This is Part 5 in our “Progress in Focus” series of blog posts highlighting the individual sections of the Progress Index. This post is focused on the healthy people part of the Healthy People and Environment section. 

Everyone in Washington state should have the opportunity to live a healthy and productive life, with affordable options to obtain quality health care. While Washington state’s investments in healthy people are starting to pay off with the implementation of the Affordable Care Act (ACA), more needs to be done to keep our most vulnerable citizens safe.

Washington state invests 27 percent of its total operating revenue on programs that protect public health and the environment. With this investment, some significant progress has been made in recent years (see “At a Glance” table for a summary; and see the full Progress Index to review all the data we use to measure progress). Progress has been especially evident when it comes to the expansion of health care coverage. Since full implementation of the ACA began in 2014 with Medicaid expansion and the creation of the Washington Health Benefit Exchange, more than 700,000 Washingtonians have enrolled in these programs to gain affordable coverage.

(Click on image to view full graphic.)

Still, state investments in the health of Washington’s residents are nearly the same as they were in 2002. This compromises the state’s ability to make progress in other areas of health – notably, protecting our most vulnerable citizens. While the state is making some progress for children placed in the child welfare system, more needs to be done to ensure their safety and stability. And Washingtonians with mental illness are not as protected as they should be. For example, our Progress Index shows that:

• The rate of out-of-home placements – when children are removed from the care of their parents or legal guardian – has declined, from 7.2 per 1,000 children in 2008 to 5.3 per 1,000 in 2013. While rates of re-entry into the child-welfare system are also declining for children who have been reunited with their family or guardians, rates remain high compared to national quality recommendations. 
• Although the number of psychiatric beds in state and community hospitals has rebounded to 2000 levels (12 per 100,000), too many people involuntarily committed for treatment for mental illness are being “boarded” in state emergency rooms due to lack of capacity. Psychiatric boarding in facilities that do not offer individualized psychiatric care is a practice the Washington State Supreme Court recently ruled as unconstitutional under the Involuntary Treatment Act. 

As this legislative session continues into special session, lawmakers still have the opportunity to advance the health and well-being of all Washingtonians. But they need more revenue to do it. The House budget raises new revenue, most notably through its capital gains tax proposal, to invest more in mental health services and hire additional staff for the child welfare system. The Senate, on the other hand continues to shortchange the health and safety of Washingtonians who lack the resources or authority to protect themselves on their own. 

Washingtonians deserve a state budget that lays a foundation of opportunity in all areas of their well-being, including their physical and mental health. To get there, our state must provide resources to help ensure all Washingtonians have access to the resources they need to be well.

To read our additional recommendations for how to protect the health of Washingtonians, visit the Healthy People & Environment section of our Progress Index.