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Health care workers concerned, advocates call for patients’ release as Eastern State Hospital tallies 2nd case of COVID-19

A second employee at Eastern State Hospital, seen in 2016, has tested positive for COVID-19. The outbreak has fueled concerns among health care workers and prompted disability-rights advocates to call for the release or transfer of many psychiatric patients. (Jesse Tinsley / The Spokesman-Review)
By Chad Sokol and Jared Brown The Spokesman-Review

A second Eastern State Hospital employee has tested positive for COVID-19 following an outbreak at Western State Hospital, fueling concerns among health care workers and prompting disability-rights advocates to call for the release or transfer of many psychiatric patients.

Legal advocacy groups on Friday sent a letter to the state Department of Social and Health Services, urging officials to coordinate the release of patients who are held involuntarily at the two state hospitals.

And, just as at other hospitals statewide, Eastern State Hospital staff report an inadequate supply of personal protective equipment, according to DSHS.

The agency plans to release as many as 60 patients from Western State Hospital, an 857-bed facility in Lakewood, to relieve strain caused by the new coronavirus. Many of those patients will be moved to group homes or assisted-living facilities.

Meanwhile, no patients are slated to be released from Eastern State Hospital, which has 317 beds in Medical Lake, due to concerns about COVID-19, said Sean Murphy, DSHS assistant secretary for behavioral health.

Eastern State Hospital could see an increase in patients as DSHS sends more West Side criminal defendants there for “competency restoration” – psychiatric treatment aimed at ensuring they are fit to stand trial. Murphy said the move also is intended to ease the strain on Western State Hospital.

As of Friday, 17 workers and six patients at Western State Hospital had tested positive for COVID-19, and one patient had died, according to DSHS.

At Eastern State Hospital, a second employee was confirmed to have the disease on Wednesday after getting tested Monday, said Kelly Von Holtz, an agency spokeswoman. The last time that employee worked was March 24 and had no symptoms at the time, Von Holtz said.

The first employee at Eastern State Hospital tested positive March 27.

Fifteen other staff members and eight patients at Eastern State Hospital had tested negative for COVID-19 as of Friday, Von Holtz said. The facility is awaiting results for four staff members and one patient.

In all, the hospital has 869 employees with 478 directly caring for patients, according to Von Holtz.

With Eastern State Hospital continuing to admit new patients, the facility has required them to stay in designated units for at least 14 days but they are not housed in isolated quarters, according to SEIU Healthcare 1199NW, a union representing health care workers across the state, including those at the psychiatric hospitals.

On Friday, Disability Rights Washington and other organizations sent a letter to DSHS saying the agency should release patients who are held at the psychiatric hospitals under Washington’s civil commitment law, meaning a judge has determined they pose a risk to themselves or others.

Kimberly Mosolf, director of treatment facilities programs at Disability Rights Washington, noted that hundreds of patients deemed “ready to discharge” are on wait lists for release due to a shortage of willing housing providers. Transfers from the state hospitals also involve “a lot of procedural hoops to jump through,” Mosolf said.

“The fact is absolutely there are too many people who are taking up beds who do not need to be there,” she said. “There’s already been a problem getting people out of there.”

With federal waivers freeing up housing options, Disability Rights Washington said DSHS should release many patients who have shown progress in their mental health treatment. Mosolf said the agency also should consider releasing so-called NGRI patients – those who enter care through the criminal justice system after pleading “not guilty by reason of insanity.” Some of those patients have shown progress and earned offsite visiting privileges, she said.

“We’re not advocating that anyone be released into dangerous situations, or that they’re released into homelessness where they’d be in a dangerous situation themselves,” Mosolf said. “What we don’t want to see is a bunch of folks shipped off to a nursing facility and end up institutionalized, just in a different setting.”

Disability Rights Washington also said staffing shortages could exacerbate the need to release patients. Murphy, the behavioral health secretary, confirmed Friday that more health care workers have been calling in sick since the pandemic began.

“If they’re down a lot of staff, I don’t even know how they could treat their current numbers of patients,” Mosolf said. “It’s not like it’s a hospital with a lot of wiggle room.”

Medical staff at Eastern State Hospital report many who have stayed home with symptoms of illness were required to use personal sick leave, according to SEUI, the statewide health care workers union representing them. Staff also say they have not been given concrete guidelines for how at-risk employees – due to age or underlying health conditions – might be allowed to work from home.

The ACLU of Washington, Columbia Legal Services, the Washington Defender Association and the Washington Association of Criminal Defense Lawyers also signed the letter to DSHS calling for the release of patients.

Columbia Legal Services also is suing Washington’s Department of Corrections and Gov. Jay Inslee, seeking the release of state prisoners with health problems who are especially vulnerable to COVID-19. A decision by the state Supreme Court is expected by April 16.

Although Western State Hospital has seen its first death from COVID-19, the statewide health care workers union says the hospital has not addressed many of its concerns.

The union’s demands at Western State Hospital included a hospital ward designated for COVID-19 patients, a voluntary team designated for COVID-19 treatment and protective equipment for workers screening and caring for patients with COVID-19-like symptoms. Other requests were for paid leave for those who contract COVID-19 and pay bumps for those caring for COVID-19 patients.

Eastern State Hospital has created a quarantine unit where patients presenting COVID-19-like symptoms await test results, said Von Holtz, the DSHS spokeswoman. The rest of the hospital’s patients are screened daily for symptoms including fever, and they are restricted from leaving their wards.

Only workers caring for patients suspected to have COVID-19 are provided personal protective equipment by the facility, said Von Holtz. Until Wednesday, staff members were prohibited from bringing in their own face masks, but Murphy has reversed course due to a global shortage of face masks and other protective gear.

DSHS also has changed its policy for screening employees at Western State Hospital following union requests, Von Holtz said. The process now involves a questionnaire rather than a physical temperature check.

Murphy said employees must attest that they don’t have a fever of 100.4 degrees or higher, and that they haven’t encountered anyone with COVID-19 in 14 days, among other criteria. A similar questionnaire is used at the University of Washington Medical Center, he said.

All other DSHS facilities, including Eastern State Hospital, still rely on a general symptom screening and temperature check of employees before they start work, Von Holtz said.

DSHS restricted visitors to legal professionals and advocates at its 24/7 facilities, including Eastern and Western state hospitals, in mid-March. The Fircrest School in Shoreline and the Child Study and Treatment Center in Lakewood – the only exception to the visitor mandate – have each reported cases of COVID-19 in employees.

Despite some improvements in workplace safety at state psychiatric hospitals, the union representing health care workers sees many unmet needs.

“We continue to demand hospital management provide proper PPE to front-line caregivers and ensure that any worker sick with COVID-19 be given paid administrative leave,” the executive vice president of the union, Jane Hopkins, a registered nurse, said in a statement. “We expect Eastern State to properly quarantine incoming patients to limit the spread of the novel coronavirus, and to follow CDC guidelines for PPE and sanitary precautions.”

Western State Hospital has been the target of state and federal investigations for safety violations in recent years. It lost its accreditation and federal funding from the Centers for Medicare and Medicaid Services after repeatedly failing health and safety inspections.

Murphy said DSHS has been in consultation with epidemiologists and other experts from the state Department of Health. Those experts, he said, confirmed that DSHS workers have been “performing infection control practices in a stellar manner.”

“They did give us some recommendations, and we are certainly learning from those recommendations,” Murphy said. “We are also taking the learning lessons that we’re getting out of Western right now, and we’re trying to reduce or mitigate the impact at the 11 other facilities that DSHS has around the state.”

The Associated Press contributed to this report.