While Washington state has 10 psychiatric beds for every 100,000 people, South King and Pierce County offer 2.8 beds per 100,000.
Realizing the mental health crisis to which those grim stats testify, MultiCare Health System and CHI Franciscan Health formed the alliance for South Sound Behavioral Health in 2015. Their intent: to raise $42 million to build a 120-bed, acute psychiatric care hospital, extending from a former wing of the Allenmore Hospital building in Tacoma, to serve the residents of Pierce and South King counties.
While MultiCare and CHI Franciscan have each pledged $10 million to the project, the coalition is looking for private funding, and has locked down $5 million public funding from the state of Washington and accepted smaller pledges from a number of cities, most of the latter in Pierce County.
The coalition’s ask of Auburn – $400,000.
“We are a community in need,” Ingrid Gourley-Mungia, government affairs manager for Multicare Health System, explained to the Auburn City Council at City Hall on Monday. “We are treating those patients in our emergency rooms and in our jails. People can be treated (at the future hospital) voluntarily and involuntarily.”
But on Monday, several City Council members wanted to know why Auburn should contribute $400,000 to the construction of a mental health hospital in Tacoma.
“Looking at the list (of actual and potential contributors) they’re pretty much cities south of us … most of these cities are nearer to Tacoma than we are,” said Councilman Bill Peloza. “I still don’t understand the rationale.”
Anna McBride, president of Behavioral Health for CHI Franciscan, began by noting that a section of Auburn is in Pierce County.
Also, McBride said, historically the federal and state governments have paid for mental health differently than they have medical care, and counties have closely monitored the residencies of patients they treat.
Gov. Jay Inslee’s plan to transform health care by 2020 will “soften that situation,” McBride said, by integrating medical care and behavioral health care.
CHI Franciscan and MultiCare and other behavioral health care providers are working to make that union a reality, McBride said.
“What we knew from our experience … is that although we have a mental health unit at St. Joseph Medical Center, patients come into our emergency room from anywhere they can get to Tacoma from, including South King County,” McBride said.
That explanation did not satisfy Peloza.
“Multicare Hospital here, they have (40 mental health beds) … and it appears to me that the City of Auburn has a complement now for that type of usage,” he said. “Why would we want to go to Tacoma?”
Multicare Auburn Medical Center (MAMC) primarily uses its psychiatric beds for involuntary treatment, Gourley-Mungia said, so that if a patient acknowledges that he or she needs treatment, that person has a rough time getting into MAMC, whereas the future mental health hospital will offer beds for voluntary treatment as well.
Second, Gourley-Mungia said, in an emergency, first responders could go directly to the new hospital in Tacoma, which would have a mental health emergency room, not only a medical emergency room.
Also, McBride said, MAMC does not offer all the necessary mental health services. It has a 20-bed geriatric psychiatry unit for patients 65 and an adult, 20-bed involuntary unit for patients who present a potential harm to themselves and to others.
But that leaves out a lot of people who need help.
“At the Allenmore campus, there will be 120 beds while there are 40 some beds at Auburn. There are patients that do come from south King County down to Tacoma – and will come, I’m sure, once we have more capacity – and there will be there what is called a ‘crisis stabilization unit’ for people who are destabilized, emotionally distraught. They can be supported there by professionals, with potentially some dedicated support, so that maybe within 24 to 48 hours they can actually center again and will be able to not be admitted into the hospital,” McBride said.
The only beds in Pierce County that aren’t at Western State Hospital are the 23 beds at St. Joseph’s Medical Center, and that’s a voluntary unit, McBride said.
While Deputy Mayor Largo Wales expressed her uneasiness with entities that treat Auburn as “one deep pocket,” she added that she is not blind to all the special needs out there, including mental illness.
“But I believe in spending Auburn’s money in Auburn first,” Wales said.
Show of support
Councilman John Holman, a retired police officer with decades of experience handling with behavioral health problems, supports the city’s involvement with the hospital project.
“Where do you serve these people? They are taking up a quarter of our jails, or more, in an inappropriate facility that is, quite frankly, extremely expensive, to just warehouse someone,” Holman said. “Just like crime doesn’t share a border with Auburn and Kent, or King County and Pierce County, neither does mental illness. The fact that we have some place to take them other than jail seems like money well spent to me.”
Mayor Nancy Backus agreed.
“As we’ve heard from some of the other human service organizations we contribute to, just because they are not physically located in Auburn does not mean they are not providing much needed services to the residents of Auburn. Let’s just say there was $400,000 available. We can’t tell MultiCare, ‘We have $400,000 for you, but you have to use it for behavioral health beds at your Auburn facility.’ Their capital plan (for MAMC) has the 40 beds, 20 of them being geri-psych, and 20 of them that are involuntary. That does not mean they have beds available for voluntary treatment. So CHI Franciscan and MultiCare have identified the Allenmore location as that place where they will provide those services.”
“…. The fact is,” Backus added, ”there are no boundaries; people do not care if they live in South King County or north Pierce County: if they need behavioral health care, they need behavioral health care.”