WENATCHEE — A mental health crisis center lauded by Gov. Jay Inslee as a statewide model for providing mental health care laid off 10 of its medical staff last week.
The layoffs are due to financial problems at Parkside and a need to better balance mental health services and medical care, Parkside Administrator Ashley Broussard said Friday. The changes in Parkside's crisis center will increase efficiency, improve client care and reduce the rate of mental relapse, Broussard said. Some of those employees who were laid off have also taken positions elsewhere in the company.
Former employees in the crisis center, however, said they are concerned that the reduced medical staff will decrease client safety. Dr. Julie Rickard, who was running Parkside, including its crisis center, when it first opened, also left about three months ago.
“There is no secret in the community we have been struggling,” Broussard said. “We are still pushing through so this is where the changes come. How do we meet the necessity that is required for someone to receive services?”
Parkside, 1230 Monitor St., opened in October 2018. In addition to the crisis center, which has about 16 rooms for clients and can accommodate close to 20, Parkside provides alcohol and drug detox services.
The governor and other state officials toured its crisis center that month. Inslee pointed to it as a model for the rest of the state to improve the quality of mental health care and reduce the burden on the state's overcrowded mental health care facilities.
Inslee focused his comments on costs during the tour.
"This doesn't come cheap. These are very expensive propositions to provide 24-hour care to people who are critically in need," he said. "These are folks who have extremely challenging lives, having a different view of reality and being in fear, and they need a lot of help. When they get it, good things could happen."
Three former Parkside employees spoke to The Wenatchee World on the condition of anonymity. They were concerned about reprisals from the company and their ability to find another job.
Staff was already overworked at Parkside before the layoffs while trying to deal with severely mentally ill patients, a former employee said.
“These people are suicidal,” the person said of some Parkside patients. “These are people who are potentially attempting in the room. So you’ve got to have staff that are capable of watching. So you can’t have patients who are monitoring themselves.”
Parkside is also using loopholes in state law to provide cheaper services, a former employee said.
“The nurses now are doing things that they are not really skilled or able to do because there is a little loophole that allows them to do it,” the former employee said. “But it means that they can under-staff and under-manage these patients. What you’re going to see is a major safety issue.”
Concerns that clients at Parkside are not safe are baseless, Broussard said. All employees are certified by the state and receive appropriate training, she said.
Some of the complaints from employees came from changes Broussard implemented when she took over as administrator, such as allowing patients to wear personal clothing and to smoke.
Staff holds onto smoking material and lets them smoke under supervision, she said. Also, things like strings in sweatshirts are removed.
“One of the bigger barriers to coming here was people weren’t allowed to smoke,” Broussard said. “And a lot of people weren’t staying as a result of it or they wouldn’t even walk through the door.”
Parkside is run by American Behavioral Health Systems (ABHS). It has a contract with the state Health Care Authority and is licensed as a behavioral health agency with the state Department of Health and Human Services.
The Health Care Authority is aware of the employee layoffs and is monitoring the situation, but is not looking at direct complaints, Health Care Authority spokesperson Amy Blondin said.
Parkside is also overstaffed for the number of patients it has, even with the layoffs, Broussard said. It has about one staff member to two clients, which is a pretty high ratio in the industry, she said.
Parkside's crisis center hired too many registered nurses and nurse practitioners when it first opened, Broussard said. It couldn't afford keeping all those medical personnel on staff and decided it needed to focus on the reason why it first opened: providing crisis mental health care.
“With the medical model, we were actually missing what we were supposed to do as a crisis center, which is to stabilize the mind,” Broussard said.
The mental health crisis center still has nurses to provide medical care to clients, Broussard said. It has one full-time registered nurse on weekdays from 9 a.m. to 5 p.m., a registered nurse who works part time on the weekends, four full-time certified nurses and one part-time certified nurse. The parent company, ABHS, also contracts with advanced nurse practitioners who are available 24/7 to respond to calls.
There are also mental health professionals and behavioral health technicians to monitor and take care of patients, she said. It also has a doctor who is available for consult 24/7, Broussard said. The doctor, who lives and works in Spokane, visits Parkside.
It is important to note that patients at Parkside are there voluntarily, she said. If patients refuse to take their prescriptions or to receive medical treatment, the company can’t force them.
The reduction in nursing staff will actually improve patient care, Broussard said. Patients before felt like they weren’t receiving enough counseling while interacting with the nurses all day, she said.
“One of the things I observed the first time (I came to Parkside was) people were like, ‘I’m ready to see my counselor,’” she said. “And what was happening is the nursing staff, they go by the things they learn in nursing school and their conversations are more medically driven.”
When the agency laid off the 10 nurses, it also offered them 20 other comparable positions in the company they could have taken, Broussard said.
One of the anonymous sources said the positions offered were not comparable. The nurses made around $50 an hour and were offered jobs at $15 to $17 an hour.
Overall, the goal of the changes is to improve efficiency and the response to patient needs, Broussard said. She believes that in six months things will have improved.
“The great part about it is even with the cost savings we are providing better services,” she said. “It would be horrible to be cost saving and provide really bad medical services. What’s the point?”