Maricopa County: Phoenix Crisis Response Center
City Profile: Maricopa County, Arizona
The Phoenix Crisis Response Center and the Arizona Model
SAMHSA’s 2025 National Guidelines cite Arizona’s integrated crisis system as a foundational model for the national crisis continuum. The Phoenix Crisis Response Center, which Connections Health Solutions describes as the nation’s largest dedicated psychiatric emergency facility, serves more than 25,000 individuals annually within a three-tier system that has operated for more than 30 years.
Background: Thirty Years Before Everyone Else
Arizona’s AHCCCS documents that its crisis response infrastructure has operated through a Medicaid financing model for over 30 years.
By the time the 988 Suicide and Crisis Lifeline launched nationally in 2022, Arizona had already operated what the national system was designed to replicate: a 24/7 crisis phone line, mobile crisis teams dispatched from that line, and facility-based stabilization centers as the terminal point for calls that needed more than phone resolution. The three-tier model that Ohio’s Governor DeWine described in 2024 (someone to call, someone to respond, somewhere to go), Arizona had been running since the early 1990s.
Andrew Medina, the state’s Medicaid crisis administrator, explained what sets the system apart: “For well over 30 years, we have created a system that’s available to any Arizonan whenever they need the help,” operational 24/7, 365 days a year, statewide.
The Phoenix Crisis Response Center
The Phoenix CRC is the largest component of the system. Connections Health Solutions, which has operated it since 2009, describes its model: 24/7 immediate access, acceptance of anyone regardless of ability to pay, rapid psychiatric evaluation (most patients seen by a psychiatric provider within one hour), and a service array that spans crisis evaluation, medication management, case management, peer support, and coordination with outpatient follow-up.
The physical facility includes two distinct clinical areas: a voluntary walk-in area for patients who present independently or with family, and a secure 23-hour observation unit for higher-acuity patients who may need monitored stabilization. The secure unit is staffed continuously by an interdisciplinary team including psychiatrists, nurse practitioners, registered nurses, case managers, behavioral health technicians, and peer specialists.
Volume: More than 25,000 individuals annually — approximately 70 per day — as reported by Connections Health Solutions.
Tucson maintains a separate Crisis Response Center, also operated by Connections Health Solutions through a contract with Arizona Complete Health. The Tucson CRC operates as a voluntary-only facility with a specific focus on substance use disorder presentations, complementing the broader scope of the Phoenix facility.
What the Research Shows
Arizona’s system has produced two peer-reviewed studies and the AHCCCS program-reported dataset that most national cost projections cite.
Patient flow: A 2024 study in Psychiatric Services, conducted by researchers from Arizona State University and Connections Health Solutions, examined how patients interact with the crisis system using linked Medicaid claims and electronic health records. The researchers found that 57.4% of individuals entered Arizona’s crisis system through mobile crisis or crisis facilities rather than emergency departments, a sign that the alternative access points are working as designed. Of patients who received care at the Tucson Crisis Response Center specifically, 63.3% did not reutilize crisis or emergency services within 30 days.
Cost and system impact: The “Arizona Crisis Now” model, developed by the Arizona Health Care Cost Containment System (AHCCCS) based on Maricopa County data, projects the following outcomes from the $100 million investment in the full crisis continuum: reduced potential state acute care inpatient expense by $260 million; avoided $37 million in hospital psychiatric boarding costs; freed the equivalent of 37 full-time police officers for other duties; and reduced cumulative psychiatric boarding time by the equivalent of 45 years. These are program-reported projections, not independently audited savings. They have been widely cited in legislative contexts; decision-makers presenting them should be prepared to explain the methodology.
Emergency department volume: The 2025 Indiana University study examining crisis stabilization availability across 1,002 zip codes in five states, including Arizona, found that access to walk-in crisis stabilization services was associated with statistically significant reductions in mental-health-related emergency department utilization, providing independent evidence consistent with the program-reported projections.
Patient experience: Not all patient experiences have been positive. PBS NewsHour’s 2024 reporting on Arizona’s system included 17-year-old Calvin Carbello’s account of spending a crisis episode at a Phoenix-area urgent psychiatric care clinic in conditions he described as inadequate: chairs instead of beds, youth in distress grouped together without meaningful treatment, little clinical intervention overnight. His mother Kelly described the experience as a holding space rather than treatment. PBS NewsHour documented this account as illustrating uneven facility-level quality within a mature statewide system.
The Financial Model
Arizona’s system is Medicaid-financed at a level most states have not achieved. The state’s Medicaid program (AHCCCS) has approved crisis stabilization as a billable service category, and Connections Health Solutions bills for the clinical encounters it provides. Arizona’s AHCCCS documentation attributes the system’s 30-year continuity to its Medicaid financing model, which provides operational revenue independent of ARPA funds, expiring federal grants, or single-administration budget priorities.
The Medicaid billing model nonetheless has limits. It reimburses clinical encounters; it does not fund capacity. Staff time spent on community outreach, training, supervision, and administrative operations (the infrastructure that makes 25,000 annual encounters possible) must be funded separately or absorbed as organizational overhead. Connections Health Solutions describes its model as “data-driven, with outcomes showing a high rate of stabilization within 23 hours and significantly reduced readmission rates.”
Law Enforcement Integration
Maricopa County’s police departments have formal integration with the crisis system that few jurisdictions match. In 2016, 21,943 individuals with mental health and addiction challenges were handed off from Phoenix-area police departments directly to the crisis system, a volume that required operational infrastructure, shared protocols, and officer familiarity with the drop-off process.
AHCCCS program-reported data projects 37 full-time-equivalent police officers freed from mental health transportation duty. The 2016 figure of 21,943 police-to-crisis-system handoffs documents the volume of integration.
What Other Jurisdictions Have Taken From Arizona
SAMHSA’s 2025 National Guidelines cite Arizona as a foundational model and describe the three-tier design as the national target. Ohio Governor DeWine, Virginia Governor Youngkin, and Georgia’s DBHDD have each referenced the Arizona model in their own crisis system development.
What Arizona Has Not Solved
Arizona’s system has documented gaps alongside its documented outcomes.
Youth quality variation. The Calvin Carbello experience documented in PBS NewsHour’s 2024 reporting — a 17-year-old placed in inadequate conditions with little therapeutic intervention — occurred at a facility within Arizona’s crisis network. The state system sets standards but does not guarantee uniform quality across all contracted providers. A mature system with 30 years of operational experience still produces uneven facility-level outcomes.
Rural coverage. Arizona’s Medicaid-financed model works best in population centers where patient volume sustains facility operations. The state’s rural areas — which span enormous geographic distances with sparse population — face coverage gaps that the urban infrastructure does not resolve. The Medicaid model that works for Phoenix does not automatically extend to communities where a facility might see 14 patients per month rather than 70 per day.
Voluntary engagement limits. Arizona’s Tucson CRC operates as a voluntary-only facility. The Phoenix CRC’s secure observation unit handles involuntary presentations, but voluntary facilities cannot serve people who actively refuse care and who may be at the highest risk. The system is built to be accessible and therapeutic, not coercive — a deliberate clinical philosophy that has real operational limits for the most acute presentations.
Arizona as National Reference
Andrew Medina of AHCCCS describes the system: “For well over 30 years, we have created a system that’s available to any Arizonan whenever they need the help.” SAMHSA’s 2025 guidelines describe the three-tier sequence — phone, mobile, facility — as the design standard, with Arizona as the reference implementation.
Key Data Points
Annual volume: 25,000+ individuals served at Phoenix CRC annually (operator-reported)
Operator: Connections Health Solutions since 2009
24/7 operation: Year-round, including all holidays and weekends
Funding model: Medicaid-financed through AHCCCS managed care contracts; sustained for 30+ years
30-day non-reutilization: 63.3% of Tucson CRC patients did not reutilize crisis or ED services within 30 days (2024 study; Connections Health Solutions was co-author)
Police integration: 21,943 police-to-crisis-system handoffs in Maricopa County in 2016
System age: Core infrastructure operational since early 1990s
National influence: Cited as foundational model in SAMHSA 2025 National Guidelines
Footnotes