Ruffled Feathers

David Reynolds continues to recover, so Daniel Mackay again provides us with another COBURG HILLS NEWS feature. Thank you, Daniel!

The Loss of CAHOOTS Service in Eugene

April 7th's announcement that CAHOOTS's (Crisis Assistance Helping Out On The Streets) service in Eugene had ended was a bit of a local calamity that engendered its own crisis response. The dramatic reduction of services from two CAHOOTS mobile response teams serving Eugene's population of 180,000 and one mobile response team serving Springfield's 60,000 down to the single Springfield team is a significant turning point for a program hailed as a national model for community-based crisis intervention. Operated by White Bird Clinic, CAHOOTS provided mobile crisis response in Eugene for thirty-five years, offering an alternative to police intervention for mental health crises, homelessness, and substance abuse. However on March 25, White Bird first announced that it would be scaling back its Eugene service before then changing the reduction to a complete termination of services. This decision has led to layoffs of twenty employees, eliminated the only twenty-four hour mobile crisis response team, and raised questions about financial mismanagement, labor disputes, and systemic challenges within the organization.

A Legacy Interrupted

CAHOOTS began in 1989 as a partnership between White Bird Clinic and the City of Eugene. The program paired medics with crisis workers trained in mental health to respond to non-violent emergencies. Funded primarily by the City of Eugene, CAHOOTS handled thousands of calls annually, diverting cases from law enforcement and emergency medical services. Its success inspired similar programs across the country.

The abrupt discontinuation of CAHOOTS services in Eugene has left many residents questioning what went wrong with a program that was integral to the city's identity and public safety infrastructure.

CAHOOTS is more than a vital local service. It has served as a model to such an extent that Congress's CAHOOTS Act (2021) was named after it. CAHOOTS shares parallels with another groundbreaking initiative: Freedom House Ambulance Service, which was established in Pittsburgh during the 1960s as a pioneering paramedicine program that empowered community members – primarily Black residents – to provide emergency medical services in underserved areas. Like CAHOOTS, Freedom House prioritized community-based care, reduced reliance on law enforcement for crisis response, and addressed systemic inequities through innovative workforce development. Both programs reimagined public safety systems by emphasizing equity, humane care, and empowerment over punitive measures.

Financial Mismanagement Allegations

One major factor contributing to the demise of CAHOOTS appears to be financial mismanagement under Executive Director Jeremy Gates (2022-2025). Under Gates, who was replaced by interim director Amée Markwardt in February, White Bird failed to apply for essential grants and neglected to use city-allocated funds fully. Payments continued to third-party contractors even after their contracts expired, further depleting resources critical for sustaining CAHOOTS operations.

Crisis response had been effectively managed through a shared relationship between White Bird and the city. During Gates's tenure, White Bird negotiated the current contract with Eugene Springfield Fire, which required twenty-four hour staffing seven days a week. The contract, though, proved untenable because city funding only covered 40% of CAHOOTS operating expenses. White Bird carried this deficit for a protracted period of time; however, this became untenable as of April 2024 when White Bird employees unionized, now represented by Teamsters Local 206. Simultaneous with the increase in staffing costs that were a consequence of a unionized work force, the freeze in Federal spending that occurred in February during the Department of Government Efficiency's (DOGE) examination of Federal spending made it substantially more difficult for CAHOOTS to operate in a deficit.

White Bird, under Gates, failed to communicate this with the city. Further, White Bird failed to both apply for additional funding with grant agencies and also failed to establish alternative funding measures with potential donors, partners, or other allies within the community. Strangely, some of the money that the city allocated for CAHOOTS remained untouched by White Bird even at its most desperate hour.

When an alternate CAHOOTS staffing proposal was presented to the city, it was both late and also failed to meet the twenty-four hour staffing requirement the City had negotiated. Found in violation of the contract, Eugene Springfield Fire terminated its contract with CAHOOTS.

Broader budgetary issues were highlighted in a February 10, 2025 Eugene City Council meeting that addressed an $11.5 million budget gap in Eugene's general fund for the 2023-2025 biennium, largely attributed to insufficient revenue growth and the consequence of city income not keeping up with inflation. In the slate of proposed reduced services that might compensate for the significant gap that she presented to the City Council, City Manager Sarah Medary included the elimination of Eugene Springfield Fire's Incident Commander and CAHOOTS, both of which when combined would contribute $1-2 million to a larger proposed cut of $2.6 million to Fire and Emergency services. Later in the meeting, the Council passed a Fire Service Fee to compensate for the $11.5 million shortage; even though CAHOOTS services were not cut at that time, the appearance of CAHOOTS on the list of potential cuts was revealing.

Unionization and Retaliation Concerns

Shortly after CAHOOTS employees successfully unionized, having cited concerns over wages, staffing shortages, and workplace safety, White Bird shuttered its Front Rooms program, which provided low barrier services like crisis support, clothing, hygiene supplies, and mail distribution to those in need. This occurred in December. Not long after that White Bird's Crisis Services, Homeless Case Management, and CAHOOTS service to Eugene – the three White Bird programs that had unionized – were closed down. Many interpret such a move as retaliatory rather than purely budgetary. However, such an accusation may be reductive.

Whereas The Daily Emerald has noted allegations of retaliation by White Bird management – after unionization with employees accusing the organization of undermining their efforts to secure better working conditions and fair pay – there is an additional party instrumental in the loss of CAHOOTS service to Eugene: Lane County and its new Mobile Crisis Response.

What is Lane County’s Mobile Crisis Response?

Launching in August of last year, Lane County’s MCR program is a new initiative designed to provide crisis intervention services for individuals experiencing mental health emergencies. The program operates as part of the county’s broader behavioral health strategy and aims to reduce reliance on law enforcement for non-violent crises. MCR teams consist of mental health professionals and peer support specialists who respond to calls routed through the county’s centralized crisis line.

Unlike CAHOOTS, which was deeply embedded in Eugene’s public safety system and dispatched directly through 911, MCR operates on a separate infrastructure. This distinction has raised questions about accessibility and integration with existing emergency response systems.

Further, MCR personnel do not receive as much training as CAHOOTS staff, and, whereas CAHOOTS staff are cross-trained for both behavioral crisis management and medical assessment, MCR staff are not certified to provide medical assessment. So, even as the City and Eugene Springfield Fire hope that MCR will be able to fill the gap left by CAHOOTS's departure from Eugene, whether MCR can achieve this is questionable.

Can MCR Meet Eugene’s Needs?

While MCR shows promise, several challenges hinder its ability to fully replace CAHOOTS:

• Limited Capacity: MCR does not yet have the staffing levels or operational scale that CAHOOTS achieved. CAHOOTS handled approximately 20% of all 911 calls in Eugene, a volume that MCR is not currently equipped to manage. Importantly, until the last couple months, CAHOOTS maintained twenty-four hour coverage in Eugene. MCR is not only incapable of such staffing at this time, but it has little incentive to staff Eugene coverage twenty-four hours. Burdened with the responsibility of covering all of Lane County, MCR's staffing plan is to expand its coverage to more remote areas of the county before increasing its staffing to twenty-four hours a day.
• Community Trust: Over three decades, CAHOOTS built strong relationships within Eugene’s unhoused and marginalized communities. It remains to be seen whether MCR can establish similar trust and rapport.
• Ability to Complete the Mission: CAHOOTS originated as a service that alleviated the burden on Eugene and Springfield's police force responding to behavioral crises. When the community asked this of the police, it resulted in an overtaxed Lane County Jail and Emergency Departments that were even more burdened than they were. With MCR personnel not having adequate medical training, they are increasingly putting patients on either medical or psychological holds. These holds require that patients be either transported to an Emergency Department or taken into custody by police. The result is that both the Jail and Emergency Departments – the very spaces that CAHOOTS's crisis response was supposed to unburden – are again stressed...this at a time when the Jail is maxed out and RiverBend Emergency Department patients sometimes experience wait times of twelve hours or more.
• Dispatch Integration: One of CAHOOTS’s strengths was its seamless integration with Eugene’s 911 system, allowing for rapid deployment alongside police or fire services when necessary. MCR’s separate dispatch system may create delays or gaps in service coordination.

During the February 10, 2025, Eugene City Council meeting, city officials acknowledged that Lane County’s expanded services could provide some relief but emphasized that they are not yet a full substitute for what CAHOOTS offered. “We have Lane County doing Mobile Crisis Response in a way that we didn’t two years ago,” City Manager Medary noted, exhibiting cautious optimism about the program's potential, yet simultaneously establishing a justification that the Council could use if it wished to break with CAHOOTS. That justification would return when the City terminated its contract with Eugene almost two months later.

Impact on Eugene

In the wake of the development of Lane County's MCR, the county eliminated funding to White Bird for CAHOOTS, which further exacerbated CAHOOTS's funding woes. Upon introducing MCR last August, Lane County even instructed dispatch to reduce call volume to CAHOOTS and divert calls to MCR. Eugene's dispatch, which serves Lane County, complied. Springfield's dispatch, which was not so beholden and which recognized the value of CAHOOTs, did not.

CAHOOTS's exodus from Eugene has depleted the city's ability to provide crisis intervention services; it has resulted in:

• Increased Pressure on Law Enforcement: Without CAHOOTS, non-violent mental health crises are now likely handled by police officers or emergency medical personnel — an approach criticized for being less effective and more costly.
• Community Backlash: CAHOOTS has built up considerable good will through three-and-a-half decades of patient care. Now, residents have expressed frustration over losing a trusted service that was a model for the nation and that aligned with Eugene’s values.
• Economic Consequences: The layoffs have further strained local employment and raised concerns about White Bird Clinic’s stability.

During the February 10 City Council meeting, Councilor Leech of Ward 7 resisted, "I refuse today to vote to lay off fifty people at least...I refuse to reduce the safety and security of our community when that is the number one priority." Her sentiment was felt by many, but any effort to address an $11.5 million budgetary gap was always going to include an array of city budget cuts that would be life-altering for many.

Why Springfield Retains CAHOOTS

Despite ending operations in Eugene, White Bird continues providing CAHOOTS services in Springfield — a decision that underscores disparities between the two cities. Springfield may have offered more stable funding or fewer administrative hurdles compared to Eugene’s strained budgetary environment.

This choice has led some residents to question why Springfield retained services while Eugene lost them entirely. A Facebook comment summarized this sentiment: "Why does Springfield get CAHOOTS but not us? We need answers from White Bird!" The answer, though, must come from Lane County, which is prioritizing its MCR.

Looking Ahead

As Eugene navigates this transition, several questions remain unanswered:

• How quickly can Lane County scale up MCR to meet the demand left by CAHOOTS’s departure?
• Will the city allocate additional funding or resources to support MCR’s expansion?
• How will the community be affected and respond to the significant differences in the way MCR operates as compared to CAHOOTS?

While Lane County’s Mobile Crisis Response program offers hope, it is clear that significant investments and strategic planning will be required to fill the void left by CAHOOTS effectively.

Birds of a Feather?

CAHOOTS's elimination represents a significant loss for Eugene’s residents and highlights systemic issues within nonprofit management and public funding frameworks — issues reminiscent of those faced by Freedom House decades earlier. Both programs serve as reminders that innovative crisis intervention models require sustained investment and strategic planning to thrive long-term.

As the city navigates this transition that it helped orchestrate, it must address both immediate service gaps and long-term strategies for sustainable crisis intervention programs. In the meantime, the city's housing crisis and behavioral emergencies continue to worsen. Most of the Eugenians in desperate need of help with behavioral health, crisis assistance, wound care, or routine check-ins may not immediately understand the differences between CAHOOTS and MCR or the political reasons why it is an MCR van now pulling up to their curb. However, Eugenians — and in fact all Lane County residents — should be very concerned with how both the two organizations' different methodologies and Eugene's move away from CAHOOTS will affect the community.