The Alaska Psychiatric Institute needs $1.6 million in urgent building fixes in order to stay out of trouble with powerful federal regulators, according to the governor’s proposed 2020-2021 budget.
A budget appropriation request released in December asks for funds to fix building design elements at the state psychiatric hospital in Anchorage including faulty door locking mechanisms and furniture being used as weapons against staff and an “obsolete” nurse call system. The capital request is in addition to the cost of operating the hospital.
The fixes are required by the Centers for Medicare and Medicaid Services, the hospital’s federal regulator, according to the document.
The state says if the renovations are not made, API — the crucial center of Alaska’s mental health infrastructure — could lose eligibility for the federal funding that makes up 83 percent of its revenues.
The Centers for Medicare and Medicaid inspectors have found problems at API on several occasions over the last year, including an incident involving a staff member pulling a patient’s hair and nurses being asked to work the night shift without adequate orientation.
Each time, the hospital has been given a chance to fix issues through a “corrective action plan.”
As of Dec. 27, the hospital was deemed “in substantial compliance” with the agency, according to a release from the Alaska Department of Health and Social Services — and out of immediate jeopardy.
It was not immediately clear when the building problems were identified by regulators, and what the timeline is for fixing them.
The appropriation request marks the first time problems with the state’s sole public psychiatric hospital’s facility located on Piper Street in Anchorage have been detailed publicly.
Among the most urgent issues: The all-important system that controls doors and locks at the secure facility is failing.
“Patients may wander, leave the building or potentially harm one another, and staff may lack reliable door control in responding to emergencies,” the document says. In an emergency, the door locking system could fail, “trapping staff and patients.”
An existing system for communication between nursing staff is “15 years old and obsolete." Software is failing and “results in false alarms and staff confusion.”
Staff can’t rely on the system for accurate alerts about when patients try to leave their rooms at night, the document said.
The heating and cooling system for the building also needs work, and a supply of glycol used to chill the facility has “degraded," the state says. It’s getting harder to control temperature in the facility, the document says.
Even the furniture is a problem.
“Existing facility furnishings are being used as weapons against staff as well as apparatus for ligature and barricading,” the document reports.
The Legislature and governor approved $46.3 million to run API for the current fiscal year, which ends in July.
The governor is preparing to ask the Legislature to add $6 million to that, then ask for an additional $9 million in funding for API for the fiscal year that starts July 1, boosting the hospital’s operation budget to $55.4 million.
The funds do not include the $1.6 million requested for the capital improvements.
On Tuesday, officials also announced that API has a new top executive, Noel Rea.
Rea’s experience includes serving as interim CEO of Alaska hospitals including South Peninsula Hospital in Homer, Cordova Community Medical Center and Southeast Alaska Regional Health Consortium in Sitka.
Rea is the fifth CEO or interim leader of the Alaska Psychiatric Institute since September 2018.
James Brooks contributed reporting to this story.