Inslee mental health network plan clears second floor vote

OLYMPIA, Wash. — A plan from Gov. Jay Inslee to create a network of regional behavioral health facilities cleared its second full floor vote in the Legislature Wednesday.

The proposal would begin a significant shift in how mental and behavioral health care are delivered, by shifting capacity away from Eastern and Western State, Washington's two main state-run psychiatric hospitals, where both civil and criminal patients with the highest needs are held.

Instead, smaller community facilities would be certified by the state, allowing patients discharged or diverted from the larger facilities to be treated closer to their homes.

In a dramatic show of consensus, the proposal has gained universal support in both halves of the state Legislature: It passed Wednesday on a 48-0 vote, after earlier passing with a unanimous vote in the House as well.

"There's large bipartisan support here," said Republican Sen. Steve O'Ban, whose Pierce County district includes the troubled Western State Hospital.

The proposed network of new facilities is a key part of lawmakers' response to the state's long-running mental health crisis, including at that facility, which has garnered scrutiny from federal officials over safety issues including patient escapes and assaults on staff.

In 2018, despite efforts to improve, federal authorities declared conditions at Western State intolerable, and pulled the hospital's accreditation — and $53 million in federal funding.

O'Ban and others confirmed that with the Legislative session winding down, the remaining unanswered questions mostly surround timing and number of facilities.

The proposal, along with a companion Senate bill, follows broad strokes laid out by Gov. Jay Inslee in his budget proposal at the start of the legislative session.

Under that plan three new types of facilities would be created in communities around the state: Residential facilities, medium-term treatment facilities, and peer support centers.

The residential facilities would take patients including those given partial releases from the state hospitals — known as least restrictive orders — who don't need to be committed but still need full-time care, as well as others who need long-term care.

The intermediate-term facilities would focus on treatment of individuals held on 90 or 180-day orders for treatment; the peer facilities would function more like drop-in day centers, with guides to connect people with resources.

Legislators said after Wednesday's vote that there was general agreement on those elements, and that the only major unknowns were exactly how many of each would open, and how soon — details that will be solidified as Democrats controlling the state Legislature move closer to a final two-year budget ahead of the April 28 end of the legislative session.

"Both budgets would try to get around 200 patients out of the hospitals and into community settings," said Sen. David Frockt of Seattle, who is sponsoring a companion bill.

The plan would also authorize regular hospitals to certify and operate their own on-site behavioral health programs.

O'Ban also confirmed that it's an open question how many will be state-run.

"If the price is right they'll take a lot of them," O'Ban said. "But I don't think we'll get all of the long-term patients into private sector beds."