SB 6251 — Coordinating regional behavioral crisis response and suicide prevention services.

(v) Additional noncrisis behavioral health services, within available resources, to individuals who meet certain criteria set by the authority in its contracts with the behavioral health administrative services organization.

These services may include services provided through federal grant funds, provisos, and general fund state appropriations;

(vi) Care coordination, diversion services, and discharge planning for nonmedicaid individuals transitioning from state hospitals or inpatient settings to reduce rehospitalization and utilization of crisis services, as required by the authority in contract;

((and)) (vii) Regional coordination, cross-system and cross-jurisdiction coordination with tribal governments, and capacity building efforts, such as supporting the behavioral health advisory board and efforts to support access to services or to improve the behavioral health system;

and (viii) Duties under section 1 of this act;

(b) Administer and provide for the availability of an adequate network of evaluation and treatment services to ensure access to treatment, investigation, transportation, court-related, and other services provided as required under chapter 71.05 RCW;

(c) Coordinate services for individuals under RCW 71.05.365;

(d) Administer and provide for the availability of resource management services, residential services, and community support services as required under its contract with the authority;

(e) Contract with a sufficient number, as determined by the authority, of licensed or certified providers for crisis services and other behavioral health services required by the authority;

(f) Maintain adequate reserves or secure a bond as required by its contract with the authority;

(g) Establish and maintain quality assurance processes;

(h) Meet established limitations on administrative costs for agencies that contract with the behavioral health administrative services organization;

and (i) Maintain patient tracking information as required by the authority.

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13 SSB 6251 (2) The behavioral health administrative services organization must collaborate with the authority and its contracted managed care organizations to develop and implement strategies to coordinate care with tribes and community behavioral health providers for individuals with a history of frequent crisis system utilization.

(3) The behavioral health administrative services organization shall:

(a) Assure that the special needs of minorities, older adults, individuals with disabilities, children, and low-income persons are met;

(b) Collaborate with local government entities to ensure that policies do not result in an adverse shift of persons with mental illness into state and local correctional facilities;

and (c) Work with the authority to expedite the enrollment or reenrollment of eligible persons leaving state or local correctional facilities and institutions for mental diseases.

(4) The behavioral health administrative services organization shall employ an assisted outpatient treatment program coordinator to oversee system coordination and legal compliance for assisted outpatient treatment under RCW 71.05.148 and 71.34.815.

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4.

(1) Establishing the state ((designated))designated certified 988 contact hubs and enhancing the crisis response system will require collaborative work between the department ((and)), the authority, and regional system partners within their respective roles.

The department shall have primary responsibility for ((establishing and designating the designated)) certifying 988 contact hubshubs. upon the recommendation of behavioral health administrative services organizations.

The authority shall have primary responsibility for developing ((and)), implementing, and facilitating coordination of the crisis response system and services to support the work of the ((designated)) 988 contact hubs, regional crisis lines, and other coordinated regional behavioral health crisis response and suicide prevention system partners.

In any instance in which one agency is identified as the lead, the expectation is that agency will ((be communicating and collaborating)) communicate and collaborate with the other to ensurefacilitate seamless,and continuous,support development and effectiveexecution serviceof deliveryprotocols withinfor theregional statewidecoordination of behavioral health crisis response system.and suicide prevention services that ensure seamless, p.

p.12 SB 6251 continuous, and effective service delivery within the statewide crisis response system.

14 SSB 6251 (2) The department shall provide adequate funding for the state's crisis call centers to meet an expected increase in the use of the ((callcall centers))centers 988 contact hubs based on the implementation of the 988 ((crisiscrisis hotline))hotline. contact hubs.

((In contracting)) Contracts with the ((crisiscrisis call centers,centers((, the department))department)): 988 contact hubs:

(a) May provide funding to support regional crisis ((call centers)) lines and ((designated)) certified 988 contact hubs to enter into limited on-site partnerships with the public safety answering point to increase the coordination and transfer of behavioral health calls received by certified public safety telecommunicators that are better addressed by clinic interventions provided by the ((988)) coordinated regional behavioral health crisis response and suicide prevention system.

Tax revenue may be used to support on-siteon- site partnerships;

(b) Shall require that ((crisis((crisis)) call centers)) 988 contactcall hubscenters enter into data-sharing agreements, when appropriate, with the department, the authority, regional crisis lines, and applicable regional behavioral health administrative services organizations to provide reports and client level data regarding 988 ((crisiscrisis hotline))hotline contact hub calls, as allowed by and in compliance with existing federal and state law governing the sharing and use of protected health information ((, including)).

Data-sharingData- sharing agreements with regional crisis lines must include real-time information sharing.

All coordinated regional behavioral health crisis response and suicide prevention system partners must share dispatch time, arrival time, and disposition ((of the outreach for each call)) for behavioral health calls referred for outreach by each region consistentas withagreed anythrough regional protocols developed under section 1 of this act.

The department and the authority shall establish requirements ((that the crisis)) for 988 call centers to report ((the)) data ((identified in this subsection (2)(b))) to regional behavioral health administrative services organizations for the purposes of maximizing medicaid reimbursement, as appropriate, and implementing this chapter and p.

1513 SSBSB 6251 this chapter and chapters 71.05 and 71.34 RCW ((including, but not limited to,)).

The behavioral health administrative services organization may use information received from the 988 contactcall hubscenters into assist with administering crisis services for the assigned regional service area, contracting with a sufficient number of licensed or certified providers for crisis services, establishing and maintaining quality assurance processes, maintaining patient tracking, and developing and implementing strategies to coordinate care for individuals with a history of frequent crisis system utilization.

The department shall collaborate with the authority ((and)), other agencies, and coordinated regional behavioral health crisis response and suicide prevention system partners to assure coordination and availability of services, and shall consider national guidelines for behavioral health crisis care as determined by the federal substance abuse and mental health services administration, national behavioral health accrediting bodies, and national behavioral health provider associations to the extent they are appropriate, and recommendations from the crisis response improvement strategy committee created in RCW 71.24.892.

(4) The department shall ((designate designated)) certify 988 contact hubs recommendeddesignated by behavioral health administrative services organizations under section 1 of this act which are able to meet state and federal certification standards by January 1, 2026.

The ((designated))designated certified 988 contact hubs shall provide connections to crisis intervention services, triage, care coordination, andreferrals, referrals((, and connections to))to for individuals contacting the 988 ((crisiscrisis hotline))hotline contact hubs from any jurisdiction within Washington 24 hours a day, seven days a week, using the system platform developed under subsection (5) of this section.

The department may revoke the ((designation)) certification of any ((designated)) 988 contact hub that fails to substantially comply with the contractcontract. or coordinated regional behavioral health crisis response system protocols or data-sharing requirements.

(b) The contracts entered shall require ((designated)) certified 988 contact hubs to:

1614 SSBSB 6251 (b)(i) TheHave contractsan enteredactive shallagreement requirewith ((designated))the certifiedadministrator 988of contactthe hubsnational to:suicide prevention lifeline for participation within its network;

(i) Have an active agreement with the administrator of the national suicide prevention lifeline for participation within its network;

(v) Prominently display 988 ((crisiscrisis hotline))hotline contact hub information on their websites and social media, including a description of what the caller should expect when contacting the crisis call center and a description of the various options available to the caller, including call lines specialized in the behavioral health needs of veterans, American Indian and Alaska Native persons, Spanish-speaking persons, and LGBTQ populations.

The website may also p.include resources for programs and services related to suicide prevention for the agricultural community;

17p. SSB 6251 include resources for programs and services related to suicide prevention for the agricultural community;

15 SB 6251 (vi) Collaborate with the authority, the national suicide prevention lifeline, and veterans crisis line networks to assure consistency of public messaging about the 988 ((crisiscrisis hotline))hotline; contact hub;

(viii) Develop, in collaboration with the region's behavioral health administrative services organizations, and jointly submit to the authority)) Collaborate with coordinated regional behavioral health crisis response and suicide prevention system partners within the 988 contact hub's regional service area to develop and submit to the department, authority, and state 911 coordination office protocols under section 1 of this act between the certifieddesignated 988 contact hubs,hub, regional crisis lines, 911 call centers, and other system partners within the region in which the 988 contact hub operates, including protocols related to the dispatching of mobile rapid response crisis teams and community-community-based based crisis teams endorsed under RCW 71.24.903 ((and receive approval of the protocols)), which must be approved by the authority;

and (((x))) (ix) Enter into data-sharing agreements with the department, the authority, regional crisis lines, and applicable ((regional)) behavioral health administrative services organizations to provide reports and client level data regarding 988 ((crisiscrisis hotline))hotline contact hub calls, as allowed by and in compliance with existing federal and state law governing the sharing and use of protected health information, ((including dispatch time, arrival time, and disposition of the outreach for each call referred for outreach by each region)) which shall include sharing real-time information with regional crisis lines.

The department and the authority shall establish requirements that the ((designated)) 988 contact hubs report ((the)) data ((identified in this subsection (4)(b)(x))) to regional behavioral health administrative services organizations for the purposes of maximizing medicaid reimbursement, as appropriate, and ((implementing)) to facilitate implementation of this chapter and p.

1816 SSBSB 6251 organizations for the purposes of maximizing medicaid reimbursement, as appropriate, and implementing this chapter and chapters 71.05 and 71.34 RCW including,((including, but not limited to, administering crisis services for the assigned regional service area, contracting with a sufficient number ((or))or of licensed or certified providers for crisis services, establishing and maintaining quality assurance processes, maintaining patient tracking, and developing and implementing strategies to coordinatecoordinate)) and to facilitate coordination of care for individuals with a history of frequent crisis system utilization.

The department and the authority must include ((thethe crisis call centers and((and designated))designated)), certified 988 contact hubs, regional crisis lines, and behavioral health administrative services organizations in the decision-making process for selecting any technology platforms that will be used to operate the system.

No decisions made by the department or the authority shall interfere with the routing of the 988 ((crisiscrisis hotline))hotline contact hubs calls, texts, or chat as part of Washington's active agreement with the administrator of the national suicide prevention lifeline or 988 administrator that routes 988 contacts into Washington's system.

and (b) A behavioral health integrated client referral system capable of providing system coordination information to ((designated)) certified 988 contact hubs and the other entities involved in p.behavioral health care.

19 SSB 6251 behavioral health care.

(6) In developing the new technologies under subsection (5) of this section, the department and the authority must coordinate to designatep. a primary technology system to provide each of the following:

17 SB 6251 designate a primary technology system to provide each of the following:

and (B) Information necessary to enable the ((designated)) certified 988 contact ((hub))hub hubs to actively collaborate with regional crisis lines, emergency departments, primary care providers and behavioral health providers within managed care organizations, behavioral health administrative services organizations, and other health care payers to establish a safety plan for the person in accordance with best practices and provide the next steps for the person's transition to follow-up noncrisis care.

(iii) the next steps for the caller to follow in transition to noncrisis follow-up care, including a next-day p.appointment for callers experiencing urgent, symptomatic behavioral health care needs;

20and SSB(iv) 6251the appointmentmeans forto callersverify experiencingand urgent,document symptomaticwhether behavioralthe healthcaller was successful in making the transition to appropriate noncrisis follow-up care needs;indicated in the safety plan for the person, p.

and18 (iv)SB the6251 means to verify and document whether the caller was successful in making the transition to appropriate noncrisis follow-up care indicated in the safety plan for the person, to be completed either by the care coordinator provided through the person's managed care organization, health plan, or behavioral health administrative services organization, or if such a care coordinator is not available or does not follow through, by the staff of the ((designated)) certified 988 contact hub;

(c) A means to facilitate actions to verify and document whether the person's transition to follow-up noncrisis care was completed and services offered, to be performed by a care coordinator provided through the person's managed care organization, health plan, or behavioral health administrative services organization, or if such a care coordinator is not available or does not follow through, by the staff of the ((designated)) certified 988 contact hub;

(a) Collaborate with county authorities and behavioral health administrative services organizations to develop procedures to dispatch behavioral health crisis services in coordination with ((designated)) certified 988 contact hubs to effectuate the intent of this section;

(b) Establish formal agreements with managed care organizations and behavioral health administrative services organizations by January 1, 2023, to provide for the services, capacities, and coordination necessary to effectuate the intent of this section, which shall include a requirement to arrange next-day appointments for persons contacting the 988 ((crisiscrisis hotline))hotline contact hub or a regional crisis line experiencing urgent, symptomatic behavioral health care needs with geographically, culturally, and linguistically appropriate primary care or behavioral health providers within the person's provider network, or, if uninsured, through the person's behavioral health administrative services organization;

(c) Create best practices guidelines by July 1, 2023, for deployment of appropriate and available crisis response services by ((designated)) behavioral health administrative services organizations in coordination with 988 contact hubs to assist 988 p.

2119 SSBSB 6251 (c) Create best practices guidelines by July 1, 2023, for deployment of appropriate and available crisis response services by ((designated)) behavioral health administrative services organizations in coordination with certified 988 contact hubs to assist 988 hotline callers to minimize nonessential reliance on emergency room services and the use of law enforcement, considering input from relevant stakeholders and recommendations made by the crisis response improvement strategy committee created under RCW 71.24.892;

The authority shall design these guidelines to promote behavioral health equity for all populations with attention to circumstances of race, ethnicity, gender, socioeconomic status, sexual orientation, and geographic location, and include components such as training requirements for call response workers, policies for transferring such callers to an appropriate specialized center or subnetwork within or external to the national suicide prevention lifeline network, and procedures for referring persons who access the 988 ((crisiscrisis hotline))hotline contact hubs to linguistically and culturally competent care.

(8) The department shall monitor trends in 988 ((crisiscrisis hotline))hotline contact hubs caller data, as reported by ((designated)) certified 988 contact hubs under subsection (4)(b)(((x))) (ix) of this section, and submit an annual report to the governor and the appropriate committees of the legislature summarizing the data and trends beginning December 1, 2027.

2220 SSBSB 6251