Behavioral health director updates commissioners on crisis services expansion and staffing challenges

Dave McClay, CEO of Okanogan County Behavioral Health Care, presented the agency’s quarterly report and outlined plans to expand crisis services, hire additional staff and work through funding uncertainty.

McClay told commissioners the agency plans to expand mobile crisis capacity and to pursue a Designated Crisis Responder (DCR) model that could co‑respond with law enforcement. He said the county is discussing whether to house a DCR in the behavioral health building so multiple law‑enforcement agencies could access the position.

“Given the size of this county, it may make sense that we just house that person in our building and then they…co‑respond with law enforcement,” McClay said. He explained the goal is to add mobile crisis teams of two later in the day and to fund responders beyond 8 a.m.–5 p.m. as funding permits.

McClay described recruitment challenges for psychiatric prescribers and other clinical staff. He said the agency has conducted recruitment interviews and brought candidates to the county, but rural living and preferences for urban amenities have limited hires. He reported a roughly 6% annual turnover rate (about 3% voluntary and 3% involuntary) and said the organization retains about 240 days of cash reserves.

McClay also discussed federal and state funding uncertainty, noting possible federal changes to Medicaid’s structure or match rates (FMAP) could reduce covered lives and state budget shortfalls could translate to cuts. “I think you need to be proactive. I think you need to take things seriously, but I don’t think you need to freak out about them,” McClay said, describing contingency planning and efforts to diversify revenue sources including commercial insurance.

Commissioners asked about hours of coverage and required qualifications for crisis and mobile teams; McClay said mobile crisis staff must meet state qualifications and include a certified peer (someone with lived experience) and typically a clinician with a bachelor’s degree and additional training. He said he will bring more detailed operational plans once financed.

McClay said the behavioral health board will hold a facilitated retreat in April to discuss future services and operationalization. He also said the agency is exploring external consultants to quantify program impact and service outcomes.

The commission did not take action during the report but requested ongoing coordination; McClay will return with contract and operational details as funding and staffing are resolved.