Marr: improved services need not be expense

David Carlson
Director of Resource Advocacy

With constant impending budget cuts looming overhead it may seem as if improving the service delivery system is impossible.  Yet while many improvements to services require additional funds, much can be done to improve services within existing resources.

Disability Rights Washington won a major decision in one such case, earlier this year. 

In Marr v. Eastern State Hospital a federal judge in Spokane ruled that the hospital had to demonstrate, to a court-ordered expert, that it adequately used data to make its treatment decisions. 

Marr is a class action lawsuit that had been filed nearly a decade ago, when people with intellectual disabilities were not getting adequate treatment at Eastern State Hospital, and languished there for years without any improvement. 

A lot has happened since then. The hospital created a specialized unit and trained staff to work with patients who have dual diagnoses of intellectual disabilities and mental illness. 

Ultimately, the court did not fault the hospital for not spending enough money on services, or allocating enough staff to perform their important function. The court recognized that the state had made efforts in those areas. 

Instead, the court ruled the hospital needed to show it knew how to use the information it had available to make good treatment decisions about its patients.

The lesson here is that while resources are important, they  must be used properly. Making good treatment decisions based upon the individualized need of a patient does not need to take extra money.

In the end, the hospital’s failure to make good clinical decisions based on data did cost them money.  The cost came in the form of paying for more external court-ordered monitoring and their attorney’s time, but here it is hospital’s failure to follow the law that cost money, not the actual delivery of adequate services. 

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