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Bill Descriptions

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 1^st substitute bill was passed by the House Committee on Health Care & Wellness and was further changed by a 2^nd 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.

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 1^st 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 2^nd 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 2^nd 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 2^nd substitute bill added a null and void clause that would make the bill null and void unless funded in the budget.

HB 1479 Concerning restraint or isolation of students in public schools and educational programs. The bill prohibits students from being subjected to isolation, mechanical restraint, or chemical restraint by school staff except when there is imminent likelihood of serious harm. Isolation rooms must remain unlocked and must be phased out by January 1, 2024. School districts must carry out trainings and other activities to support the elimination of isolation and chemical restraint and to reduce the use of restraint in schools.

• The 1st substitute bill delayed the date of the prohibition on student isolation to August 1, 2025, made student isolation and restraint provisions applicable to all providers of public educational services, required reporting of room clears, directs that student isolation and restraint policies be reviewed and revised with input from appropriate members of the community, requires updating of professional development plans, and requires a report on a plan for integrating instruction on student isolation and restraint requirements into educator preparation programs and paraeducator certificate requirements.

• The 2nd substitute bill added room clears to the types of incidents that the bill addresses. It revised the date by which student isolation is prohibited, extending the date to the effective date of the act for students in prekindergarten through grade 2, and to January 1, 2026 for students in grade 3 through 12. The date when isolation rooms must be removed or repurposed is extended to January 1^st, 2026. It clarified that the use of physical force prohibited in the bill did not include temporarily touching or holding a student’s hand, shoulder or back for the purpose of guiding them.

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 2^nd 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 5130 Concerning assisted outpatient treatment. When deemed appropriate, this bill provides for a less restrictive mental health treatment option than inpatient hospitalization for persons who have been involuntarily committed.

• Amendments were made to the bill before passing the Senate. The amendments changed the burden of proof for a petition for assisted outpatient treatment from clear, cogent, and convincing evidence to a preponderance of the evidence. A behavioral health case manager may provide the supporting declaration for the petition. The declaration provided by a the treating mental health provider does not have to be cosigned by a supervising physician, physician assistant, or ARNP.

SB 5189 Establishing behavioral health support specialists. These are companion bills. They establish 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.

• The 1st substitute bill delayed the date of the prohibition on student isolation to August 1, 2025, made student isolation and restraint provisions applicable to all providers of public educational services, required reporting of room clears, directs that student isolation and restraint policies be reviewed and revised with input from appropriate members of the community, requires updating of professional development plans, and requires a report on a plan for integrating instruction on student isolation and restraint requirements into educator preparation programs and paraeducator certificate requirements.

• The 2nd substitute bill added room clears to the types of incidents that the bill addresses. It revised the date by which student isolation is prohibited, extending the date to the effective date of the act for students in prekindergarten through grade 2, and to January 1, 2026 for students in grade 3 through 12. The date when isolation rooms must be removed or repurposed is extended to January 1^st, 2026. It clarified that the use of physical force prohibited in the bill did not include temporarily touching or holding a student’s hand, shoulder or back for the purpose of guiding them.

 

How To Be Involved

• Local Leagues in Washington have action chairs who coordinate action teams. Some local Leagues have health care teams to take action locally. Contact your local League action chair to find out and join.
• You may also express your opinion on legislation with the LWVWA issue chairs. We will take your perspectives under considerations as we determine our support for legislation and prepare testimony. Mary Lynne Courtney, Behavioral Health Issue Chair, mlcourtney@lwvwa.org.
• Another way to be involved is to join the Healthcare Affinity Group meetings on Zoom. The group meets every six weeks during the legislative session. If you are interested, please email Kim Abbey at kabbey48@gmail.com for the date of the next meeting and a link.