The Chronicle
LEWIS COUNTY, Wash. — The Riverside Fire Authority (RFA) and Cascade Community Healthcare on Thursday announced the successful completion of a year-long pilot project providing alternative outreach to persons experiencing mental health crises.
Over the last year, emergency medical responders in RFA’s service area have been able to transport patients directly to Cascade’s Crisis Stabilization Unit release center in Centralia — instead of a hospital emergency department, according to an April 9 news release from RFA.
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Based on its performance, RFA said, the state Department of Health granted permission to expand the project to all fire departments and EMS agencies throughout Lewis County.
The pilot program was initiated in anticipation of Cascade’s crisis relief center (CRC) opening in February, according to the release.
“By being able to take patients directly to Cascade’s Crisis Stabilization Unit, the pilot project reduced time and streamlined their care,” RFA Lt. Jason Shepherd , manager of the project, said. “It also gave Cascade and RFA time to work out any issues that arose in order to be able to move forward seamlessly into the opening of the CRC.”
According to RFA, all 911 response patients transported by ambulance were traditionally driven to a hospital emergency department, after which they were sometimes taken to Cascade for specialty care.
“Our primary goal was to get patients experiencing a mental health crisis to the most appropriate care in the least amount of time,” Shepherd said. “Patients benefited by going directly to the CRC, a safe environment where they were cared for by people specializing in taking care of their needs.”
Mindy Greenwood, Cascade’s chief of inpatient services, said the organization’s “first goal is to get them out of their immediate crisis,” where they are “surrounded by kindness and human compassion, which are both critical to their recovery.”
Greenwood said patients brought to the CRC receive a nurse assessment, followed by mental health and psychological evaluations by mental health professionals.
They can also do immediate in-house lab work, according to Greenwood.
The 18-bed CRC allows patients to stay up to 23 hours and 59 minutes inside the facility, as outlined under state law.
According to previous Chronicle reporting, the 23-hour crisis center is a new model for treating behavioral health prompted by legislation passed by the Washington state legislature in 2023.
The center was added on to Cascade’s existing crisis stabilization facility and had been in the works for about two years prior to its opening.
Following their initial stay, patients can either leave or remain at Cascade in a longer-term unit, where they receive three meals a day, showers, a bed, individual and group therapy, and medication therapy, according to the release.
“While they are here, we develop a stabilization plan and connect them to the resources they need to stay stable on their own,” Greenwood said.
According to Greenwood, these patients typically stay for three to five days.
“This project reflects the very best of what strong community partnerships can accomplish,” RFA Fire Chief Kevin Anderson said. “By streamlining resources and improving access to specialized care, individuals experiencing a mental health crisis are able to receive meaningful, immediate support.”
Next steps, according to Shepherd, include developing patient care protocols for all county EMS responders. Responders will also be trained to use screening tools to identify patients in crisis.
Lewis County EMS Medical Program Director Dr. Peter McCahill said he was grateful to Cascade for taking on the project.
“Resource management is always a concern and this program provides benefits on so many levels,” McCahill said.
“Most importantly,” he continued, “it allows eligible patients experiencing a mental health crisis direct access to a therapeutic environment. Secondly, it helps to address the issue of crowding in our local ER’s. Mental health resources are in short supply across the country and I am excited to see Lewis County setting a positive example with this partnership.”
RFA said it expects countywide implementation of the project by April 1 , when the updated Lewis County EMS Patient-Care Protocols go into effect.
According to Shepherd, EMS responder training will be included in the 2026 EMS Protocol update, emphasizing how to identify patients that could benefit from the service.
“Our responders now have a more effective option for addressing the complex mental health needs we routinely see,” Chief Anderson said. “This is the core purpose of RFA’s Community Assistance, Referrals and Education Services (CARES) program — to identify the underlying issues affecting our patients’ quality of life and connect them with the community resources best equipped to help.”
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