Regional crisis line shifts to local operator as Washington prepares 988 hub rollout

At a Cowlitz County Board of Health meeting, Great Rivers Behavioral Health Administrative Service Organization officials said Olympic Health and Recovery Services began operating the Great Rivers regional crisis line on April 1 and will seek designation as a 988 hub as the state aligns crisis services with the national 988 Suicide & Crisis Lifeline.

The change matters because Washington is reconfiguring how people access crisis care: state guidance calls for 988 to become the primary public entry point while regional crisis lines shift toward professional consultation and dispatch of local mobile crisis teams. Great Rivers officials said the shift aims to preserve local dispatch knowledge and faster in‑person response for the five‑county region that includes Cowlitz.

Trinidad Medina, chief executive director of Great Rivers Behavioral Health Administrative Service Organization, told the Board that Olympic Health and Recovery Services (OHRS) “began taking calls April 1” and that she tested the transition by calling at 9 a.m. and getting a live operator. Medina said the regional crisis line and 988 both provide telephone crisis intervention but that the regional line is community based and “local.”

Joe Avalos, executive director of Olympic Health and Recovery Services, said OHRS has provided designated crisis responder services in the Great Rivers region since 2018 and is familiar with hospitals, law enforcement and local crisis teams. Avalos said OHRS will apply to be a 988 hub when state applications open, and that the organization is seeking to preserve “regionalized service and local control” if selected.

Drew McDaniel, CEO of Columbia Wellness, which has operated the regional crisis hotline and mobile crisis teams for decades, described why local teams matter. “I want people to define their own crisis. We all have that right,” McDaniel said, and described a longstanding practice of locally tailored, trauma‑informed responses — including an anecdote about staff buying milk to stabilize a client — to illustrate why regional familiarity matters.

Great Rivers and presenters reviewed the policy and legislative background they said is driving the transition. Mandy Moore, a Great Rivers clinical team member, summarized state guidance and legislation, saying the Department of Health and the Health Care Authority’s joint policy statement identified that “988 suicide and crisis lifeline will become the primary entry point for crisis services for the public.” Moore said that professionals — emergency departments, first responders and behavioral health clinicians — will still be able to contact regional lines directly for consultation or to dispatch mobile crisis teams.

Presenters and Board members discussed call volumes and operational implications. Great Rivers staff said the regional crisis line historically handled about 3,500–4,000 calls per month in the five‑county area while 988 currently receives roughly 300–400 calls a month for the region; they expect 988 call volume to grow after statewide marketing and hub designation. Presenters said the Department of Health holds the 988 hub contracts and that ASOs can participate in workgroups but do not hold the hub contract.

The group described the state mobile crisis endorsement program created by 2023 legislation. Presenters said endorsement is a voluntary credential with staffing and response‑time standards; Columbia Wellness and Cascade Community Healthcare are two of eight teams that applied statewide, and both regional teams had met initial compliance steps. Moore said endorsed mobile crisis teams must meet response windows — 20 minutes from request to departure in the current standard, moving to 15 minutes in 2026 — and that Columbia Wellness’s benchmark when not triaging the region’s entire call volume is to meet the 20‑minute standard.

Board members asked practical questions about when to call 988 versus the regional crisis line and whether concerned citizens can request assistance for people living outdoors. In response to a question about a persistent unhoused person in Castle Rock, McDaniel said callers should contact the regional crisis line and added, “that would be a beautifully appropriate call to make.” Medina and the presenters explained that crisis responders will attempt least‑restrictive interventions first and that designated crisis responders (DCRs) or peace officers may detain someone for mental‑health evaluation only when statutory criteria are met; presenters said DCR holds can last up to five days and trigger a judicial review if inpatient involuntary treatment continues.

Presenters also described a federal database link used in one example: when a court issues an involuntary commitment order, clerks enter the qualifying event into a database that feeds into the federal NICS system used during firearm background checks. Medina recounted coordinating with local law enforcement after a flagged gun purchase attempt led officers to intervene and reconnect a person with care.

Presenters asked the Board and the public to support OHRS’s 988 hub application with letters of support; Medina said a template letter could be included in meeting documents for community partners. The presenters provided contact information for follow‑up questions and said they will analyze operational data from the first month under OHRS and continue coordination with the Department of Health and Health Care Authority.

No formal vote or ordinance took place at the meeting; the session was informational and focused on the operational transition, the pending 988 hub application, and the mobile crisis endorsement process.