- Associated Press - Tuesday, November 3, 2015

SEATTLE (AP) - The head of the Washington state health services agency said Tuesday concerns about safety at Western State Hospital, the state’s largest psychiatric facility, have led him to end all expansion until they can hire more staff.

Kevin Quigley, the secretary of the Department of Social and Health Services, sent a letter to hospital staff saying their inability to fill vacancies has kept the facility from providing quality care and treatment. He said the problem stems from a recent federal ruling that requires the state to provide timely competency services to mentally ill defendants. Quigley said they’ve tried to meet the court’s deadline but now believes they can’t safely achieve that goal. The new wards were spreading the staff too thin and raising safety concerns.

In a statement Tuesday evening DSHS said the results from an investigation by federal authorities this week have “officially placed the hospital in jeopardy of losing its Medicare certification.” That could mean a loss of federal funds for Western.

“There is no sugar coating this, federal regulators have recognized that staff vacancy rates are so severe that services do not meet the necessary standards despite the best efforts of the dedicated staff at Western State Hospital,” Carla Reyes, acting assistant secretary of the Department of Social and Health Services’ Behavioral Health and Service Integration Administration, said in a statement.

The 800-plus bed hospital has been under fire by the federal Centers for Medicare and Medicaid Services for failing to protect staff and patients. Federal officials have threatened to cut millions in funding if changes are not made. The agency sent a 90-day termination letter to the hospital on Sept. 21 after investigators said staff mishandled a patient-on-patient assault. It was the third funding-cut threat against the hospital this year. Western State Hospital receives $4.7 million from Medicaid and $11.2 million from Medicare annually.

Over the past seven days, agency inspectors have been conducting a survey at hospital, according a note CEO Ronald Alder sent to staff on Tuesday and acquired by The Associated Press. The department’s decision to shut down expansion of two wards that would accommodate competency patients is an effort to ensure the hospital meets the federal agency’s demands about safety.

Quigley said he takes responsibility for the hospital’s current crisis. He apologized to staff “for not being firm enough and courageous enough with the courts.”

“The state and federal court systems continue to mandate that we accept additional patients on their timelines, and that we - nearly instantly - open four new wards,” he said. “As you know firsthand, opening four new wards is much like mandating that we open an additional hospital.”

In order to ensure a safe facility, Quigley said he’s putting a “full pause” on expansion.

David Carlson, a lawyer with Disability Rights Washington, an advocacy group that filed the federal complaint in the behalf of people who languished in jails for weeks or months awaiting competency services, said Quigley’s announcement that he is abandoning the plan to meet the competency needs of the state “is not an appropriate response.”

“It’s very troubling to hear that Secretary Quigley thinks that there would be less of a problem if he had only been firm and courageous with the courts,” Carlson said. “His administration has a long history of ignoring court orders. This was not lost on the federal court. This letter looks like more of the same.”

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Follow Martha Bellisle at https://twitter.com/marthabellisle

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