After CAHOOTS: Two visions emerge for ‘alternative response’ services in Eugene

Bidding has closed on a contract to run a new alternative response service in Eugene, leaving city officials to choose between two proposals that offer different visions for the pilot program.

It is part of the city’s effort to rebuild its alternative response system after CAHOOTS, a nationally recognized mobile crisis service that operated in the city for more than three decades, stopped operating in Eugene in April 2025.

Two organizations — Ideal Option, a multistate addiction treatment provider, and Willamette Valley Crisis Care, a Eugene-based crisis response group — submitted proposals for the city’s new “Peer Navigation Alternative Response” program on March 3.

City officials are expected to select one provider to run the program by March 31. The city has $500,000 budgeted for the contract’s initial term of one year, and both bidders submitted proposals within that figure.

“As soon as we get a team in the field that can report data back to us and help us understand what’s going on, that really informs where we invest,” Eugene Springfield Fire Chief Mike Caven told Lookout Eugene-Springfield. “Is it more community paramedicine? Is it more peer navigation? What’s the thing that actually shows a trend of success for people?”

For decades, CAHOOTS’ two-person mobile units functioned in Eugene as a kind of “Swiss Army knife” for situations where police or fire were not always needed — responding to mental health and substance use crises, performing wellness checks and first aid, and connecting people to social services.

When CAHOOTS ceased operations in Eugene last year, other agencies began absorbing calls it once handled. Lane County Mobile Crisis Services now responds to high-severity behavioral health calls, while the fire department and Eugene Police Department have launched two separate pilot programs to handle others.

But a review by the fire department last fall concluded the resulting system — described by officials as a “patchwork” — still lacks a “peer-based social services function” that connects people who have frequent contact with law enforcement or emergency services to housing, treatment and other resources.

Police last year saw a 28% increase in welfare check calls — requests for an officer to check into an individual’s safety — up to 5,748 from 4,497 in 2024.

The city believes the new pilot program is the “right resource” for those calls, Eugene Police Chief Chris Skinner said last month, adding that there’s no way to know how someone is doing “until you go out and check.”

Filling those gaps helped shape the city’s request for proposals for a new pilot program. 

The request for proposals calls for at least one response unit staffed by two case managers operating 10 to 12 hours a day, seven days a week, in the Highway 99 corridor, River Road, the Whiteaker and three streets in west Eugene.

The city wants the successful bidder to begin work within 60 days of signing the contract, and the city will provide vans for the provider to use for transport.

Beyond those specifications, however, the city left significant flexibility in the document, and the two bidders have proposed different approaches to the work — underscoring broader questions about what Eugene’s next alternative response system should look like.

Ideal Option’s proposal

Ideal Option, founded in Washington state by two emergency medicine doctors in 2012, operates clinics in nine states providing medication-assisted treatment for substance addiction.

Eugene already contracts with the organization to provide peer navigation services for the police department’s downtown community response program, which Caven said has “seen successes” since its launch in January. Ideal Option also helps the county run its deflection program.

Navigators on that team use their own experience navigating the criminal justice system to build rapport with people struggling with addiction or homelessness and connect them to community services, said Josh Lair, Ideal Option’s director of community development. 

In its call for proposals, the city described the new service as an expansion of that work, and Lair said he built Ideal Option’s proposal around that idea. Still, he acknowledged that the city’s request was “vague.”

“I don’t know that anybody knows exactly what it is that they’re wanting,” Lair said.

Being a “CAHOOTS 2.0” is not what Ideal Option is “trying to do” or “trying to be,” Lair said, describing the team as a connector to services, not a behavioral health or paramedicine organization.

“There’s so many resources within Lane County, amazing organizations that do fantastic work that my team currently refers people to,” he said. “We’re getting them there. So is the community ready for even more? Because that’s all my team is going to do, is bring more.”

Willamette Valley Crisis Care’s proposal

Designing a proposal that fit within the city’s request was more complicated for the other bidder, Willamette Valley Crisis Care.

The Eugene-based crisis care provider — founded last year by former CAHOOTS workers — has been among the most outspoken advocates for restoring a stand-alone mobile crisis response service in the city.

But the city’s request did not call for a program resembling the CAHOOTS model of two-person teams of medics and crisis workers that the organization has advocated for, said Michelle Perin, Willamette Valley Crisis Care’s operations director. Those teams were able to rule out medical emergencies and provide basic wound care in the field, services that Perin described as a gap in the current system.

“We did what we do best as crisis workers, and we’re like, ‘OK, you gave us a problem. How do we try to navigate within that?’” she said.

Throughout the bidding process, Willamette Valley Crisis Care submitted questions to the city seeking clarification on the program, which the city attached to its request for proposals through seven addendums. In one response, the city said it would be “open” to evaluating proposals that included an EMT on the team, but that it was “not asking for that scope.”

Perin said the nonprofit’s final proposal includes a two-person response team consisting of a medic and a crisis worker operating seven days a week and an “aftercare” team staffed by Restored Connections Peer Center, a peer recovery group serving Lane County, which would provide peer navigation services five days a week.

“We’re willing to try to negotiate what this looks like while staying true to ourselves,” she said. “We’re not going to make ourselves into a peer navigation team, because that’s not what we are, and that’s not what the community has asked for, and that’s not what the City Council asked for.”

A future without CAHOOTS

The debate over the new pilot program is inseparable from the question of what, if anything, will replace CAHOOTS, which handled thousands of calls per year for decades. Over the past months, some advocates for Willamette Valley Crisis Care have urged the city to rescind and reissue the request for proposals to more closely align the program with what CAHOOTS used to provide.

Caven said recreating a program that offers a “full suite of services” is unlikely.

“There’s other people doing it, and when public dollars are tight, paying one program to do all of the things when other programs are doing similar work, it doesn’t fit,” he said.

After CAHOOTS stopped operating in Eugene in April, the City Council directed staff to investigate how an alternative response program with “CAHOOTS-like services” could be provided — at a cost estimated at about $2.2 million.

At the time, councilors allocated the $500,000 for fire and emergency medical services to address immediate impacts on the street, which then-City Manager Sarah Medary described as “placeholder” funding.

“I want to make sure that there’s at least some funds on the table while we determine: How does the service need to transform? Who’s the right provider?” Medary said last April.

The two proposals offer different answers to that question. Ideal Option’s focus on peer navigation mirrors the work described in the city’s request for proposals, while Willamette Valley Crisis Care’s two-team model incorporates a response model similar to the one CAHOOTS used for decades.

“I trust the process, but what is the city actually wanting?” Perin said. “I’m pretty sure that the two proposals are going to look very different.”

The city plans to pursue ongoing funds for the pilot in the fiscal year 2026 supplemental budget. 

If data reveals persistent response gaps after the city launches the program, Eugene will authorize a second request for proposals or a contract amendment to add a clinician and medic unit integrated with existing county, fire and police providers. 

The city said the timeline for that second phase is “unknown,” but may include changes to geographic service areas and dispatch processes.

White Bird Clinic, which used to operate CAHOOTS in Eugene and still does in Springfield, wasn’t among the bidders for the pilot project. The city ended its contract with the clinic after compliance issues with a new federal law allowing state Medicaid to cover crisis response services, which created stricter medical and administrative standards.

The new pilot wasn’t the “right fit” for the clinic, said Amée Markwardt, the organization’s executive director. 

She said the city was clear that it didn’t want a CAHOOTS model for the program, and she is concerned about the pilot program’s “sustainability” because funding is only guaranteed through the first year.

“I do believe that there’s other folks within our community that could do this better than what White Bird can do,” she said, though she added that some community members want to “reestablish some connections” with the clinic in the future. She declined to provide additional details.

Caven said the city doesn’t expect to send an “expert” to every call through the pilot program, but somebody who can determine a person’s needs and match them to the best resource. Looking ahead, the fire department is “probably not that far away” from providing mobile urgent care to “fill a gap” in the community, he said.

“Social safety is a network,” Caven said. “It’s no one thing. We’re just looking to plug that next thing into the network, and being open to what they’re able to do from day one, and what they’re able to help inform needs to happen going forward.”