Lawmakers raise alarms about SWITC at budget hearing

February 2, 2019
Jeff Agenbroad

BOISE — With all the high-profile problems at the Southwest Idaho Treatment Center in Nampa, the state needs to be looking at whether that’s even the right type of institution to treat the 18 patients with disabilities who still are housed there, members of the Legislature’s joint budget committee said Thursday.

As they held a budget hearing for the state Department of Health and Welfare division that includes SWITC, Joint Finance-Appropriations Committee members raised concerns.

“This is pretty visible, and we’re hearing from our constituents,” said Sen. Abby Lee, R-Fruitland. She noted that the proposed budget for Services for the Developmentally Disabled for next year, which includes SWITC, is a maintenance budget with no additional line items; it reflects just a 1.5 percent increase in state general funds.

“Often we identify things, that if we have enough money we can solve it,” Lee said. “We may not have enough money, but we have to solve this.”

A state performance evaluation report released Jan. 17 found that SWITC suffers from “organizational trauma” due to a “haphazard downsizing” and recent damaging events, including reports of abuse, neglect, assault and patient death. While it now has just 18 resident patients, it had close to 1,000 in the 1950s, and has dropped from 30 just four years ago in 2015.

The only budget increases requested for SWITC, aside from statewide adjustments to state employee salaries, were replacements of two vehicles, a van and a sedan, both of which are old and high-mileage and both of which have been urinated in multiple times, and the smell can’t be removed as replacing the tainted interior parts would cost more than the vehicles are worth.

Little recommended replacing a 2008 sedan with 99,333 miles on it, but not a 2001 van with 109,225 miles on it.

Sen. Van Burtenshaw, R-Terreton, said, “Is there anything we could do to remedy that problem?” He asked representatives of the governor’s Division of Financial Management, “Why wouldn’t you replace this van? I mean, I understand the budget situation, but I don’t think any of us would want to ride to work in a van in this condition.”

Sara Stover, DFM analyst, told the lawmakers, “When we went through the replacement items this year, we reached out to the department and tried to determine the ones that they felt were the absolute most critical, knowing that we weren’t going to be able to provide all replacement items statewide. … We did follow the department’s guidance on that.”

Dave Taylor, Health and Welfare deputy director, confirmed that. “I reached out to the administration for SWITC to talk about the needs that they had there,” he said. “The vehicle from 2008 was the highest priority. … They felt they could get by with the van for another year.”

Miren Unsworth, administrator of Health & Welfare’s Division of Family and Community Services, said, “I think there’s some precautions we can take. … But accidents happen with this population. … I think it’s just a reality with the folks we serve.”

Sen. Jeff Agenbroad, R-Nampa, who represents the district where SWITC is located, said, “This is clearly a very difficult population and a population that needs to be taken care of.” He said he was glad that the creation of a four-bed secure facility within SWITC came to fruition after an appropriation in 2017, for up to four patients who need to be separated from others temporarily.

“This population is clearly in need of some immediate action,” Agenbroad said, “the people that we’re serving, the staff, the facility, and quite honestly the community, because this has had a negative impact on the community.”

The secure facility has yet to open, Health and Welfare spokeswoman Niki Forbing-Orr told the Idaho Press Thursday in an email.

“The rules have been approved by the Legislature, but the policies are still not finalized,” she wrote. “The facility is built and ready to operate, but we just need to finalize those policies and train staff.”

Agenbroad asked where SWITC stands now and “where you see us going.”

Unsworth said, “Today we are serving 18 individuals at SWITC. … That census has declined dramatically over the years as we’ve been more successful at keeping individuals with complex needs in their communities and supported in community living.”

“In terms of where we’re going,” she said, that approach of keeping patients with disabilities in appropriate settings within their communities is where Health and Welfare would like to go. However, she said, “I think there will always be a place” needed for a “small population of individuals for a short period of time to receive that treatment and stabilization.”

“We will likely be coming back to report to the Legislature next year: What is the right model to serve that very special population?” Unsworth said. “Is it SWITC, the institution that we have today, or is it something else? So we’re looking at other states, other options.”

She said as the state continues to operate the facility, “improving operations out there and supporting staff and our clients,” it also will be “really looking at what’s the best pathway on that continuum of care. … Do we have it right today, or do we need to look at something different? Because there are some other options out there.”

“That’s I think the direction we need to go,” Agenbroad responded. “I’m not a very patient person, and I’m impatient with what we’ve known and and seen out there. I think we really need to step back and take a holistic look at this. ... I do believe we need to get this solved sooner rather than later.”

Rep. Rick Youngblood, R-Nampa, JFAC co-chair, noted that he, too, represents the district that contains SWITC. He said he’s visited the facility multiple times over the summer. He, like Agenbroad, offered to help. “This is definitely something we need to take care of,” he told Unsworth, “so count on our support.”

Lee noted “we have a couple more weeks” before JFAC sets the budgets for Health and Welfare. “There are conversations we could have to make sure that we’re providing resources where possible,” she said.

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