Pierce County will close down most of its mental health services and lay off 130 employees next month as the state and a private contractor seek to revamp services here.
The reshuffling of services will affect thousands of people suffering mental health crises, many of them a danger to themselves or others.
State officials say the quality of care for those patients will not suffer.
“The county is not losing any services,” said Doug Porter, an assistant secretary at the state Department of Social and Health Services. “We hope the quality of care is the same if not better.”
County officials – who bargained unsuccessfully to keep the existing system – sounded less confident.
“All we can go on is the assurances we’ve been given by the state,” said Deputy County Executive Kevin Phelps.
Pierce County provides inpatient and crisis services to thousands of people each year. Among the services it offers:
• A 30-bed evaluation and treatment center for voluntary and involuntary patients. The center admitted 793 people last year and 419 people through the first six months of this year. About 85 percent of patients are involuntarily committed because they pose a danger to themselves or others or because they are gravely disabled.
• An 18-bed crisis triage center. The center admitted 3,562 people last year and 1,803 people through the first six months of this year. About 35 percent of people admitted to the center are brought in by police officers. Others are diverted from community hospital emergency rooms, which are not equipped to treat mentally ill people who are manic, loud, violent or otherwise disruptive.
• A 24-hour crisis telephone line for emergencies, information, referrals or phone counseling.
• Mobile outreach crisis teams that provide mental health services in Pierce County from 7 p.m. to 7 a.m. and on weekends.
State officials say they will not reduce the level or quality of services Pierce County provides. But beginning Oct. 1 those and other services will be provided by a variety of new contractors to be announced as soon as today.
The move follows months of negotiations and is driven in part by efforts to obtain more Medicaid funding during a tight budget season. The federal program will pay only to care for low-income patients housed in facilities of up to 16 beds. Pierce County Mental Health operates 48 beds.
OptumHealth, the for-profit company that administers Pierce County mental health services for the state, asked county officials to continue serving as one of several service providers. The company asked Pierce County to provide a 16-bed facility.
But Pierce County officials say a facility that small wouldn’t pencil out because the county would lose economies of scale. Phelps said operating a 16-bed facility would force the county to subsidize mental health – which county officials maintain is a state responsibility – to the tune of $2.6 million a year.
Pierce County offered to take a 9 percent state funding cut and maintain the same services. But OptumHealth and the state ultimately said no.
“Pierce County can’t be in the business of providing a narrow set of services,” said County Executive Pat McCarthy. “The model we built has been very successful for us. Optum feels there are other providers out there that can deliver these services.”
Now the county will lay off about 130 employees as it ends nearly all of its mental health services. It will still provide mental health care to inmates at the county jail.
County officials notified employees of the layoff Thursday afternoon. State and county officials say some of the employees may be hired by the new mental health services contractors.
Now the parties are trying to ensure a smooth transition to the new system that begins Oct. 1.
During the transition Western State Hospital will accept some patients that otherwise might have gone to Pierce County’s facility. That interim facility will have 45 beds – three fewer than Pierce County provides. But in the long run there will be about 48 beds, according to MaryAnne Lindeblad, director of DSHS’ Division of Health Care Services.
Another concern: ensuring hospitals and police agencies can continue to bring mentally ill people directly to mental health facilities, instead of taking them first to the emergency room or to jail. Porter said hospitals and police will still be able to do that.
McCarthy said her goal is to protect patients and support county employees. She also wants to support hospitals, police and others with a stake in the mental health system.
“I want folks to feel confident that we’re working in those interests,” McCarthy said.
The reshuffling of crisis services is just the latest jolt to Pierce County mental health services.
Two years ago Pierce County announced it would stop administering mental health services for the state. County officials said the Legislature was not providing enough money.
As a result, the state contracted with OptumHealth this year to administer those services.
David Wickert: 253-274-7341