Lawmakers are right to be frustrated that Western State Hospital has yet to implement a common-sense tool to manage staffing, especially after the state shelled out $25 million for the hospital’s overtime costs this year.
State lawmakers are losing their patience with mismanagement at Western State Hospital, and for good reason.
The state has been pouring money into the 857-bed psychiatric facility for the past several years. Yet the Lakewood hospital remains in danger of losing about $53 million in federal funding after inspectors found another 57 deficiencies there last year. Meanwhile, in a separate federal court case known as Trueblood, the state continues to accrue more than $3 million in fines per month due to the hospital’s failure to provide timely treatment for criminal defendants deemed mentally incompetent to stand trial.
In its latest effort to halt the hospital’s free fall, the Legislature just added about $142 million in state spending on mental health to its budget that runs through July 2019.
But less than half that money is going directly toward new, ongoing investments in state services for people struggling with mental illness. Instead, about $46 million is going toward paying the mounting court fines in the Trueblood lawsuit, while another $35 million is going toward paying for overtime and other one-time cost overruns incurred in the past year.
The Department of Social and Health Services, which runs Western State, must get staffing levels and overtime spending under control.
Inexplicably, however, the agency has yet to implement an interactive staffing tool that many hospitals use to help them do just that.
Without such a tool to analyze patient needs and adjust staffing levels from day to day, the hospital is racking up unnecessary overtime costs. Overtime spending at Western State is expected to total $25 million for the 2018 fiscal year, accounting for most of the $35 million in cost overruns included in this year’s budget.
The lack of this recommended tool also can lead to insufficient staffing levels at high-demand times, potentially contributing to some of the patient-care problems and facility issues the federal inspectors noted in their most recent survey.
Even worse, lawmakers say that without the staffing tool — something they have sought for years — they don’t really know how much progress they are making at Western State.
“I don’t have any sense as a legislator if we are close to fully staffing that hospital, or if we are nowhere close, or where we are at,” said state Rep. Laurie Jinkins, D-Tacoma. “We are wandering around in the middle of the woods.”
To its credit, the Legislature is attempting to put its foot down this time. In the supplemental budget lawmakers approved this year, they directed DSHS to finally get the so-called acuity-based staffing tool up and running. By September, Western State must deliver a report comparing actual daily spending on hospital staffing to what is budgeted, and whether that lines up with the recommended staffing plan.
Judy Fitzgerald, assistant secretary for DSHS’ financial services administration, said the agency has made substantial progress and will be working to get the new system operational over the summer.
So far, however, following through has not been the agency’s strong suit. The hospital must not delay any further in putting this crucial management tool into place.
If necessary, Gov. Jay Inslee must step in and insist the work gets done.
Changes in leadership may help. State officials are now interviewing candidates to become Western State Hospital’s new permanent CEO, after former CEO Cheryl Strange was promoted to DSHS secretary in August. A new assistant secretary, Ken Taylor, took over the agency’s behavioral-health administration earlier this month.
These new leaders must prioritize cutting wasteful spending and making the hospital more efficient. Bringing the new staffing tool online is one of the easiest ways to do that.
This time, there should be no more excuses.