Working to transform the child welfare system.

SB 6312 addresses a variety of issues related to the purchase and provision of mental health and chemical dependency treatment services. Among other things, the bill:

Adds to the responsibilities of the task force, established to address issues related to the adult behavioral health system, the requirement to make recommendations regarding how services are purchased through DSHS; guidance for the creation of common regional service areas for purchasing behavioral health and medical care services; the design and requirements of future Medicaid behavioral health and health care delivery systems and purchasing; and state interactions with the federal centers for Medicare and Medicaid services related to the State’s method of purchasing Medicaid mental health services.

Directs DSHS and the Health Care Authority to jointly establish regional service areas by Sept. 1, 2014.

Identifies stipulations that must be included in agreements or contracts by DSHS or the Health Care Authority for the provision of behavioral health services.

Includes language assuring that any regional support network (or county community mental health program provides medically necessary services to Medicaid recipients consistent with the state’s Medicaid state plan or federal waiver authorities, and Non-Medicaid services consistent with priorities established by DSHS.

Allows the secretary of DSHS to use resources to incentivize improved performance with respect to client outcomes, integration of behavioral health and primary care services at the clinical level, and improved care coordination for individuals with complex care needs.

Allows the boundaries for the regional service areas to be consistent with those of the regional support networks.

Changes made by the Human Services and Corrections Committee: The dates by which DSHS and HCA must jointly establish regional services areas and the date by which WSAC must submit a proposal for regional service areas are extended. Language requiring WSAC to propose no more than nine regional service areas is deleted. The starting date for the Behavioral Health Task Force is extended to April 1, 2014, and certain reporting dates are extended. The taskforce must study whether a statewide ombuds office should be created and need only provide recommendations concerning negotiations with CMS if CMS provides written guidance to Washington concerning its rationale for changing state purchasing.

As amended in Senate Ways and Means: The authority for DSHS and HCA to establish new regional service areas for managed care and behavioral health service contracting is contingent on a positive recommendation to do so by the Adult Behavioral Health System Task Force.

As amended on the House Floor: The amendment specifies that the Adult Behavioral Health Task Force must consider incentives for behavioral health care providers, in addition to physical health care providers, to use community resources to reduce utilization of the criminal justice system. It also specifies that behavioral health and recovery organization contracts with Medicaid managed care systems must promote access, rather than provide access, to certified chemical dependency professionals and mental health professionals, as determined by the Department of Social and Health Services in rule.

The amendment also limits the flexibility of behavioral health and recovery organizations to design their mix of services to require that they include coverage of services funded by Medicaid and prohibits an entity from operating a behavioral health services organization without a contract, in addition to the prohibition on operating an organization without a certification or license.

Another amendment directs the Department of Social and Health Services and the Health Care Authority to develop a plan to provide integrated managed health and mental health care for foster children enrolled in Medicaid. It requires the plan to address the necessary steps to implement and operate an integrated program for foster children. The amendment requires the plan to meet the requirements for providing mental health services to children under the T.R. v. Dreyfus and Porter settlement and requires the plan to be submitted to the Legislature by December 1, 2014.

Final Bill:  As amended by the House, and passed by the legislature, the bill does the following: