Gov. Jay Inslee is seeking a $300 million revamp of Washington’s mental health system that has been plagued by safety and capacity issues for years.
The governor Wednesday unveiled a plan that includes reshaping the state’s two psychiatric hospitals, Western State and Eastern State, to reduce an overload of patients.
Inslee’s proposal would shift nearly all civilly committed — or noncriminal — patients at the hospitals to other treatment centers around the state by 2020. The two hospitals currently have about 830 beds for such patients.
For years, the state has been trying to find places outside state hospitals to send patients who are ready to be discharged but still need a place where they can continue mental health treatment. Some patients also have been held in area hospital emergency departments — a practice known as “boarding” — while waiting for a bed to open up at Western State.
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Inslee’s proposal tries to tackle that capacity problem while simultaneously opening up space for forensic, or criminal, patients at the hospitals. That population — now about 400 at both hospitals — is growing, said Western State CEO Cheryl Strange.
In part, Inslee is aiming to fund nine new 16-bed treatment centers around the state. He also would increase psychiatric beds in local communities by sending more money to public and private care organizations to increase their capacity. In all, the governor’s budget would add about 1,000 new beds.
“We are not just nibbling on the edges,” Inslee said Wednesday. “We are transforming this system, starting today.”
The governor painted the change as one that will move Washington more in line with how other states serve people struggling with mental health issues.
Western State, located in Lakewood, is one of the largest psychiatric hospitals in the country. It has faced quality-of-care issues and safety concerns for years, drawing federal scrutiny that requires improvement for the facility to continue getting millions of federal dollars.
A report released in September says staffing cuts and poor management, particularly during the Great Recession, have caused safety and morale issues.
Though Washington has put about $145 million toward the mental health system since 2015 to fix issues, Inslee pledged on the campaign trail in his re-election effort this year to find more money for new staff and other upgrades in the system. He now is seeking about 700 new staff positions in the state’s mental health system, including staff at Western.
Strange heralded Inslee’s proposal.
“There is not enough beds and they should be in people’s home communities,” she said.
Creating more beds around the state instead of adding beds at Western State is a plan that some in the governor’s office and the Legislature have been pondering for a while.
Just one issue with the large, centralized hospital: It’s difficult for patients who are from Snohomish County, or even farther away from the Lakewood site, to maintain connections with family and friends and to find housing and employment, said Andi Smith, a senior policy adviser to the governor.
During the last legislative session, Republican state Sen. Andy Hill, R-Redmond, sought to reduce the number of patients at Western State in part by giving money to regional organizations to handle some patient care. Inslee vetoed that measure.
Hill died of cancer in late October.
The mental health investments were part of Inslee’s final unveiling of his two-year $46-billion spending plan that mainly aims to overhaul the state’s education system.
The plan would rely on $4.4 billion in new tax revenue, much of which would come from new taxes on capital gains and carbon emissions. About $2.3 billion would come from hiking the business and occupation tax for service businesses from 1.5 percent to 2.5 percent.
The vast majority of the new revenue — about $3.9 billion — will go toward K-12 schools, addressing a court ruling that says the state is failing to fully fund education while also increasing spending on other school needs, Inslee said.
The plan includes money for a freeze on college tuition. It calls for helping 14,000 more students pay for college through the state need grant.
The governor’s capital and operating budgets would also spend about $120 million to combat homelessness. His capital budget for construction and building projects would fund about 1,700 affordable housing units.
Already, the taxes in the governor’s plan are proving hard for Republicans to stomach.
State Sen. Mark Milosica, a Republican from Federal Way who is vice chairman of the Senate’s Human Services, Mental Health and Housing Committee, said he is not against the concept of shifting non-criminal patients away from the state hospitals or providing more staffing for the mental health system.
But he criticized Inslee’s overall budget plan, which he said wasn’t a sensible proposal.
“If (additional mental health money) is in the context of pretending we’re going to pass three new huge tax increases it’s hard to talk seriously about it,” Miloscia said.
State Sen. John Braun, a Centralia Republican who is the Senate’s lead budget writer, said that after two years, the proposed taxes in the governor’s plan would balloon to $8 billion every two-year budget cycle.
He called Inslee’s proposal a “wish list” and “not very helpful in coming up with a solution for the state.”
Democrats, who own a majority in the House, and Republicans, who control the Senate, each release budget proposals of their own during the legislative session, which begins on Jan. 9.
“The governor’s got an easy situation,” Braun said. “He’s only got to get one guy to vote for his budget. We’ve got to get 25 (votes) in the Senate and 50 in the House.”