psychiatric care. This unit will be attached to two complementary units with 16 new 23-hour crisis
stabilization beds, and 16 new 120-hour evaluation and treatment beds.

Skagit County: Skagit County Crisis Stabilization Center
The Skagit County Crisis Stabilization Center will create 48 new beds among three separate units: 16 beds in
the mental health stabilization services unit, 16 beds in an acute/medical withdrawal
management/detoxification services unit, and 16 beds in a residential substance use/co-occurring treatment
program unit.

SOUND: Adult Crisis Triage Facility (King County)
This project funds the development of a crisis stabilization facility with 12 recliners. Sound’s facility will be a
non-residential facility allowing those in crisis to be seen for up to 23 hours and 59 minutes. Individuals in
crisis needing crisis intervention services beyond 23 hours will be connected to appropriate long-term crisis
and diversion facilities. Sound’s facility will serve all adults including those with intellectual and developmental
disabilities regardless of their ability to pay for services.

TouchStone Behavioral Health: Youth Crisis Triage, Stabilization and Intensive Outpatient Treatment
(Whatcom County)
This project will acquire an existing facility to create dedicated space for three crisis stabilization recliners,
Intensive Outpatient Substance Abuse Group Therapy, and Crisis Triage and Stabilization. TouchStone
anticipates this project will result in doubling its average number of annual therapeutic visits with 12,840 visits
per year.




1 " … observation units (OU) provide a setting where patients can be evaluated and given short term treatments while … staff
determines if an inpatient admission is required or if ambulatory care is sufficient." Washington Office of Financial Management,
Observation Unit stays in Washington State


    BEHAVIORAL HEALTH FACILITIES CRISIS STABILIZATION REPORT                                                                        5


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