Part of the answer to Washington state’s mental-health crisis could be found in a mothballed fabric and craft store in Spanaway.
Community health centers are asking the Legislature to put $15.1 million in the 2019-21 capital budget to expand behavioral health services around the state. Behavioral health focuses on serving people with mental health or substance abuse challenges or both. The state’s two-year capital budget pays for bricks-and-mortar projects.
Among the 22 projects that would be funded with the requested money is a $1.25 million proposal to renovate the former Jo-Ann Fabric store on Pacific Avenue South in Spanaway.
Two nonprofit agencies based in Tacoma — Community Health Care and Comprehensive Life Resources — would serve patients from the Spanaway and Parkland areas in the same clinic.
The goal is to catch behavioral health challenges before they become more severe. If lawmakers provide the funding, community health center officials say they will be able to provide behavioral health services to 19,000 more patients statewide.
“The most cost-effective place to address behavioral health is at the front end, and that’s where community health centers are well under way in integrating behavioral and physical health,” said Dekker Dirksen, director of public policy for the Community Health Network of Washington.
The funding request comes as legislators decide whether to study building a new Western State Hospital and consider Gov. Jay Inslee’s multimillion-dollar proposal to build nine smaller facilities around the state for mentally-ill patients who are committed through the civil court system.
Key lawmakers have said overhauling the state’s troubled mental health care system is a top priority, although there is not a bipartisan agreement on how to pay for it.
Community Health Care offers primary care to anyone, with a special emphasis on those covered by Medicaid or who are uninsured or under-insured, said David Flentge, the agency’s president and chief executive officer.
“They come to see us for diabetes. They come to see us for asthma. They come to see us for routine health care check-ups,” Flentge said.
It’s the job of behavioral health consultants at Community Health Care to assess patients for mental health and substance abuse issues.
If long-term behavioral health care treatment is needed or if patients need more intensive services, they are referred to Comprehensive Life Resources.
Comprehensive Life Resources is a nonprofit behavioral health agency that has a variety of clinical staff members who can help patients with mental illnesses, including bipolar disorder and schizophrenia. It also provides intensive substance-abuse counseling.
“There are two challenges in making referrals to providers. One is literally pragmatics — bus lines, people having the money to get on a bus or schedule para-transit to get to that appointment,” said Kim Zacher, the Comprehensive Life Resources chief executive officer. “There’s also the fear factor. In our country, only about half of the people who need mental health services receive them. One side of that is there’s not enough services available.
“But another big part of it is it’s hard for people to take that step.”
When people meet with their doctor and confide they are dealing with severe depression, that’s the moment they need help, Zacher said.
That’s where the former JoAnn Fabric store owned by Goodwill would enter the picture. A person who comes to Community Health Care for a check-up can walk down the hall if they need longer-term or more intensive behavioral health care treatment
“There can be fear about disclosing something to somebody you don’t know,” said Marjorie Page, a behavioral health manager at Community Health Care. “What happens in this kind of setting is that we are able to say, ‘Hey, there’s a therapist here named Karen that I know really well, and she’s fabulous and I think you should go and see her.’”
The proposed location was chosen because the Spanaway and Parkland areas need behavioral health services, Page said.
If the Legislature provides the $1.25 million, the former store would be renovated for treatment and group-therapy rooms, health care examination rooms, offices for primary health and behavioral health employees and a pharmacy.
Legislators are crafting their own version of a capital budget.
Sen. Steve Conway and Rep. Steve Kirby, both Tacoma Democrats, have asked for the project to be included in the new version of the bill that will be released within weeks.
“It’s hard to tell how it’s going to turn out,” said Kirby. “My job is to go around or through any obstacles to getting the funding.”
The Community Health Network of Washington has asked legislators to push for the remaining $13.8 million for the projects in their districts. The health network is making the capital budget request with the Washington Association for Community Health.
Sea Mar Community Health Centers is requesting $500,000 to expand its behavioral health clinic in Bellingham.
The project is needed because “patients need services to address anxiety, depression, trauma, and psychosis to improve level of functioning,” according to a synopsis provided to legislators. “This population includes individuals with severe and chronic mental illness (often with psychosis) who require services from a mental health therapist and psychiatric provider frequently in order to maintain them in the least restrictive environment, avoiding repeated hospitalizations.”
Rep. Steve Tharinger, the Sequim Democrat who chairs the House Capital Budget Committee, said decisions have not been made on funding requests. Tharinger said he expects a new version of the capital budget bill will be released late this month.
“The good news is the Legislature is looking at a comprehensive strategy dealing with behavioral health and it’s bi-partisan and bi-cameral,” said Tharinger, referring to both the House and Senate.
Decker, the director of public policy for the Community Health Network of Washington, said a large chunk of the increased spending on behavioral health that Inslee has proposed in the operating and capital budgets is focused on the “crisis” end of the spectrum.
The governor’s proposed capital budget calls for spending $33.5 million at Western State for critical infrastructure and building improvements and another $46.5 million to address short-term bed shortages and add modern treatment space.
Inslee also has called for spending $110 million on grants to community hospitals and private health care providers to help them add beds, so civil patients don’t have to be sent to state hospitals and current patients can be released from them.
Decker said community health centers provide the “most cost-effective way to keep people from actually entering the system in the first place. Fixing the crisis system is important. We understand that. But we believe we have a real important role to play.”