If officials at the Department of Social and Health Services’ mental health division are right, there’s something of a Catch-22 going on at Western State Hospital in Lakewood.
The federal government is threatening to cut off almost $16 million in federal Medicaid and Medicare funds to the state’s largest psychiatric hospital — for the third time this year — because inspectors found conditions that pose a danger to patients.
But according to the Behavioral Health and Service Integration Administration, Western State can’t operate safely with the money it already receives from state and federal sources. The $9.4 million it got in the latest state budget wasn’t enough.
So lose the federal funding and it becomes even harder to provide a safe environment for patients. Staff, too, would be more at danger with a big funding cut as that would likely translate into fewer workers to handle patients at the 800-bed facility.
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It’s easy enough to believe that Western State needs more funding than it already has, given the short shrift the state has given mental health since the Great Recession, when lawmakers cannibalized the system due to budget shortfalls. That resulted in closure of wards and delays in competency evaluations of persons charged with crimes.
Lack of mental health resources also led to the unintended consequence of psychiatric boarding: mentally ill patients being detained at hospitals without treatment — essentially transferring the problem from the state to private hospitals.
How bad is the state of mental health care here? Washington ranked 48th in the nation for availability of psychiatric treatment, according to a November 2014 report by the nonprofit Mental Health America. Along with Arizona, Mississippi, Nevada and Louisiana, Washington was one of the states with the highest prevalence of mental illness and lowest rates of access to care.
Even if Western State’s resources are stretched to the limit, it must give the highest priority to patient safety — and to doing whatever it takes to keep from losing federal money.
Some of the problems inspectors have pointed out could reasonably be related to shortage of staff or a lack of leadership by administrators, including failures to monitor restrained patients, failures to supervise violent patients, and soiled bedding and showers.
Other problems are more puzzling and include the kind of thing that can’t easily be explained away by lack of money — like having broken fire alarms and smoke detectors, walls and doors that wouldn’t stop smoke and fire from spreading, unsafe electrical outlets and medical supplies that were years out of date.
Western State has, once again, submitted a correction plan in a bid to keep its federal money. But getting a third 90-day termination notice in a span of nine months should be a wakeup call for lawmakers to figure out if there’s more going on here than just a lack of money.