In addition to an ambitious plan for fully funding schools and introducing a carbon tax upon polluting companies — which was discussed in Wednesday’s editorial — Gov. Jay Inslee has proposed an increase in funding for the state’s two psychiatric hospitals. The proposed supplemental budget, which lawmakers will consider during the 2018 legislative session, calls for an additional $106 million for the facilities.
There is, undoubtedly, a need for change in Washington’s mental health care. But the governor must convince legislators and the public that an increase in funding is not simply a matter of throwing good money after bad. Persistent problems at Western State Hospital near Tacoma, Washington’s largest mental health facility, speak to a need for systemic improvements rather than simply trying to fix the situation with more funding.
Last month, Western State Hospital, an 850-bed facility, entered a second improvement agreement with the federal Centers for Medicare and Medicaid Services. At risk is about $60 million in federal funding that has been threatened because of poor oversight at the hospital. The latest agreement followed a federal survey that found 57 deficiencies at the site and gave administrators until May to fix the problems.
In addition, a separate federal court ruling has resulted in the state being fined $3 million a month over a failure to provide treatment for criminal defendants deemed incompetent to stand trial. Although this issue has been in the courts for several years, there are few signs of improvement. In March 2015, 83 citizens were waiting to be admitted to Western State Hospital for treatment to have their competency restored; now that number is more than 170.
In the process, Washington is poorly serving vulnerable citizens who are in crisis. The state’s mental health system has repeatedly been rebuked by the courts, and increased funding has not provided solutions. Since 2016, the Legislature has invested more than $150 million in the state’s mental health system, and this year lawmakers approved nearly 150 more staff members at Western State Hospital.
As The Seattle Times wrote editorially: “The hospital must enact other changes to ensure these investments don’t go to waste. For instance, the hospital still has no staffing plan in place to ensure employees are being used effectively and deployed where they are most needed.” The lack of planning results in excessive overtime expenditures and in one-on-one supervision for patients who do not require it.
Inslee’s proposed supplemental budget calls for $33 million to cover such cost overruns, but improved management and scheduling could render that unnecessary. The federal survey determined that Western State Hospital does a poor job of monitoring its care standards and its own operations; any additional expenditures must be accompanied by reforms that shore up management of the facility and ensure that money is being spent effectively.
To be fair, it must be noted that Inslee inherited many of the problems at Western State Hospital. But those problems have continued to linger — and have worsened in many cases — despite much attention from the Legislature and sharp increases in spending. The lesson has been that throwing money at a problem is not in itself a solution.
Lawmakers next year should focus upon systemic changes that will result in real improvements for vulnerable citizens and insist upon strict quality-control measures at the state’s psychiatric facilities.
