State lawmakers agreed this month for the second year in a row to spend more money to keep mentally ill patients from sitting parked in local hospitals for days awaiting treatment.
Much of the money will pay for the operation of more detention beds. But this time, the Legislature didn’t approve any money to build space for the beds.
“It will be hard for everybody to work around that,” said Jane Beyer, an assistant secretary at the Department of Social and Health Services. “We’ll be doing a lot of hard thinking.”
Lawmakers usually pass a capital budget that funds construction and other one-time projects. But lawmakers skipped it this year for the first time since 1996.
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Beyer and others were pleased with the funding that did come through. Local agencies are in line to get $7.3 million from the main state budget, now awaiting Gov. Jay Inslee’s signature, to operate extra space and services.
The funding is designed to take pressure off Western State Hospital in Lakewood and Eastern State Hospital near Spokane, both stretched thin after years of state cuts. Emergency rooms and even jails have had to pick up the slack.
“It’s sort of a widely shared community shame in this state and in many states that our largest mental-health facilities are our jails and prisons,” said Don Sloma, Thurston County’s health and social services director.
Some of the money isn’t dependent on construction. A share was earmarked for Pierce County to add a second team of interdisciplinary professionals available around-the-clock for outreach to high-risk patients. The new Pierce team and another one slated for Eastern Washington might each serve up to 50 patients, while a larger one for King County might serve as many as 100 patients.
There’s also money directed to the north Puget Sound area, Grays Harbor County and Eastern Washington that Beyer said could allow local agencies to team up with providers of housing.
But in a state that has among the fewest psychiatric beds in the country as a share of population, the most obvious way to keep people from languishing in emergency rooms is to add beds.
So lawmakers called for operating at least an extra 48 beds this year for people whose mental illness is severe enough for them to be involuntarily detained. Three areas are supposed to each get a 16-bed facility — King County, Thurston and Mason counties and a swath of rural Eastern Washington.
Sloma, whose agency in Thurston and Mason counties already oversees a similar facility in Olympia, said the extra capacity is sorely needed. It’s also supposed to help people in the counties to the south and west, Beyer said.
The money for beds isn’t necessarily unusable just because the state isn’t providing construction money. Agencies may be able to use some existing facilities, Senate budget chairman Andy Hill said.
“You can do an awful lot without making those capital investments,” Hill, R-Redmond, said after announcing the final budget deal.
Said Sloma: “It’s possible to lease facilities and renovate them … and there are also capital resources that are available from other sources that we might be able to use if that becomes necessary.”
The possibilities are still being worked out by officials around the state, said Beyer, who met Thursday with officials from regional mental-health agencies. “They do have real concerns about the capital budget not having passed,” she said.
Certainly Tacoma, the biggest beneficiary of beds from last year’s infusion of money by the Legislature, was lucky a capital budget passed that year.
Remodeling is due to start this week inside the MDC headquarters in downtown Tacoma to create a 16-bed evaluation and treatment facility there. It would be the third of its kind in Pierce County but the only one in Tacoma. (Olympia has one, too.) The small size allows the state to pull down federal Medicaid money to match its own spending.
Troy Christensen, chief of operations and strategy for MDC, formerly known as the Metropolitan Development Council, said the facility has to be self-contained and secure, with new wall and ceiling coverings that can stand up to damage.
Making it happen took a $1.3 million grant from the state capital budget on top of $4.9 million of state and federal money from the state operating budget.
The center will be housed on the first floor of the building at 721 S. Fawcett Ave., where the agency provides drug detox and other services.
Other grants from last year’s capital budget went to hospitals in Sunnyside and Kirkland and to the Thurston-Mason agency, which is considering where to put a facility that would allow officials to triage cases of people showing bizarre or threatening behavior.
Last year’s capital grants went to creating 56 new beds, according to the Department of Commerce.
Capital money failed to emerge this year because Republicans in the Senate couldn’t work out a deal with Democrats in the House.
Democrats made a last-minute procedural move to force the Senate to agree with the House’s version of the capital budget, but the mostly Republican majority voted down that version. Sen. Joe Fain, R-Auburn and the majority floor leader, calls the House version a “bloated, irresponsible budget.”
“I think the Republicans never wanted to pass a capital budget,” said Rep. Hans Dunshee, the House capital budget chairman and Snohomish Democrat, who said there were no serious negotiations. “I just think they were there to get out of there as fast as possible.”
Sen. Bruce Dammeier, R-Puyallup, said the talks ran into big disagreements about school construction and a planned State Patrol building, and the House refused to pass a “skinny” budget containing areas of agreement — “including almost all of the mental health treatment,” Dammeier said.
Dunshee said that offer came at the last minute, and he doesn’t recall the other side agreeing on mental health funding. The breakdown, he said, reflected the tone of the 60-day session. “It was pretty much a ‘let’s do nothing and work real hard at doing nothing’ session,” he said.
But lawmakers from both parties agreed the mental health funding included in the operating budget was a bright spot.
The Legislature chipped in more than $22 million total, including money to settle a lawsuit on children’s treatment and to cover overtime costs at the state hospitals.
“Maybe we’re making little tiny dents,” Rep. Dawn Morrell, D-Puyallup, said.
“We’re grateful the Legislature is addressing the need,” Sloma said of the extra 16 beds for Thurston County. “But I would hate for the public or for anyone who is interested in this to believe that, well, we’ve solved the problem. It’s so much bigger than 16 beds will fix.”