Why does DSHS tolerate Western State offenses?

Olympia attorney Brendan Williams is a former state representative.
Olympia attorney Brendan Williams is a former state representative.

The Department of Social and Health Services would never allow any private care facility it regulates to get away with what it tolerates at Western State Hospital.

The federal government has sent three notices this year threatening to cut federal funding for the hospital due to dangerous conditions. Any private facility receiving a 57-page list of violations, as Western State did in March, would be immediately denied by DSHS the ability to admit new patients or collect Medicaid payment for them until the deficiencies were remedied.

And that double standard would be applied to any private nursing home, even though the state is today still “reimbursing” them based on 2007, not 2015, costs.

Those facilities must somehow simply make do, amidst state reimbursement-forced closures, whether they are average or exceptional like Tacoma’s sole remaining family owned facility, Heartwood Extended Health Care – which has a five-star federal quality rating.

Western State’s latest troubles are part of a pattern of serial offenses.

The state is already in trouble with the federal courts for its neglect of the mentally ill. In response, additional funds were begrudgingly appropriated in the last legislative session, and a significant increase in patients served was projected for 2016 in the budget for both state mental hospitals: 12.3 percent.

Most state psychiatric hospital patients – more than 92 percent – are medically indigent and on Medicaid. As half that cost is borne by the federal government, the loss of the funds would be devastating. Line staff is already overburdened.

DSHS falters while government accountability ideas come and go. Gov. Gary Locke came up with “priorities of government,” a means of triaging for budget purposes (curiously, vulnerable people were never a POG for Locke).

Gov. Chris Gregoire pushed “government management accountability and performance,” which atrophied into just another acronym on the books.

Not to be outdone, Gov. Jay Inslee campaigned on “lean management,” which is borrowed from the manufacturing sector and may prove useful if DSHS ever starts making Toyotas.

None of these initiatives have done a thing to reduce the liability that flourishes, year after year, under DSHS management. Hardly a month goes by without news of a major settlement or judgment involving some facet of the vast agency’s oversight, which ranges from children, whether incarcerated or in the foster system, to the mentally ill, to senior citizens.

The Children’s Administration division alone, for example, has paid out more than $141.4 million over the past eight years. That's a hefty price for overworking and underpaying social workers.

It is dumbfounding that an implicit state endorsement of the human toll (quite apart from financial toll) from this state neglect has persisted for so long. The Legislature has also, of course, ignored its paramount duty – funding K-12 education – since the first 1977 decision finding the state derelict in that duty.

Government is not the private sector, and its vulnerable wards are not widgets. Management theories are no substitute for real reforms. I can’t be the only Washingtonian feeling a moral outrage over an inert status quo, especially in a year in which status quo disaffection, finally, is apparent even on the national stage.

Years ago, a bipartisan group of members of the state House of Representatives supported breaking up DSHS into more accountable, and more manageable, pieces. It’s time to think big again.

Olympia attorney Brendan Williams represented the 22nd Legislative District in the state House of Representatives from 2005 to 2011.