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Court orders Western State CEO to jail unless ‘boarded’ patient is admitted to state care

Cheryl Strange is the new CEO of Western State Hospital in Lakewood, part of DSHS.
Cheryl Strange is the new CEO of Western State Hospital in Lakewood, part of DSHS. The Seattle Times

Western State Hospital’s new CEO was ordered jailed after a hearing Friday in the case of a patient who had been wait-listed for admission to the psychiatric hospital.

Pierce County Superior Court Commissioner Craig Adams on Friday afternoon told Cheryl Strange to admit a patient who had been ordered to the state’s largest psychiatric hospital. She said she would not.

On April 20, a civil court ordered the patient to be detained for 14 days, according to Adams. The patient was again ordered detained in early May for another 90 days, but in neither instance was admitted to Western State Hospital, Adams said.

Instead, the patient has been held under what’s known as a “single-bed certification,” a bed at a general hospital, because Western State didn’t have any space available.

The Washington State Supreme Court ruled in 2014 that single-bed certifications, sometimes known as “psychiatric boarding,” were unlawful. The genesis of the ruling came from Adams, who ruled in 2013 that the practice violated the constitutional rights of patients. The Legislature has since made the practice legal under certain circumstances.

The Washington State Supreme Court ruled in 2014 that single-bed certifications, sometimes known as “psychiatric boarding,” were unlawful. The genesis of the ruling came from Pierce County Superior Court Commissioner Craig Adams, who ruled in 2013 that the practice violated the constitutional rights of patients. The Legislature has since made the practice legal under certain circumstances.

Adams, however, said that state law doesn’t allow a patient to be boarded in a hospital for more than one 30-day stint.

“To leave anyone stranded in a single-bed certification is a disservice and a violation of their constitutional rights,” said Adams.

If Strange doesn’t admit the patient, Adams said she must report to jail Wednesday. The order also includes fines of $2,000 per day against the state.

Friday afternoon, Adams told The News Tribune that the patient is a disabled veteran with symptoms of dementia who had received prior treatment in Olympia, then at the American Lake VA hospital in Pierce County. Following aggressive behavior at American Lake, the patient received a mental-health evaluation and was ordered in early April to a single-bed certification at St. Clare Hospital in Lakewood.

The patient has been there ever since, Adams said, despite a May 4 hearing during which he ordered a transfer to Western State, and a second hearing at which he renewed the order.

“What do they do? Nothing,” Adams said.

In addition to Strange, Adams’ jail order applies to Bea Dixon, executive director of the OptumHealth Regional Support Network, a private corporation that serves Pierce County mental-health patients.

Strange said she doesn’t intend to admit the patient. She cited testimony during the hearing that the patient is stable in the current arrangement. Admitting the patient would mean skipping over patients on a waitlist to get into the hospital who are more sick, she said.

After the hearing, held in a courtroom on the hospital’s campus, Strange said she doesn’t intend to admit the patient. She cited testimony during the hearing that the patient is stable in the current arrangement. Admitting the patient would mean skipping over patients on a waitlist to get into the hospital who are more sick, she said.

“I will not override that (waitlist) to place somebody to avoid going to jail,” she said.

A statement from Strange released Friday underscored her position. She said while she had authority to order the patient’s admittance, she would not exercise it because the man’s “stable” condition didn’t warrant it. She also alluded to the dilemma faced by the hospital.

“Today’s ruling places the hospital in a catch-22: We are held in contempt because we don’t have the staff needed to provide an appropriate level of care, and we have patients who have completed treatment and are waiting to get out of the hospital, but there is a lack of support services and stable places for them to live in the community.”

Western State Hospital is experiencing a staff shortage that led the facility last year to close a brand-new patient ward.

Late Friday, news reports suggested that Strange would report to jail rather than admit the patient. The News Tribune sought confirmation. Kathleen Spears, spokeswoman for the state Department of Social and Health Services, which oversees the hospital, said simply, “She (Strange) will follow the law.”

Adams said the state would need a judge to overturn his order to prevent the jail stint.

“I ultimately said, look, this is Western State’s intentional action,” he said. “They’ve created this waitlist and all these other things. They have the ability to put him in, and they’re not doing it.”

Adams suggested that the problem isn’t limited to one patient seeking admission. He has a hearing scheduled for Tuesday, involving three other patients ordered to Western State who haven’t been admitted.

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