Washington State Struggles to Pay for Crisis Center Care

But first, in Nairobi, at Kenya’s largest mental health referral hospital, barbering becomes a men’s practice for mental health. Personal grooming is critical to mental illness recovery, experts tell ABC News, as declines in personal hygiene and self-care can be signs of illness.

Washington state spent millions to build crisis care centers – and never figured out how to pay for them

Washington’s mental health crisis centers were built on a simple promise: anyone who walks through the door receives care, insured or not. Since receiving authorization in 2023 the facilities have proliferated across the state fueled by tens of millions in state capital grants. But despite running a 24/7 walk-in care model and accepting drop-offs from first responders, and being legally mandated to care for all who come through their doors, Washington’s legislature has yet to resolve how to reimburse providers for any patients who aren’t insured or on Medicaid. 

Medicare and military insurance aren’t required to cover crisis care, and though commercial insurers are, they frequently deny claims. “A lot of money got poured into building these things, but how we’re going to fund it became an afterthought,” Brad Banks, a policy consultant for the Washington State Association of Counties, told the Seattle Times. “It probably should have been the other way around.”

Heading into this year’s legislative session, the state’s Health Care Authority requested $38 million to cover non-Medicaid costs at the crisis centers and crisis stabilization units, but lawmakers appropriated only half of that, about $19.3 million, drawn partly from the general fund and mostly from a telecom tax that supports the state’s 988 hotline, the Times reported. 

The remaining gap has already stalled at least one project. Whatcom County received more than $11 million in state capital funds to build a crisis center in Bellingham, Washington. After observing the challenges caused by the lack of funds at the first center in Kirkland, county leaders paused the project. Talks with state legislators to address the gap last year went nowhere, said Jed Holmes, Whatcom County’s public affairs and strategy manager, so they’re hoping the state will allow the funds to be applied toward other behavioral health needs instead. 

“There can be gaps the county might be able to fill, but right now the gap is so large that we can’t even consider it,” Holmes told the Times.

Other counties have chosen to absorb the risk rather than wait on the state. In Benton County, a 0.1% mental health sales tax enacted in 2022 helped fund construction of a new crisis center in Kennewick and is providing $850,000 a year for Comprehensive Healthcare, the center’s operator, from which to draw whenever insurance won’t cover a patient’s care. The county also put up about $4 million to cover the center’s early operating costs, including supplies, staffing and training, to give the provider room to get established.

 “We don’t want to see them losing money on this,” said deputy county administrator Matt Rasmussen, “because if they lose money they close and the services go away and then we have no services again.”

The tension between counties improvising solutions and a state funding model that’s still working out the kinks is likely to intensify. Anticipated federal Medicaid changes are projected to shrink coverage for people across Washington later this year, worsening the funding gap providers are already struggling to close. 

Lawmakers have another shot at a fix next session, but providers aren’t waiting around to find out. Comprehensive Healthcare’s CEO, Jodi Daly, said the state needs a dedicated funding model rather than relying on startup grants alone — a frustration shared widely enough that some providers want the whole reimbursement structure rethought. The centers are required to maintain consistent staffing levels 24/7, regardless of actual or expected demand . Some argue that they should be funded like a “firehouse model,” providing dedicated, steady funding as is done for public safety rather than per-service billing.

The Health Care Authority is conducting a review of how other states fund similar centers and will begin monthly meetings with providers in July to hear their experiences. Whether that translates into real money next session remains an open question.

Take aim, let go: How archery is helping women heal

At the Woodley Park Archery Range in Van Nuys, Los Angeles, Mindful Archery helps women process and prepare for everything from breakups to burnout to reaching their highest dreams one arrow at a time. Led by self-described “soul-collaborator” Angie Fadel, a former pastor with more than 15 years of archery experience, the workshop blends meditation, breathwork and forest bathing with hands-on archery instruction. The goal is to provide attendees more than stress relief, Fadel tells the Los Angeles Times, but acceptance of self and a regulated nervous system as they reach for their dream life of their dreams. 

Participants begin each session by grounding themselves, then drawing a personal target on paper — sometimes an abstract feeling, sometimes a word cloud of hopes, sometimes a source of harm. The physical act of shooting, Fadel explains, unlocks personal power. 

“Even if the arrow doesn’t go where you want, there’s this immediate thing that happens in your body that feels good,” she says. “When you let go of that string, there’s an energy, there’s a movement — actual, physical energy moves. Something magical happens. It helps the things that are stuck in the body get unstuck. It’s somatic. Then it’s an extra bonus if you do hit your target, because the slap of the paper feels even better.”

Fadel came to this discovery by accident and initially thought it was only helpful for her. An archery lesson from a master archer friend triggered an unexpected emotional release, so she began pairing the sport with introspective journaling, eventually adding targets to process everyday stress. When she saw the same relief show up in a struggling friend she brought along for a lesson, she realized the practice could help others too.

“Think about what would feel good to either annihilate, or bring in, or let go of, or make peace with. You can put all of it on your target,” Fadel says. Almost everyone hits their target at least once, due less to technical skill than to repetition and most of all to the trust attendees build in her coaching and, eventually, in themselves. It’s a lesson that tends to outlast the workshop. “Archery isn’t about doing it right, it’s about repetition. The more you can be in your body, and relaxed with the repetition, the better you are.”