Inslee tours site of new behavioral health teaching hospital, previews legislative agenda for 2023
Gov. Jay Inslee visited the University of Washington today to tour the first-of-its-kind behavioral health teaching hospital currently under construction.
Inslee proposed the hospital in 2018 as part of a larger effort to transform and expand the state’s behavioral health system. The hospital will not only provide 150 behavioral health beds; it will provide dozens of training slots to help fill the depleted ranks of mental and behavioral health providers.
While at the hospital, Inslee offered a preview of legislative policy and funding proposals for the upcoming legislative session to address growing demand for behavioral health services.
“We have been building and adding capacity all across the state, but here’s the hard reality — even with the progress we’re making, demand for services is growing faster than we are keeping up,” Inslee said. “We must continue full funding for facilities like this, shore up our workforce, and address the underlying causes driving up demand for certain services.”
Legislative priorities include focus on services for youth and forensic patients
Inslee will release his detailed 2023–25 budget proposal next week. He shared some of the priorities that will be included, including:
Intensive services for youth. The Washington State Health Care Authority has been working on several initiatives over the past four years to address the specialized needs of youth and their families who need intensive behavioral health services and support.
The current state budget more than doubled capacity for the Children’s Long-Term Inpatient Program (CLIP), and included funding to plan for 32 new short-term youth crisis stabilization beds, the first of their kind in Washington state. Among the investments, Inslee will propose for the 2023–25 budget four additional CLIP facilities, additional navigator resources for families seeking inpatient treatment services, and continuing a pilot project with Seattle Children’s Hospital and Providence of Spokane that provides intensive outpatient and partial hospitalization services.
Full funding for new forensic hospital and planned community facilities. To ensure patients have access to the right kind of care when they need it, the Legislature must ensure continued, full funding for planned capital projects including the new 350-bed forensic hospital at Western State Hospital. Other projects include a new residential treatment facility and forensic unit at the Maple Lane campus and new facilities in Clark County and Stanwood. The governor will propose funding that allows for an additional 21 community facilities.
Behavioral workforce investments. The nationwide behavioral healthcare workforce shortage is making it difficult to recruit and retain skilled professionals, in both community behavioral health and our state workforce. Beyond continued recruitment efforts, the governor will propose improved compensation rates, more training opportunities, additional safety measures at the state hospitals, and improved technology such as electronic health records.
Specialized community services. A crucial tool for crisis response and stabilization will come from the expansion of the 988 crisis network which will allow for additional mobile crisis teams across the state. The governor will also propose funding for specialty care for people with specific needs, such as traumatic brain injury or dementia. These services will improve the ability of hospitals to transition patients to the community and free up hospital beds. In addition, the governor will propose increased investments for addressing opioid and fentanyl use as part of the State v. McKesson Corp. lawsuit settlement won by Attorney General Bob Ferguson.
Forensic services and competency restoration reforms. Following the Trueblood v. DSHS lawsuit settlement in 2016, the state has been implementing a plan to ensure timely competency evaluation and restoration services. Since 2018, however, there’s been a nearly 60% increase in court orders for in-jail competency services and a 145% increase in inpatient referrals since 2013. This is not sustainable, even with the expanded staffing levels and capacity the governor will propose. Partnerships with local governments to provide treatment rather than incarceration will be necessary.
To address immediate needs, however, the governor will propose funding to contract for additional forensic services at two behavioral health hospitals and an evaluation and treatment center. The governor will also propose expanding opportunities for early treatment and intervention that will free up beds at forensic facilities.
“We are designing and creating a completely new approach to how we deliver behavioral health services. We know Washingtonians are eager to see progress on this work,” Inslee said. “I am confident that if we continue investing in our people and communities, we will get there.”
Recent investments are helping shift the state’s system to a community-based model of care
For more than a century, the state has operated two state hospitals where patients were civilly committed or provided forensic care. Research is clear that treatment is much more effective when patients are treated closer to home and their community, so the governor announced in 2018 that the state hospitals would become dedicated for forensic and hard-to-place civil commitment patients. New investments would focus on building a network of smaller facilities and programs throughout the state.
Forensic capacity: The Department of Social and Health Services, which operates the state hospitals, has added hundreds of additional forensic beds following the Trueblood trial in 2015. This includes over 140 additional forensic beds at WSH than in 2016, and expanded forensic capacity at Eastern State Hospital where the state created three new forensic residential treatment facilities. The agency is currently planning for a new 350-bed forensic hospital on the WSH campus that will also serve as a Forensic Center of Excellence. Construction is scheduled to finish between 2027 and 2029.
Crisis and diversion services: In 2017, the state began funding mobile crisis teams and now each of the state’s 10 regions has at least two units — one for adults, and one for youth. The state’s 988 plans will expand the number of these teams. The state has built 15 facilities across the state to provide crisis stabilization services that help patients avoid hospitalization or jail.
Civil commitment capacity: To replace the capacity for 90- and 180-day civil commitments at Western and Eastern state hospitals, the state has added 15 new facilities in 11 counties totaling 204 beds. An additional 10 facilities will be completed by 2024 and provide 239 beds. Construction will then begin for another 76 beds.
Community capacity: As the focus has shifted to expanding services within communities across Washington, dozens of facilities have opened that provide a range of specialized care. While crisis services are a major focus of new investments, new facilities are also opening to help patients with developmental disabilities, dementia, substance use issues, and more. We’re also bringing on new facility types in the state such as intensive behavioral health facilities and peer respite centers.
