The Columbia Valley Center for Recovery (CVCR) is a multi-phase project to build a comprehensive center to assist persons in recovery from mental health or substance use disorder. The center aims to encompass multiple services, delivered in different ways, to provide both short and long term treatment options for the region. The initial phase of the project consists of four primary components:
- Short term treatment (Crisis Relief)
- Crisis Stabilization
- Withdrawal management
- Residential substance use treatment
These components were selected for the CVCR because they have been identified as critical needs in the region.
Crisis Relief
Short term treatment at the Recovery Center consists of a facility where persons in mental health or substance use crisis can be admitted for stays of 24 hours or less. Models in the state include Crisis Triage Facilities and 23-hour observation units and crisis relief centers. The current model the County is pursuing for the Recovery Center is the Crisis Relief Center. This facility is built as a “living room” type environment. They typically have recliner chairs in a large open area where people can receive short term treatment and assessment to determine what longer-term care services are needed.
The crisis relief center will also serve as the point of entry for clients in crisis coming into the recovery center. Clients may come in voluntarily or be dropped off by law enforcement or emergency medical responders. Clients will receive a shower, meals, laundry services, a place to rest and access to counselors on site. These counselors will help to stabilize the client and, depending on the needs of the person, recommend transfer to a longer-term unit or referral to outpatient services.
Clients coming in via drop off by law enforcement or emergency medical responders will enter through what is known as the ten minutes drop off. This service aims to be able to intake a client being dropped off and release the officer or emergency technician in ten minutes or less. This ensures a rapid transition for the client to needed services as well as frees up valuable resources for first responders to be able to return to their scheduled duties.
Crisis Stabilization
Crisis stabilization at the Recovery Center focuses on treatment for clients whose primary diagnosis is for a mental health disorder. The model envisioned for the recovery center is a crisis stabilization unit. A crisis stabilization unit serves as a place for clients to be assessed, diagnosed and treated for a mental health disorder without the need for long term hospitalization. Typical stays at the crisis stabilization unit will be for less than five days, though longer stays can happen on a voluntary basis or through a court order for involuntary clients.
Like the short term treatment facility the crisis stabilization unit will provide showers, meals, laundry services and a place to stay for clients. Treatment options are generally more intensive as clients being admitted to the crisis stabilization unit often require higher level services than those in the short term treatment facility. The facility can be designed as a single room with individual cubical type areas for clients or as multiple separate rooms. The County and it’s selected facility operator are still working with the design team to determine the final layout. These facilities typically also contain isolation rooms for people suffering from acute crisis, calm down rooms where people can voluntarily go to have some privacy, as well as group counseling rooms and family meeting rooms.
Withdrawal Management
Withdrawal management at the Recovery Center provides treatment for person actively under the influence of drugs or alcohol. The model planned to be used in the Recovery Center is a Secure Withdrawal Management and Stabilization (SWMS) facility. Clients of the SWMS will receive assessment and treatment, stabilization and detoxification services and discharge assistance to residential treatment or outpatient treatment as appropriate.
The SWMS facility will offer two levels of withdrawal management services as described by the American Society of Addiction Medicine. Sub-acute detox (ASAM level 3.2) and acute detox (ASAM level 3.7). Sub-acute detox offers limited medical coverage by staff. Clients are regularly monitored and self-administer medications. Acute detox offers medical coverage by nurses with doctors available on a 24 hour a day basis. Medications are administered by nurses or self-administered by the clients. Both acute and sub-acute detox programs are available as a voluntary or involuntary service.
The SWMS facility will be designed and offer client amenities similar to that of the crisis stabilization unit.
Residential Substance Use Treatment
Residential SUD treatment at the CVCR will provide a program with length of stays dependent on initial and ongoing assessments and progress towards treatment goals. The CVCR will provide ASAM level 3.1, long term residential treatment. This program provides a structure recovery environment with high-intensity clinical services to support clients in their recovery from substance use related disorders. Facilities of this type provide an extended length of stay typically ranging from 90 to 180 days. The majority of clients are at the facility on a voluntary basis but in rare instances people may be ordered by a court to the facility for treatment.
Patients would be given an initial screening and then placed into the short the observation unit for further assessment. After assessment is complete patients would be moved to either the Crisis Stabilization Unit, the SWMS unit or would remain in the short term observation unit as determined by the behavioral health provider. After the initial crisis is stabilized, patients seeking longer term treatment could be referred to the residential substance use treatment facility. Providing these four services in the initial phase provides a comprehensive treatment response to the first stage of recovery for persons suffering from mental health or sub stance use issues.