If anyone should go to jail for Western State Hospital’s continued dysfunction, it’s Gov. Jay Inslee.
Craig Adams might have come across as a bit erratic last week when he threatened to use his power as a Pierce County Superior Court commissioner to throw the head of Western State Hospital in jail.
But Adams had a bona fide point. He was fuming because he’d ordered a patient admitted to the psychiatric institution but found the patient was scheduled to wait 90 days, and counting, in a community hospital not qualified for long-term treatment.
What really made Adams mad? “This is not the unusual; it’s the usual. It’s virtually every case,” Adams told me last week from his chambers on the Western State Hospital grounds. “This is our most vulnerable section of the population. Who speaks for them?”
If taxpayers were to understand what’s going on, they would be rooting for Adams to throw Gov. Jay Inslee in jail instead of the hospital’s brand-new CEO, Cheryl Strange.
The dysfunction in Washington’s mental-health system is not new. The state Legislature and weak leadership in the state agency allowed a crisis to fester until Washington ranked near the bottom in the nation in access to community psychiatric beds.
You may remember the recent headlines. Patients routinely “boarded” in emergency rooms, sometimes strapped to gurneys without treatment.
Join Jonathan Martin and Cassie Sauer of the Washington State Hospital Association at 2 p.m. Wednesday for a live chat on Facebook. Go to facebook.com/SeattleTimes. Submit questions and comments in advance in the comments section of this column.
Adams earned my “unsung hero of the year” nomination when he spotlighted the issue three years ago, asking the state’s lawyers how this could possibly be legal — taking away someone’s liberty through the involuntary commitment process, yet not providing treatment.
The state Supreme Court in 2014 agreed with Adams that it was unconstitutional. And it forced the Legislature finally to begin funding the mental-health system. Lawmakers poured in at least $120 million in the last two years by opening more than 150 new short-term psychiatric beds in community hospitals and paying for two new wards at Western State Hospital.
Problem solved? Nope.
After all that spending, the rate of emergency-room boarding briefly dipped but is now back up to the level it was before the Supreme Court ruling. Patients in King County are actually waiting longer on average to get into Western State Hospital — more than a month. Overall, the waiting list for civilly committed patients is more than 70 names long.
The bottleneck at Western State Hospital is caused by a severe staffing crunch. Part of that is inadequate pay for difficult-to-fill positions. Inslee wants to blame that on the Legislature’s budget-writers — but the hospital’s budget is now up to pre-Recession levels, adjusted for inflation.
Meanwhile, the hospital has a toxic labor-management culture, with rapid turnover, union votes of no confidence in the leadership and a pattern of retaliation against whistleblowers. Three years into Inslee’s administration, this is on him.
Inslee did not step up and change management after rebukes by the state Supreme Court or by U.S. District Court Judge Marsha Pechman, who has put the hospital’s criminal wards under her oversight. Nor did a series of threats by the feds to yank $64 million in funding because patients were in “immediate jeopardy.”
Inslee fired one CEO and hired Strange — the woman Adams is threatening to jail — only after two patients escaped in May.
Message: If patients are at risk, wait. If the public is at risk, act.
You know whom Inslee does listen to regarding Western State Hospital? The union.
After a meeting and a letter from the Washington Federation of State Employees, Inslee vetoed new authority for Western State Hospital to ease its staffing crunch by quickly hiring advanced registered nurse practitioners to ease the workload for doctors. The veto baffled everyone, including fellow Democrats in Olympia who championed the change.
Message: A crisis is not a crisis if a major campaign contributor asks for a favor.
Adams sees the consequences and is rightly frustrated as patients he’s ordered into Western State Hospital wait months to get in. He could issue fines, but more than $700,000 in fines already issued by judges around the state have been mostly ignored.
“And who am I really sanctioning? The taxpayers of the state of Washington,” Adams said. “What else am I going to do? How else do I get someone’s attention?”
He’s scheduled a hearing next Monday to force attention to the boarding issue once again. Jailing the CEO is not the solution, of course. But godspeed, Craig Adams. Rattle some cages.