HB 1876 — Concerning children's mental health.

H-1664.3SUBSTITUTEH-1268.2HOUSE HOUSE BILL 1876State of Washington66th Legislature2019 Regular SessionByHouseSessionByRepresentatives HumanFrame, ServicesEslick, &Appleton, EarlyDavis, LearningBergquist, (originallyPollet, sponsoredand byDoglioRead Representativesfirst Frame,time Eslick,02/04/19.Referred Appleton,to Davis,Committee Bergquist,on Pollet,Human andServices Doglio)READ& FIRSTEarly TIMELearning.AN 02/20/19.AN ACT Relating to implementing policies related to children's mental health as reviewed and recommended by the children's mental health work group;

adding a new section to chapter 74.0928A.310 RCW;

adding a new section to chapter 28A.415 RCW;

adding a new section to chapter 28A.300 RCW;

adding a new section to chapter 28B.20 RCW;

(1)A Subjectnew tosection theis availabilityadded ofto amountschapter appropriated28A.310 forRCW thisto specificread purpose,as beginningfollows:(1) JulyEach 1,educational 2019,service thedistrict healthmust careprovide authorityto shallthe collaborateschool withdistricts thein Universityits ofregion Washingtonbehavioral departmenthealth ofcoordination psychiatrythat, andat behaviorala sciences,minimum, Seattleincludes:(a) children'sProviding hospital,support andfor theschool officedistrict ofdevelopment theand superintendentimplementation of publicplans instruction,for torecognition, developinitial ascreening, planand response to implementemotional aor two-yearbehavioral pilotdistress programin calledstudents theas partnershiprequired accessunder lineRCW for28A.320.127;(b) schools.(2)Facilitating Thepartnerships pilotand programcoordination mustbetween beschool implementeddistricts, bypublic Januaryschools, 1,and 2020,existing regional and shalllocal supportsystems twoof educationalbehavioral servicehealth districtscare selectedservices byand thesupports officein oforder theto superintendentincrease ofstudent publicand instruction.(3)family Elementsaccess ofto thethese pilotservices programand mustsupports;(c) include:(a)Assisting Developingschool adistricts generaland behavioralpublic healthschools supportin curriculumbuilding appropriatecapacity forto theidentify rolesand ofsupport schoolstudents staff;(b)in Deliveringneed of behavioral health trainingscare forservices schooland counselors,to sociallink workers,students psychologists, nurses, teachers, and administratorsfamilies with contentcommunity-based designedbehavioral specificallyhealth forcare theseservices;(d) roles;(c)Identifying, Providingsharing, schooland staffintegrating, whoto havethe participatedextent inpracticable, trainingbehavioral underand thisphysical sectionhealth accesscare toservice telephonedelivery consultationmodels;(e) withProviding psychologistsmedicaid andbilling psychiatristsrelated totraining, supporttechnical schoolassistance, staffand incoordination managingbetween childrenschool withdistricts; challenging behaviors;

and(d)and(f) ProvidingGuidance timelyin crisisimplementing managementbest appointments,practices delivered in personresponse orto, through interactive audio and videoto technology,recover betweenfrom, partnership access line clinical staff and school staff when assessed as clinically appropriate by the partnershipsuicide accessor lineattempted andsuicide whenof similara supportstudent.(2) isFunds notappropriated immediatelypursuant available in the local community.(4) By December 1, 2022, the health care authority shall submit a report to thethis governorsection andmust thebe legislatureused describingsolely thefor services delivered through the pilotpurposes programoutlined andin recommendingthis whethersection.NEW theSECTION.  Sec. pilot program should continue or be made permanent.(5) This section expires December 30, 2022.Sec.

RCW(1) 28B.20.445Subject to the availability of amounts appropriated for this specific purpose, beginning July 1, 2019, the health care authority shall collaborate with the University of Washington department of psychiatry and 2018behavioral csciences, 175Seattle schildren's 11hospital, areand eachthe amendedoffice of the superintendent of public instruction, to readdevelop asa follows:Subjectplan to theimplement availabilitya oftwo-year amountspilot appropriatedprogram called the partnership access line for thisschools.(2) specificThe purpose,pilot theprogram childmust be implemented by January 1, 2020, and adolescentshall psychiatrysupport residencytwo programeducational atservice districts selected by the Universityoffice of Washingtonthe shallsuperintendent offerof ((one))twopublic additionalinstruction.(3) twenty-fourElements monthof residencythe positionspilot thatprogram ((is))aremust approvedinclude:(a) byDeveloping a general behavioral health support curriculum appropriate for the accreditationroles councilof school staff;(b) Delivering behavioral health trainings for graduateschool medicalcounselors, educationsocial toworkers, ((one))twopsychologists, residentsnurses, specializingteachers, and administrators with content designed specifically for these roles;(c) Providing school staff who have participated in childtraining under this section access to telephone consultation with psychologists and adolescentpsychiatrists psychiatry.to support school staff in managing children with challenging behaviors;

Theand(d) ((residency))positionsProviding musttimely eachcrisis includemanagement aappointments, minimumdelivered ofin ((twelve))eighteenperson monthsor ofthrough traininginteractive audio and video technology, between partnership access line clinical staff and school staff when assessed as clinically appropriate by the partnership access line and when similar support is not immediately available in settingsthe wherelocal children'scommunity.(4) mentalBy December 1, 2022, the health servicescare areauthority providedshall undersubmit a report to the supervisiongovernor ofand experiencedthe psychiatriclegislature consultantsdescribing the services delivered through the pilot program and mustrecommending whether the pilot program should continue or be locatedmade westpermanent.(5) ofThis thesection crestexpires ofDecember the30, Cascade2022.NEW mountains.Sec.SECTION.  Sec.

RCWA 28B.30.357new andsection 2017is cadded 202to schapter 928A.415 areRCW each amended to read as follows:Subjectfollows:(1) toBeginning in the availability2019-20 school year, school districts must use one of amountsthe appropriatedprofessional forlearning thisdays specificfunded purpose,under WashingtonRCW State28A.150.415 Universityto shalltrain offerschool ((one))twodistrict twenty-fourstaff monthin residencymental positionshealth thatfirst ((is))areaid, approvedsuicide byprevention, thesocial-emotional accreditationlearning, counciltrauma-informed forcare, graduateand medicalantibullying educationstrategies.(2) Funds appropriated pursuant to ((one))twothis residentssection specializingmust inbe childused andsolely adolescentfor psychiatry.the purposes outlined in this section.NEW SECTION.  Sec.

The ((residency))positions must each include a minimum of ((twelve))eighteen months of training in settings where children's mental health services are provided under the supervision of experienced psychiatric consultants and must be located east of the crest of the Cascade mountains.NEW SECTION.  Sec.

A new section is added to chapter 74.0928A.300 RCW to read as follows:(1) The authorityoffice shallof collaborate with the Universitysuperintendent of Washingtonpublic andinstruction ashall professionalprovide associationmental ofhealth licensedliteracy communityand behavioralhealthy healthrelationships agenciesinstructional materials for school districts to developuse aas statewideguidelines planfor tostudent implementinstruction evidence-basedin coordinatedthese specialtysubjects.(2) careFunds programsappropriated thatpursuant provideto earlythis identificationsection andmust interventionbe forused psychosissolely infor licensedthe andpurposes certifiedoutlined communityin behavioralthis healthsection.NEW agencies.SECTION.  Sec.

The authority must submit the statewide plan to the governor and the legislature by March 1, 2020.

The statewide plan must include:(a) Analysis of existing benefit packages, payment rates, and resource gaps, including needs for nonmedicaid resources;(b) Development of a discrete benefit package and case rate for coordinated specialty care;(c) Identification of costs for statewide start-up, training, and community outreach;(d) Determination of the number of coordinated specialty care teams needed in each regional service area;

and(e) A timeline for statewide implementation.(2) The authority shall ensure that:(a) At least one coordinated specialty care team is starting up or in operation in each regional service area by October 1, 2020;

and(b) Each regional service area has an adequate number of coordinated specialty care teams based on incidence and population across the state by December 31, 2023.(3) This section is subject to the availability of amounts appropriated for the specific purposes of this section.(4) This section expires June 30, 2024.Sec.

RCWA 43.216.745new andsection 2017is cadded 202to schapter 528B.20 areRCW each amended to read as follows:(1)(a)follows:Subject Subject to the availability of amounts appropriated for this specific purpose, the departmentUniversity of Washington shall establish ((acertificate childprograms care))anin infantevidence-based andpractices earlyfor childhoodbehavioral mental health consultationcare programprofessionals linkingas ((childfollows:(1)(a) care))earlyThe learningUniversity providersof Washington school of social work, in collaboration with evidence-based,the trauma-informed,University of Washington department of psychiatry and bestbehavioral practicesciences, resourcesshall regardingestablish caringa forcertificate infantsprogram in evidence-based practices that have been shown to be effective in treating adolescents and young childrenadults whowith presentmental behavioralhealth concernsdisorders, orincluding:(i) symptomsDialectical ofbehavior trauma.therapy;

and(ii) The wellness recovery action plan.(b) The certificate program must be designed for graduate students pursuing a master of social work degree.(2)(a) The University of Washington department mayof contractpsychology, in collaboration with anthe entitydepartment withof expertisepsychiatry inand childbehavioral developmentsciences, school of social work, and earlycontinuum learningcollege, programsshall establish a certificate program in orderevidence-based topractices operatethat thehave ((childbeen care))shown consultationto program.(((2)))(b)be Ineffective establishingin treating adolescents and operatingyoung theadults program,with themental departmenthealth ordisorders, contractedincluding:(i) entityEvidence-based shall:parenting interventions;(ii) Evidence-based treatments for anxiety and mood disorders;

(((a)))(i)and(iii) AssistTrauma-focused ((childcognitive care))earlybehavior learningtherapy.(b) providersThe certificate program must be designed for licensed behavioral health care professionals who wish to receive additional education in recognizingevidence-based practices.(3) Participants in the signscertificate programs under this section are eligible to apply for the health professional loan repayment and symptomsscholarship ofprogram traumaunder inchapter children;28B.115 RCW.Sec.

(((b)))(ii) provide support and guidance to ((child care))early learning staff;

(((c)))(iii) consult and coordinate with parents, other caregivers, and experts or practitioners involved with the care and well-being of the young children;

and (((d)))(iv) provide referrals for children who need additional services.(2)(a) Subject to the availability of amounts appropriated for this specific purpose, the department shall develop an infant and early childhood mental health consultation model for children ages birth through five and provide the model to the governor and the legislature by November 1, 2019.(b) In the development of the model, the department must consult with public and private partners, including tribal representatives, to ensure the model meets community needs in a culturally responsive manner.(c) The model must include:(i) A workforce development plan that addresses initial training and ongoing professional development for infant and early childhood mental health consultants in accordance with nationally recognized competencies in the field;(ii) Consultation standards that are informed by current evidence in the field, trauma-informed, and culturally responsive;(iii) A program evaluation protocol for outcome measurement;

and(iv) A plan for a data tracking system for consultation activities.(d) The department must phase in service delivery and begin implementation in at least two regions by July 1, 2020, followed by full statewide implementation by December 31, 2023.NEW SECTION.  Sec.

RCW 28B.20.445 and 2018 c 175 s 11 are each amended to read as follows:Subject to the availability of amounts appropriated for this specific purpose, the child and adolescent psychiatry residency program at the University of Washington shall offer ((one))two additional twenty-four month residency positions that ((is))are approved by the accreditation council for graduate medical education to ((one))two residents specializing in child and adolescent psychiatry.

The ((residency))residencies must each include a minimum of twelve months of training in settings where children's mental health services are provided under the supervision of experienced psychiatric consultants and must be located west of the crest of the Cascade mountains.Sec.

8.

RCW 28B.30.357 and 2017 c 202 s 9 are each amended to read as follows:Subject to the availability of amounts appropriated for this specific purpose, Washington State University shall offer ((one))two twenty-four month residency positions that ((is))are approved by the accreditation council for graduate medical education to ((one))two residents specializing in child and adolescent psychiatry.

The ((residency))residencies must each include a minimum of twelve months of training in settings where children's mental health services are provided under the supervision of experienced psychiatric consultants and must be located east of the crest of the Cascade mountains.NEW SECTION.  Sec.

9.

(1) The health care authority shall collaborate with the University of Washington and a professional association of licensed community behavioral health agencies to develop a statewide plan to implement evidence-based coordinated specialty care programs that provide early identification and intervention for psychosis in licensed and certified community behavioral health agencies.

The health care authority must submit the statewide plan to the governor and the legislature by March 1, 2020.

The statewide plan must include:(a) Analysis of existing benefit packages, payment rates, and resource gaps, including needs for nonmedicaid resources;(b) Development of a discrete benefit package and case rate for coordinated specialty care;(c) Identification of costs for statewide start-up, training, and community outreach;(d) Determination of the number of coordinated specialty care teams needed in each regional service area;

and(e) A timeline for statewide implementation.(2) This section expires June 30, 2020.NEW SECTION.  Sec.

10.

(1) Subject to amounts appropriated for this specific purpose, the University of Washington shall convene a work group of educators and researchers to develop a statewide multitiered system of school supports that includes academic, social-emotional, and behavioral supports.

The work group must include representatives of:

Public K-12 schools;

school districts;

educational service districts;

the office of the superintendent of public instruction;