Social and Economic Policy
Everyone should have access to affordable, quality behavioral healthcare across a full spectrum of services, from preventative care to inpatient hospitalization, with a workforce sufficient to provide these services.
The League at both the state and national level supports access to affordable and quality behavioral healthcare for all. Restrictions to access, provider availability, and reimbursement have always plagued behavioral healthcare. These problems were only made worse by the pandemic and the increased social isolation that resulted from it.
The Governor and the Legislature recognized these problems and the Legislature introduced legislation to address them. They passed bills and the funding needed to enhance the 988 crisis response line, provide support and services for prenatal substance exposure, provide services to children with developmental delays who are in out-of-home placements, facilitate interaction between a parent of a child who is in out-of-home care and the person with whom the child is placed, established short-term crisis stabilization centers (less than 24 hours), and established the profession of behavioral health support specialist to address the behavioral health workforce shortage. They also passed a bill closing gaps in privacy protections for healthcare data. Of course, more is needed, but this is a good start to addressing the problems in behavioral healthcare.
|House Bills||House||Senate||After Passage|
|Bill #||Bill Name (Brief Title)||League Position||Take Action||In Committee||On Floor Calendar||Passed||In Committee||On Floor Calendar||Passed||Passed Legislature||On Governor's Desk||Signed|
|HB 1134||Implementing the 988 behavioral health crisis response and suicide prevention system||Supports||
|HB 1155||Addressing the collection, sharing, and selling of consumer health data||Supports|
|HB 1168||Providing prevention services, diagnoses, treatment, and support for prenatal substance exposure||Supports|
|HB 1188||Concerning individuals with developmental disabilities that have also received child welfare services||Supports|
|HB 1204||Implementing the family connections program||Supports|
These weekly updates will provide you with a "deep dive" into the progress of each bill, along with more analysis of the potential impact of the bill if it should pass.
HB 1134 Implementing the 988 behavioral health crisis response and suicide prevention system. This bill has several provisions regarding the 988 crisis hotline, mostly changes and enhancements due things learned during the initial implementation. It extends several dates related to reporting, and funding of the crisis call centers; establishes liability protection for activities related to the dispatching decisions of 988 crisis hotline staff, directs the Department of Health to develop informational materials and a social media campaign to promote the 988 crisis hotline, directs the University of Washington to establish a crisis training and secondary trauma program for personnel in the behavioral health crisis system, and establishes mobile rapid response crisis teams to respond to the 988 calls when needed.
A 1st substitute bill was passed by the House Committee on Health Care & Wellness and was further changed by a 2nd substitute bill passed by the House Appropriations Committee. The combined changes in the substitute bills required that persons contacting the 988 crisis hotline be screened to see if they were part of the agricultural community and if they would prefer to be connected to an agricultural hotline and required that dispatch protocols be developed for transferring 988 calls to rapid response crisis teams. They also required that 988 rapid response crisis teams include appropriately credentialed and supervised staff from a behavioral health agency, but excludes law enforcement. the required response time in rural areas also is gradually lowered from 60 minutes to being on route within 10 minutes in 2027. The substitute bill eliminates the University of Washington from responsibility for establishing a program of crisis training and instead establishes the UW School of Social Work as responsible for collaboration among the parties involved in providing the service and other stakeholders.
HB 1155 Addressing the collection, sharing, and selling of consumer health data (aka, Washington, My Health, My Data Act). Generally, people assume that their healthcare information is private and this privacy is protected by a federal law, HIPAA. However, health data collected by certain apps and websites is not covered. This bill closes these gaps in privacy protections for healthcare data. Privacy is particularly important in regard to certain sensitive healthcare data such as reproductive health care, gender-affirming care, and behavioral health diagnoses. Exposure of an individual’s healthcare information could have negative consequences, and concerns about exposure might hinder someone from seeking health information or care.
The substitute bill passed by the House Committee on Civil Rights & Judiciary changes the prohibition on the sale of consumer health data to selling consumer health data without authorization. It modifies the geofencing prohibition to provide that it is unlawful to implement a geofence to collect data from a consumer who enters an in-person health: geofencing around the facility is not illegal by itself. It also added several exemptions for deidentified health care information. These changes weakened the bill. Nevertheless, the substitute bill still provides much needed privacy protection for healthcare information and we support it.
HB 1168 Providing prevention services, diagnoses, treatment, and support for prenatal substance exposure. This bill would provide for increased access to services for children with fetal alcohol spectrum disorders and other prenatal substance disorders, as well as increasing prevention efforts.
The 1st substitute bill specifies that the provider contract for prenatal substance exposure treatment and family support applies to children over the age of 3 and makes the services optional instead of required. It expanded the scope of the bill to include exposure to prenatal substances other than alcohol. A 2nd substitute bill required that the Department of Children, Youth, and Families contract with at least three agencies across the state to provide comprehensive treatment services for prenatal substance exposure and family supports for children exposed to substances before birth who are, or were, involved with the child welfare system.
HB 1188 Concerning individuals with developmental disabilities that have also received child welfare services. This bill provides that services through the Children's Intensive Behavior Support Services waiver may supplement the child welfare services that a child may be receiving; may be provided to children in out-of-home placement, and may be provided even if the family is subject to an unresolved child protective services referral. These are services that would be available to children who qualified if they were living with a parent and not in an out of home placement.
A substitute bill applied the bill prospectively; applied it to children in tribal dependencies; added a requirement that a qualifying person must begin receiving waiver services before they are 25 in order for the entitlement to receive waiver services to apply; and required that the Department of Social and Health Services, in collaboration with the Department of Children, Youth, and Families, seek a new Medicaid waiver to meet the needs of dependent children and youth age 20 and under who have developmental disabilities; and delayed the effective date of the provisions outlining caseload forecasting and the entitlement to waiver services to January 1, 2025. The 2nd substitute bill added a null and void clause that would make the bill null and void unless funded in the budget
HB 1204 Implementing the family connections program. This bill establishes the Family Connections Program, a pilot program, as a permanent program. Currently, the Department of Children, Youth, and Families contracts with Amara to operate the program in King, Pierce, Mason, Clark, Grays Harbor, Pacific, Kitsap, and Skamania counties. The program facilitates interaction between a parent of a child who is dependent and in out-of-home care and the person with whom the child is placed. The facilitated contact benefits the child, the parent, and the foster parent.
A substitute bill expanded the process by which families may be referred to allow referral in any manner determined to be appropriate by the Program, specifically including a referral by the parent or caregiver.
The 2nd substitute bill added a null and void clause that would make the bill null and void unless funded in the budget.
SB 5036 Concerning telemedicine. This bill extends the time frame (until 07/2024) in which real-time telemedicine, using audio or audio-video technology may be used. Telemedicine has provided increased access to medical and behavioral health services during the pandemic. This bill would extend these benefits.
SB 5120 An act relating to establishing crisis relief centers in Washington state. (Previously, Establishing 23-hour crisis relief centers in Washington state). This bill provides for the establishment of 23-hour crisis relief centers. These are community-based facilities open 24-7, offering access to brief care (<24 hours) for adults experiencing a mental health or substance use crisis. They would accept walk-ins and drop-offs from ambulance, fire, and police.
The substitute bill specified that the Centers serve only adults. It expanded the definition of first responder, indicated that the Center is limited to minor wound care, requires that the Center have access to a provider who can prescribe medication and must have access to medication, and requires that standards be developed to determine medical stability before a person can be dropped off by EMT services.
The 2nd substitute bill shortened deadline for the Department of Health to create rules for 23-hour crisis relief centers (CRCs) from January 1, 2025, to January1, 2024, allowed a police officer who has reasonable cause to believe an individual has committed a crime to take the individual to a CRC., and amended the title of the bill to, “An act relating to establishing crisis relief centers in Washington state”.
SB 5189 Establishing behavioral health support specialists. This bill establishes the profession of behavioral health support specialist. To be eligible for this designation the person must have a bachelor's degree, have completed an accredited behavioral health support specialist educational program, and have passed an exam. The educational program must include a supervised clinical practicum. This person would practice under the supervision of a licensed behavioral health provider. Establishing this profession would increase the behavioral health workforce and free behavioral health professionals to work at the top of their scope of practice.
In addition to the paths to the credential that are specified in the original bill, the substitute bill allows applicants to complete a registered apprenticeship in combination with an approved bachelor’s degree or postbaccalaureate certificate. It also directs insurance carriers to provide access to behavioral health support specialists in a manner sufficient to meet network access standards by July 1, 2025