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Mental Health Funding Crisis: County Has to Cut Number of Patients at Western State, Audit Warns

Posted on: Friday, 16 June 2006, 06:00 CDT

By M. Alexander Otto, The News Tribune, Tacoma, Wash.

Jun. 16--Pierce County must reduce the number of its residents held at Western State Hospital in coming months, or risk a financial hit that could leave psychiatric patients who rely on publicly funded county services without care, a new audit report warns.

The report, released Thursday, said that beginning in September, the state will charge county mental health systems $414 a day for each patient over the number allotted to them at the 643-bed Lakewood facility.

Pierce County's allotment is 166 beds. Right now, there are about 210 Pierce County residents at Western State. The extra charges could add up $3.9 million a year, according to the audit.

The report says that's too much to bear for a county that's shouldered:

-- A roughly $7 million cut in annual state mental health funding.

-- Extra costs caused by the temporary shutdown of its mental health center.

-- Reductions in county funding for the kind of outpatient services that keep people out of the hospital in the first place.

The added costs from Western State are slated to be borne by the agencies that contract with the county to provide those outpatient services: Greater Lakes Mental Health Care, Comprehensive Mental Health, and Good Samaritan Community Health Care.

The extra costs could push them, as well as the entire mental health system, into bankruptcy, according to the audit.

The county needs to "focus like a laser beam to get the census down" at Western State, or it will face an "acute care crisis," said the audit's lead author, accountant Dale Jarvis.

Jarvis said that in his years of working with mental health systems in Washington, Pierce County's funding crisis is among the worst he's seen. "This is very serious," he said.

Getting the numbers down at Western State is possible, Jarvis said, if the mental health community puts aside years of bickering over funding, and works together to do such things as increase space at group homes.

One of the reasons county numbers are high at Western State is because the state shut down the county's treatment facility in January while health and safety problems were being fixed. It's since reopened, but it's still not up to capacity.

The situation with Western State is the most pressing of many problems uncovered in the audit, which was commissioned by the County Council after the county treatment facility was closed.

Culled from data supplied by the county mental health system and community mental health agencies, the audit found more than $10 million have been spent over the past six years for the purchase and upkeep of the county treatment facility, built in the early 1950s.

The report, which pegs the worth of the building and property at $20 million, suggested looking into the wisdom of maintaining such "an aging physical plant."

The audit also suggests that more than 80 percent of the Western State patients listed as Pierce County residents seem to have drifted in from elsewhere.

Among many recommendations, the audit suggests plugging funding gaps in the short term by shifting money to outpatient providers and away from the short-term "evaluation and treatment" unit recently opened at the county treatment center, known as the Puget Sound Residential Treatment Facility.

The report also calls for improving relationships between county mental health system administrators and community mental health agencies and state regulators.

Friction between the county and the state over Western State charges in nothing new. The county recently won a lawsuit against the state to recoup earlier fees it paid to house residents at Western State.

Dave Daniels, operations chief for the state mental health division, said he couldn't talk about much of what's in the audit because it raises questions involved in the lawsuit, which is under appeal.

But "it's not a bad report," he said. "The recommendations are good."

M. Alexander Otto: 253-597-8616

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Copyright (c) 2006, The News Tribune, Tacoma, Wash.

Distributed by Knight Ridder/Tribune Business News.

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Source: The News Tribune

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