Children and their families face systemic barriers to accessing necessary mental health services. The legislature finds that greater coordination across systems, including early learning, K-12 education, workforce development, and health care, is necessary to provide children and their families with coordinated care. Therefore, HB 1713 intends to implement recommendations from the children's mental health work group, as reported in December 19 2016, in order to improve mental health care access for children and their families through the early learning, K-12 education, and health care systems.
Specifically, HB 1713 addresses the following areas: Access to and coordination of resources and services through the managed health care system to ensure that the child receives the treatment and appropriate care based on their assessed needs, regardless of the origin of the referral; A reporting requirement regarding the number of children’s mental health providers available in the previous year and the overall percentage of children’s mental health providers who were actively accepting new patients; adolescent depression screens; child care consultation; the role of the Educational Service Districts and OSPI; workforce issues, including a focus on the availability of culturally/linguistically diverse services; child psychiatry residencies; the Partnership Access Line; and, telemedicine.
Summary of amendments by the House Early Learning and Human Services committee:
The report must also include the number of children's mental health providers available in the previous year and the overall percentage of children's mental health providers who were actively accepting new patients.
Replaced language regarding adolescent screens with: Effective January 1, 2018, the authority shall require provider payment for depression screening for youth ages twelve through eighteen as recommended by the bright futures guidelines of the American academy of pediatrics, as they existed on January 1, 2017. Providers may include, but are not limited to, primary care providers, public health nurses, and other providers in a clinical setting. This requirement is subject to the availability of funds appropriated for this specific purpose.
Added language related to maternal depression screens: Effective January 1, 2018, the authority shall require provider payment for maternal depression screening for mothers of children ages birth to five. This requirement is subject to the availability of funds appropriated for this specific purpose.
Removes the section related to the partnership access line.
As amended in the Appropriations Committee:
- Removes the requirements for managed health care systems and behavioral health organizations to ensure that an individual has completed a mental health appointment and
to track the individual's utilization of services.
- Requires the Health Care Authority (HCA) to report on languages spoken by children's mental health providers as part of the annual report on available providers.
- Clarifies that depression screening for youth ages 12-18, for which the HCA must require provider payment, is an annual screening.
- Changes the requirement for maternal depression screening payment to apply to mothers of children ages birth to one year rather than children ages birth to five years.
- Removes the requirement for the Department of Early Learning (DEL) to develop an Early Childhood Mental Health Training and Consultation Program to provide training and onsite consultation for child care providers on trauma-informed care.
- Requires the DEL to establish a Child Care Consultation Program to link child care providers with evidence-based, trauma-informed, and best-practice resources regarding caring for infants and young children who present behavioral concerns or symptoms of trauma. Allows the DEL to contract with an entity with expertise in child development and early learning to provide the program.
- Removes the provisions for mental health leads at each Educational Service District (ESD) and removes provisions for the Office of the Superintendent of Public Instruction (OSPI) to designate a "lighthouse" ESD to provide technical assistance to other ESDs.
- Removes the requirement for the OSPI to employ a children's mental health services coordinator and associated duties.
- Requires the OSPI to produce a case study of an ESD that is successfully delivering and coordinating children's mental health activities and services. Requires the OSPI to deliver the case study and recommendations for replicating the model to the Governor and Legislature by December 1, 2018.
- Removes the requirement for the Workforce Training and Education Coordinating Board to collect and report on workforce survey and administrative data for children's mental health clinicians.
- Removes each of the 24-month child and adolescent psychiatry residencies at the University of Washington and Washington State University.
NOTE: By way of an amendment to the proposed 2nd substitute, the residency programs at WSU was added back. There was also a null and void clause included.
House floor amendments:
Requires, subject to the availability of appropriated funds, the Office of the Superintendent of Public Instruction to: - designate two educational service districts (ESD) in which to pilot a lead staff person for children's mental health; - select pilot projects by October 1, 2017; - and report on the results of the pilot, provide a case study of an ESD that is successfully delivering and coordinating children's mental health services, and provide recommendations to the Governor and Legislature by December 1, 2019.
Provides an expiration date for this section of January 1, 2020.
The reimbursement of depression screenings for youth ages 12 to 18 and mothers of children ages 0 to 1 is made subject to the amounts provided in the operating budget. The Child care Consultation Program is made subject to the amounts provided in the operating budget. The case study of an educational service district is made subject to amounts provided in the budget. Removes the null and void clause.
Provides for consistent agency designations in the event that either HB 1388 or SB 5259, relating to transferring responsibilities for behavioral health services from the Department of Social and Health Services to the Health Care Authority and the Department of Health, is enacted.
Requires the educational service district pilot projects to coordinate and facilitate services related to children's substance use disorder treatment in addition to children's mental health services.
Changes the requirement for maternal depression screening payment to apply to mothers of children ages birth to six months rather than children ages birth to one year.