Construction Projects Underway to Help Meet Demand for Patient Beds at Washington Psychiatric Hospitals - State of Reform

Construction Projects Underway to Help Meet Demand for Patient Beds at Washington Psychiatric Hospitals – State of Reform

Washington psychiatric hospitals don’t have enough beds to meet the demand for patients in need, but several construction projects are underway to help provide more capacity.

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Kelci Karl-Robinson, coordinator of the Washington State House of Representatives Office of Program Research, discussed capacity issues at the state’s two psychiatric hospitals during a budget committee meeting. of the Chamber on Thursday.

The Washington State Department of Health and Human Services (DSHS) operates both hospitalsWestern State Hospital in Lakewood and Eastern State Hospital in Medical Lake– who care for both forensic and civilian patients. As of September 1, Western had a total funded capacity of 747 beds, including 400 for forensic patients, with 347 for civilian patients. Eastern has been funded for 367 total beds, including 175 for forensic patients, Karl-Robinson said.

Forensic patients are adults who are referred when a court determines that a mental disability may prevent a defendant from assisting in their own defense, Karl-Robinson said. They receive an assessment to determine if they are fit to stand trial. The majority of these assessments are conducted in a prison. If found incompetent, they are referred to a public hospital for up to 90 days of skill restoration treatment.

“An additional group of patients in a public hospital are those who may be found competent and stand trial, but who have pleaded not guilty by reason of insanity,” Karl-Robinson said. “On the civilian side, individuals are committed to a hospital for a treatment period of 90 or 180 days if it is determined that they pose a danger to themselves or others.”

In April 2015, a federal court found that DSHS was taking too long to provide skills assessments and restoration services.

“In most cases, DSHS is required to provide assessments within 14 days and restoration services within seven days,” Karl-Robinson said.

The passing of House Bill 1394 in 2019 directed the Washington State Health Care Authority (HCA) to work with community hospitals and voluntary assessment treatment facilities to provide treatment to adults on 90- or 180-day recognizance orders.

The HCA’s contract bed capacity for 90-day and 180-day treatment is expected to increase over the next few years.

Civilian use of beds by patients doubled at Western over the past four and a half years to 304 people in July, Karl-Robinson said.

“When you compare that number to the projected capacity of 287 beds at Western, you can see that there is a civilian capacity issue at Western,” she said. “The number of civilian patients occupying forensic beds at Western has increased. The projected need for beds is expected to increase by 86 beds per year, so there is a projected gap of almost 250 beds in fiscal year 2023 and a projected gap of 250 beds in fiscal year 2027.”

Kevin Bovenkamp, ​​assistant secretary for behavioral health at DSHS, spoke about the state’s urgent need for more beds.

“Public hospitals have reached a tipping point in admissions due to a sharp increase in referrals, around 40% in the last year alone,” Bovenkamp said.

Several projects are underway to help the state meet patient demand. To meet future forensic bed capacity needs, two new wards are being built at Western, Karl-Robinson said. The project will provide 58 additional beds, which should be available in March 2023.

A new 350-bed forensic hospital is currently being designed for Western.

“If construction continues as planned, it should be complete by July 2027,” Karl-Robinson said.

Columbia Cottage in Maple Lane is being converted to 30 beds [not guilty by reason of insanity patient] ward, which is expected to open in September 2023, Karl-Robinson said.

To help meet future civilian bed capacity, a 16-bed community facility is under construction in Maple Lane and is scheduled to open in February 2023. A 48-bed community facility is under construction in Vancouver and is scheduled to open in January 2025, Karl -Robinson said.

Rep. Steve Tharinger (D-Dungeness) asked about finding more community facilities for civilian beds.

“If we can find placement in community hospitals for civilian beds, there are opportunities to perhaps take back some beds from Western that could be used for forensic purposes,” Bovenkamp said. “The current condition is that a lot of civilian patients are sitting in forensic beds. So he tipped in the wrong direction.

There are some really difficult patients at Western. But there are also a number of patients who are quite stabilized and who could probably move to community beds if they are available to us.

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