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‘We’re at our breaking point’: Washington physicians ask state to ease burden on slammed facilities

UPDATED: Thu., Jan. 6, 2022

By Arielle Dreher and Laurel Demkovich The Spokesman-Review

Health care providers and emergency room physicians are asking the state to help ease the stress felt in emergency departments statewide.

At most hospitals , there are patients who could be discharged to other facilities like adult family homes, nursing homes or long-term care facilities. These patients no longer need hospital care but cannot be discharged for various reasons.

Some patients have COVID-19 that can be treated elsewhere, but there are no facilities to take them. Others need a guardianship before they can be discharged to a new facility if they are unable to make that decision themselves. Others are waiting to be approved for an assessment or for Medicaid before being transferred to a care home.

While this phenomenon pre-dates the pandemic, health care providers are now asking for immediate change to free up bed space to take care of more COVID patients seeking care due to the omicron surge.

“We’re at our breaking point now unlike we’ve ever been,” said Dr. Nathan Schlicher, director of quality assurance at Franciscan Health System and immediate past president of the Washington State Medical Association.

Schlicher said hospitals are running out of staff and space to adequately provide care to everyone.

The association, along with a statewide chapter of emergency physicians, sent the governor and Department of Health a letter requesting immediate assistance to address the crisis. They asked for more incentives to long-term care facilities to take these patients.

There are 84 COVID beds in long-term care facilities statewide, Dr. Charissa Fotinos, the state Medicaid director, said on Thursday, and at the start of this week half of those beds were full.

Staff at the Department of Social and Health Services, in charge of assessing people who might need to go to a facility, have also been impacted by omicron, Fotinos said, which has meant the agency is struggling to fulfill the assessments needed before hospitals can discharge these patients.

The Washington State Medical Association has asked the state to increase funding to the agency in order to expedite this process.

Gov. Jay Inslee acknowledged the letter during the Associated Press Legislative Preview on Thursday.

“I emphasize and share those concerns with the health care system,” Inslee said.

Inslee said the state is preparing for use of the National Guard but is currently in the process of determining how they can be used.

He hasn’t made a final decision on calling in the guard.

Schlicher said hospitals are in need of help to do all kinds of work that even National Guard members without medical experience could do.

Environmental services, kitchen and support staff in hospitals are also impacted by the recent omicron surge. The kitchen at his hospital had to close due to short staffing at one point, Schlicher said. Hospitals need runners to carry swabs to the lab or help turning over rooms.

“We could put people to work if we had them there ready to work,” Schlicher said.

Inslee said the state hasn’t been asked specifically by hospitals for deploying the National Guard.

“The Guard cannot solve the problem singlehandedly of a lack of nurses and physicians,” Inslee said.

The Department of Health still has a contract with ACI Federal to send contracted health care workers to hospitals that request the assistance. In the last two weeks, the department has received three requests from hospitals.

While some fixes might be quicker than others, changing state law to allow loved ones and family members to make discharge decisions for loved ones without a guardianship might take more time.

Inslee said he is looking at a way to accelerate the guardianship process.

It’s not clear whether changing this law would require legislative action or could be done by the governor through an emergency order.

“Based on what we know from the letter, it sounds like this would need to involve legislative action,” Mike Faulk, a governor spokesperson, wrote in an email.

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.

Laurel Demkovich's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.

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