Joint agreement ensures continued access to care, bringing key programs under the Tribe’s nationally-recognized Health and Human Services Department

The Cowlitz Indian Tribe (CIT) and Columbia River Mental Health Services (CRMHS) have announced a letter of intent to transition CRMHS programs and operations under the leadership of Tribe’s Health and Human Services Department. This collaborative effort will preserve access to essential behavioral and substance use disorder health services for thousands of patients in Southwest Washington, while extending the reach of the Tribe’s nationally recognized, culturally-grounded care model.

The newly struck joint agreement builds on the relationship between the two organizations and sets the stage for a phased and thoughtful transition of many CRMHS programs, staff, and clients into the Tribe’s health system. The effort will start with the transition of CRMHS adult and youth outpatient services, as well as the NorthStar Clinic – one of the largest opioid treatment programs in Southwest Washington – with the goal of ensuring service continuity and stabilizing a critical regional resource for the long term.

“This is a powerful opportunity to build upon our Tribe’s legacy of healing, care, and service,” said Cowlitz Indian Tribe General Council Chairman Bill Iyall. “Columbia River Mental Health Services has been a trusted provider in our region for decades, and we are proud to step forward and work toward stabilizing services, uplifting shared values, and ensuring this vital care continues to reach our neighbors when they need it most.”

Both CIT and CRMHS are committed to supporting a smooth transition for patients, with efforts focused on minimizing disruptions and maintaining access to essential services throughout the process. Under the agreement, CRMHS patients will be able to continue seeking care under the Tribe’s Health and Human Services Department. The Tribe will securely maintain records for client access and continuity of care, can provide treatment to all eligible community members in need, accepts Medicaid and all major insurers, and can treat patients in both Washington and Oregon.

Founded more than 80 years ago, CRMHS has served over 5,000 patients annually with a range of behavioral health programs. After facing prolonged financial and operational challenges, the organization was forced to pause operations earlier this year, creating vast uncertainty for patients and staff, and additional pressure on treatment providers across the region. In April, the Cowlitz Tribal Foundation provided $1.6 million in emergency funding to stabilize CRMHS operations while working to identify a long-term solution. The Tribe is also committed to providing ongoing operational funding to ensure uninterrupted services throughout the transition period.

“This agreement ensures that the critical services CRMHS has been providing for so long now will continue into the foreseeable future,” said Craig Pridemore, CEO of Columbia River Mental Health Services. “The Tribe’s commitment to behavioral health, cultural humility, and service makes them the ideal partner to carry this mission forward. We’re grateful for their leadership and look forward to ensuring a smooth and thoughtful transition for our clients, staff, and community.”

As the transition moves forward, the Tribe will work with CRMHS to assume operational oversight and expand services under its Health and Human Services Department. This includes the onboarding of licensed mental health professionals, psychiatric nurse practitioners, psychiatrists, substance use disorder professionals, electronic health record support positions, clinical and administrative leadership positions, as well as clinical support staff. All CRMHS staff will be able to apply for new roles with the Cowlitz Indian Tribe as they become available. Eventually the CRMHS entity will dissolve as the transition concludes.

Cowlitz Health and Human Services Department is widely recognized as a leader in tribal healthcare, offering integrated medical, behavioral, and traditional services to Native and non-Native clients alike. The Cowlitz HHS department operates a network of clinics that serve communities from Vancouver to Tukwila, WA, along with a newly integrated mobile MAT van, enabling an on-demand treatment model.

“This isn’t just about protecting what exists—it’s about building what’s possible,” said Chairman Iyall. “Together, we are creating a stronger foundation for compassionate, culturally aligned care that will serve future generations.”

The Tribe and CRMHS are currently engaged in planning and are working to complete a robust due diligence process associated with the transition. Services will continue without interruption throughout the transition, which is expected to be finalized in October 2025.

About the Cowlitz Indian Tribe

The Cowlitz Indian Tribe is a sovereign and federally recognized Tribal nation with its ancestral homelands in Southwest Washington. The Tribe is governed by a 22-person democratically elected Council and is a leading employer in Clark County. The Tribe is dedicated to the health, prosperity, and cultural preservation of its members and the broader community. Through its Health and Human Services Department, the Tribe delivers comprehensive, integrated care across primary care, behavioral health, dental, and culturally specific treatment programs.

About Columbia River Mental Health Services

Founded in 1942, Columbia River Mental Health Services is a nonprofit behavioral health provider that has served Clark County for over 80 years, offering outpatient and crisis services for individuals experiencing mental health and substance use challenges.