Gov. Jay Inslee’s veto of thoughtful, bipartisan reforms at the troubled Western State Hospital sends a lousy message.
WITH a few strokes of his red veto pen this week, Gov. Jay Inslee — intentionally or not — finally claimed the mess at Western State Hospital as his to fix.
To the bafflement of lawmakers and mental-health advocates, Inslee gutted an important, bipartisan piece of legislation intended to force reforms on the dysfunctional psychiatric institution.
Lawmakers had acted in frustration to the administration’s fumbling efforts to correct the mess, combining policy reforms with funding. Lawmakers passed a bill that would have helped ease the hospital’s severe shortage of psychiatrists by adding psychiatric advanced registered nurse practitioners (ARNPs) to the mix. It would have mandated better staffing models and discharge plans — both serious problems at the institution.
Most important, it would have set in motion a longer-term shift away from the antiquated model of having a single, mammoth institution for the most seriously ill and would have encouraged more community-based treatment.
All good, needed reforms; all sections of the legislation vetoed by Inslee. He essentially took the money, but not the reforms.
Meanwhile, the problems at Western State Hospital are profound. Under the Inslee administration’s management, the hospital has failed a series of federal audits because of substandard patient care, endangering $65 million in federal funding. Patients linger far longer than necessary — an expensive and dehumanizing situation reminiscent of the bad old days of institutional care.
And a federal judge seems poised to appoint a special master because criminal defendants needing competency services are instead languishing in jails with minimal mental-health treatment, often in solitary confinement.
Yet Inslee’s veto message sent a clear signal: Back off, Legislature. He wants to wait for yet another consultant’s report — there have been many — about the hospital. He objected to expedited hiring of ARNPs, preferring the bureaucratic sausage-making process of creating a new job classification.
Inslee has made a few encouraging — albeit late — moves. The entire leadership at Western State has turned over; he appointed a new CEO, who starts this week. And he did not veto legislation setting up a new oversight committee packed with lawmakers.
But Inslee seems to believe the problems are mostly caused by a lack of money. True, during the Great Recession, the Legislature whacked about 400 jobs.
But since then, funding has spiked as lawmakers woke up to the damage done by the cuts. The hospital’s 2016 budget ($120 million from the general fund) is nearly $18 million more than the pre-recession peak.
Yet the number of patients served is down, and their length of stays are unnecessarily long. Patients needing long-term psychiatric care at Western State are stacked up at hospitals across the state, their lives and their families in limbo, despite a Supreme Court order ruling this practice unconstitutional. So far, more money has not equaled better care.
Three-plus years into Inslee’s administration, he can no longer merely say he inherited the mess at Western State Hospital. In vetoing thoughtful reforms passed by huge majorities of the Legislature, Inslee now has to prove he can manage his way out of yet another crisis in the mental-health system.