Inslee’s proposed budget includes millions for mental health

SEATTLE — Gov. Jay Inslee’s new budget proposal includes more than $137 million for the state’s beleaguered mental health system at a time when it’s under fire on several fronts.

Washington is struggling to comply with a federal court order that requires it to provide timely competency services to mentally ill defendants and the state’s largest psychiatric hospital is under threat of losing federal funding because of safety concerns.

“We know we have to do more for mental health in this state,” Inslee said in a statement Thursday. “We have urgent short-term needs, but we also need to take a long view on how to build a stronger mental health system.”

Four times in 2015, the federal Centers for Medicare and Medicaid threatened to cut millions in funding for Western State Hospital after inspections found that system-wide failures caused serious harm to patients and placed their health and safety at risk.

The latest 90-day termination notice is effective March 1, spokeswoman Stephanie Magill said. An unscheduled revisit to the facility will occur sometime in the future to ensure hospital officials are fixing the problems, she said.

And an investigation by The Associated Press found assaults on staff by patients have resulted in millions of dollars in medical costs and thousands of missed days of work. Injured employees missed 41,301 days of work between 2010 and 2014, and workers compensation insurance paid $6 million in wage and medical costs for claims to injured hospital workers between January 2013 and September 2015, The AP found.

In response to the violence, Kevin Quigley, the secretary of the Department of Social and Health Services, recently ended all expansion plans at Western until more staff could be hired. The expansion was part of the effort to comply with a federal ruling requiring the state to provide timely competency services to mentally ill defendants.

Quigley and his staff came under fire in a Snohomish County courtroom Thursday, when a judge demanded to know what has been done to alleviate delays for defendants who aren’t able to assist with their own defenses.

The data provided to Superior Court Judge Anita Farris showed that wait times have grown longer, not shorter.

She instructed public defenders to serve Quigley and others with subpoenas, ordering them to appear in her courtroom to explain why the state has failed to meet the federal court’s mandates. Farris threatened to have the state officials arrested if they didn’t show up.

In April, U.S. District Judge Marsha Pechman said Washington was violating the constitutional rights of mentally ill defendants and gave officials until Jan. 2 to start providing competency evaluations and restoration treatment within seven days of a judge’s order.

Quigley said they tried to meet the court’s deadline but couldn’t safely achieve that goal. Inslee’s budget plan addresses those problems in several ways.

The plan would add 62 new positions, including 51 registered nurses for day and evening shifts at Western State Hospital, at a cost of $6.8 million.

Inslee also would improve staff recruitment and retention rates by using $9.5 million to offer salary raises and bonuses for psychiatrists and other psychiatric staff, the plan said.

Ralph Thomas, spokesman for the Office of Financial Management, said the health services agency stopped working on the Forensic Ward at Western State Hospital because of staff and safety concerns raised by the federal agency and the governor’s budget provides the staff and resources needed to address those problems.

In the meantime, the agency is working to build bed capacity for competency services and is contracting with sites in the community until the hospital is staffed appropriately, he said.

To satisfy a settlement agreement with the Washington Department of Labor and Industry, the state would spend $2.2 million for 11.2 new staff at Eastern and Western state hospitals to attain a 24/7 staffing level, the budget plan said.

“This would allow some staff to leave ward duty for additional annual safety training to fulfill recommendations of an ad hoc safety committee on strategies to decrease violence at state psychiatric hospitals,” the budget plan said.

Inslee also wants to invest in community-based services to treat people who are in an acute mental health crisis in order to minimize the need for sending them to the overcrowded and understaffed psychiatric hospitals.

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