Commissioners approve fee for psychiatric hospital beds

Spokane County commissioners approved a plan Tuesday aimed at reducing the number of patients sent to the state’s psychiatric hospital in Medical Lake.

A state contract effective Sept. 1 will require the county to pay $514 a day for each bed filled at Eastern State Hospital over the amount of beds allocated to the county by the state’s Mental Health Division.

As of this week, the county was using 112 beds, 11 more than will become the county’s allocation under the agreement.

Spokane County contracts with the state to administer mental health care to about 5,000 people a month.

Commissioners unanimously approved spending an extra $1.17 million from September through the end of the year for initiatives aimed at reducing the number of patients at Eastern State. About $680,000 of the money will come from the mental health system’s reserves. The rest will be covered by Medicaid.

“This is a critical first step,” said Commissioner Mark Richard.

New initiatives will include an expansion of beds at other mental care operations, and a variety of preventative efforts that include the funding of extra visits by psychiatrists to nursing homes to ensure patients receive proper medication and care.

“Every single one of these additional services is going to be very important to reducing our hospital use,” said Christine Barada, county director of community services.

Bed allocation fines have been a controversial topic the past few years and were suspended soon after Pierce County won a lawsuit against the state in 2005 for charging the fees.

Since then Spokane County sued the state in an attempt to be refunded more than $2.5 million in fines it paid for not meeting bed allocation requirements since 2003. The state has decided to repay the county more than $1.7 million, but the lawsuit still is pending.

Spokane County hospitalizes more patients in state mental hospitals per capita than any other group that contracts with the state to administer mental services.

Pierce and Spokane counties argue that their high hospitalization numbers are partially the result of being home to the state’s only two psychiatric hospitals.

Richard said the county agreed to the contract that included the fines because the alternative was handing operations to the state and losing local input.

“We felt there really was no alternative,” Richard said.

Barada said initiatives to reduce numbers at Eastern State will not prevent the admission to the hospital of people who need that kind of care.

“The provider community is very clear on their clinical roles and their responsibilities to the people who need help and assistance,” Barada said.