The mess at Western State Hospital is untenable, putting patients, employees and the public in peril.
WESTERN State Hospital is Washington’s oldest institution, dating to 1871. And, as of this year, it is the most screwed up.
Federal auditors threatened to pull Medicaid funding from the psychiatric hospital in Lakewood four times last year. In November, following up on staff complaints, the auditors found “immediate” jeopardy to patients and staff.
Simultaneously, the hospital is in the crosshairs of a federal judge who has found Western State Hospital’s ability to quickly evaluate and treat mentally ill defendants is unconstitutionally deficient.
Washington badly needs this vital piece of the safety net to work. Now the road to recovery for too many people with mental illness is blocked. Their families are in anguish. State workers are endangered and public safety is at risk.
But the way forward is murky. Gov. Jay Inslee proposes hiring at least 80 new staff members and bumping pay for some to slow attrition.
Earlier this month, Kevin Quigley, head of the state Department of Social and Health Services, put the blame squarely on the Legislature during unusual testimony in a court case in Everett. Called to explain why a mentally ill defendant wasn’t more quickly admitted to Western State Hospital, Quigley was pugnacious.
“If you want to crucify the secretary of DSHS, fine, but you’re not going to solve the problems for clients,” said Quigley, the (Everett) Daily Herald reported. Quigley has since submitted his resignation.
But the Legislature, and the public, should also demand more from Quigley, his successor and the hospital’s administration. That starts with Inslee, who should take a firmer management role as he picks Quigley’s replacement.
Signs of dysfunctional management are everywhere. Nearly 300 jobs remain unfilled at the hospital funded for 1,800. A month after federal auditors cited “ineffective” hospital management, they rejected the hospital’s corrective action plan.
An independent expert in the federal court case regarding psychiatric evaluations dinged state administrators for failing to use all tools available to fill vacancies. Meanwhile, the hospital administration imposed mandatory overtime, leaving burned-out staff to treat patients they don’t know.
No wonder that doctors at the hospital twice have voted no confidence in current hospital CEO Ron Adler.
That vote now could extend to the Legislature. Lawmakers added tens of millions to the hospital’s budget in July — a robust acknowledgment of the underfunded mental-health system. But under questioning before a Senate committee last week, Adler acknowledged that the hospital, which has a $179 million annual budget, had an “antiquated governance structure” and lacked a basic way to measure a patient’s recovery from mental illness.
State Sen. Andy Hill, R-Redmond, the Senate’s lead budget-writer, was equally incredulous when asking about Inslee’s request for new positions when so many jobs were unfilled. “If you can’t even hire the 300, why are you coming to us for even more money?” asked Hill.
The dysfunction puts lawmakers in a pickle. The federal lawsuit over delinquent evaluations is serious, and fixing it requires additional staff. At least two defendants recently died in jail while waiting for pretrial mental-health services from Western State Hospital. And the federal audit can’t be ignored.
But before opening the state’s purse again, lawmakers need assurance that Western State Hospital has competent management.