Two units used mainly for elderly patients with dementia are among the five wards of Western State Hospital that would be mothballed under the plan. Many of those patients have histories of aggressive behavior, and employees who work in those wards described daily battles with the most volatile of them who punch, kick and scratch their caregivers.
Repeating the concerns of fellow employees after a staff meeting Monday to brief them on the cuts, counselor James Robinson, president of Washington Federation of State Employees Local 793, said: “They said, ‘If some of these patients go to a nursing home, they’re going to kill those people.’”
State government would save millions from the closures that would allow them to eliminate about 220 jobs. Gov. Chris Gregoire will consider the idea among many other unpalatable options as she writes a proposal for how state lawmakers can cut as much as $2 billion in an emergency budget session.
While state agencies are pitching some of the ideas to Gregoire as options to be avoided rather than proposals they are endorsing, the hospital stands behind these.
Hospital CEO Jess Jamieson said the loss of staff would be difficult. About 100 Western State employees have been laid off since budget cuts began three years ago, the hospital says, with some of them able to find new jobs in state government. The layoffs haven’t helped an unemployment rate in Pierce County that climbed just shy of 10 percent last month.
But Jamieson said the patients being proposed for discharge are ready for community settings – if there were places available and equipped to deal with them.
That’s a big “if.” Many patients are there because nursing homes and homes run by caretakers can’t handle them. A couple of state senators who attended Monday’s meeting, Republican Mike Carrell of Lakewood and Democrat Steve Conway of Tacoma, said they doubt that will change.
Hospital officials said no one would be simply dumped into a home. Releases would be phased in as places open up for patients and a portion of the money saved by closing the wards would pay for the community care. Western State Hospital, as of Monday, had 528 patients.
“As long as you increase community services to meet the needs of these folks,” medical director Brian Waiblinger said, “I think it’s a doable plan.”
The Department of Social and Health Services would have to develop plans for 90 mostly younger patients, whom Jamieson said are ready to be discharged but lack the right housing or safety net in the community, or have histories of violent behavior. And they would have to do the same for about 30 patients proposed for release from Eastern State Hospital in the Spokane area.
Workers’ worries ran especially high over the 60 patients in special wards primarily for people older than 50, many with dementia and some with traumatic brain injuries. The federal government has stopped paying for them because they can’t be rehabilitated at a hospital.
The department would come up with a plan for helping nursing and adult-family homes develop the credentials or insurance necessary to accept patients who might lash out, Waiblinger said.
It’s unusual in other states for state psychiatric hospitals to care for people who have dementia and brain injuries, Jamieson said.
But union leaders said people don’t want their elderly parents or grandparents living in homes with potentially dangerous patients.
Scott Ault, a mental health technician at the hospital who also works at a nursing home, is taking a wait-and-see attitude about the proposal’s merits, but said nursing homes aren’t capable of handling the elderly patients he sees.
Helping them with personal hygiene requires multiple staff to make sure no one is hurt, he said.
“I’m just not sure how cost-effective it would be when people start being assaulted in the community,” he said.
Jordan Schrader: 360-786-1826
jordan.schrader@thenewstribune.com
blog.thenewstribune.com/politics
