The Gristle

Turn That Corner

Wednesday, December 19, 2018

TURN THAT CORNER: Governor Jay Inslee was in Bellingham last week, directed in a variety of purposes but the bulk of which served to introduce the public to elements of a new spending plan he’ll deliver to a largely supportive Legislature next session.

Perhaps the most ambitious aspect of the governor’s plan is a multi-pronged effort to improve the state’s response to mental health care, including the public health emergency of the opioid crisis in America.

“My budget and accompanying legislation will build upon substantial work already underway to treat more of those in need of services and prevent the epidemic from claiming more lives,” Inslee said. “My proposed 2019-21 biennial budget invests $10.7 million for prevention and $19.3 million in treatment and recovery efforts” for opioid abuse.

The governor detailed budget investments to improve the state’s behavioral health system based on treatment in community-based facilities. His plan includes a first-of-its-kind partnership with University of Washington Medical School to establish an innovative new teaching hospital.

The plan is part of a 2019–21 biennial budget that continues to invest in K-12 education and includes strategies to fight climate change and protect southern resident orcas. In the area of improved social and criminal justice outcomes, the budget homes in on the complexity of the state’s state’s behavioral health response.

“We have an obligation to help our friends and family who depend on these services for their quality of life and recovery,” Inslee told listeners at a press conference.

As demand for behavioral health services increases, state officials have grappled with a shortage in the number of beds available in the state’s two large mental health hospitals, as well as a shortage in community placement options for patients ready to be discharged.

At the local level, construction continues on a North Whatcom Health Center to provide primary medical, dental, pharmacy and behavioral health services to 9,500 north county residents. The 23,393-square-foot facility is expected to open in the summer of 2019.

Additionally, a new 32-bed public center to treat people struggling with mental illness and substance abuse may also open in 2019. The $9.5 million project to expand Whatcom County’s Crisis Triage Center was identified in 2009.

Construction of the expanded facility was made possible by a $7 million allocation from the state’s 2018 capital budget. The North Sound Behavioral Health Organization, which oversees behavioral health crisis services in the Northwest Washington region, contributed an additional $2.5 million from their state allocation to the project.

Building on that around the state, Inslee’s plan includes a program dedicated to integrated behavioral health care. A teaching hospital will serve patients and provide support for what he described as the nation’s first comprehensive training program for integrated behavioral health, which may help address a shortage of behavioral health professionals.

The governor also detailed his initiative to strengthen his 2016 response plan to reduce the number of prescribed opioids in Washington, increase public education, and make treatment more available through what he described as a hub-and-spoke opioid treatment model.

The hub-and-spoke program is about creating a help network within a community. There is a hub, which is a facility where staff are certified to administer addiction-treatment drugs such as Suboxone, and there are a variety of nearby spokes, which are other places a person might find help for opioid use disorder.

Inslee rolled out his $19.3 million proposal last week to further build upon the statewide effort against opioid use disorder. The governor highlighted how a major federal grant award of more than $7 million will go toward service gaps in emergency departments, jails and homeless facilities—the spokes that serve the hub.

Opioid overdose deaths are now the leading cause of accidental deaths in nearly every part of the state. About two people a day died from opioid overdoses in Washington last year, according to the Department of Health.

Whatcom County has witnessed a particularly acute rise in opioid abuse, with overdose deaths increasing by more than 22 percent over a ten-year study period., according to data provided by UW’s Alcohol and Drug Abuse Institute.

The governor’s overall response to behavioral health proposal focuses on needs he outlined to listeners.

First, Inslee proposed a significant expansion of community-based behavioral health treatment facilities, statewide, expanding how and where patients receive care.

Next, the state can offer these individuals housing resources for getting back on their feet. Housing assistance is a key part to helping people stay stable so they can focus on recovery, he said.

Finally, the state can address the national shortage of behavioral health workers by investing in a larger network of care, investing in state hospitals and continue with behavioral health integration efforts for patients.

The plan includes elements included in the approved settlement agreement in a federal lawsuit against the state, challenging the unconstitutional delays in competency evaluation and restoration services. The settlement agreement includes investments the state must make with a goal of keeping individuals with mental illness out of the criminal justice system. This includes integrating behavioral health with primary care, moving stable patients into community-based facilities in a timely manner, and shoring up the behavioral health workforce.

“Let’s bring hope,” Inslee said. “Let’s turn that corner.”

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