Politics & Government

With $50M in fines piled up over help for mentally ill, the state is seeking a settlement

FILE - In this file photo taken April 11, 2017, a security officer stands on steps at the entrance to Western State Hospital, in Lakewood, Wash. (AP Photo/Elaine Thompson, File)
FILE - In this file photo taken April 11, 2017, a security officer stands on steps at the entrance to Western State Hospital, in Lakewood, Wash. (AP Photo/Elaine Thompson, File) AP

State officials are working to settle a long-running federal court case in which Washington has racked up nearly $50 million in fines for not providing faster care to mentally ill defendants.

The details of an eventual settlement are still being negotiated but it appears the state will agree to pursue ambitious upgrades to Washington’s mental health system in the next several years.

A Feb. 5 agreement between the Department of Social and Health Services and the advocacy group Disability Rights Washington says the two groups believe collaborating on broad reforms to the mental health system will bring compliance with the court faster than the current status quo of “litigation of piecemeal issues.”

David Carlson, advocacy director for DRW, said in an interview Monday the current legal battle could lead the state to seek short-term solutions to what he described as a systemic problem. Instead, a settlement may bring bigger change, he said.

“This is the most significant opportunity to transform our mental health system that we have had, and that I can foresee,” Carlson said.

Top lawmakers at the state Capitol appear to be on board with the strategy, which comes with promises of fewer fines and less litigation on other mental health issues in the future.

Key legislators are pledging to pay existing fines and stay on track with efforts to end the lawsuit. The class-action case, known as Trueblood, is named after attorney Cassie Trueblood, who originally filed a suit over competency services on behalf of a client.

Democrats who control Washington’s Senate released a 2018 supplemental budget proposal Monday that state Sen. David Frockt, D-Seattle, said is in line with early talks on the settlement. Frockt is vice chair of the Senate’s Ways and Means fiscal committee.

The plan would spend an extra $163 million on the mental health system, including nearly $10 million to build 45 psychiatric beds at the roughly 800-bed Western State Hospital in the aim of lowering wait times for services. It would also stop an expansion at a small psychiatric facility in Yakima that DRW has criticized for not providing adequate care.

A proposal for the state’s supplemental construction budget would start work toward building another 60 beds on Western State’s campus in Lakewood.

“We are bringing to a conclusion, I hope, the Trueblood saga and the McCleary saga and we can move forward as a state,” Frockt told reporters, also referencing a state Supreme Court order to boost funding for public schools.

In the Trueblood case, a federal court in 2015 found the state was taking too long to provide evaluations that determine whether someone is competent enough to stand trial.

Washington is also lagging behind on providing mental health treatment to restore the competency of defendants, the court has said.

The state says the problems are caused by a crush of demand and not enough services to handle the need. Lawmakers have spent significant money on the mental health system in the last several years after deep budget cuts during the Great Recession.

Exacerbating the problem recently has been an influx of patients in the criminal justice system, known as forensic patients.

When patients are waiting to get into Western State, they sometimes sit in jails with inadequate help.

To address the lawsuit, Washington’s lawmakers have been working to reshape Western State and Eastern State hospitals to primarily serve forensic patients.

The psychiatric facilities currently serve a mix of forensic patients and civil patients who are involuntarily committed to mental health treatment but are not in the criminal justice system.

Lawmakers say civil patients are better treated closer to where they live, not in centralized locations such as Western State. Moving civil patients away from Western State also frees up space for forensic patients at the more secure facilities.

The 2017 state operating budget had more than $100 million in new spending for mental health, including funds to create more psychiatric beds for civil patients in community hospitals and elsewhere.

It also invested money in programs to divert people with mental illnesses away from the criminal justice system by treating them before the issue becomes serious enough to warrant involuntary treatment.

Carlson said any settlement agreement is likely to continue that plan to reshape Western State while adding other reforms aimed at long-term upgrades to the mental health system.

Under the Feb. 5 agreement, Carlson said the state and DRW will be taking input on what a proper mental health system should look like for several months before hammering out a proposal in the early summer to meet their goals.

From there, the federal courts will get a chance to approve the proposal.

If the court does approve the plan, it would be incorporated into Gov. Jay Inslee’s 2019 budget proposal, Carlson said.

Lawmakers will then decide whether they want to implement it or tweak it.

Sen. Steve O’Ban, R-Tacoma, said he believes there is bipartisan political will to reach a settlement and follow through with the attempt to end Trueblood.

O’Ban is the top Republican on the state’s Human Services and Corrections Committee. He also works as Pierce County’s senior counsel for behavioral health.

“I’m absolutely for reaching some sort of resolution that not only keeps the state from paying fines but using that money in a much more direct way to help the class members of Trueblood,” he said.

Carlson said if lawmakers do reverse course and abandon ship, more litigation for faster services is always on the table.

He called the settlement idea a “bold” but necessary step to make sure people suffering from mental illness get the help they need.

“I get that this looks really difficult from the outside and audacious even,” Carlson said. “If I didn’t have faith that we have a really good shot at doing this, I wouldn’t be here.”

Walker Orenstein: 360-786-1826, @walkerorenstein