Politics & Government

State plans 50 mental-health beds to start addressing court mandate

Gov. Jay Inslee’s administration plans to add 50 beds in the next two weeks for mentally ill patients who a court said can no longer be detained in emergency rooms while waiting for treatment at overcrowded state facilities.

The Washington State Supreme Court’s ruling forbidding so-called psychiatric boarding takes effect Aug. 27 and applies to about 200 patients, state officials said.

By that date, the state wants to add 50 more slots for patients, split between state-run Eastern State Hospital near Spokane, private psychiatric hospitals in Kirkland and Tukwila, and community boarding homes.

A big gap will remain between supply and demand. Officials from Inslee’s policy staff and his Department of Social and Health Services who described the short-term plan to reporters Thursday also outlined possible longer-term solutions to overcrowding – which could include more beds inside or on the grounds of Western State Hospital.

“We will work as hard at implementation as we possibly can, but the problem will not be solved on Day One,” said Andi Smith, an adviser to Inslee on human services.

Smith said state officials would need “tens of millions of dollars in the short term.”

State lawmakers are not due back to Olympia until January. Smith said Inslee isn’t ruling out calling the Legislature into a special session earlier, but said DSHS may be able to shuffle money around within its budget until lawmakers can approve a supplemental budget request next year.

The agency is still working out a dollar figure. Any request would have to compete for money with another court mandate to fund schools, whose price tag stands in the billions of dollars.

State budget cuts have slashed the amount of space for psychiatric patients, triggering an increase in boarding of patients, a practice that amounts to warehousing them in emergency rooms. The state has argued the alternative is dumping them on the streets.

Now, with no prospect of a full immediate solution, some patients could indeed end up released. How many depends on how aggressive defense attorneys are in fighting detentions and how willing hospitals are to keep patients, said Jane Beyer, an assistant secretary at DSHS.

In the longer term, Smith and Beyer said officials are focused on faster discharge of patients and making sure they have services back home. The Legislature has put money toward those goals in the past year and a half.

Smith and Beyer said the administration is also looking at opening a ward at Western State Hospital and finding a contractor to operate beds on the grounds of the Lakewood hospital, which would be eligible for more federal funding than beds inside the hospital.

The effort to open new space for patients is a shift in direction for state officials who until recently were looking at reducing Western State Hospital beds to fund safety improvements.

A lawyer for Pierce County patients who challenged boarding said he’s glad the state is now scrambling to open more space.

Chris Jennings said he and other public defenders don’t want their clients to end up in jail, “under bridges and in the gutters,” but saw their legal fight as the only way to apply pressure for proper treatment.

“I wish this didn’t have to be done in such a crisis mode,” Jennings said, “but I’m glad that they’re finally addressing it.”