The state has an enormous challenge in addressing a federal court order related to mental health care, but pulling treatment resources out of communities can’t be part of the solution.
Call it unintended consequences or poor planning, but if the state Legislature doesn’t offer counties relief from witless penalties, mental health care services will suffer and nobody will benefit.
The genesis of this conundrum can be traced to 2014 when a federal court ruled that the civil rights of criminal defendants suspected of mental illnesses were being violated because they were not being evaluated in a timely manner.
Instead, many people were being warehoused in jails, often in solitary confinement, for weeks and months before getting an evaluation to determine whether they were competent to stand trial.
Everyone agrees that this situation needed to be remedied, and the state has spent millions more on evaluators and state hospital beds.
But one consequence of this improvement is that more patients move from the criminal side of the system to the civil side when it’s determined they need longer stays – as much as six times longer – before reaching competence.
As civil patients, they are the responsibility of their county’s behavioral health organization. Each organization is given an allotment of beds at the state hospitals, and if they exceed the quota, they are penalized. As evaluations sped up, it became more difficult to manage bed allotments.
Spokane County paid Eastern State Hospital about $76,000 in 2014, and the penalties kept growing as the need for civil beds grew. For the first half of this year, the county’s penalties are projected to be about $1.5 million. If this continues, the county estimates penalties could rise to between $3 million and $6 million in the next fiscal year.
Penalties must be paid with non-Medicaid funds. The Spokane County Regional Behavioral Health Organization, which covers seven Eastern Washington counties, has an annual budget of $12 million for non-Medicaid services. So anywhere from one-quarter to one-half of that budget could be blown on penalties.
As a result, the county informed Frontier Behavioral Health that it will lose $1.6 million in funding for non-Medicaid services.
Taking huge chunks of money from mental health services makes no sense.
County commissioners and behavioral health officials are asking the state Legislature to waive the penalties for two years and to conduct a review of the consequences from the federal court ruling.
State Sens. Shelly Short, R-Addy, and Andy Billig, D-Spokane, are aware of the issue and are optimistic about a solution.
Let’s hope so, because nobody is being served by the penalties.