Washington health department seeks greater power to regulate private psychiatric hospitals

The Washington State Department of Health is putting together legislation to give it greater enforcement power over private psychiatric hospitals, including the authority to immediately halt patient admissions and to levy fines of up to $10,000 per violation.

The agency also wants the Legislature in the session that begins Jan. 13 to create a provisional, two-year license for new facilities that would bring more frequent inspections, and require psychiatric hospitals to report every escape and death of a patient within three days, according to a draft reviewed by The Seattle Times.

“Several hospitals have failed to comply with state licensing requirements for extended periods of time,” the draft legislation states. “Additional enforcement tools are needed to address noncompliance and protect patients from risk of harm.”

The bill in its current form would direct the department to post health-care facility inspection reports online, starting with psychiatric hospitals, as many other states do. The reports are currently only provided in response to a public-records request.

The push comes after a Seattle Times investigation found the Department of Health had cited several psychiatric hospitals for repeated, serious violations but kept the records private by default and hadn’t taken any enforcement action in more than 13 years. While hospitals had reported to the state a total of 15 events of serious harm over three years, The Times found 350 incidents over the same period in which patients or staff were assaulted, suffered an injury, attempted suicide, escaped or died suddenly.

In response to the articles, Gov. Jay Inslee asked the department in September to draw up measures for tighter enforcement. He included funding for the requested legislation in the budget he proposed this month.

Inslee’s administration has been under pressure to expand mental-health-care services for years, and that has only intensified with plans to transition more civilly committed patients out of the state’s troubled Western State Hospital. Since 2012, the state has approved or expanded 10 private psychiatric hospitals — eight of which have opened — that will add a combined 850 licensed beds.

Inslee had supported this expansion. “We can’t just decide we’re not going to open facilities because at one point there was care that was not sufficiently of quality,” he said in a July interview. But after the investigation published, he sent a letter to Secretary of Health John Wiesman, writing, “It is clear to me that our existing regulatory structures are inadequate for ensuring that new, privately run facilities are meeting the levels of transparency, safety and quality that patients and their families deserve.”

The department hasn’t settled on a legislative sponsor, a spokeswoman said, but Sen. Karen Keiser, D-Des Moines, has been working with the administration on the legislation.

“We need to get this right,” she said, describing a need for more inpatient mental-health facilities. “If we don’t,” she added, “communities won’t accept them, they’ll push back and not allow the buildings to get built.”