Working to transform the child welfare system.


HB 2639: Relating to state purchasing of mental health and chemical dependency treatment services

HB 2639 is a companion bill (same as) to SB 6312

Substitute bill: As amended, HB 2639 changes the term “regional support network” to “behavioral health organization.” The substitute bill directs the Department of Social and Health Services (Department) to adopt criteria to distinguish between: (1) persons with mild mental illness and those with moderate or severe mental illness; and (2) persons with mild chemical dependency and those with moderate or severe chemical dependency. Behavioral health organizations must enroll clients within their regional service areas who have moderate or severe mental illness and moderate or severe chemical dependency. Medicaid managed care contracts must include services for persons with mild chemical dependency by April 1, 2016.

Additionally, the bill delays the beginning of the Adult Behavioral Health System Task Force (Task Force) until April 1, 2014. Chemical dependency advocates and chemical dependency experts working with drug courts are added to the stakeholder list.

Recommendations of the Task Force must include: (1) means to promote recovery and prevent harm associated with chemical dependency; and (2) public safety practices involving chemical dependency with forensic involvement.

HB 2639 directs the Department to initiate a procurement process for behavioral health organizations. Under the process counties within a regional service area must form an interlocal agreement and respond to a request for qualifications. If the county does not participate as a regional support network, then a private entity serving as the regional support network may respond to the request for qualifications. If the private entity is in a regional service area with multiple counties, then the multiple counties shall respond to the request for qualifications and the private entity may also apply for the whole regional service area. If they both meet the request for qualifications, they must follow the Department’s procurement process.

Further, the substitute bill removes substantive provisions regarding the use of funds for programs to serve people with mental illness from a legislative intent section and into a separate section. 

Second substitute: 

Expands the scope of the work and membership for the Adult Behavioral Health System Task Force.

Directs the Department of Social and Health Services and the Health Care Authority to establish up to nine regional service areas.

Establishes a process for awarding contracts for behavioral health organizations in regional areas.

Establishes contract requirements for the purchase of behavioral health services for Medicaid and non-Medicaid clients and factors to consider in the purchasing process.

Establishes requirements for contracts to assure that primary care services are available in behavioral health settings and behavioral health services are available in primary care settings.

Directs that mental health, chemical dependency, and medical care services for Medicaid clients must be fully integrated by January 1, 2020.

Floor Striking Amendment:  As amended on the floor, the bill:  Requires the full integration of medical and behavioral health services to occur by January 1, 2019, instead of 2020.  Requires entities submitting detailed plans to serve as a behavioral health organization to demonstrate that they comply with federal regulations regarding managed care contracting, including provider network adequacy, ability to maintain adequate reserves, and the maintenance of quality assurance processes. Adds that the Department of Social and Health Services’ (DSHS) procurement process that applies to cases of multiple qualified entities and entities that do not meet qualifications, also applies to case in which no entity submits a detailed plan. Requires that behavioral health organizations offer contracts to Medicaid managed health care systems or primary care practice settings to provide chemical dependency and mental health services integrated into primary care settings for persons with behavioral health and medical comorbidities. Authorizes county authorities to request that DSHS and the Health Care Authority jointly purchase behavioral health services through an integrated medical and behavioral health contract with a behavioral health organization or a managed health care system. Requires contracts with behavioral health organizations to authorize DSHS to take action when the behavioral health organization’s financial status jeopardizes, rather than seriously jeopardizes, the ability to meet contractual obligations. Requires contracts with behavioral health organizations to allow for remedies for noncompliance including injunctive remedies and financial deductions. Requires chemical dependency treatment services to be purchased primarily through managed care contracts by April 1, 2016. Adds the Department of Commerce to the list of stakeholders to be consulted by the Adult Behavioral Health Systems Task Force. Corrects terminology and statutory references.