Vancouver OKs $4.94M Cowlitz Tribe Mobile Opioid Treatment Contract

The Vancouver City Council on Monday approved a five-year, $4.94 million contract handing operation of the city's mobile opioid treatment program to the Cowlitz Indian Tribe, rescuing a service that had been thrown into uncertainty by the financial collapse of its original operator, The Columbian reported.

The vote makes the tribe responsible for a motorhome-style clinic that delivers methadone, buprenorphine and counseling directly to shelters and encampments across Vancouver, Washington's fourth-largest city. It also caps a year-long upheaval in Southwest Washington's behavioral health landscape, during which the region's largest nonprofit provider effectively ceased to exist and a tribal health system stepped in to keep its patients from losing care.

A contract born from a provider's collapse

Vancouver launched the mobile program in early 2025 with Columbia River Mental Health Services, agreeing to pay the nonprofit $1.65 million for the first year of operation out of the city's $2.58 million share of national opioid settlement funds, according to OPB. The arrangement never got the chance to mature. Financial and operational problems that had dogged Columbia River for years forced the organization to pause operations in early 2025, according to a joint announcement from the two organizations, leaving thousands of patients uncertain about where they would continue treatment.

The Cowlitz Tribal Foundation first stepped in with $1.6 million in emergency funding in April of that year. By July 2025, the tribe and the nonprofit had signed a letter of intent to move Columbia River's programs — beginning with adult and youth outpatient services and the NorthStar Clinic, one of the largest opioid treatment programs in Southwest Washington — under the tribe's Health and Human Services Department.

"This is a powerful opportunity to build upon our Tribe's legacy of healing, care, and service," Cowlitz General Council Chairman Bill Iyall said at the time. "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."

Columbia River had operated for more than 80 years and served over 5,000 patients annually before its pause. Monday's council action extends that absorption to the mobile treatment contract itself.

What the mobile program delivers

The clinic-on-wheels was designed around a simple observation: people living in shelters and encampments rarely make it to fixed-site appointments. Patients can receive medication-assisted treatment, medical evaluations and one-on-one counseling aboard the vehicle, and be screened for diabetes, hepatitis and HIV. Jamie Spinelli, Vancouver's homeless response manager, told OPB when the program launched that a mobile unit "just reduces barriers to access" — including the reluctance of unsheltered people to leave belongings unattended at a clinic.

The unit visits existing shelters and temporary encampments and is eventually to be based at the 150-bed bridge shelter the city is building in the Van Mall neighborhood, which was expected to open in mid-2026. The tribe accepts Medicaid and all major insurers and can treat patients in both Washington and Oregon, a meaningful flexibility in a city that sits directly across the Columbia River from Portland.

A tribe with a growing treatment footprint

The contract builds on treatment infrastructure the Cowlitz Indian Tribe has been assembling for years. The tribe unveiled a mobile medication-assisted treatment van at a ceremony in Tukwila in late 2023 — an event that drew U.S. Sen. Patty Murray months later — and put it into full operation in 2024. Its Health and Human Services Department runs clinics along the Interstate 5 corridor in Vancouver, Longview, DuPont and Tukwila, serving tribal members and the broader public alike. While Native populations remain the focus of the tribe's programs, its services are open to all eligible community members.

That model — a tribal government assuming responsibility for regional addiction treatment once provided by faltering nonprofits — has drawn attention as one answer to a chronic shortage of stable providers. The Vancouver agreement converts that role into a long-term municipal commitment.

Mobile units gain ground in the Northwest

Vancouver's program is part of a widening experiment with wheels-based addiction care in the Pacific Northwest. In May, Comprehensive Healthcare deployed a mobile unit dispensing methadone and buprenorphine in Ellensburg, in rural Kittitas County, where patients previously had to travel to Yakima for the same medications. Pierce County has funded up to two mobile treatment vans staffed by medical and behavioral health professionals and peer recovery specialists, using a mix of federal grants and opioid settlement proceeds, according to the county.

Whether the Cowlitz operation can stabilize what Columbia River could not will be measured in patient retention over the contract's five years. For Vancouver officials, Monday's vote at least guarantees that the city's settlement-funded investment in mobile treatment keeps rolling — now under an operator whose regional footprint has only grown through the crisis.

People seeking help for opioid use disorder can reach SAMHSA's National Helpline at 1-800-662-4357, a free, confidential, 24-hour referral service.