Gov. Jay Inslee’s recently announced supplemental state budget serves more as a policy statement than an actual proposal. Because the governor does not need to present a balanced budget but the Legislature is constitutionally mandated to make sure that expenses are in line with revenues, Inslee’s plan for 2016 is really more of a suggestion.
Yet, while lawmakers might view Inslee’s proposals with a jaundiced eye, they should not ignore the governor’s attention to the state’s mental health system. Inslee has called for $137 million to go to a system that is under fire on several fronts:
▪ Four times this year, the federal Centers for Medicare and Medicaid have threatened to cut funding to Western State Hospital over concerns about patient and staff safety. Western State, near Tacoma, is Washington’s largest mental health facility.
▪ An investigation by The Associated Press found that injured Western State employees missed more than 41,000 days of work between 2010-14. It also found that workers’ compensation insurance paid more than $6 million in claims to injured hospital workers between January 2013 and September 2015.
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▪ And in April, U.S. District Judge Marsha Pechman ruled that “psychiatric boarding” violated the constitutional rights of patients. The practice involves the placement of patients in hospital emergency rooms that often do not have the necessary expertise or staffing, leaving patients strapped to a bed without receiving proper evaluations.
“We know we have to do more for mental health in this state,” Inslee said in announcing his budget proposal. “We have urgent short-term needs, but we also need to take a long view on how to build a stronger mental health system.” The governor is correct, with mental health services being an essential safety net and directly addressing how a state treats some of its most vulnerable citizens. Inadequate mental health care is not only a moral failing, it also leads to increased expenditures for homeless services, corrections and the court system.
Inslee’s plan would provide 62 new positions at Western State Hospital, including 51 nurses, at a cost of $6.8 million. It also would earmark $9.5 million for salary raises and bonuses for psychiatrists and psychiatric staff. As demonstrated by a simultaneous proposal to increase salaries for public school teachers in an effort to attract and retain them, Inslee’s solutions often involve throwing money at a problem and paying more for state employees. While many members of the Legislature will seek alternative ideas, there is little doubt that the state’s mental health system is in need of immediate attention.
This will be difficult for lawmakers, who this year went through a lengthy and contentious legislative session before passing a budget for the 2015-17 biennium. Since then, the state Economic and Revenue Forecast Council has projected a budget shortfall of $474 million for the next biennium, ending in mid-2019. That shortfall is driven by an expected increase of $700 million to maintain current services and cover mandatory costs for 2017-19.
In other words, the Legislature has its work cut out for it. Over the past decade, one preferred solution has been to limit expenditures on mental health, but that no longer is an option. The state has an obligation to enhance services that have been diminished in recent years, performing one of the most basic and most compassionate duties of state government.
This year’s Legislature increased funding for Western State Hospital by $9.4 million. That is a good start, but as Inslee has emphasized, it is only a start.