Proposed, for board reviewDisclaimer and crisis doors published in the first 90 days; founder rotation first, funded coordinator by month six; first public timing report by month 12
One person owns every referral, and we promise a process we can keep
Fund one paid, licensed, part-time intake coordinator housed inside a partner agency that already holds health records; publish a one-page promise (acknowledged within one business day, first contact within two, a first appointment targeted within ten business days, with a defined escalation when a target is missed); say plainly that the network is not a crisis service; set a written scope and referral doors; and publish days from referral to first contact by town every quarter.
A volunteer roster cannot guarantee appointment dates, and the honest design starts there. The national pro bono counseling networks that have lasted promise a process, not a window: Pro Bono Counseling, for example, screens every client by phone with clinical staff, matches them to volunteer clinicians and names no response window. We would say just as plainly that this network is not an emergency service. Central Oregon has a benchmark to borrow: the federal certified community behavioral health clinic standard (CCBHC) of an initial evaluation within ten business days. The acute tier here is stronger than the ongoing tier: the county Stabilization Center is open 24/7 to all ages at no cost, with a crisis response team that goes out into the community. Imminent danger belongs there, not with a volunteer.
The single staffing decision that determines whether referrals bounce is one paid, licensed person who screens every referral, matches it, owns it until a clinician accepts in writing, and keeps the log. The local reason matching matters: most youth appointments are in Bend, and in a 2024 survey only 4 of the 23 Medicaid providers offering appointments for youth had openings outside Bend. The county’s evaluation credits the Healthy Schools partnership’s work on the handoff with raising the share of referrals that became appointments from 52 to 67 percent, and that handoff is this person’s whole job.
Where this person sits matters as much as who it is. A nonprofit employee holding names of threat-assessed minors is a list no district will populate. So we propose housing the coordinator inside the county Access Team, BestCare or Mosaic, or at the ESD as a designated school official, with the group funding the hours and holding only counts with no names. The mission also promises care for young people flagged by families and counselors, not only threat assessment teams, so the doors would be written down: school counselor, Level 2 team, pediatrician, school-based health center, or a parent calling directly.
Why we think it works
- Pro Bono Counseling screens clients by phone with clinical staff (a licensed social worker handles intake), matches them to volunteer clinicians, requires volunteers to upload a copy of their liability insurance, and states no specific response window. Neither page mentions background checks. (Pro Bono Counseling, FAQs and Become a Volunteer Clinician pages, moderate evidence)
- Certified community behavioral health clinic (CCBHC) criteria set an initial evaluation within ten business days as the routine access benchmark. (SAMHSA, CCBHC Certification Criteria (Updated March 2023), strong evidence)
- In the district's Care Solace referral system, the share of adolescent behavioral health referrals resulting in appointments rose from 52 to 67 percent over the 2022 to 2025 school years, which the report credits to Healthy Schools promoting Care Solace to families and urging them to answer its calls; nonresponsive referrals fell from 41 to 29 percent. (2025 Deschutes County Healthy Schools Outcome Evaluation (Snyder and colleagues), moderate evidence)
- In a September 2024 PacificSource Community Solutions survey cited in the Central Oregon Health Council's assessment, only 17 percent of the 23 Oregon Health Plan (Medicaid) providers offering appointments for youth under 18 had openings outside Bend, and 89 percent of their available appointments were in Deschutes County. (Central Oregon Health Council: Assessment of Health Promotion, Prevention, and Treatmen..., moderate evidence)
- The Deschutes County Stabilization Center is open 24 hours a day, 7 days a week, to all ages at no cost, and Deschutes County's Community Crisis Response Team provides crisis intervention in the community 24/7 when called by partners such as law enforcement. (Deschutes County Behavioral Health: Crisis Services, strong evidence)
What we would do
- Publish the disclaimer and the 24/7 doors first, once each pathway is confirmed: 988, the Deschutes County crisis line and the Stabilization Center (confirm its rule for minors with the county before publishing), YouthLine, and the Crook and Jefferson county crisis lines; publish the timing promise only when the intake line, the log and a named owner exist; Oregon counsel reviews the wording.
- Write the scope rule: young people roughly 10 to 24 referred by a school counselor, the regional threat assessment team with county and law enforcement partners (the Level 2 team), a pediatrician or school-based health center, or a family calling directly; adults, including the households in any protective order matter, would be directed to county behavioral health and BestCare Treatment Services (the behavioral health provider serving Jefferson and Crook counties); imminent danger goes to 988 or the Stabilization Center, never to the roster; most referrals are ordinary distress, and the promise page says so in care language.
- House the coordinator inside an organization already bound by the federal health privacy law (HIPAA), such as the Deschutes County Access Team (the county's behavioral health intake team), BestCare in Madras or Prineville, or Mosaic Community Health (the region's community health centers), or at the High Desert Education Service District (the regional agency that supports all six school districts) as a designated school official named in the annual notice required by the federal student records law (FERPA); the group funds a share of an existing position, a retired or semi-retired licensed clinician where possible so no licensed hours leave the public system; the group receives counts with no names, and nothing more.
- Until funded, rotate intake weekly among three founding clinicians with a shared line, a published weekly cap, a conflict rule (no matching to one's own practice or employer, reason for each match logged), a voicemail script routing to 988 and the Stabilization Center, mandatory reporter training before the first call, and a month-six end date; pause new intake rather than stretch the rotation.
- Propose a short escalation agreement to Deschutes County Behavioral Health and BestCare that defines escalation as a call to the family and the Access Team to coordinate, not a crisis dispatch, with volumes and hours; confirm and publish the after-hours youth crisis pathway for each county, including whether youth mobile crisis response (MRSS) is live in Crook and Jefferson counties.
- Under 14, the parent is the first call and gives consent; for 14 to 17 the coordinator explains the brief screen to the parent as the same questions a pediatrician asks, within Oregon's minor consent law; any positive screen gets a clinician's assessment the same day under the host entity's written protocol and professional liability.
- Keep the log at the host agency: referral date, acknowledgment, first contact, first appointment, town and insurance, if any, no clinical content, with a written retention limit; report rolling twelve-month figures by town, with numbers too small to protect privacy not shown and towns grouped where needed.
- Report quarterly to the Safe Schools Alliance (convened through the ESD), the Central Oregon Suicide Prevention Alliance and funders, and publish the capacity ceiling beside the promise so schools know the honest number before they refer.
How we would know it is working
- Percent of referrals acknowledged within one business day
- Median days from referral to first contact and to first appointment, by town and insurance type, rolling twelve months
- Percent of referrals escalated at the deadline, and zero referrals without a named owner at any point
- Zero youth-identifying records held by the nonprofit at every quarterly review
- Coordinator funding requested by month three; hiring status reported at month six
What could get in the way
- A nonprofit employee holding name, age, town, referral source and outcome for threat-assessed minors is a list no district will populate: not a school official under FERPA, not an organization bound by HIPAA, and subject to the state privacy law.
- Resolve it in one direction before any district conversation: the coordinator sits inside an organization bound by HIPAA or at the ESD as a designated school official, the group funds the hours, and the group holds only counts with no names.
- A published response target becomes an expectation; if a counselor refers on the strength of it and the window is missed, the referral becomes a liability chain.
- The promise binds the coordinator and the process, never an individual clinician; the headline number is first contact, which the coordinator controls; the escalation rule and the not-a-crisis-service disclaimer are the safeguards; every district document would state that school duties are unchanged.
- A stranger phones a 12-year-old with suicide questions before the parent has met anyone.
- Under 14 the parent is the first call and gives consent; for teens the coordinator explains the screen to the parent as ordinary questions, within state law.
- No funder exists before month six, a licensed hire at licensed rates competes with the county and BestCare for the same scarce person, and the coordinator can become an unofficial crisis line that schools call instead of 988.
- A founding gift as the first ask; a share of an existing partner position or a retired clinician; published hours, a voicemail script and an agreement line that schools call 988 or the county for imminent risk.
Who we would work with: Deschutes County Behavioral Health (Access Team and Stabilization Center), BestCare Treatment Services (Jefferson and Crook counties), Mosaic Community Health, High Desert Education Service District (the ESD), Lines for Life (988 and YouthLine), Fiscal sponsor and Oregon counsel, PacificSource Foundation and St. Charles Community Benefit (asked for year two funding)