Lane County hears plan for crisis stabilization center as Connections outlines national standards

Lane County commissioners on Feb. 12 received a briefing from Connections Health Solutions on models and emerging federal standards for behavioral health crisis care, including crisis stabilization centers, 988 call routing and mobile crisis response. The presentation aimed to inform county siting and partnership work; commissioners and county staff asked questions but took no formal vote.

The presentation, led by Dr. Margie Balfour, chief of quality and clinical innovation for Connections Health Solutions, laid out the three pillars the Substance Abuse and Mental Health Services Administration (SAMHSA) is promoting: a 988 crisis contact capacity, mobile crisis teams that respond in the community, and facility-based crisis centers that provide urgent assessment, 23-hour observation and short-term stabilization. "A behavioral health crisis system is an essential community service, just like police and fire and EMS," Dr. Balfour said, and she described newly published SAMHSA definitions that aim to standardize what terms such as "crisis stabilization center" mean across jurisdictions.

Why it matters: Commissioners and staff framed the briefing as groundwork for Lane County’s ongoing effort to site a stabilization center that could provide an alternative to emergency departments and jail for people in behavioral health crisis. Presenters said coordinated crisis systems can reduce emergency room and jail use, speed law-enforcement drop-offs, and improve linkage to follow-up care.

Key details from the presentation

- System design and national context: Dr. Balfour described the SAMHSA guidance and prior work such as the National Council for Behavioral Health’s road map. She said the model mirrors medical-emergency systems by providing layered levels of response and care so people can be matched to the least-restrictive appropriate setting.

- Typical crisis-center services and outcomes: Using data from Pima County/Tucson as examples, presenters said a mature system’s crisis line can receive roughly 6,000 calls per month and resolve more than 80% of calls by phone. Mobile crisis teams (typically two-person clinician or clinician-plus-peer teams) resolve about 70% of field contacts without a higher-level facility transfer. Crisis facilities combine urgent-care-style visits (median visit about two hours), 23-hour observation units and short-term stabilization beds (often three to five days). Presenters reported that 60–70% of people presenting to facilities are discharged back to community care rather than sent to an inpatient hospital.

- Pathways into the system: Presenters described multiple entry routes: walk-ins, family or EMS transport, mobile crisis referral, transfers from emergency departments and law-enforcement drop-offs. Connections staff said roughly half of their observation patients come via law enforcement, about 10–15% via mobile crisis teams and about 10% as transfers from emergency departments (figures were presented from their Tucson operations and cited as context for planning).

- Youth services: Dr. Balfour said youth require separate spaces and different programming; some facilities operate youth services on one side of a building and adult services on the other, with shared staffing cross-trained to respond to volume fluctuations. She noted that longer-term, medium-intensity crisis residential options for youth can be important because family-system issues often take longer than a 23-hour observation to resolve.

- Reimbursement and transport barriers: Presenters discussed state-level constraints on EMS reimbursement; Dr. Balfour noted Oregon statute generally limits EMS reimbursement to deliveries to hospital emergency departments, which complicates use of crisis centers as alternative destinations. She described policy options others have used, including state-level changes and use of CCBHC (Certified Community Behavioral Health Clinic) funding models to cover transportation costs.

Select direct quotes

- "A behavioral health crisis system is an essential community service, just like police and fire and EMS," Dr. Margie Balfour said.

- "We never turn them away," Balfour said of high-acuity crisis centers configured to accept involuntary and voluntary patients, adding that early engagement can convert many involuntary patients to voluntary treatment.

Commissioner and staff responses

Commissioners asked about local 988 call volumes, youth capacity and transportation reimbursement. Eve Gray, Director of Health and Human Services for Lane County, said county-level 988 and crisis-call data are not yet fully parsed because multiple lines and routing arrangements remain in transition. Commissioners and staff discussed the importance of education and outreach to cities; staff said they will continue efforts to present the model to Eugene and Springfield councils and to coordinate regional partners.

Next steps and direction

No formal action or vote was taken. County staff and Connections representatives said they will continue planning work, share materials with city partners and pursue policy and funding avenues to address transport and reimbursement limits. Commissioners were invited to further briefings; the Board’s next regular meeting was announced for Feb. 25 at 9 a.m. at Harris Hall.

Ending

Presenters and commissioners framed the briefing as informational and part of an ongoing siting and planning process. Staff said they would return with more locally specific data and continue outreach to municipal partners.