As Columbia River Mental Health Services explores ways to restore behavioral health programs it suspended last week, patients and advocates are still reeling. On March 24, financial woes forced the Vancouver-based nonprofit to abruptly pause most of its operations. The agency serves 5,000 people a year. Columbia River Mental Health Services’ future remains “fluid and dynamic,” Chief Operating Officer Kelly Ferguson said. Ferguson said $1.6 million from the Cowlitz Tribal Foundation enabled the nonprofit to keep the doors open at NorthStar Clinic, which serves 850 people with opioid-use disorder. Programs are also continuing for those at high risk of psychiatric hospitalization and those awaiting court-ordered competency evaluations.

Founded in 1942, Columbia River Mental Health Services has a history of financial instability. According to the nonprofit’s 2023 tax forms, it spent $23.1 million and received $21.1 million in revenue, a $1.97 million budget deficit for that year. After Columbia River Mental Health Services announced it was suspending programs, residents posted on Facebook, Reddit and other social media platforms in search of answers and to express alarm about the potential dissolution of Southwest Washington’s oldest behavioral health provider. Rather than stew in disappointment and confusion, community advocate Nikki Taylor organized a meeting with a dozen concerned behavioral health professionals from various Vancouver nonprofits, including Lifeline Connections, XChange Recovery, Restored and Revived, and Outsiders Inn. The group gathered Monday at Couve Collective Recovery Cafe in downtown Vancouver to voice their concerns, share resources and discuss ways to bridge the gap if Columbia River Mental Health Services’ suspension were to become permanent. “When I became aware of the closure of Columbia River Mental Health, I immediately thought of those marginalized and vulnerable communities that I served throughout the years,” Taylor said. “I thought of women breaking a generational line of domestic violence. I thought of foster youth. For me, it’s important to move that grief and that anger and alchemize it into action.”

Kami McKinzey, substance use disorder counselor at XChange Recovery, said she’s grateful that Columbia River Mental Health Services kept NorthStar open. In the future, XChange Recovery hopes to add medication monitoring and management to its services, but like any organization, it has to look at funding and sustainability over time, McKinzey said. “Even if they keep their doors open, there’s now a break in trust with the patients,” McKinzey said. Couve Collective Executive Director Karen Peterson said Columbia River Mental Health Services has been an invaluable resource to her organization, but she noticed the agency paring back its services over the past six months. “It’s really disheartening to see someone as big as Columbia River suddenly shut their doors, in a way that, to me, feels very irresponsible,” Peterson said.

Abrupt suspension Columbia River Mental Health Services’ board is continuing to evaluate options to get other services back or restructure as needed, Ferguson said in an email Tuesday. Columbia River Mental Health Services has four locations, including its main offices at 6926 N.E. Fourth Plain Blvd., and its NorthStar Clinic at 7105 N.E. 40th St. In the fall, the nonprofit’s management became aware of its deteriorating financial state, due to a culmination of billing inefficiencies, a larger number of insurance claim denials and the gap between billing to payment doubling in length of time, Ferguson said. This led to the first round of layoffs, salary reductions and a closer look at operational expenses. Then, the Trump administration’s federal freezes cut the flow of funds for three to five days at the end of January.

Although the federal funding freeze was not the direct cause of the financial crisis, the nonprofit was unable to cover expenses during that time period, Ferguson said. It would have needed to acquire at least $3 million by March 28 to reopen all services and pay staff, Ferguson said. The state Employment Security Department issued a notice March 24 that Columbia River Mental Health Services began rolling furloughs Nov. 4, affecting 120 workers. The continuous delivery of behavioral health services has always been financially challenging, Ferguson said. According to the Washington State Hospital Association, 70 percent of Washington’s hospitals and health systems are continuing to lose money from operations four years after the pandemic.

Reimbursement rates often do not or barely cover the real costs of delivering services. There is also no way for providers to recover the gaps in rates when about 90 percent of Columbia River Mental Health Services clients use Medicaid or Medicare to pay for services, Ferguson said. “Cuts to behavioral health services at the state or federal level can have life and death implications to the people needing care while the number of people accessing these resources increases year over year,” Ferguson previously said. Since opening in August 2023, NorthStar Clinic has increased its client population month after month. It currently serves 300 patients a day and has more than 850 clients in total. Despite Medicaid providing care for 1 in 5 low-income Americans, it is often a target for cuts. Meanwhile, licensing standards, medication costs and employee cost-of-living rates continue to increase the overall cost to provide services every year, Ferguson said. She said Columbia River Mental Health Services will continue to update the community, its clients and employees as it assesses a number of options for a full restoration of services. But patients and advocates still worry.

“Even if they stay open, we now know that this could happen, and it could happen suddenly,” Taylor said. “Let’s not panic, but let’s prepare for the future.” Chrissy Booker: 360-735-4613; chrissy.booker@columbian.com About the project: This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation that is funded by community member donations. The Columbian controls all content. For more information, visit columbian.com/cfj.

This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.