PLANS FOR A MUCH-NEEDED crisis center for mentally ill adults may finally be set in concrete after years of promises, public process, and funding-related setbacks.
Formerly referred to as a "sub-acute facility" and now called the Crisis Assessment and Treatment Center, the center will be a 16-bed facility offering mental health treatment and housing for up to a week for adults experiencing mental health crises. The center is expected to serve 800 adults a year—the police, hospital emergency rooms, and other providers will refer clients there.
The center will be located at SE Grand and Couch, where the Hooper Detoxification Center was located before moving to a new facility near the Rose Quarter.
Construction is expected to start this summer. Karl Brimner, the director of Multnomah County's mental health and addictions programs, says he is "relatively certain" the center will open in April 2011.
"The Crisis Assessment and Treatment Center has long been identified as a critical gap in our mental health delivery system. It's very important that it is completed," says former Multnomah County Chair Ted Wheeler.
Wheeler made it a priority to fund the center and its construction. When he abruptly left county government to become state treasurer in March, many wondered if the project would suffer from the lack of Wheeler's advocacy for mental health care funding.
But the city's $1.6 million settlement with the family of James Chasse, a schizophrenic man who died while in police custody in 2006, brings to the fore the necessity of building the center. Had such a facility existed at the time, it could have treated Chasse.
The old Crisis Triage Center, which was similar to the new center, was operated by the county and closed in 2001 because of lack of funding.
Also giving "urgency to the issue," says current County Chair Jeff Cogen, are the recent fatal police shootings of Aaron Campbell, Jackie Dale Collins, and the May 12 shooting of Keaton Otis. All three victims suffered from mental illness.
"It shows what can happen when things go wrong," Cogen says, adding that the shootings demonstrate that Multnomah County's mental health system is "frayed."
Cogen emphasizes that the center will not solve every problem related to mental illness in Multnomah County. "It's a piece of the puzzle and it will make things better," he says.
Certainty that the center will be built and operational by April 2011 only came after the county gave up its efforts to fund the center by itself, when they reached out to the state, the City of Portland, and other entities to split the costs.
"Funding has a lot to do with it not being implemented earlier," says Brimner. "It was essential for that collaboration to occur."
Construction is expected to cost $4.5 million and annual operating costs will be approximately $3.2 million. The money for construction is coming from a variety of sources, including the Portland Development Commission, the county, Central City Concern, and new market tax credits. The county is trying to wrap up the funding package for construction to begin this summer.
The state, county, city, and Medicaid reimbursements are covering operating costs. The city and county will pay $137,500 each for operating the center in the last fiscal quarter of 2011.
It is still not entirely clear how the center will be funded in the future. The county is requesting the State of Oregon Addictions and Mental Health division to pay $1 million for construction costs. But when contacted, division spokesperson Andrea Cantu-Schomus would not confirm whether the state is contributing funding.
And negotiations are underway to determine whether the city will split the county's $1.1 million share of the operating costs, meaning that each entity would pay $550,000. Mayor Sam Adams says he is "absolutely" committed to splitting costs with the county, "even if the state ends up not funding it."
Although he hopes the city will help pay the operating costs, Cogen says he is "fully committed" to monetizing the center with ongoing funding in the county's budget. "The last thing I would want is to open it for the last quarter and then close it," he says.
Jason Renaud with the Mental Health Association of Portland says facilities like the center should not be the victim of political and budget "whims" because of how many people rely on their services.
"When you make a promise to open a facility like this, you are a making a promise... that this will be open for a long period of time," Renaud says.
Renaud, for one, says he is skeptical that the county is going to be able to keep its implicit promise, in this case. Multnomah County's general fund relies in part on money funneled from the state for mental health and addictions treatment.
"State funding is about to fall off a cliff," he says. "We're in a world of hurt next year, and every new project that doesn't have a strong constituency is going to be cut to the bone. This is not a good time to be starting with patchwork solutions."
This article has been corrected from its original version. It incorrectly stated that Multnomah County requested $1 million form the state for operating costs. The request is actually for construction costs.