New Washington Mental Health Budget ‘Doesn’t Look Promising’

By Martha Bellisle , Associated Press

SEATTLE (AP) — Washington state’s latest budget plan falls far short of what’s needed to fix the state’s floundering mental health system, advocates said Friday.

Gov. Jay Inslee’s proposed budget requested $300 million for the mental health system, but the newly released two-year proposal from the Legislature only contains $116 million.

“It doesn’t look promising,” said David Carlson, a lawyer for Disability Rights Washington, which sued the state in federal court for failing to provide timely competency services to mentally ill people charged with crimes. “While we don’t know exactly how the allocated money will be spent, we do know it is nowhere near what the governor said he needed.”

And on Wednesday the Centers for Medicare and Medicaid Services issued a “statement of deficiencies” to Western State Hospital, the state’s largest psychiatric facility, after finding safety violations during a recent inspection. Julius Bunch, a CMS branch manager, said they expect to receive the hospital’s plan to correct the violations within the next 10 days.

The 800-bed facility is already under a special “Systems Improvement Agreement” with the federal agency due to multiple safety violations found last year. The deadline to satisfy that agreement is July 1.

“Upon initial review, nothing indicates that the hospital is being decertified at this time,” said Kelly Stowe, a spokeswoman for the Department of Social and Health Services, which oversees the hospital. She said CMS plans to give the state more information on the next steps it needs to take to comply with the agreement.

Failure could cost the state about $65 million in federal funds.

The state has been accruing millions in federal contempt-of-court fines since 2016 for failing to provide timely competency evaluations and treatment to mentally ill people who must wait weeks or months in jails after being charged with a crime. The fines represent the number of days people are forced to wait for competency services beyond the court-ordered seven days.

The first month of fines following the contempt order from July to August 2016 came to $498,000, but they’ve continued to rise each month. For February to March 2017, the total was $1.8 million and the May to June fine was $3.1 million.

“The trend is going in the wrong direction,” Carlson said.

In the first six months of 2017, the fines have topped $21.5 million.

When asked how the fines will be paid, the Office of Financial Management said: “In the 2017 supplemental budget there is an appropriation for $15 million to cover fines for FY17. There is no appropriation in the biennial. We assume we’ll see a request in the 2018 supplemental for fines incurred in FY18.”

The governor’s office did not immediately respond to requests for clarification on the discrepancy between the fines ordered and what was allocated.

The portion of the budget for mental health coverage is broken down into four areas:

—$60 million to cover problems at the state’s two psychiatric hospitals.

—$27.7 million for mental health crisis centers, community long-term inpatient beds, and clubhouses.

—$17.7 million for community beds to divert and discharge patients from the state psychiatric hospitals.

—And $11.7 million to increase the Medicaid capitation rates for the Behavioral Health organizations by 2.5 percent.

The total comes to $116 million.

When the Department of Social and Health Services appeared before the federal judge in the competency case in May, it said the state needed $300 million to cover various improvements to the mental health system, and thereby satisfy the court’s ruling.

“The court, the parties, and experts have all agreed that to come into compliance, DSHS must have sufficient resources to provide timely competency services,” Carlson said. “The resources include having a sufficient budget to hire and retain sufficient staff, maintain bed capacity to respond to the demand for competency services, and serve class members in community settings.”

The latest budget falls short of achieving that goal and the court-ordered requirements.

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