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Washington trails all but two other states in providing hospital beds for mentally ill patients, according to a report released Thursday.

The state is also among the least prepared for a public-health disaster, but it does lead the country in high seat-belt use and low infant-mortality rates, according to the far-ranging Report Card on Emergency Care Environment by the American College of Emergency Physicians.

Overall, Washington placed 35th out of 51 (the District of Columbia is included), earning a D+ on a scale that also gave the United States as a whole a D+.

The last time the report card came out, in 2009, Washington ranked 19th and earned a C.

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The state-by-state comparisons in the irregularly published analysis of 136 metrics are widely cited by officials, despite being produced by emergency physicians with a vested interest in more resources going toward emergency care.

“Washington state did it again — we failed rather miserably,” said Nathan Schlicher, an ER doctor and former state senator.

“Work to do”

Schlicher and others said they were especially concerned about Washington state’s low ranking on mental-health-treatment beds and disaster preparedness.

The report found Washington has 8.3 hospital psychiatric-care beds for every 100,000 people — 49th in the country.

The ranking was a smidgen better than 2009, when Washington ranked last, but that was only because Colorado and New Mexico lost beds while Washington’s per capita bed number was virtually unchanged from 2009.

This year, the national average was 26.1 beds per 100,000 residents. The highest three states each had 50 or more.

The Seattle Times reported in October that a lack of beds was causing thousands of mentally ill residents who had been involuntarily detained to languish for hours or days in hospital emergency rooms before getting treatment.

“It feels like the mental-health population has just been sort of shoved to the side, that there hasn’t been a commitment to it,” said state Rep. Tami Green, a Lakewood (Pierce County) Democrat and psychiatric nurse, in an interview Wednesday.

The chairman of the state Senate committee overseeing mental health, University Place Republican Sen. Steve O’Ban, said the new report “tells us we’ve got work to do.”

Stephen Marshall, a former president of the state chapter of the American College of Emergency Physicians, said the group’s priority will be to use the report to lobby for more psychiatric beds.

More communication needed

But also disturbing, officials said, was the disaster-preparedness section.

Washington ranked 50th in that section, plummeting from 33rd in 2009.

The report said the state has been spending less on preparedness and “lacks many policies and procedures that ensure that medically vulnerable patients receive care in a disaster and that help coordinate responses between different responders.”

Rep. Roger Goodman, chairman of the state House Public Safety Committee, said he was not surprised the state ranking fell.

“I’ve been saying for years that we’re not prepared for the big one,” said Goodman, D-Kirkland. He added that a major earthquake has been waiting 300 years to happen, “and we need to invest a lot in making sure that the essential services, hospitals, schools, other public agencies can communicate.”

Goodman said top-notch communication systems costs tens of millions of dollars and he can’t get colleagues on board because “people don’t care about emergencies or disasters because they’re not right in front of them.

“The bridge isn’t a problem until it falls down,” he said.

The report also faulted Washington for not doing as much as other states to protect doctors from lawsuits.

Some good grades

But the report did list several things the state is doing well. In particular, Washington earned an A- for public health and injury prevention, the fifth highest grade in the country.

The state’s 97.5 percent seat-belt-usage rate topped the country, its infant-mortality rate of 4.5 deaths per 1,000 live births ranked sixth and only 17.5 percent of adults are current smokers, according to the report.

Washington also has above-average patient-care procedures, protocols and triage guidelines and “a strong prescription-drug monitoring program,” according to the report.

Stephen Anderson, another past president of the state group, said the good news should not be overlooked.

“We’re the national standard for doing things good and doing things right in certain areas,” he said.

Brian M. Rosenthal: 206-464-3195 or

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