Legislators advance mental health plan, debate privatization

Treatment for civilly committed patients would transfer to a network of smaller regional facilities.

By Tom James / Associated Press

OLYMPIA — A proposal for a statewide network of community mental health facilities advanced on a bipartisan vote Friday amid questions over whether they should be publicly operated.

The bill that advanced unanimously from the Health Care and Wellness Committee is one of a pair of linked measures that seeks to implement plans proposed by Democratic Gov. Jay Inslee. The measures would respond to the state’s mental health crisis by transferring treatment for capacity for civilly committed patients from two mental hospitals to a network of smaller regional facilities.

But while lawmakers from both parties have broadly embraced the idea, leading Republicans and Democrats said who would run the facilities remains an open question.

“We haven’t made any final decisions,” said Sen. David Frockt, D-Seattle.

Options include having the facilities be managed by the state, by community-based nonprofits or by existing hospitals, said Sen. Manka Dhingra, D-Redmond, who has taken a leading role on the issue in the Senate.

Democrats currently control both halves of the state Legislature, and numerous lawmakers from the party said this week they were open to a mix of state and locally managed facilities. That matches language in Inslee’s latest proposal, although he originally called for an entirely state-run network.

But University Place Sen. Steve O’Ban, a Republican active on the issue, said he wanted the state out of running the facilities entirely, citing failures including assaults and escapes at the state’s largest psychiatric hospital, Western State.

“If I had my druthers none of them would be state-run,” said O’Ban.

O’Ban has introduced a bill that would allow nonprofits and for-profit businesses to qualify to run the facilities. Independent operators would be licensed by the state, then kept in line by the threat of closure.

“If they fail, you bring in another,” O’Ban said.

The proposed network of new facilities is a key part of lawmakers’ response to the state’s long-running mental health crisis.

Western State Hospital, Washington state’s largest psychiatric facility, has long garnered scrutiny from federal officials over safety issues and understaffing, highlighted by assaults on staff and patient escapes, including one man in 2016 accused of murdering a woman by tying her up, stabbing her 24 times and slashing her throat.

In 2018, despite improvement efforts, federal authorities declared conditions had gotten so bad that they cut the hospital’s accreditation and $53 million in federal funding.

But local, independently-run facilities haven’t been immune from problems either.

In 2016 disability rights advocates asked courts to block new patients from being sent to a Yakima facility run by Central Washington Comprehensive Mental Health, a local nonprofit, because it was unsafe.

A U.S. District judge agreed and partially closed the facility, operated in a building formerly used as a jail, after finding parts of its layout could facilitate suicide attempts.

While the question of who will run the facilities remains open, lawmakers involved in the discussions said it wouldn’t derail the proposal, which has prominent signers from both parties, including O’Ban, who said he favors the plan overall.

“It’s around the edges – for the most part, we’re together,” Cody said.

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