Many state lawmakers say Washington needs more mental health facilities to unclog backups for psychiatric services.
To help fix that, a group of legislators have proposed asking voters later this year to approve $500 million in bonds to pay for a variety of mental health projects such as crisis centers and transitional housing.
The measure has drawn some praise but also concerns from the Republican state treasurer over whether the plan’s borrowing strategy is fiscally responsible.
State Sen. John Braun, a Centralia Republican who sponsored the legislation, said his bill is necessary to kick-start a bipartisan effort to build mental health facilities around Washington that take pressure off overburdened Western State Hospital.
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Western State, a roughly 800-bed psychiatric facility in Lakewood, is facing federal demands to improve patient care and federal court orders to speed up services for mentally ill defendants.
Despite hundreds of millions of dollars spent on the mental health system in recent years, Western State still faces an uphill battle toward compliance. The situation was partly created by years of budget cuts during the Great Recession.
“We have a long-term history of under-investing in mental health facilities and operations,” Braun said in a Friday interview. “We’ve worked in a bipartisan basis over the last two bienniums to ramp up the funding, and I think that’s the right thing, but ... we’re still not getting there.”
Braun’s effort has already won support from some Democrats in the Senate as well as positive early reviews from key lawmakers central to mental health reform at the Capitol.
State Rep. Eileen Cody, a Seattle Democrat who chairs the House Health Care & Wellness Committee, said Braun’s measure could be used to supplement any upgrades of the mental health system approved by the Legislature this year and beyond.
Cody said in a Friday interview she wanted to learn more about the bond process through which Braun’s bill is funded but said it could “maybe accelerate the ability to make the changes that we need to make.”
Lawmakers have been working toward reshaping Western State and Eastern State Hospitals in order to improve quality of care and safety concerns while decreasing wait times.
The state’s primary psychiatric hospitals currently serve two sets of involuntarily committed patients: forensic patients who have been charged with or convicted of a crime, and civil, noncriminal patients.
U.S. District Court Judge Marsha Pechman has ruled Western State has been taking too long to evaluate forensic patients and restore their competency to stand trial. Such wait times can leave such patients waiting in jails for treatment.
Compounding the situation has been a recent influx in new forensic patients in Washington.
To free up more beds at Western State, the Legislature has been trying to move nearly all civil patients into other treatment facilities across the state. Lawmakers contend the move is a win-win, saying civil patients are better treated closer to home rather than at a central location.
Legislators have also spent money on other services, such as crisis walk-in centers, meant to stave off mental health problems before they become serious enough to warrant involuntary commitment.
To facilitate the shift at Western State and improve safety and quality of care issues, legislators approved more than $100 million in new money for mental health along with raises for front-line nurses at Western State during the 2017 legislative session.
Lawmakers on Thursday also approved a roughly $4 billion construction budget that had more than $130 million for community mental health projects and renovations and other upgrades at Eastern State and Western State hospitals.
That money had been held up for months over a rural water rights dispute between Republicans and Democrats.
Braun said those investments still are not enough, and money needs to be set aside “to get us ahead of the problem and really fix it.”
“It’s easy to say well we need to get folks out of Western State and Eastern State and get them in our communities,” he said. “But if you have no place for them to go it’s not a workable strategy.”
The biggest questions to arise so far on Braun’s bill center on how it’s paid for.
If approved by voters, the bonds would not apply to Washington’s constitutionally set debt limit, which governs how much the state can borrow for construction projects.
State Treasurer Duane Davidson, a Republican, said in an emailed statement that he understands “the need for more mental health treatment in our state” but that he would prefer to see the money come from within existing dollars that aren’t exempt from the debt limit.
“As the State Treasurer, our state’s high debt load already worries me and adding an additional $500 million to that should be of concern,” Davidson said. “There are so many valuable projects that require funding around the state ... I just hope that we can get away from the need to bond so many of them.”
Braun said he agrees with Davidson “in principle” but said his bill is necessary to set aside money specifically for the mental health construction projects. That way, he said, lawmakers don’t have to balance mental health money with other priorities such as school construction and environmental projects.
“I felt like this is something that really deserves additional attention,” Braun said.
Braun said he believes curbing wait times and treating people before they need to be committed to state hospitals also will save money in the long run.
State Sen. David Frockt, a Seattle Democrat and the top co-sponsor on Braun’s bill, said he also wants to see a larger investment in mental health facilities.
But Frockt, the top Senate negotiator on the construction budget, said he’s open to hearing concerns about the debt limit and didn’t rule out fully or partially funding the mental health projects within the debt limit. Construction bonds within the debt limit don’t need voter approval.
“It’s important to put out big ideas and then work them,” he said.
If lawmakers approve the measure, voters will ultimately have a say on the November 2018 ballot.
Braun’s pitch to voters: “It is the humane thing to do. These are truly vulnerable people, they are struggling with mental health issues and the right thing to do is to take care of them and the right way to take care of them is in our communities.”