In Our View: Vulnerable people stuck in the hospital

Clark County’s two hospitals – Legacy Salmon Creek Medical Center and PeaceHealth Southwest Medical Center — are busy places. So busy, in fact, that it is not uncommon for patients to have to wait for hours in the Emergency Department until a bed becomes available on an inpatient floor.

A part of the reason these beds are full was highlighted in a recent story by The Columbian’s Brianna Murschel. The hospitals have been inadvertently turned into long-term care facilities for people with intellectual or developmental disabilities who don’t need acute care, but have nowhere safe to go. In one local case, a person spent six months in the hospital until a more suitable placement could be located.

Although that length of stay is unusual, even a short-term hitch in finding a good placement is a loss for the hospital, which has trouble recovering its costs to provide services to a person who isn’t in need of inpatient care. It’s a loss for the general public, who needs access to hospital beds, sometimes on short notice. And most of all, it is a loss to the disabled person, who is denied basic comforts including activities, freedom and fresh air.

Here’s how these cases can arise: a person with a permanent developmental or intellectual disability they’ve had since childhood, such as cerebral palsy or autism, arrives at the hospital. They may have a medical need, or perhaps their caretaker is no longer able to safely care for them. They’re admitted, but can’t be discharged until there is an adequate care plan. So they end up staying in the hospital indefinitely. According to the state’s 2023 report covering Southwest Washington and the Olympic Peninsula, three adults ended up residing in a medical hospital, and another 22 lived in a psychiatric hospital. That’s out of 1,768 clients served by the Developmental Disabilities Administration, which is part of the Washington State Department of Health and Social Services.

Noah Seidel, who advocates for these patients from Southwest Washington, said he’s worked with people who have lived in hospitals anywhere from a week to more than a year.

“It’s a housing issue — having enough apartments and homes that providers can help people get in supportive living,” he told Murschel.

According to a 2019 study, Washington ranked 30th among the states in supporting people with intellectual and developmental disabilities.

Luckily, there are advocates, starting at the hospital, where discharge planners are eager to get people out of their beds and into the right environment. Seidel’s office is another advocate, and so is the nonprofit Arc of Southwest Washington. “Usually, these families have desperately sought out assistance,” explains Stacy Dym, executive director of the The Arc of Washington State. “They sort of know what they need, and the system has failed to provide that before it got to a crisis situation.”

Finally, a local organization called Peace NW helps individuals with intellectual or developmental disabilities walk the complicated path to housing, personal care and benefits. Darla Helt, executive director, points out that every case is different. “You can’t create a road map,” she said.

The common denominator in all of this seems to be the lack of available, suitable housing. With the state already short of housing for other people in need, including older adults and people experiencing homelessness, it’s difficult to focus on better serving this small but important, and vulnerable, population. But suppose it was your relative that needed housing or a hospital bed?