SB 5259 — Changing the designation of the state behavioral health authority from the department of social and health services to the health care authority and transferring the related powers, functions, and duties to the health care authority and the department of health.

S-1655.1SUBSTITUTEZ-0416.1SENATE SENATE BILL 5259State of Washington65th Legislature2017 Regular SessionBy Senate Health Care (originally sponsored by Senators Rivers, Cleveland, Darneille, Fain, and Keiser;

by request of Governor Inslee)READInsleeRead FIRSTfirst TIMEtime 02/17/17.AN01/18/17. ACT Relating to changing the designation of the state behavioral health authority from the department of social and health services to the health care authority and transferring the related powers, functions, and duties to the health care authority and the department of health;

amendingReferred RCWto 43.20A.025,Committee 43.20A.025,on 43.20A.065,Health 43.20A.433,Care.AN 43.20A.890,ACT 43.20A.892,Relating 43.20A.893,to 43.20A.894,changing 43.20A.896,the 43.20A.897,designation 74.04.015,of 71.05.026,the 71.05.026,state 71.05.027,behavioral 71.05.040,health 71.05.100,authority 71.05.203,from 71.05.203,the 71.05.214,department 71.05.214,of 71.05.215,social 71.05.240,and 71.05.285,health 71.05.320,services 71.05.320,to 71.05.325,the 71.05.325,health 71.05.330,care 71.05.335,authority 71.05.340,and 71.05.340,transferring 71.05.350,the 71.05.380,related 71.05.435,powers, 71.05.435,functions, 71.05.510,and 71.05.520,duties 71.05.525,to 71.05.560,the 71.05.560,health 71.05.590,care 71.05.590,authority 71.05.590,and 71.05.620,the 71.05.620,department 71.05.720,of 71.05.732,health; 71.05.740, 71.05.745, 71.05.745, 71.05.750, 71.05.750, 71.05.755, 71.05.760, 71.05.801, 71.05.940, 71.24.015, 71.24.030, 71.24.035, 71.24.037, 71.24.045, 71.24.045, 71.24.061, 71.24.100, 71.24.155, 71.24.160, 71.24.215, 71.24.220, 71.24.240, 71.24.300, 71.24.310, 71.24.320, 71.24.330, 71.24.330, 71.24.340, 71.24.350, 71.24.360, 71.24.370, 71.24.380, 71.24.385, 71.24.400, 71.24.405, 71.24.415, 71.24.420, 71.24.430, 71.24.455, 71.24.460, 71.24.470, 71.24.480, 71.24.490, 71.24.500, 71.24.515, 71.24.520, 71.24.525, 71.24.530, 71.24.535, 71.24.540, 71.24.545, 71.24.555, 71.24.565, 71.24.580, 71.24.590, 71.24.595, 71.24.605, 71.24.610, 71.24.615, 71.24.620, 71.24.625, 71.24.630, 71.24.640, 71.24.645, 71.24.650, 71.24.805, 71.24.810, 71.24.850, 71.24.860, 71.24.902, 71.34.010, 71.34.300, 71.34.365, 71.34.375, 71.34.375, 71.34.380, 71.34.385, 71.34.385, 71.34.390, 71.34.395, 71.34.400, 71.34.400, 71.34.405, 71.34.420, 71.34.420, 71.34.600, 71.34.600, 71.34.610, 71.34.630, 71.34.630, 71.34.640, 71.34.720, 71.34.720, 71.34.760, 71.34.760, 71.34.780, 71.34.780, 71.34.780, 71.34.790, 71.36.025, 71.36.040, 71.36.060, 70.96A.011, 70.96A.020, 70.96A.095, 70.96A.097, 70.96A.110, 70.96A.120, 70.96A.140, 70.96A.148, 70.96A.160, 70.96A.180, 70.96A.235, 70.96A.240, 70.96A.245, 70.96A.260, 70.96A.265, 70.96A.915, 70.96B.010, 70.96B.020, 70.96B.030, 70.96B.045, 70.96B.050, 70.96B.070, 70.96B.090, 70.96B.140, 41.05.015, 41.05.021, 41.05A.005, 74.09.050, 74.09.055, 74.09.080, 74.09.120, 74.09.160, 74.09.210, 74.09.220, 74.09.230, 74.09.240, 74.09.260, 74.09.280, 74.09.290, 74.09.315, 74.09.325, 74.09.522, 74.09.530, 74.09.540, 74.09.730, 74.09.780, 74.64.010, 74.66.010, 70.02.010, 70.02.230, 70.02.240, 70.02.250, 70.02.260, 70.02.340, 70.02.350, 43.70.080, 43.59.030, 48.21.180, 48.44.240, 48.46.350, 69.50.540, 2.30.020, 2.30.030, 9.41.300, 9.94A.703, 10.05.040, 10.05.050, 18.205.080, 18.88A.020, 46.61.5056, 72.09.350, 72.09.370, 72.09.370, 72.09.380, 72.09.381, 72.09.585, and 74.34.020;

amending RCW 43.20A.025, 43.20A.025, 43.20A.065, 43.20A.433, 43.20A.890, 43.20A.892, 43.20A.893, 43.20A.894, 43.20A.896, 43.20A.897, 74.04.015, 71.05.026, 71.05.026, 71.05.027, 71.05.040, 71.05.100, 71.05.203, 71.05.203, 71.05.214, 71.05.214, 71.05.215, 71.05.240, 71.05.285, 71.05.320, 71.05.320, 71.05.325, 71.05.325, 71.05.330, 71.05.335, 71.05.340, 71.05.340, 71.05.350, 71.05.380, 71.05.435, 71.05.435, 71.05.510, 71.05.520, 71.05.525, 71.05.560, 71.05.560, 71.05.590, 71.05.590, 71.05.590, 71.05.620, 71.05.620, 71.05.720, 71.05.732, 71.05.740, 71.05.745, 71.05.745, 71.05.750, 71.05.750, 71.05.755, 71.05.760, 71.05.801, 71.05.940, 71.24.015, 71.24.030, 71.24.035, 71.24.037, 71.24.045, 71.24.045, 71.24.061, 71.24.100, 71.24.155, 71.24.160, 71.24.215, 71.24.220, 71.24.240, 71.24.300, 71.24.310, 71.24.320, 71.24.330, 71.24.330, 71.24.340, 71.24.350, 71.24.360, 71.24.370, 71.24.380, 71.24.385, 71.24.400, 71.24.405, 71.24.415, 71.24.420, 71.24.430, 71.24.455, 71.24.460, 71.24.470, 71.24.480, 71.24.490, 71.24.500, 71.24.515, 71.24.520, 71.24.525, 71.24.530, 71.24.535, 71.24.540, 71.24.545, 71.24.555, 71.24.565, 71.24.580, 71.24.590, 71.24.595, 71.24.605, 71.24.610, 71.24.615, 71.24.620, 71.24.625, 71.24.630, 71.24.640, 71.24.645, 71.24.650, 71.24.805, 71.24.810, 71.24.850, 71.24.860, 71.24.902, 71.34.010, 71.34.300, 71.34.365, 71.34.375, 71.34.375, 71.34.380, 71.34.385, 71.34.385, 71.34.390, 71.34.395, 71.34.400, 71.34.400, 71.34.405, 71.34.420, 71.34.420, 71.34.600, 71.34.600, 71.34.610, 71.34.630, 71.34.630, 71.34.640, 71.34.720, 71.34.720, 71.34.760, 71.34.760, 71.34.780, 71.34.780, 71.34.780, 71.34.790, 71.36.025, 71.36.040, 71.36.060, 70.96A.011, 70.96A.020, 70.96A.095, 70.96A.097, 70.96A.110, 70.96A.120, 70.96A.140, 70.96A.148, 70.96A.160, 70.96A.180, 70.96A.235, 70.96A.240, 70.96A.245, 70.96A.260, 70.96A.265, 70.96A.915, 70.96B.010, 70.96B.020, 70.96B.030, 70.96B.045, 70.96B.050, 70.96B.070, 70.96B.090, 70.96B.140, 41.05.015, 41.05.021, 41.05A.005, 74.09.050, 74.09.055, 74.09.080, 74.09.120, 74.09.160, 74.09.210, 74.09.220, 74.09.230, 74.09.240, 74.09.260, 74.09.280, 74.09.290, 74.09.315, 74.09.325, 74.09.522, 74.09.530, 74.09.540, 74.09.730, 74.09.780, 74.09A.030, 74.64.010, 74.66.010, 70.02.010, 70.02.230, 70.02.240, 70.02.250, 70.02.260, 70.02.340, 70.02.350, 43.70.080, 43.59.030, 48.21.180, 48.44.240, 48.46.350, 69.50.540, 2.30.020, 2.30.030, 9.41.300, 9.94A.703, 10.05.040, 10.05.050, 18.205.080, 18.88A.020, 46.61.5056, 72.09.350, 72.09.370, 72.09.370, 72.09.380, 72.09.381, 72.09.585, and 74.34.020;

This change will streamline processes leading to improved patient safety outcomes.(8) The legislature therefore intends to integrate and consolidate the behavioral health licensing and certification functions within the department of health.NEWhealth.PART SECTION.  Sec. 1002.  (1)2Sec. 2001.  RCW The43.20A.025 authorityand shall1998 establishc a296 works group34 are each amended to assureread thatas thefollows:The transition((department of thesocial stateand behavioral health services)) authority fromshall adopt rules defining "appropriately trained professional person" for the departmentpurposes of socialconducting andmental health servicesand to((chemical thedependency)) healthsubstance careuse authoritydisorder doesevaluations notunder affectRCW the((71.34.052)) integration71.34.600(3), of((71.34.054)) behavioral71.34.650(1), health70.96A.245(3), servicesand by70.96A.250(1).Sec. 2002.  RCW 2020.43.20A.025 and 2016 sp.s.

The work group shall identify multiple options for structuring the services delivery and financing for integrating behavioral health services.

Among the various structures for consideration, the work group shall examine:(a) A model in which the health care authority contracts directly and separately with both a managed care organization to provide behavioral health services in the regional service area and a county administrative service organization to provide crisis services and non-medicaid services;

and(b) A model in which the health care authority approves an organization operated by the county governments within a regional service area to function as the coordinating entity for any managed care organization that provides fully-integrated medical care within the regional service area.

The organization's activities shall include coordinating a network of behavioral health providers, operating a health information technology infrastructure, providing crisis services, and providing non-medicaid services.(2) The work group shall consist of no more than fifteen members and shall include a representative of the health care authority, a representative of the department of social and health services, representatives of behavioral health organizations, representatives of managed care organizations, representatives of behavioral health providers, representatives of counties, and representatives from each caucus in the house and senate.

The director of the health care authority, or his or her designee, shall serve as the chair.(3) The work group shall submit a report to the legislature and the governor by December 1, 2017.

The report shall identify recommendations for reducing barriers to the full-integration of behavioral health and physical health.

The report shall provide a description of the different alternative delivery and financing structure options that shall be made available to regional service areas and allow counties within the regional service areas to select the most appropriate structure to meet the needs of the communities within the regional service area.PART 2Sec. 2001.  RCW 43.20A.025 and 1998 c 296 s 34 are each amended to read as follows:The ((department of social and health services)) authority shall adopt rules defining "appropriately trained professional person" for the purposes of conducting mental health and ((chemical dependency)) substance use disorder evaluations under RCW ((71.34.052)) 71.34.600(3), ((71.34.054)) 71.34.650(1), 70.96A.245(3), and 70.96A.250(1).Sec. 2002.  RCW 43.20A.025 and 2016 sp.s.

and(c) Reflect natural medical and behavioral health service referral patterns and shared clinical, health care service, behavioral health service, and behavioral health crisis response resources.(3) The Washington state association of counties must submit their recommendations to the department, the ((health care)) authority, and the task force described in section 1, chapter 225, Laws of 2014 on or before August 1, 2014.Sec. 2008.  RCW 43.20A.894 and 2014 c 225 s 3 are each amended to read as follows:(1) Any agreement or contract by the ((department or the health care)) authority to provide behavioral health services as defined under RCW 71.24.025 to persons eligible for benefits under medicaid, Title XIX of the social security act, and to persons not eligible for medicaid must include the following:(a) Contractual provisions consistent with the intent expressed in RCW 71.24.015, 71.36.005, ((70.96A.010,)) and 70.96A.011;(b) Standards regarding the quality of services to be provided, including increased use of evidence-based, research-based, and promising practices, as defined in RCW 71.24.025;(c) Accountability for the client outcomes established in RCW 43.20A.895, 70.320.020, and 71.36.025 and performance measures linked to those outcomes;(d) Standards requiring behavioral health organizations to maintain a network of appropriate providers that is supported by written agreements sufficient to provide adequate access to all services covered under the contract with the ((departmentdepartment or the health((health care)) authority and to protect essential existing behavioral health system infrastructure and capacity, including a continuum of chemical dependency services;(e) Provisions to require that medically necessary chemical dependency and mental health treatment services be available to clients;(f) Standards requiring the use of behavioral health service provider reimbursement methods that incentivize improved performance with respect to the client outcomes established in RCW 43.20A.895 and 71.36.025, integration of behavioral health and primary care services at the clinical level, and improved care coordination for individuals with complex care needs;(g) Standards related to the financial integrity of the responding organization.

c 15 s 62 are each amended to read as follows:(1) The secretary of social and health services shall be the responsible state officer for the administration and disbursement of all funds, goods, commodities, and services, which may be received by the state in connection with programs of public assistance or services related directly or indirectly to assistance programs, and all other matters included in the federal social security act as amended, or any other federal act or as the same may be amended except as otherwise provided by law.(2) The director shall be the responsible state officer for the administration and disbursement of funds that the state receives in connection with the medical services programs established under chapter 74.09 RCW, including the state children's health insurance program, Titles XIX and XXI of the social security act of 1935, as amended, and programs established under chapter 71.05, 71.24, and 71.34 RCW that are under the director's authority.(3) The department and the authority, as appropriate, shall make such reports and render such accounting as may be required by federal law.PART 3Sec. 3001.  RCW 71.05.020 and 2016 c 155 s 1 are each reenacted and amended to read as follows:The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Admission" or "admit" means a decision by a physician, physician assistant, or psychiatric advanced registered nurse practitioner that a person should be examined or treated as a patient in a hospital;(2) "Antipsychotic medications" means that class of drugs primarily used to treat serious manifestations of mental illness associated with thought disorders, which includes, but is not limited to atypical antipsychotic medications;(3) "Attending staff" means any person on the staff of a public or private agency having responsibility for the care and treatment of a patient;(4) "Authority" means the Washington state health care authority;(5) "Commitment" means the determination by a court that a person should be detained for a period of either evaluation or treatment, or both, in an inpatient or a less restrictive setting;(((5))) (6) "Conditional release" means a revocable modification of a commitment, which may be revoked upon violation of any of its terms;(((6))) (7) "Crisis stabilization unit" means a short-term facility or a portion of a facility licensed or certified by the department of health ((and certified by the department of social and health services)) under RCW 71.24.035, such as an evaluation and treatment facility or a hospital, which has been designed to assess, diagnose, and treat individuals experiencing an acute crisis without the use of long-term hospitalization;(((7))) (8) "Custody" means involuntary detention under the provisions of this chapter or chapter 10.77 RCW, uninterrupted by any period of unconditional release from commitment from a facility providing involuntary care and treatment;(((8))) (9) "Department" means the department of ((social and)) health ((services));(((9))) (10) "Designated chemical dependency specialist" means a person designated by the county alcoholism and other drug addiction program coordinator designated under RCW 70.96A.310 to perform the commitment duties described in chapters 70.96A and 70.96B RCW;(((10))) (11) "Designated crisis responder" means a mental health professional appointed by the county or the behavioral health organization to perform the duties specified in this chapter;(((11))) (12) "Designated mental health professional" means a mental health professional designated by the county or other authority authorized in rule to perform the duties specified in this chapter;(((12))) (13) "Detention" or "detain" means the lawful confinement of a person, under the provisions of this chapter;(((13))) (14) "Developmental disabilities professional" means a person who has specialized training and three years of experience in directly treating or working with persons with developmental disabilities and is a psychiatrist, physician assistant working with a supervising psychiatrist, psychologist, psychiatric advanced registered nurse practitioner, or social worker, and such other developmental disabilities professionals as may be defined by rules adopted by the secretarysecretary;(((14))) of the department of social and health services;(((14))) (15) "Developmental disability" means that condition defined in RCW 71A.10.020(5);(((15))) (16) "Director" means the director of the authority;(17) "Discharge" means the termination of hospital medical authority.

or(c) Dependence on alcohol and one or more psychoactive chemicals, as the context requires;(((7))) (8) "Chemical dependency professional" means a person certified as a chemical dependency professional by the department of health under chapter 18.205 RCW;(((8))) (9) "Commitment" means the determination by a court that a person should be detained for a period of either evaluation or treatment, or both, in an inpatient or a less restrictive setting;(((9))) (10) "Conditional release" means a revocable modification of a commitment, which may be revoked upon violation of any of its terms;(((10))) (11) "Crisis stabilization unit" means a short-term facility or a portion of a facility licensed or certified by the department of health ((and certified by the department of social and health services)) under RCW 71.24.035, such as an evaluation and treatment facility or a hospital, which has been designed to assess, diagnose, and treat individuals experiencing an acute crisis without the use of long-term hospitalization;(((11))) (12) "Custody" means involuntary detention under the provisions of this chapter or chapter 10.77 RCW, uninterrupted by any period of unconditional release from commitment from a facility providing involuntary care and treatment;(((12))) (13) "Department" means the department of ((social and)) health ((services));(((13))) (14) "Designated crisis responder" means a mental health professional appointed by the behavioral health organization to perform the duties specified in this chapter;(((14))) (15) "Detention" or "detain" means the lawful confinement of a person, under the provisions of this chapter;(((15))) (16) "Developmental disabilities professional" means a person who has specialized training and three years of experience in directly treating or working with persons with developmental disabilities and is a psychiatrist, physician assistant working with a supervising psychiatrist, psychologist, psychiatric advanced registered nurse practitioner, or social worker, and such other developmental disabilities professionals as may be defined by rules adopted by the secretarysecretary;(((16))) of the department of social and health services;(((16))) (17) "Developmental disability" means that condition defined in RCW 71A.10.020(5);(((17))) (18) "Director" means the director of the authority;(19) "Discharge" means the termination of hospital medical authority.

All rights, privileges, or immunities conferred by this ((chapter [subchapter])) subchapter or any acts done pursuant thereto shall exist subject to the power of the legislature to amend or repeal this ((chapter [subchapter])) subchapter at any time.Sec. 7023.  RCW 74.64.01074.09A.030 and 20122011 c1st 234sp.s. s 2 are each amended to read as follows:The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Authority" means the Washington state health care authority.(2) "Enrollee" means an individual who receives benefits through a medical services program.(3) "Medical services programs" means those medical programs established under chapter 74.09 RCW or other applicable law, including medical assistance, the limited casualty program, children's health program, medical care services, and state children's health insurance program.Sec. 7024.  RCW 74.66.010 and 2012 c 241 s 201 are each amended to read as follows:Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter:(1)(a) "Claim" means any request or demand made for a medicaid payment under chapter 74.09 RCW or other applicable law, whether under a contract or otherwise, for money or property and whether or not a government entity has title to the money or property, that:(i) Is presented to an officer, employee, or agent of a government entity;

c 15 s 120 are each amended to read as follows:Health insurers, as a condition of doing business in Washington, must:(1) Provide, with respect to individuals who are eligible for, or are provided, medical assistance under chapter 74.09 RCW or other applicable law, upon the request of the authority, information to determine during what period the individual or their spouses or their dependents may be, or may have been, covered by a health insurer and the nature of coverage that is or was provided by the health insurer, including the name, address, and identifying number of the plan, in a manner prescribed by the authority;(2) Accept the authority's right to recovery and the assignment to the authority of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under chapter 74.09 RCW or other applicable law;(3) Respond to any inquiry by the authority regarding a claim for payment for any health care item or service that is submitted not later than three years after the date of the provision of such health care item or service;(4) Agree not to deny a claim submitted by the authority solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if:(a) The claim is submitted by the authority within the three-year period beginning on the date the item or service was furnished;

and(b) Any action by the authority to enforce its rights with respect to such claim is commenced within six years of the authority's submission of such claim;

and(5) Agree that the prevailing party in any legal action to enforce this section receives reasonable attorneys' fees as well as related collection fees and costs incurred in the enforcement of this section.Sec. 7024.  RCW 74.64.010 and 2012 c 234 s 2 are each amended to read as follows:The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.(1) "Authority" means the Washington state health care authority.(2) "Enrollee" means an individual who receives benefits through a medical services program.(3) "Medical services programs" means those medical programs established under chapter 74.09 RCW or other applicable law, including medical assistance, the limited casualty program, children's health program, medical care services, and state children's health insurance program.Sec. 7025.  RCW 74.66.010 and 2012 c 241 s 201 are each amended to read as follows:Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter:(1)(a) "Claim" means any request or demand made for a medicaid payment under chapter 74.09 RCW or other applicable law, whether under a contract or otherwise, for money or property and whether or not a government entity has title to the money or property, that:(i) Is presented to an officer, employee, or agent of a government entity;