Senate plan adds mental health dollars

Aim is to keep dangerous people off street in treatment



TACOMA — As state senators proposed cuts in social services this week, one area gained ground: money for treating mental illness.

Budget writers understand how crucial this spending is in preventing dangerous people from being on the street instead of in treatment, The News Tribune reported in Sunday’s newspaper.

“We had to put some resources there, or there would be no room at the inn for people who were in serious trouble,” Hoquiam Sen. Jim Hargrove, lead budget negotiator for the Democrats, said Friday night after senators approved the Republican-flavored plan.

The Senate proposal and Democratic Gov. Jay Inslee’s spending plan both spend nearly $16 million to avoid making mental health treatment backlogs any worse. And lawmakers have proposed loosening standards in detaining patients with mental illness. Existing standards are seen as too high to catch some dangerous people.

The two budgets also add $2.6 million to cover state psychiatric hospitals’ unexpectedly high overtime costs. And they agree to add millions over the next two years for fences, metal detectors and other equipment, as well as extra nurses and security personnel.

Budget cuts in previous years put workers on unpaid furloughs, leaving holes in hospitals’ schedules even as they scrambled to ramp up staffing to respond to a pair of homicides last year at Western State Hospital in Lakewood and Eastern State Hospital near Spokane. Western State also had a suicide, and Eastern State briefly had its accreditation suspended.

“You can’t flip a switch and hire new staff,” Jane Beyer, head of behavioral health within the Department of Social and Health Services, said in an interview, “so you need to ask your existing staff to work more.”

That overtime led both the state hospitals to overspend by millions, Beyer told lawmakers at a recent hearing. She said monthly overtime costs varied widely from a bit more than $300,000 in April 2012 to more than $1 million in December.

The most costly part of the Senate’s and Inslee’s budgets for mental health is the new standards for involuntary commitment of patients. Lawmakers voted to change the rules in 2010 but never funded them. This year the House and Senate have agreed to let the changes finally take effect in 2014.

The new rules would allow more consideration of patients’ past behavior in addition to the immediate threat they pose.

To cope with the likely influx, DSHS plans to add three freestanding 16-bed evaluation and treatment centers. Similar facilities exist around Washington.

None of the budget plans would open more wards at the state hospitals. Nor will the House push for more wards, lawmakers said. “Our philosophy is to stabilize the state hospitals — stop adding, taking away,” said Rep. Tami Green, D-Lakewood.

A trickier goal is helping patients who might already be eligible to be committed, but who sit in local emergency rooms because of a lack of space.

No budget plan so far has called for additional evaluation facilities to take the burden off emergency rooms, but Green said Friday that House Democrats’ budget is likely to have capital-construction money for new facilities. She expects rural hospitals to apply.

Another proposal that might help with the backlog: The Senate budget calls for nearly $1 million for a DSHS-backed measure passed in different forms by both the House and Senate that would start the process of funding long-promised facilities for patients who can be moved out of state hospitals.