HomeMy WebLinkAboutInterlocal Agreement between Mason County and Thurston Mason Behavioral Health Organization - Interlocal Agreement INTERLOCAL AGREEMENT
BETWEEN MASON COUNTY
- and the
THURSTON MASON BEHAVIORAL HEALTH ORGANIZATION
This Interlocal Agreement{AGREEMENT) is made and entered into pursuant to-the
provisions of Chapter 39.34 RCW lnterlocal Cooperation Act by and between Mason
County-(COUNTY)and the Thurston Mason-Behavioral Health Organization (BHO)
collectively known as the parties to this AGREEMENT.
Purpose:
Provide.$275,000 from Sales and Use Tax for Chemical Dependency or Mental Health
Services as defined in RCW 82.14.460 to be used to purchase and renovate a building in
Mason County to.providebehavioral health diversion services for both inappropriate
incarceration of the mentally ill from jail and inappropriate utilization of local hospital
emergency department by individuals with behavioral health disorders.
Term:
The facility will be used for the purpose detailed in BHO's 2016 Community Behavioral Health
Beds-Acute and Residential grant application submitted the Washington State Department of
Commerce (DOC)for a minimum of ten (10) years.
Ownership:
The building purchased and renovated will belong to the BHO. Should the BHO become
defunct, ownership of the building will be transferred to Mason County. Should-the BHO elect
to sell the property after ten (10)years COUNTY reserves the right of first refusal. If the facility
is sold BHO will reimburse COUNTY's original$275,000 investment.
Administration:COUNTY and BHO have designated the fallowing representatives to serve
as the Administrators for this AGREEMENT.The parties agree to provide notification to the
other paity of change of designated Administrator.
COUNTY:
Frank Pinter
Support Services Director
Mason County
411. N.5th Street
Shelton,`WA 98584
Phone: 380-427-9670 Ext. 530
PPinter@co.mason.wa.us
BHO:
Mark Freedman
412 billy Road NE
Olympia,.WA 98506
Phone: 360-867-26.58
E<mail:freedman@cothurston.wa.us
thurston.wa.us
Notices and Written Communication: Notices and other communication may be conducted
via email, U.S. mail,fax, hand-delivery or other generally accepted manner including delivery
services.
Indemnification:
1: Mutual Indemnity. To the extent of its comparative liability, each party agrees to indemnify,
defend and hold the other party, its elected and appointed officials, employees, agents and
volunteers, harmless from and against any and all claims, damages,losses and expenses,
including but not limited to court costs, attorhey%fees and alternative dispute resolution costs,
for any personal injury,.-for any bodily injury, sickness., disease or death and for any damage to
ordestruetion of any property (including the loss of use resulting therefrom)-which are alleged_or
proven to be caused by an act or omission,negligent or otherwise,of its elected and appointed
officials, employees,agents or-volunteers.
In the event of any concurrent act or omission of the.parties, each party-shall pay its
proportionate share of any damages awarded. The parties agree to maintain a consolidated
defense to claims made:against them and to reserve all indemnity claims against each other
until after liability to the claimant and.damages, if any, are adjudicated. If any claim is-resolved
by voluntary settlement and the parties cannot agree upon apportionment of damages and
defense costs,they shall submit apportionment to binding arbitration.
2. Survival of Indemnity Obligations. The parties agree all indemnity obligations shall survive
the completion,expiration or termination of this AGREEMENT.
Independent Capacity:
Employees or agents of each party who are engaged in the performance of this AGREEMENT
shall continue-to be employees or agents of that party and shall not be considered for any
purpose to be employees or agents of the other party.
Assignment and Subcontracting:
The performance of all-acti.vhties.contemplated by this AGREEMENT shall be accomplished by
BHO. No portion of this AGREEMENT may be assigned or subcontracted to any other
individual, firth or entity without the express and prior written approval of COUNTY.
Non-Discrimination in Employment:
COUNTY's policy is to-provide equal opportunity in all terms, conditions and privileges of
employment for all qualified applicants and employees without regard to race, color, creed,
religion, national origin,sex,sexual orientation, age, marital status,disability, or veteran status.
shall comply with all laws prohibiting discrimination against any employee or applicant for
employment on the grounds of race, color,creed, religion,national origin, sex,sexual
orientation, age, marital status, disability, or veteran status, except where such constitutes a
.bona fide occupational qualification.
BHO shall take of itmative action to insure that applicants are employed,and treated during
ern.ployment,without regard to their race,.color, creed, religion,national origin, sex; age, marital
status,sexual orientation,disability,or veteran status, except where such constitutes a bona
fide occupational qualification. Such action shall include, but not be limited to: advertising,
hiring, promotions, layoffs orterminations; rate of pay or other forms of cornpensation benefits,
selection for training including.apprenticeship, and participation in recreational and educational
activities. In all solicitatibris.or advertisements for employees placed by them or on their'behalf,
BHO. shall state that all qualified applicants w me
ill receive consideration for employment without
regard to race,color, religion,sex or national origin.
Nun-Discrimination in Customer Services:
BHO shall not discriminate on the grounds of race, color, creed, religion, national origin, sex,
age, marital status, sexual orientation, disability, or veteran status; or*deny an individual or
business any service or benefits under this AGREEMENT; or subject an individual or business
to.segregation or separate treatment in any manner related to his/herClts receipt any service or
services or other benefits provided under this AGREEMENT; or deny.an individual or business
an opportunity to participate in any program provided by this AGREEMENT.
Compliance with Applicable;Laws, Rules and Regulations:
This AGREEMENT shall be subject to all laws, rules, and regulations of.'the United States of
America,the State of-Washington, political subdivisions of the State of Washington and Mason
County, BHO also agrees to comply with applicable Federal,State, County or municipal
standards for licensing,,certification and operation of facilities and programs; and accreditation
and licensing of individuals.
Amendments:
Either party may request changes-in the AGREEMENT.Any and all agreed amendments,to be
valid.and binding upon either party, shall be in writing and signed by both of the parties.
Right to Review:
This AGREEMENT is subject to review by any Federal, State or COUNTY auditor. COUNTY or
its designee shall have-the right to review and monitor the financial and'service components of
this program by whatever means are deemed expedient by COUNTY's AGREEMENT
Administrator or by CO,UNTY's Auditor's Office. Such review may occur with or without notice
and may include, but is not limited to, on-site inspection.by COUNTY agents or employees,
inspection of all records or other materials whlch COUNTY deems pertinent to the
AGREEMENT and its performance,:and any and all communications with or evaluations by
service recipients under this AGREEMENT. BHO shall preserve.and-maintain all financial
records and records relating to the:-perflormarice of work,under this AGREEMENT fnr six (6)
years after AGREEMENT termination, and shall make them available for such review,within
Mason County, State of Washington,.upon request. BHO also agrees to notify the COUNTY's
AGREEMENT Administrator in advance of any inspections, audits, or program review by.any
individual, agency,ar,governmental unit whose purpose is to review the services provided within
the terms of this AGREEMENT. If no advance notice is given to BHO,then BHO agrees to
notify the COUNTY's AGREEMENT Administrator as soon as it is practical.
Disputes:
Differences between.COUNTY and BHO, arising under and by virtue of the AGREEMENT.
Documents, shall be brought to the attention of COUNTY at the earliest possible time in order
that such matters may be settled or other appropriate action promptly taken. Decisions of
COUNTY's Adrministrator shall be final and conclusive.
Venue and Choice of
In the event that any Iitigation,should arise concerning the construction or interpretation of any
Of the terms of this AGREEMENT,the venue of such action of litigation shall be in the courts of
the State of Washington in and-for Mason County. Unless otherwise specified herein,this
AGREEMENT shall be governed by the laws of Mason County and the State of Washington.
Severabllity:
If any term or condition of this AGREEMENT or the application thereof to.any persons)or
.circumstances is held-invalid, Such invalidity shalt not affect otherterms,conditions or.
applications which can be-given effect without the invalid'term,condition or application. To this
end, the terms and conditions of this'AGREEMENT are declared severable.
Waiver_
Waiver of any breach or condition of this AGREEMENT shall not be deemed a waiver of any
prior or subsequent breach. No.term or condition-of this AGREEMENT shall be held to be
waived, modified or deleted except by an instrument, in writing, signed by the parties hereto.
The failure of COUNTY to insist upon strict performance of any of the covenants of this
AGREEMENT, or to exercise any option herein conferred-in any one or more Instances,shall
not be construed to be a waiver or relinquishment of any such, or any other covenants or
contracts; but the same shall be and remain in full force and effect.
Order of precedence:
A.Applicable.federal; state and county statutes, regulations, policies, procedures,federal Office
of Management and Budget(OMB) circulars and federal and state executive orders.
B.AGREEMENT
C.Attachment A-2016 Community Behavioral Health Beds-Acute and Residential grant
application.
Entire Agreement,
This written AGREEMENT,comprised of the writings signed or otherwise identified and
attached hereto, represents the entire AGREEMENT between the parties and supersedes any
prior oral statements,discussions or understandings between the.parties.
IN WITNESS WHEREOF,COUNTY and BHO have executed this AGREEMENT as of the
date and year last written below.
Ti HURSTON MASON, BO.AR.D OF COUNTY COMMISSIONERSBEHAVIORAL.HEALTH ORGANIZATION MASON COUNTY,WASHINGTON
Terri Jeffreys, it
Dated; . f ` is � (4. Dated: f 15
APPROVED A5 TO FORM:
Tirn Whitehead,Chief DPA
RESOLUTION NO.. B11016-14
A RESOLUTION OF THE THURSTON-MASON BEHAVIORAL HEALTH ORGANIZATION
GOVERNING BOARD ESTABLISHING AN AGREEMENT WITH
MASON COUNTY FOR FACILITY PURCHASE
WHEREAS,chapter 39.34 RCW permits local governmental entities to make the most efficient
use of their powers by enabling them to cooperate with other localities on the basis of mutual advantage;
and
WHEREAS,Mason County shall provide$275,000 from Sales and Use Tax for Chemical
Dependency or Mental Health services as defined in RCW 82.14.460 to be used to purchase and
renovate a building in Mason County to provide behavioral health diversion services for mentally ill
individuals.
WHEREAS,the facility will be used for the purpose detailed in TMBHO's 2016 Community
Behavioral Health Beds-Acute and Residential grant application submitted to the Washington State
Department of Commerce(DOC)for a minimum of ten(10)years.
WHEREAS,the building purchased and renovated will belong to TMBHO. Should TMBHO
elect to sell the property after ten(10)years,Mason County reserves the right of first refusal.If the
facility is sold,TMBHO will reimburse Mason County the original$275,000 investment.
NOW,THEREFORE,in consideration of the promises recited herein and the mutual benefits to
be derived and to coordinate their efforts is mutually agreed by the Parties as follows:
ADOPTED by the Board of the Thurston-Mason Behavioral Health Organization,at a regular meeting
thereof held on the d_(;rK day o r 20 1
Thurston-Mason Behavioral Health
ATTEST: Governing Board
Tina Gehrig,Cle and
H Blake,Chair
Approved As To Form: Terri Jeffreys,
Jon Tunheim,Prosecuting Attorney
_ _absent _
Cathy Wolfe,Commissioner �-
Attachment
Department of Commerce
2016 Community Behavioral Health
Beds - Acute & Residential
Grant Application
Submission deadline: Thursday, July 28, 2016 at 5:00 p.m.
(must be emailed or postmarked)
For questions regarding the application and selection process and submission of the application:
Bill Cole
Department of Commerce
P.O. Box 42525
Olympia,WA 98504-2525
(360)725-3005
Bill.cole@commerce.wa.gov
For questions regarding Residential Treatment Facility, Hospital licensing, or Construction Review:
Julie Tomaro
Department of Health
(360) 236-2937
NOTE: If you are one of the projects listed in Section 1007(3), (4), or(7) of the 2016 Supplemental Capital
Budget, please fill out this application to provide us with the information we will need to write a contract for
your project. You do not have to submit this form by July 28, but the sooner you provide us with this
information, the sooner we can execute a contract and start reimbursing you for eligible project costs.
Application Due Date: Thursday, July 28, 2016 at 5:00 p.m.
Please read Section 1007 of the 2016 Supplemental Capital Budget(included at the end of
the application) as well as EHB 2212 prior to filling out your information and answering the
questions. EHB 2212 can be found at http:/Ilawfilesext le.g wa gov/biennium/2015-
16/Pdf/Bills/Session%20Laws/House/2212.SL.pdf
This application is for grants to hospitals or other entities to establish new community hospital
inpatient psychiatric beds, free-standing evaluation and treatment facilities, triage facilities, or
crisis stabilization facilities with sixteen or fewer beds for the purpose of providing short term
detention services through the publicly funded mental health system.
Enhanced Services Facilities (ESFs) do not qualify for this grant.
Note: The limit of sixteen or fewer beds only applies to crisis stabilization facilities and not to
other types of facilities. "Short Term" is defined as 72 hours to 14 days.
Grant Limit: Each competitive award is limited to $2.0 million. If you are applying for more than
one project you must indicate the priority of the projects. Based on demand, Commerce reserves
the right to offer reduced award amounts in order to fully obligate the grant funding. Commerce
will notify applicants prior to announcing awards to inform them of a reduced offer. Commerce
also reserves the right to prioritize grants to applicants that have not previously received funding
through this program.
Applicant: Thurston Mason Behavioral Health Organization
Contact Name: Mark Freedman
Phone: 360-867-2558
Email: freedmm@co.thurston.wa.us
Address: 412 Lilly Rd NE
City: Olympia WA Zip: 98506
County: Mason
State Legislative District of the Project: 22
Congressional District of the Project: 10
Will your project be licensed as a psychiatric hospital (WAC 246-322) or acute care hospital
(WAC 246-320)? ❑Yes 9 No
Is your facility a critical access hospital? ❑ Yes ❑x No
Do you currently have a Certificate of Need for new beds identified in this application (WAC 246-
310)?
❑ Yes FX1 No
Would you be exempt from Certificate of Need requirements under EHB 2212 if you receive a
grant? 0 Yes 0 No
For Certificate of Need questions contact the Certificate of Need Program at the Washington
State Department of Health at (360) 236-2955. Funds awarded through this grant process may
be contingent on receiving a Certificate of Need, if required for your facility. If a Certificate of
Need is required for your facility, please start the application process with the Department of
Health as soon as possible.
Will your project be licensed as a Residential Treatment Facility (WAC 246-337)?
0 Yes ❑ No
1. List the Managed Care Entity or Entities (MCEs) and contact information of the person(s) you
collaborated with to develop this application below. An MCE could include a: Behavioral
Health Organization (BHO), Behavioral Health Administrative Services Organization
(BH-ASO) or a Managed Care Organization (MCO).
MCE(s): Thurston Mason Behavioral Health Organization Click here to
enter text.
MCE Contact Name: Marls Freedman Click here to enter text.
MCE Contact Phone: 360-867-2558 Click here to enter text.
MCE Contact Email: freedmm@co.thurston.wa.us Click hereto enter text.
MCE(s): Click here to enter text. Click here to enter text.
MCE Contact Name: Click here to enter text. Click here to enter text.
MCE Contact Phone: Click here to enter text. Click here to enter text.
MCE Contact Email: Click here to enter text. Click here to enter text.
2. If the project is not at the location above, where is your project located?
Address: 307 W. Cota St
City: Shelton WA Zip: 98584
3. Please describe your project, including:
a. Whether this project is a stand-alone facility or part of a larger facility;
b. Total square footage of the project;
c. Number of new community hospital inpatient psychiatric beds;
d. Free-standing evaluation and treatment facilities;
e. Triage facilities;
f. Crisis stabilization facilities;
g. Specific use of state grant funds; and
h. Total number of beds.
Thurston Mason Behavioral Health Organization (TMBHO) is requesting capital funding to
purchase and renovate an existing building in Mason County to provide Evaluation and
Treatment/Triage services (E&T). The overall plan, to occur in two stages, is to create two
treatment units for involuntary behavioral health services for the region served by
Thurston Mason BHO with improved geographical access for Mason County individuals.
One unit is for involuntary Evaluation and Treatment (E&T) services, and the other for
Secure Withdrawal Management (formerly referred to as Detoxification or Detox)
services. For the initial phase, TMBHO is requesting funding to purchase and renovate
the first floor of a building already identified in Mason County to construct 10 E&T beds.
Because the grant funding currently available is insufficient to renovate the complete
building for both units, phase will be done at a later date, and will include the complete
renovation of the second floor to construct ten secure withdrawal management beds.
These two units must operate separately from each other per licensing requirements.
Having a two floor building would help facilitate this separation as well as the staging for
construction. Requested funding is for the purchase and renovation of the building.
Operational services will be funded by TMBHO. This past year, community meetings
were held in Mason County to discuss local needs/gaps analysis for diversion services
from the criminal justice system and emergency departments for those with a behavioral
health disorder. Participants included: County Commissioners, Prosecuting Attorney,
Defense Council, Sheriff, service providers, Mason County General Hospital staff and the
BHO. While stakeholders identified that E&T beds be built first, they would just as well
prioritize secure withdrawal management beds. If the grant funders felt that the overall
statewide mix of new facility beds were better served by prioritizing secure withdrawal
management beds first for construction, the TMBHO Governing Board and stakeholders
would willingly accept that change to the order that this facility be built. As already noted,
the proposed project is to renovate an available building located in Mason County to
provide behavioral health diversion services for both inappropriate incarceration of the
mentally ill from jail and inappropriate utilization of local hospital emergency department
by those individuals with a behavioral health disorder. Currently, to access services,
citizens in Mason County must travel to Thurston or other counties for acute or diversion
services. While Mason County is part of the Thurston Mason Behavioral Health
Organization, geographical access to appropriate acute care is lacking. On September 1,
2016, TMBHO will begin operation of a new Triage Facility located in Thurston County.
This is a ten bed E&T facility designed for diversion of those with a behavioral health
disorder who committed a crime due to their mental illness from incarceration. While
these ten beds will have an impact, they are insufficient to meet the needs of the region
are geographical distant from Mason County, and as a result,more beds are needed for
the region. For effective jail and emergency department diversion, the following conditions
are essential 1) immediate access to behavioral health services otherwise called
"treatment on demand" is critical The wait time to transport a client to another county by
police or emergency transport does not promote effective or humane treatment. 2), the
time it takes for law enforcement to transport an individual out of county significantly
affects their ability to cover patrol requirements and is not an efficient use of their time.
Transportation time for law enforcement must be reduced. 3), there's a great need for law
enforcement to have alternatives to jail for individuals 24 hours a day, 7 days a week to
ensure community safety. We need to add to law enforcements "tool kit" for an alternative
place to jail for those individuals who commit crimes due to their behavioral health
disorder. As police have said frequently, Crisis Intervention Training for police is not
particularly effective if there is no place to actually bring an acutely ill individual who
cannot be left to their own recognizances. This facility will provide 24 hour 7 days a week
services through licensed residential beds credentialed for voluntary and involuntary E&T
care. Several issues are driving the need for these services and additional beds. 1): At
this time there exists only limited access to E&T beds for residents in Mason County
through transportation to Thurston County. Since behavioral health integration, access to
E&T beds in other BHO's has become extremely restrictive. Additionally, there are no
withdrawal management beds in the region. The closest withdrawal management beds
that TMBHO has access to are located in Port Angeles. There are no "secure withdrawal
management" beds statewide at this time. 2) In order to impact the census at Western
State Hospital and reduce the use of emergency rooms for single bed certification
TMBHO region needs additional beds just to cover the individuals in need: 3) To impact
the use of the Mason County jail for both psychiatric and withdrawal management
services, additional beds with the necessary licensing and service levels to facilitate
diversion are required. For jail diversion to be effective, police must have easy and close
proximity to the appropriate facility. Driving to Thurston County when there are only two
sheriff deputies on shift at night is not feasible. TMBHO and the Mason County
community are requesting accessible services for their County to provide appropriate
care at the right level at the right time. As evidence, Mason County has been conducting
an ongoing "Jail Diversion Work Group" to address the issues of over utilization of the jail
for inappropriate incarceration of individuals displaying acute behavioral health issues,
and inappropriate use of the emergency departments by police and community when no
other acute services are available. This issue is now well documented as a national issue,
citing more than 40% of those in jails have behavioral health issues. .This community
work group was orchestrated by the County Commissioners and includes: Sheriff's
Department, Prosecuting Attorney's Office, Defense Counsel, Mason General Hospital,
City of Shelton Police, and other service agencies. The outcome was to prioritize the
need for an involuntary jail diversion program, withdrawal management services, and
mobile crisis outreach teams. TMBHO has already proceeded with the development of a
dedicated mobile crisis outreach team tied with intensive case management for Mason
County. It's anticipated that services begin September 1, 2016. To assist with these
needed services, TMBHO is proposing the renovation of an existing building to create two
separate units: 1) first we will create a ten bed evaluation and treatment facility
functioning to triage and divert those with an acute behavioral health disorder from jail,
hospital emergency room and Western State Hospital diversion.2) as funding becomes
available a second unit to function as a secure withdrawal management unit. This unit
will provide an additional ten beds for withdrawal management services in a "secure"
setting. This secure setting will be similar to an E&T pending completion of the State
WACs to fully define these requirements. While the E&T will focus on residents from
Mason County depending on availability, they could receive referrals from Thurston or
other contiguous counties. The secure withdrawal management unit will be designed as
a regional program being the only local resource. The need for additional E&T beds and
withdrawal managementbeds are based on historical utilization information including
census overflow at WSH, inability to access beds at WSH, number of inmates in Mason
County Jail due to their behavioral disorder, prior utilization of detox beds when
Providence St. Peter Hospital was operating a unit, and estimated need based on police
encounters on the "street" in Mason County. In 2015 TMBHO was on average over
census at WSH by three beds. To date, TMBHO has six individuals who are unable to go
to WSH due to hospital overall census. This creates a back log and further impacts our
community by averaging at least two single bed certification in emergency room settings,
unable to place them into any E&T beds. The Sheriff and City of Shelton police chief
estimate 40% of individuals incarcerated at the Mason County Jail have a chronic
behavioral health problem. Not all of these individuals were incarcerated due to their
behavioral health issue but the estimate is that approximately 40 individuals could be
diverted each month. This number does not include the individuals waiting in the jail for a
forensic evaluation due to incompetence to stand trial. This average is between 10 and
12 inmates. Based on prior history TMBHO's has a treatment demand for detox services
is for over 600 individuals per year with an average length of stay of15 days. The facility
we are proposing to purchase is the previous PUD facility in Shelton. It has 13,000
square feet on two different floors. Our plan is to utilize the 6,500 square feet on the first
floor for E&T beds and supporting services. The second floor, also 6,500 square feet is
planned for detox services. There is an elevator to ensure ADA access for both floors.
The estimated cost for purchase is approximately $350,000. Construction renovation is
projected at approximately $250 per square foot and additional "soft costs" (please see
attached budget for description) at a total with purchase of$2,598,025. TMBHO is
requesting $2,000,000 from this grant and will fund the rest of the cost with local funds.
The facility shall be a stand-alone facility with regards to any other licensed facility. The
new facility will be certified as an E&T facility for ten beds in one unit and later will include
a ten bed secure withdrawal management in the second unit, by the Department of Social
and Health Services, Division of Behavioral Health and Recovery under RCW 71.05 and
WAC 388-865. Policies and procedures will be developed to meet all requirements for
Department of Health Licensing as an Adult Residential Rehabilitative Center under WAC
246-337. A DSHS licensed service provider for the E&T will be selected through a
procurement process to operate the service programs
4. List any existing licensed facilities that will be part of this project. Include license number and
expiration date.
The new facility will be certified as an evaluation and treatment facility in one
unit and secure withdrawal management in the second unit by the
Department of Social and Health Services, Division of Behavioral Health and
Recovery under RCW 71.05 and WAC 388-865. The facility shall be a stand
alone facility with regards to any other licensed facility. Policies and
Procedures will be developed to meet all requirements for Department of
Health Licensing as an Adult Residential Rehabilitative Center under WAC
246-337. A licensed service provider for the E&T will be selected to operate
the service programs. The facility will be part of the larger TMBHO network
of services and providers for the acute behavioral health services for
Thurston and Mason Counties.
5. What assessment have you completed that the project would meet gaps in geographical
access to short term detention services under Chapter 71.05 RCW in your region?
TMBHO has conducted both a community needs and a geographical access assessment
to identify gaps in geographical access to short term detention services under Chapter
71.05 in our region. The purpose of the Triage/E&T facility is to serve all clients who
either come through the Mason County criminal justice system, emergency care services
and/or the Thurston Mason Behavioral Health Organization involuntary commitment and
crisis care system who are detainable under RCW 71.05. Additionally, this program
would be available as space allows, for detained individuals under RCW 71.05 from the
Cascade Pacific Action Alliance, Accountable Communities of Health region. This region
is made up of the seven (7) counties: Thurston, Mason, Grays Harbor, Lewis, and Pacific,
Cowlitz and Wahkiakum. The purpose of this E&T is to serve as a mental health
diversion program from higher levels of restricted care such as Western State Hospital,
the emergency room at local hospitals and from incarceration. We are requesting to
renovate a facility by which police, other emergency responders, and the community can
bring an individual who is 1) in a psychiatric crisis; 2) at a level of acuity where immediate
intervention is necessary to stabilize; and/or, 3) having committed or at risk to commit a
crime or endanger themselves or others due to a mental health disorder. The intent of
this facility is to provide a 24 hour 7 days a week response program where a client can be
"held" on an Involuntary Treatment Act commitment for up to seventy-two (72) hours,
where both security, safety, and psychiatric needs are provided at the proposed facility.
Additionally, a client may be further detained by the Superior Court if a fourteen day
detention is required. The target population we are looking to impact are individuals who
are engaged by the police or other first responders for an illegal activity or displaying at
risk behavior, where either a crime has been committed, is at-risk of being committed, or
the individual cannot be left alone without supervision due to their possible behavioral
health disorder. This target population will be those individuals who have or are eligible
for Medicaid or other public funded health care. Despite Medicaid expansion, E&Ts
around the State are serving over 25% individuals who do not have Medicaid and require
other public funding sources for services. Overall, these are individuals who have
possibly committed a crime due to their behavioral health disorder where jail is not
necessary for community safety. Often these individuals are co-disordered, where both
psychiatric and substance abuse is at the cause of their behavior. The result is that the
Mason County Jail now identifies that forty percent (40%) of their jail population have a
major mental health disorder and up to eighty percent (80%) of those are drug involved.
Many of these individuals are inmates whom the jail requests forensic evaluations under
State Legislation 10.77. Once requested, these evaluations can take several weeks to
occur at which time the mentally ill inmate is not being discharged from the jail nor
obtaining necessary treatment to help them resulting in extended lengths of stay, far
longer than the average inmate. If these individuals who are determined incompetent to
stand trial are diverted and provided services in such a facility-as ours, then we will be
able to reduce the overall mentally ill population incarcerated to jail. In short, the focus
populations for Triage/E&T services are: 1) Acute mentally ill adults who are detainable
under RCW 71.05 and reside in Mason Counties (Thurston County and other contiguous
Counties are included but priorty is for Mason). 2) This service is for individuals that the
police, other emergency first responders and hospital emergency rooms are being asked
to serve who are displaying acute behavioral symptoms where immediate intervention is
necessary to stabilize and/or c) have committed a crime or endanger themselves or
others due to behavioral health disorder; and 4) When an individual is evaluated by a
DMHPs to meet involuntarily detention under RCW 71.05 and no other ITA bed is
available in order to avoid use of single bed certifications at local hospitals. Geographical
Assessment: On a regular basis, TMBHO conducts a geographical study for access to
services in our region, for outpatient, inpatient and commitment services. Under contract
we try to limit any travel for acute care to 30 minutes. In the case of Thurston and Mason
County, we have determined that we could improve care by siting acute services in
Mason County.
6. What is your commitment to serve persons who are publicly funded and persons detained
under the involuntary treatment act at Chapter 71.05 RCW?
As a Behavioral Health Organization, TMBHO mission includes the commitment to serve
persons who are publicly funded and persons detained under the Involuntary Treatment
Act, Chapter 71.05 RCW. The E&T facility identified for this grant, whole focus is to
serve: adults with an acute mental illness, who reside in Thurston and Mason Counties
(other contiguous Counties will be served as well), who meet commitment criteria under
Chapter 71.05 RCW. Those involved in the Mason County judicial or medical emergency
response system will be a priority. Other individuals regionally will be served dependent
on available space. This facility will provide services for an involuntary 72 hour
commitment as well as those determined by a Superior Court Crisis Commitment Court to
be detainable for up to 14 days. The facility will staff 10 licensed beds for these services
including: psychiatric care, Designated Mental Health Professionals and the rest of the
required staff to meet both Department of Health and Department of Behavioral Health
and Recovery requirements.
7. How long will your project maintain the beds or facility and how will you pay for the on-going
operation of the project?
The on-going cost for the treatment service operation of this facility will be funded though
the TMBHO Medicaid and Non-Medicaid budget. TMBHO has an annual operating
budget of over$57,000,000. Operating services for the E&T are a Medicaid allowable
service and therefore covered by the BHO. This facility will be an asset of the TMBHO
and as such, will be maintained to operate as described here for at least ten years or
longer based on the continued funding of the TMBHO.
8. What is your commitment to work with local courts and prosecutors to ensure that prosecutors
and courts in the area served by the hospital or facility will be available to conduct involuntary
commitment hearings and proceedings under Chapter 71.05 RCW?
Local Superior Court and the Mason County Prosecutor, Defense Counsel and the
Mason County Clerk have already been involved in identifying the need for these services
and recognize the impact it will have and acknowledge the requirement for them to
conduct involuntary commitment hearings and procedures under Chapter 71.05 RCW. In
Thurston and Mason County, TMBHO does fund all elements of these procedures:
Superior Court, Prosecutor, Defense Counsel and Clerk, as well as the treatment support
of this function. At present, TMBHO funds involuntary commitment court services in two
locations in Thurston County-with a third site beginning soon at the new involuntary
Triage; when this Mason County facility opens, Crisis Commitment Court will be held at
the facility under the venue of Mason County. TMBHO will continue to fund these legal
services
9. Please list any local resources, including non-Medicaid operating reserves, and regional fund
balances that are not contractually encumbered. Please attach Statements of Commitments
for any local funding or partnership sources.
Currently, all TMBHO non-Medicaid reserves are encumbered. This includes funding that
TMBHO has already encumbered for Long Term Replacement costs and Operations and
Maintenance of each Evaluation and Treatment facility. TMBHO will commit from existing
non-Medicaid maintenance and operating reserves $500,000 to make up the difference
for the request of this grant and the presumptive cost of this project. These funds are
available as part of TMBHO's Long Term Operations and Maintenance reserves for
current operating TMBHO facilities
10. What is the projected timeline for your project?
Project
Components Start Date End Date % Completed
Design 9/15/16 11/23/16 Click here.
Structural Modification
or Construction 5/25/17 12/20/17 Click here.
Occupancy 2/6/18
11. How much money are you requesting from this grant program?
$$2,000,000
12. What is the total project cost? $$2,598,025
Cost Category Budgeted Funds
Site Acquisition $350,000
Architecture and Engineering $172,274
Structural Modification or Construction $1,837,140
Capitalized Equipment $0
Construction Management (from external sources only) $75,000
Contingency $Click here to enter text.
Total Project Cost $2,598,025
NOTE: Commerce does not pay for in-house labor.
What documentation do you have to support the total project cost and timeline?
Please include a copy of the relevant budget and timeline information used to develop the
information above.
Please see attached budget for additional costs such as LEED Certification, not included above
and timeline detail.
Sec. 1007. 2015 3rd sp.s. c 3 s 1036 (uncodified) is amended to read as follows:
FOR THE DEPARTMENT OF COMMERCE
Community Behavioral Health Beds-Acute & Residential (92000344)
The appropriation in this section is subject to the following conditions and limitations:
(1) The appropriation in this section is provided solely for the department of commerce, in
collaboration with the department of social and health services,to issue grants to hospitals or
other entities to establish new community hospital inpatient psychiatric beds,free-standing
evaluation and treatment facilities, enhanced services facilities,triage facilities, or crisis
stabilization facilities with sixteen or fewer beds for the purpose of providing short-term
detention services through the publicly funded mental health system. Funds may be used for
construction and equipment costs associated with establishment of the community hospital
inpatient psychiatric beds, free-standing evaluation and treatment facilities, enhanced services
facilities,triage facilities, or crisis stabilization facilities.These funds may not be used for
operating costs associated with the treatment of patients using these services. The department
shall establish criteria for the issuance of grants and priority must be given to those proposals to
establish new community hospital inpatient psychiatric beds or free-standing evaluation and
treatment facilities.The criteria must include:
(a) Evidence that the application was developed in collaboration with one or more
regional support networks, as defined in RCW71.24.025;
(b) Evidence that the applicant has assessed and would meet gaps in geographical access
to short-term detention services under chapter 71.05 RCW in their region;
(c) A commitment by applicants to serve persons who are publicly funded and persons
detained under the involuntary treatment act under chapter 71.05 RCW;
(d) A commitment by the applicant to maintain the beds or facility for at least a ten-year
period;
(e)The date upon which structural modifications or construction would begin and the
anticipated date of completion of the project;
(f) A detailed estimate of the costs associated with opening the beds;
(g) The applicant's commitment to work with local courts and prosecutors to ensure that
prosecutors and courts in the area served by the hospital or facility will be available to conduct
involuntary commitment hearings and proceedings under chapter 71.05 RCW; and
(h) A lack of local resources, including nonmedicaid operating reserves, and regional fund
balances that are not contractually encumbered.
(2) To accommodate the emergent need for inpatient psychiatric services,the
department of health and the department of commerce, in collaboration with the department of
social and health services shall establish a concurrent and expedited process for the purpose of
grant applicants meeting any applicable regulatory requirements necessary to operate inpatient
psychiatric beds, free-standing evaluation and treatment facilities, enhanced services facilities,
triage facilities, or crisis stabilization facilities.
(3) The following list is subject to the criteria in subsection (1) of this section:
Cascade mental health $3,000,000
((WeedrneRt)) I(ent recovery center $5,000,000
Parkside conversion to behavioral health beds (( 4-1 0))
4 000 000
(( ))
Central Washington comprehensive mental health $2,000,000
Swedish Ballard psychiatric unit $3,000,000
Substance abuse & mental health facilities $2,000,000
Fairfax behavioral health - Providence health &services facility $1,000
Daybreak Youth Services $1,500,000
(4) Multicare-Franciscan joint venture $5,000,000
(5) State Mental Hospital Diversion Protects $7,552,000
(a)The appropriation in this subsection is provided solely for the department of
commerce, in collaboration with the department of social and health services and the health care
authority,to issue grants to entities for the development of facilities that provide for the
diversion or transition of patients from the state hospitals.
(b) Funds may be used for construction and equipment costs directly associated with the
- establishment of community hospital inpatient psychiatric beds, free-standing evaluation and
treatment facilities, enhanced services facilities, crisis triage centers, and crisis stabilization
facilities; secure detoxification facilities and co-occurring treatment facilities; or other transitional
facilities that provide for the diversion or transition of state hospital patients.These funds may
not be used for operating costs associated with the treatment of patients using these services.
(c) The department, in collaboration with the department of social and health services
and the health care authority, shall establish criteria for the issuance of grants including but not
limited to: (i)A clear demonstration of need; (ii) a commitment to serving persons who are
publicly funded; (iii) a commitment to maintain the beds or facility for at least a ten-year period;
and (iv) specific performance and outcome measures to ensure greatest benefit to the region.
The department may only fund proposals that provide evidence that the application was
developed in collaboration with one or more behavioral health organizations as defined in
RCW71 24 025 or the health care authority in the case of an application submitted from a region
that has become an early adopter of integrated medical and behavioral health services pursuant
to RCW71 24 380(5) In awarding these funds,the department must prioritize an equitable
distribution for facilities in both rural and urban areas with the greatest demonstrated need.
(6) Competitive grants $10,499,000
(7) Clallam county respite center 8847,000
Appropriation:
State Building Construction Account—State
$44,399,000
Prior Biennia (Expenditures) $0
Future Biennia (Projected Costs) $0
TOTAL (($82,000,000))
$44,399,000