Although improvements have been made and Gov. Jay Inslee is quick to trumpet those improvements, much work remains to be done at Western State Hospital.
The state’s largest psychiatric facility, located near Tacoma, still is subject to staffing shortages, budget debates in the Legislature and questions from the federal government about the quality of care provided. In the process, it serves as a harbinger for the effectiveness and efficiency of Washington’s state government and that government’s ability to serve and protect its most vulnerable citizens.
Last week, Inslee visited the troubled 800-bed hospital and highlighted some of the progress that has occurred. In recent months, he noted, 388 positions have been filled, leaving about 60 needed hires to bring the facility to full staffing. That represents a strong first step for a hospital that remains under federal oversight and has been subject to a series of embarrassing court rulings regarding the state’s failure to meet the needs of patients. A report last year found that 165 patients were on the “ready to discharge” list, but with no appropriate place for them to go, they waited an average of 176 days to be released.
Inslee’s approach has focused upon new leadership, safety improvements, and competitive pay to retain staff for work that is emotionally draining and often thankless. New labor agreements with psychiatrists and registered nurses are among the contracts the governor’s office negotiated last year with public-employee unions, and while they represent progress for the hospital, they also point out an ongoing issue for the state.
Negotiations with unions are cloaked in secrecy and then sent to lawmakers for an up-or-down vote. That limits lawmakers’ ability to react when the need is greatest — for example, psychiatrists and nurses at Western State — while limiting pay increases in less competitive fields. Sen. John Braun, R-Centralia, the Senate’s top budget writer, told The (Tacoma) News-Tribune, “In the perfect world, we’d be able to isolate where we have employee turnover problems and emergent state needs.”
Indeed. Republicans in the Legislature should continue to push for reforms in the negotiating process while seeking increased transparency. Determining priorities when it comes to contracts for public employees should require input from the public in the form of that public’s representatives, rather than being held behind closed doors.
That issue extends well beyond Western State Hospital, and it represents only one part of what must be a multi-pronged approach to the facility. In recent years, federal auditors have decried conditions there, and an inspection expected in the next couple months could jeopardize $64 million in annual funding from the feds. The Legislature deserves part of the blame for this situation, having slashed funding for Western State by more than 10 percent during Recession-era budget cuts. Inslee rightly notes the dangers of running a state hospital “on the cheap.”
That budget cutting helped create a situation in which mentally ill patients were boarded in hospital emergency rooms or jails that were ill-equipped to treat them, an approach that has been struck down by the courts. And still, the state is struggling to find an adequate solution.
All of this points out Washington’s shameful inattention to a population that is among our most vulnerable. Providing protection and assistance for the mentally ill counts as one of society’s most basic duties. Washington has made strides in that regard, but there still is much work to do.