WSH Has 101 Problems But A WPA Isn’t One!

This week we were “told by Administration” that the top secret CSM Report revealed that Western State Hospital has 101 areas where corrections must be made in order to retain CMS funding of $65 million per year.  We have to take administrations word on this as the CSM Consultant Report remains top secret. 


We have encountered a series of lies provided by DSHS/WSH Administration, including the lie that the top secret CSM Report required (mandated) a $2.6 million per year expansion of an additional layer of Administration through the initiation of numerous WPA positions.  I am told that many of these positions have already been promised to specific individuals even prior to the posting of the positions officially.  The concept of the Ward Program Administrator expansion (of a corrupt administration) must be extinguished and those members of the Executive Leadership Team that played a role in secretly eliminating TJC Accreditation and attempting to extort an additional $2.6 million per year from our Legislature must be held legally accountable for their actions.  The actions that were taken constitute a criminal level of misconduct as we learned that the expansion was disguised as being REQUIRED by the top secret CSM Report when it was not. 


Until the Executive Leadership Team members of Western State Hospital that were responsible are replaced, Legislative oversight will be required.  The corruption extends to the Governor level as it was the Governor level that green lighted the funding for the administrative expansion when they had TOTAL access to the CSM Report.   That CSM Report and all future taxpayer paid consultant reports MUST be made transparent and available to the public to prevent similar abuses in the future.  


This week we also learned that Eastern State Hospital has attained full accreditation, without the requirement of additional administrative expansion.  Note that Eastern State did NOT secretly withdraw TJC accreditation.  When I served on the Ad Hoc Safety Committee, I learned first hand the differences between Western State and Easter State “Hospital.”  While Western State massively expanded administration and administrative support personnel as well as administrative equipment, Easter State invested in direct care personnel and patient care equipment.  While Eastern State is a much smaller facility, they were on the correct path.  Western State to this day, even at the point of losing all federal funding, sees its problems as being based on not having enough layers of ADDITIONAL administration while there are not enough direct care providers to operate the hospital without massive daily overtime and hundreds of on-call personnel that do not appear in Western State’s staffing budget (not to mention daily Agency Staffing).  Even when a consultant firm was established (CSM), Western State administrators attempted to extort $2.6 million per year in funding to expand administration and administrative support personnel by lying about the contents of top secret consultant reports.  I do not believe that this is something that CSM had any control over, this is witnessed by the input Doctor Fields provided to the Doctor Union.


It is clear that WSH Administration and Governor must have public oversight established before any other funding is approved for Western State Hospital through the Legislature…  Taxpayers need to know where the funding is going.  I would advocate for almost all additional funding going to direct patient care provider positions and to establish competitive wages for recruitment and retention.  Western State Hospital administration needs to be delayered, this is where great savings can be found for the expansion of direct care permanent positions to a level where DAILY overtime will no longer be required. The elimination of the illegal WPA expansion alone will provide an additional $2.6 million per year to help accomplish this task (which the Governor level has apparently already approved). 


My immediate recommendation is to utilize Easter State administration to lead Western State during this CSM Consultant correction period.  Easter State apparently has the correct leadership philosophy.  The current WSH CEO and Executive Leadership Team members that are responsible for the recent actions and lies must be replaced by competent personnel.  Teleconferencing can be utilized during this period of time.  Another option is to utilize an interim CEO that we had in the past who did an outstanding job prior to being replaced by the Adler Administration, she was on loan to us from Eastern State.  This interim CEO lives in the eastern part of the state, perhaps she can lead through teleconferencing during this period while CSM Consultants remain present daily at Western State.


The Legislature must address the fact that neither Western State nor Eastern State are a true “hospital” under Washington law, this is an unaddressed artifact of the old institution days and must be corrected.  This is THE root cause of failure.  DSHS facilities MUST be licensed to operate under the Department of Health as are all other hospitals in the State.  Once licensed by the Department of Health, mandatory reporting relationships will be implemented.  DSHS will not be able to routinely violate hospital laws, cover up major events, and violate health standards as they have done in the past by claiming they are not a hospital.  Further, all laws that apply to protect hospital employees and patients would now apply to DSHS facilities once they are properly licensed.  This would create the additional problem that DSHS facilities cannot currently meet the standards required of a licensed Department of Health Facility.  Thus, the Department of Health will have to work with the Consultants to bring ALL standards to a level of safe patient care and safe staffing environments for the first time in Western State history.   


If the current level of administrative incompetence at Western State Hospital was eliminated, I believe that the CSM Consultants working with the Department of Health and Legislature can have Western State become a licensed true HOSPITAL under Washington law which is CSM credentialed and TJC accredited within the current Systems Improvement Agreement timeframes.  To accomplish this, the Legislature must move QUICKLY!  


© Paul Vilja 2017