Senate Bill 5512 (The True Solution for WSH)

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The above summary describes Senate Substitute Bill 5512’s immediate functions… Oversight of the facility by the Department of Health.  This component of 5512 will assure that WSH and ESH remain accredited and meet federal standards for medicare (CMS) funding.  This would force DSHS to comply with laws that pertain to all hospitals within the state of Washington.  Why is this important?  Western State is currently NOT a hospital under Washington law, it never has been a “hospital” under the law.  This has allowed DSHS to cover up major incidents, violate State and County health standards, in short…  DSHS was allowed to oversee itself since “insane asylum” days, as laws pertaining to “State Mental Institutions” never coincided with laws that pertained to actual hospitals.  Laws that pertain to hospitals, do not apply to Western State or Eastern State as they are not hospitals under the law currently, but SB 5512 would actually change this.  SB 5512 substitute bill states:

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SB 5512 actually addresses the root cause of Western State’s failure to meet accreditation and federal funding standards.  What is not mentioned is that laws that apply to “hospital” patients and staff would suddenly apply to Western State because it would become a “Hospital” under Washington law.  Suddenly Western State would have to comply with laws pertaining to all areas of its operation.  Illegal practices that endanger patients and staff that have gone on for decades would become exposed and require correction for the first time.  This is why DSHS violently opposes implementation of 5512.  Recently a document was created by DSHS to state that Western State was NOT a hospital, therefore laws for “mandatory reporting” did not necessarily apply.  That document would be null and void if SB 5512 was passed.  Western State currently does not employ sufficient direct patient care staffing to provide daily care without massive use of overtime as well as regular use of mandatory overtime, something which is illegal under Washington law for actual “Hospitals.”  Mandatory overtime for LPN’s and RN’s is illegal for health care facility employees.  With passage of SB 5512, this law protecting staff and patients would apply at Western State. 

DSHS created a document which outlines their objections to 5512.  Those objections are the following:

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  As stated, passage of SB 5512 would expose years of DSHS misconduct.  I will address each objection:


WSH is defined under the jurisdiction of 72.23 RCW-Public and Private Facilities for Mentally Ill.  This bill adds an additional jurisdiction to state hospitals that is unnecessary.

This is an absurd argument.  SB 5512 places the same jurisdiction upon DSHS as it places on ALL hospital facility operators.  It implements mandatory reporting relationships that have kept all Washington Hospitals compliant with accreditation standards and federal funding standards.  The fact that Western State has lost its accreditation and is about to lose its federal funding indicates it is in dire need of becoming a “Hospital” under Washington Law.  Further, this documents’ existence is proof that SB 5512 must be passed (DSHS has no intent to meet standards). 


State Hospitals are certified by the Center of Medicare and Medicaid services (CMS) Part 482, Appendix AA for Psychiatric Hospitals.  This is a stringent regulatory agency.  The organizations surveys for Conditions of Participation and investigates complaint currently.  They are regularly at WSH and ensuring compliance.  This CMS team is contracted through DOH.  This survey team has a check and balance as they report to Region 10 office of CMS and do not make decisions independently.

This is also an absurd argument.  ALL licensed hospitals that provide psychiatric care are certified by CMS (in order to receive federal funding) and are also licensed to operate their facilities through the Department of Health.  SB 5512 places ZERO additional burden upon Western State or DSHS than it does upon any owning entity of a hospital.  The difference is that Western State currently is not accredited and is in danger of losing federal funding because it has NOT maintained standards at an acceptable level…  SB 5512 fixes the root cause of the failure. 


This bill implies DOH Hospital Licensure Department will inspect state hospitals causing a second inspection to the state law/rules.  Hospitals are required to allow the most restrictive regulation that applies; state hospital will now need to be compliant with multiple other laws and corresponding rules/regulations with all hospital licensure regulations in addition to CMS Conditions of participation.  In addition, if DOH issued a licensing action, that could have significant impact to 837 patients and their continuity of care.  

DSHS rewords objection number two and again presents the same absurd objection…  With passage of SB 5512, DSHS would NOT be burdened to meet any requirement that is not required of all hospitals within Washington.  With passage of SB 5512, when Western State must meet all standards of a Hospital, multiple abuses will be exposed and administrators will be held accountable.  I again make reference to the document which was drafted to cover up events from report to the Department of Health.  


Currently, WSH reports all allegations of abuse and neglect to DOH.  DOH is regularly on hospital grounds completing investigations to ensure patient safety and WSH compliance with RCW 70.124.  State Hospitals currently have a partnership with DOH regarding staff licenses.  This bill adds additional DOH authority.  

WSH does NOT historically reported ALL allegations of abuse and neglect to DOH, as is evidenced by this document.  Again, SB 5512 would put zero additional burden upon Western State than it would upon the operators of any hospital within Washington.  The additional burden that would be put upon Western State is that ALL incidents would require mandatory reporting and the document to cover up such events would be null and void.


There are significant complexities when a state licenses itself.  DOH is a sister agency and could cause conflicts of interests.  Currently, DOH’s contract with CMS allows a check and balance through the supervision of CMS region 10. If DOH hospital survey teams and rules become law, there is not check and balance for that system. 

This is a very odd argument for a failing unaccredited DSHS facility to make.  Lack of DOH oversight is the root cause of Western State / DSHS failure.  No further checks and balances are required for Western State than are required of any hospital operator in Washington if SB 5512 was passed.  DSHS knows that if Western State were examined to meet the same standards as any hospital under the law, many improvements would have to be made…  Resulting in DSHS administration behind held responsible for their actions.


The rules passed by DOH for Hospitals are not specifically aligned with those of CMS and as a result Western State Hospital will need to become expert in both sets of rules.

This objection is laughable…  As a State agency, DSHS/WSH has full access and use of the Office of Attorney General for daily operation.  This is the one burden that is lessened for DSHS when Western State becomes a Hospital compared to all other hospital operators within the State.  Access to legal advice is minimal cost to state agencies.


DOH licenses have fees that apply.  Will state hospital be charged license and renewal fees per patient bed?  Are these fees waived for a sister agency?

DSHS operates under a budget where all fees and costs are crunched by OFM.  This structure and budget would be somewhat redundant when all agencies are budgeted as a whole.  This would in fact result in another advantage DSHS and Western State would have over the operators of all other hospitals within Washington.


The state regulations/rules and the federal regulations/rules would need to be reviewed regularly in order to meet the most stringent.  This creates complexity for Western State Hospital because the framework of a topic will not flow across two divergent regulations (Federal and State).  This will cause further fiscal impacts to meet state regulations/rules.

Once again, SB 5512 puts zero additional burden upon DSHS / WSH than the burden that is put on ALL hospital operators within Washington.  With SB 5512, the root cause of failure will be eliminated and within a short period of time WSH will operate with HIGHER standards than it has operated in its past.  The “insane asylum” days will be put in the past.  Western State will become a true “Hospital” under Washington law.

To learn more about SB 5512 and provide input see below:

Senate Bill Report SB 5512

Original Senate Bill 5512

Substitute Senate Bill 5512

Fiscal Note of 5512 SSB

SB 5512 Legislative Web Page

Comment on SB 5512

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Email your Legislator!

© Paul Vilja 2017