DSHS chief blames lawmakers for state mental-health logjam

EVERETT — An impassioned and combative Kevin Quigley testified for three hours Thursday about the steps the state Department of Social and Health Services has taken to bring more timely mental health treatment to inmates languishing in county jails.

Quigley, the department’s secretary, blamed years of neglect on lawmakers, who, he said, have failed to fully fund the state’s mental health hospitals.

Washington routinely has ranked last in the country for the number of available adult psychiatric beds. There are 100 fewer beds than there were 10 years ago, Quigley said.

“It’s an incredible embarrassment to this state,” he said while being questioned in Snohomish County Superior Court.

Quigley also testified that under his three-year tenure, spending on mental health services has increased by $800 million.

“I’ve pushed as much as I could. I’ve colored outside the lines as much as I could,” Quigley said. “The law doesn’t allow us to spend money that’s not budgeted.”

The needs of those people living with mental illness have gone unfunded, but not unnoticed by his department, he said. Quigley said he’s been forced to make tough decisions and he has prioritized mental health services for children and those under civil commitment in the state’s hospitals over criminal defendants.

“No one on God’s green Earth can say I wasn’t rigorous about this,” he said Thursday.

Quigley announced Tuesday that he planned to resign once Gov. Jay Inslee found a successor to run the department. That night he was served with a subpoena ordering him to testify Thursday before Superior Court Judge Anita Farris.

Public defender Tiffany Mecca asked Farris to find the state in contempt for not admitting her client, a mentally ill man charged with stalking, to Western State Hospital within seven days. The admission was delayed for months, despite a court order and a federal injunction setting the one-week timeline.

Farris has demanded that DSHS account for the $40 million it was allocated in July to answer to the federal injunction. She also ordered that Quigley and others show up to explain why the department isn’t able to admit defendants in a timely manner.

U.S. District Court Judge Marsha Pechman ruled in April that the state was routinely violating the constitutional rights of inmates awaiting treatment at the state’s two psychiatric hospitals. She ordered that the state come up with a plan to add more beds for defendants who are too mentally ill to assist with their own defense.

Inmates wait weeks to be admitted to the hospitals. They often go untreated in jails. County judges routinely are asked to release inmates, dismiss charges or find the state in contempt.

Mecca’s client had been waiting since November. He was admitted to Western on Tuesday, despite hospital officials testifying earlier that a bed likely wouldn’t be available until Jan. 11.

Assistant Attorney General Amber Leaders on Thursday attempted to keep Quigley off the witness stand, saying the contempt issue was moot because the defendant had been admitted.

Quigley said he wanted to testify.

“I don’t want any remote appearance that I’m not willing to answer questions,” he said.

Thursday was part of series of hearings in front of Farris, who has insisted on explanations for why delays have gotten longer since Pechman’s ruling. In April the average wait time was 15 days. The latest data show that inmates are waiting an average of 36 days.

Quigley testified that wait times will not improve until the state can add more beds, and that is going to take at least until May, well beyond Pechman’s Jan. 2 deadline.

The state plans to contract with outside providers to open beds elsewhere, including at a former juvenile detention center in Centralia.

Adding capacity doesn’t happen overnight, Quigley said.

“What we’re building here has to be as secure as a jail in a work environment that is more conducive to healing and recovering,” he said.

Additionally, the state’s mental hospitals are plagued by an inability to recruit and retain staff, including psychiatrists. Quigley and others testified that the state doesn’t pay enough to attract and keep doctors, psychologists, nurses and social workers. The hospital has hired 300 people in the past year, but has only been able to retain about 100 of those employees. A recent federal audit found that understaffing contributed to patient safety concerns at Western. The hospital was notified in the fall that it risked losing federal funding if problems weren’t fixed. That led Quigley to stop expansion intended to meet Pechman’s mandate.

“I was worried we were pushing the hospital too hard to open new beds,” he said.

Staff hired for those additional restoration treatment beds was moved to backfill openings in the rest of the hospital.

“I knew the courts would be grumpy with me,” Quigley said. “Nobody could do it faster than we have done it.”

Lawyers, however, argued Thursday that this problem did not surface overnight.

Farris on Thursday pointed to a legislative committee report from 2012 that mandated DSHS to come up with a plan to address the long wait times. A state audit found DSHS not only didn’t follow its plan, it was claiming improvements that were never made.

The situation is more complicated than it appears, Quigley said.

“It’s all the same story. If you want to crucify the secretary of DSHS, fine, but you’re not going to solve the problems for clients,” he said.

His agency is acutely aware that people’s constitutional rights are being violated, something that’s likely been going on for a decade, Quigley said.

His department has had to prioritize with the money it’s been given. Before the federal lawsuit, there hadn’t been any major efforts to reduce the wait times, he said. They have taken significant steps to meet other mandates for mentally ill juveniles and those who are civilly committed.

The money is there now for forensic services and the department can add beds. It will continue to be a challenge to hire and keep staff. Yet Quigley insisted that the department has “turned a corner.”

“There’s zero doubt in my mind that we’re on a trajectory to solve this problem,” he said.

Quigley’s indignation became palpable when public defender Jason Schwarz asked if a lack of funding by the legislators was a good reason for Quigley to disregard the state and U.S. Constitutions.

“Be real,” Quigley answered. The state Constitution doesn’t allow spending money that isn’t authorized.

“I followed the law. I can’t believe what you would do to public service,” Quigley said. “ … Your question is so far out of line.”

Farris ordered Quigley to answer Schwarz’s question about intentionally disobeying court orders.

DSHS is in an impossible situation, Quigley said, and he isn’t going to open more beds if it means putting the safety of patients and staff at risk.

“Throw me in jail if you want,” he said.

Diana Hefley: 425-339-3463; hefley@heraldnet.com. Twitter: @dianahefley.