Emerald City Behavioral Health proposes Medicaid-funded therapeutic-court services for Cowlitz County

Michael Clark, chief operating officer of Emerald City Behavioral Health, told the Cowlitz County Board of Commissioners at a Monday workshop in Longview that his company would serve as the county’s therapeutic-court treatment provider and bill Medicaid for services rather than relying on county funds. “What I’m asking for today is straightforward. A resolution of support confirming that Emerald City Behavioral Health will serve as this county's therapeutic court treatment provider,” Clark said.

Clark described a model he said is already used in other counties: when the court refers a participant, Emerald City’s clinicians would deliver treatment, case management and peer support, bill Medicaid for billable encounters, and report aggregated outcomes to the court and county. He said Emerald City operates two outpatient clinics (Tacoma and Spokane), manages intensive residential teams and is building an intensive behavioral health treatment facility in Tacoma. Clark said the company would “hire and supervise the clinicians, deliver all behavioral health and case management services, and bill Medicaid directly, not using your county funds for the work that's being done.”

Nut graf: The proposal arrives after Cowlitz County voters rejected a behavioral-health sales tax that previously sustained some court-focused clinical positions. Emerald City’s pitch aims to preserve court-based clinicians and case-management jobs by shifting reimbursable clinical work to Medicaid, while leaving courts and county oversight in place. Commissioners and court officials said they would need more county-level data and a formal plan from the courts before supporting a resolution.

County and court officials pressed Emerald City on details. Dallas De LaGrange, program manager for therapeutic courts, clarified funding streams: “None of the money that we receive for funding goes to pay for treatment. I just wanted to make that clear,” he said, noting county drug-court funds are used for case management and program operation, not clinical treatment. Judge Hahn, presiding, said the therapeutic-court program “is a court program. So, yes, we would have to go through it and approve it.”

Commissioners and local providers raised other concerns. Several asked how Emerald City would sustain bed capacity without importing patients from other counties; Clark said the company typically commits a high proportion of beds (he cited a typical approach of reserving roughly 90% of beds for the host county) and would coordinate transportation and aftercare if other counties referred clients. Columbia Wellness CEO Drew McDaniel said Emerald City had not contacted local providers or community stakeholders before the presentation and urged more outreach; Clark replied he was in the early stages of community conversations.

Questions also focused on facility type and supervision. Clark said some services (evaluation and treatment facilities and intensive behavioral health treatment centers) would be locked for patients ordered under the Involuntary Treatment Act, while enhanced-service or step-down facilities would be unlocked. He said juvenile programming is not yet available: “Short answer, yes. Long answer, not yet,” meaning Emerald City expects to develop youth services only after establishing sustainable adult programs and securing necessary approvals.

Several court-affiliated speakers asked for county- or Washington-state-level outcome data rather than national figures. Clark said he would provide county- and Washington-specific data and referenced comparable models in Thurston and Spokane counties. Commissioners repeatedly said the courts should lead any transition: if the judges approve a transition plan, the board would consider whether to support it.

The presentation concluded with Clark’s formal request for a resolution of support; the board did not act on the request during the workshop.

Ending: County staff and court officials asked Emerald City to supply Washington-state and local outcome data, a clearer transition plan for existing staff and details about facility locations, juvenile services and bed-allocation commitments before the board will consider a resolution. Several court representatives said any change to therapeutic-court providers would start with the courts’ formal review and approval.