Humboldt County officials outline crisis continuum, plan to end answering service and expand mobile teams

Humboldt County behavioral health deputies presented an overview of the county's crisis continuum at the Humboldt County Behavioral Health Board meeting, describing 24/7 call coverage, mobile response teams, short-term stabilization options and gaps in step-down capacity. County staff said they will end the contract with an answering service on June 30 and transition to county-staffed call handling.

The presentation, given to the advisory board that meets monthly, described the crisis pathway from an initial call (including local numbers and the 988 lifeline) through mobile response, subacute stabilization and the county's acute psychiatric hospital. County staff told the board they are hiring to expand mobile-response capacity and to move toward broader, county-run call handling after July 1.

County context and why it matters: Deputies said the county receives substantial call volume and has been building out mobile teams and step-down sites so people experiencing crisis can be treated in the least restrictive setting possible. Staff noted continuing gaps in subacute step-down beds and in aftercare placement that extend some hospital stays. The county described planned capital and staffing projects intended to address those gaps.

Key elements of the crisis system

Call intake and 988: County staff said 988 and the county crisis numbers both route calls to local behavioral-health hubs. A county call-volume study for the first half of 2024 recorded 7,876 calls to two local numbers (about 43 calls per day), with 2,929 received after hours, staff reported. Deputies said 988 nationally resolves a high share of calls by phone and that multiple regional call centers (including North Bay and Sacramento centers) receive calls routed from Humboldt.

Mobile response teams and in‑person crisis work: The county described distinct mobile units. An adult mobile response team (a clinician plus case manager) and children's mobile clinicians and parent partners respond in community settings; a separate MIST (Mobile Interventions and Supports Team) responds countywide outside emergency departments; and a mobile response team that focuses on emergency departments assesses people brought in on involuntary holds.

Staff provided 2024 activity figures for the mobile programs: 571 adult assessments in emergency departments, 92 children assessed in emergency departments, and 40 community contacts by the MIST team, for a total of 673 unique individuals served and about 1,582 total staff interactions (initial and follow-up contacts) across those teams.

Crisis stabilization and acute care levels: Staff reviewed subacute and acute options available locally: a four‑bed short-term Crisis Stabilization Unit (CSU), Hyperion (a 10‑day adult crisis residential program), Crestwood Pathways (a 43‑bed mental health rehabilitation center with a 15‑bed short-term Pathways program) and Sempervirens, the county's 16‑bed acute psychiatric hospital. Deputies said Sempervirens served 275 individuals last year; average length of stay for non‑conserved patients was about 12 days and for conserved patients about 94 days, which staff linked to limited step‑down capacity for people who cannot be discharged safely without placement.

Use of involuntary holds and outcomes: County staff described the legal framework for emergency holds and hospital reporting (meeting participants used the meeting language "51 50" and referenced Health and Safety Code 1799.111). Staff reported that clinicians, nurses, psychiatric technicians, hospital physicians and sworn peace officers may write holds in the county. Of the holds reassessed by county teams in the period discussed, staff said about 520 were rescinded after reassessment (roughly half of the holds rechecked), allowing those people to be treated in less restrictive settings.

Planned changes, hiring and capital projects: Deputies said the county will stop renewing the contract for an outside answering service on June 30 and will staff the crisis line from county teams thereafter; they said a decision about whether to add a dedicated call‑handler role or to assign the work to existing CSU staff will be made after further review. Staff asked the board for assistance in outreach to hire additional clinicians, peers and case managers to expand 24/7 coverage for MIST and mobile response.

Staff also described capital projects in development: they said the county intends to break ground on a behavioral health crisis triage center near Mad River Hospital (described by staff as a triage/sobering/crisis hub that can flex to serve minors and adults) and that several other projects funded by recent state grant rounds (including a triage/relief site) are under construction. Staff said those projects, if completed, would increase local bed and step‑down capacity by more than 60 beds overall.

Budget and constraints: County deputies noted ongoing fiscal pressure on adult crisis services, calling Sempervirens and the CSU among the largest cost drivers. They described a shortfall in the most recent closed fiscal year and said they continue to pursue state/federal billing and grant draws to close the gap while prioritizing direct services.

Board questions and next steps: Board members asked about 24/7 coverage, the answering service contract and how calls will be managed after the contract ends; staffing plans for the CSU; whether mobile teams can be expanded to provide round‑the‑clock community response; and how often holds originate with law enforcement versus hospital staff. Deputies said they will hold a staff meeting to define the post‑June 30 call model and continue work to hire clinicians, peer coaches and case managers. They also said the county will form a steering group to plan implementation of SB 43 (which expands criteria for conservatorship to include severe substance use disorder) and other new mandates.

Votes at a glance: The board approved the minutes from the Jan. 23, 2025 meeting (motion made during the meeting and carried; individual tallies were not specified in the minutes).

Looking ahead: County staff listed several deliverables they expect to pursue in coming months: finalize the staffing model for the county crisis line before the contract end date, continue hiring to expand mobile teams, advance triage‑center construction and convene the SB 43 implementation work group. The presenters asked board members to help with outreach to recruit clinicians, peers and case managers for mobile response coverage.