State lawmakers recently approved $3.25 million in planning funds for a 16-bed mental-health crisis facility in Sequim.

The supplemental capital budget allocation from the legislative session will pay for architectural services, engineering work, a cost analysis, an operational analysis, permitting and public outreach, said Rep. Steve Tharinger (D-Port Townsend), the capital budget committee chair, on March 11.

The funds do not cover construction — estimated at $15 million in 2019, when the facility was the Jamestown S’Klallam Tribe’s Phase 2 piece to its Phase 1 medication-assisted drug treatment (MAT) clinic.

Phase 2 was never funded, and that estimate has more than doubled to about $31 million, Brent Simcosky, the tribe’s health director, said last week.

The MAT clinic — also called the Healing Clinic — at 526 S. Ninth Ave. is set to open in early April, located on an approximate 50-acre parcel of tribal-owned land behind Costco in Sequim.

The Healing Campus is a likely site for the evaluation and treatment (E and T) psychiatric hospital south of the new facility, Simcosky said.

It will be “a state of the art facility,” W. Ron Allen, Jamestown S’Klallam Tribal chair/CEO, said Monday.

“It (and the Healing Clinic) will be a complement to the area,” he said.

Patients would stay at the facility on a short-term basis.

“It can be anywhere from 48 to 72 hours to a couple of weeks would be the average,” Simcosky said.

Establishment of the mental-health crisis facility is supported by public hospitals in Port Angeles, Port Townsend and Forks, said CEOs for Jefferson Healthcare hospital and Forks Community Hospital, and a spokesperson for Olympic Medical Center.

Simcosky said Port Angeles-based OMC would likely contract with the tribe to staff the facility.

He said the building likely would be 15,000-20,000 square feet, a size similar to the Healing Clinic, and will require a conditional use permit through the City of Sequim.

Funding

Simcosky predicted the tribe likely won’t receive funding to begin the slew of studies and analyses until June, just seven months before the state Legislature meets to hammer out a two-year biennial budget.

“With the current cost of construction, with costs going through the roof, I don’t know that we’ll build it until the cost goes down a bit,” Simcosky said.

Simcosky said they’ve always intended to build the psychiatric hospital, but funding wasn’t available so they postponed it.

He was surprised Tharinger approached him in February, in the middle of the session, and asked him to put together a construction proposal after the lawmaker had visited Jefferson Healthcare officials in Port Townsend who touted the need for a crisis facility.

A contractor’s quick estimate put the price tag at about $31 million based on a Vancouver, Wa., clinic, Simcosky said.

Tharinger’s office told Simcosky that was too much, suggesting he put together a preliminary-work estimate, which the Legislature approved.

Forefront

Simcosky said the pandemic may have brought the issue to the forefront among North Olympic Peninsula healthcare professionals who have been struggling with beds filled by COVID-19 patients and services squeezed tight for mental-crisis patients that hospitals are ill-equipped to care for.

“There’s not a good place to put someone who could be damaging to themselves or others,” Simcosky said.

“There’s no 24-hour safety room.

“You want people in crisis to become stable,” he added. “You don’t want them running around in the community, so (psychiatric) hospitals like this make sense.”

The E and T facility would house patients in 16 safety rooms with 24-hour cameras and be absent of fixtures and other features with which they could use harm themselves.

Allen said it would be a locked down facility including its recreation areas outside.

“Security is as important to us as the treatment,” he said. “The Healing Campus is also working to prevent patients from going (to the psychiatric hospital) too.”

There are similar 16-bed facilities in other cities in Washington, part of a statewide effort to regionalize crisis care and keep patients closer to their homes, Simcosky and Tharinger said.

Simcosky said hospitals would have to offer services similar to what the tribe envisions at a loss, unlike the tribe, which has a higher Medicare reimbursement rate.

“The nice thing about us is, we all collaborate and work together,” he said. “We might have a better hospital reimbursement rate, but don’t have the skills OMC does, so we end up teaming up and helping everybody.”

Peninsula Behavioral Health in Port Angeles offers crisis stabilization and housing for mental health patients.

Collaboration

The closest inpatient facility like the proposed Sequim psychiatric hospital is in Bremerton.

CEO Wendy Sisk with Peninsula Behavioral Health said the facility would complement other mental health services on the North Olympic Peninsula.

“The state is reporting high numbers of patients throughout the state being housed in medical facilities while awaiting inpatient psychiatric care,” Sisk said in a text message.

“As with other healthcare, it is important to have access to the full spectrum of care for mental health conditions,” she said.

“Providing intensive care close to home allows us to engage a person’s natural support system to improve outcomes upon return to their normal daily life.”

Tharinger said he would review what is proposed by the tribe for the 2023 legislative session to determine if money is available.

“We should be able to do something for them in the biennium,” he said.

“It’s a pricey proposition, but we funded a couple this year.”

Tharinger endorsed the placement of facilities like the one being contemplated in Sequim as an alternative to residents in crisis going elsewhere.

“These people end up in the hospitals, in ER, and that’s just not a good place,” Tharinger said.

“It’s expensive, if fills up a room and they don’t get the correct treatment.”

Over the last eight years or so, lawmakers have tried to focus on behavioral health delivered on a community level, close to where patients live.

“We’re going to have to build a state hospital and want to build that as small as possible,” Tharinger said.

Jennifer Burkhardt, OMC’s legal counsel and human resources director, said OMC and Jefferson Healthcare representatives have been meeting with state lawmakers to discuss the need for a psychiatric hospital on the North Olympic Peninsula.

“Our emergency department sees behavioral health and substance use disorder patients on a daily basis,” she said, adding OMC is looking forward to partnering with the tribe as the project moves forward.

Simcosky said the need for the psychiatric hospital is especially acute for West End patients who must be transported several hours for the kind of crisis care the tribe’s facility will offer.

“(Forks Community Hospital) and (West End Outreach Services) is aware of this project,” hospital CEO Heidi Anderson said in an email.

“Brent has spoken in the past with WEOS Director Tanya MacNeil and FCH is in support of this project.”

Jefferson Healthcare hospital has supported the tribe’s Healing Campus since its inception, hospital CEO Mike Glenn said last week in an email.

“With rising numbers of our neighbors in Jefferson County suffering from mental health and substance use disorders, we believe that a local, comprehensive and culturally sensitive solution is critical for addressing this crisis,” he said.

“We are grateful to the Jamestown S’Klallam Tribe for their leadership in this space and look forward to supporting our communities as partners.”

State Sen. Kevin Van De Wege of Sequim said the community needs the evaluation and treatment center.

“I’ve always been excited about the MAT clinic, but the second phase is what has interested me the most,” he said.

“I think it will be a game changer.”

The facility should make a difference in the lives of those in mental crisis, in how they are treated and could stay close to their families during their struggle, Van De Wege said.

He said he does not see the state spending $31 million on the facility.

Van De Wege predicted the tribe “will have some sort of package to get this across the finish line.”

Sequim Gazette reporter Matthew Nash contributed to this report.