Politics & Government

Republican budget proposal brings disagreements over Western State reform to light

A sign is shown near an entrance to Western State Hospital in Lakewood.
A sign is shown near an entrance to Western State Hospital in Lakewood. The Associated Press

State lawmakers from both sides of the aisle agree on a broad strategy to reform Washington’s largest psychiatric hospital with the aim of fixing its persistent safety and capacity issues.

But a budget proposal released by Senate Republicans on Tuesday shows the harmony may only be surface deep.

The GOP plan includes $95 million for mental health upgrades, offering less money and fewer new beds for patients than a $227 million proposal by Democratic Gov. Jay Inslee.

The Republican plan would take more than twice as long to meet a key bipartisan goal at the 800-bed Western State Hospital and the smaller Eastern State Hospital: reducing patient load by shifting most non-criminal patients to other facilities around the state.

Republican budget writer John Braun, a state senator from Centralia, said the GOP is being realistic and would get good results with less money. Inslee on Tuesday said he had yet to go over details of the Republican plan, but was prepared to negotiate.

“We do recognize that mental health is important,” Braun said. “We also recognize that, both financially and, frankly physically, it’s going to take a long time to build out mental health facilities in our state.”

Inslee’s plan would add about 1,000 new beds to the mental health system, in part by building nine new 16-bed state facilities. He would also transition the civil patients away to the community beds by 2020.

Republicans would add about 500 beds and shift civil patients over the next decade. Both budgets add beds by paying local hospitals a higher reimbursement to take long-term mental health patients.

A greater point of immediate contention appears to be over how the budgets pay hospital workers. While Inslee negotiated a raise up to 27.5 percent for frontline nurses as part of a larger contract agreement with state employees, the Republican budget would give flat $1,000 increases to most state employees over the next two years.

Inslee attacked the Republicans’ idea, saying it will hurt the hospitals’ ability to recruit and retain staff.

“We are making progress at those hospitals,” he said. “It will be going backward if Republicans essentially cut our ability to have people working there.”

Western State Hospital has struggled to fill vacant positions since the Great Recession. While the hospital has made hiring strides as of late, more than 11 percent of permanent direct care positions at Western remain unfilled as of March 3, according to the Department of Social and Health Services.

Leaders of the Service Employees International Union local serving nurses at Western State say hiring new staff and keeping existing employees at the hospital is crucial to the state’s ability to comply with an agreement with federal regulators to improve conditions — or lose millions in federal dollars.

Braun said he’s “comfortable” that the Republican budget proposal won’t put the agreement with the feds at risk.

“We take a longer term approach” to reforming the mental health system, Braun said. But, he said, the Republican plan does “a lot” in the short term, too.

Walker Orenstein: 360-786-1826, @walkerorenstein