BillTracker

Concerning the addition of services for long-term placement of mental health patients in community settings that voluntarily contract to provide the services (Schmick, Cody, Ormsby)

Revises the community mental health services act with regard to the insufficient capacity at eastern and western state hospitals to meet current and growing demand for services and patients. Requires the department of social and health services and the entities identified in RCW 71.24.310 and 71.24.380 (sections 2 and 3 of this act) to: (1) Work with willing community hospitals to assess their capacity to become certified to provide long-term mental health placements and to meet the requirements of the community mental health services act; and (2) Enter into contracts and payment arrangements with the hospitals choosing to provide long-term mental health placements.

EFFECT OF FLOOR STRIKER:
Allows evaluation and treatment facilities to provide treatment to adults on 90- and 180-day involuntary commitment orders and contract with behavioral health organizations to provide that treatment to the same extent as community hospitals. Clarifies that the requirement that behavioral health organizations contract with facilities certified to provide long-term inpatient treatment in the community is only applicable to the extent that willing certified facilities are available. Allows hospitals, without having to contract or become certified, to treat adults who are subject to a 90- or 180-day involuntary commitment order if they are waiting for placement at the state hospital or a certified facility that voluntarily contracts to provide treatment to patients on a 90- or 180-day involuntary commitment order. Directs the Department of Social and Health Services (DSHS) to adopt reporting requirements for facilities certified to provide long-term mental health placements so that the performance of the certified facilities may be monitored and compared with the performance of the state hospitals. Requires the measures to align with data reported to the select committee on quality improvement in state hospitals, including length of stay, outcomes after discharge, employee-related measures, and demographic information. 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 DSHS to the Health Care Authority and the Department of Health, is enacted.

EFFECT OF COMMITTEE STRIKER:
Replaces the bill with similar provisions from ESSB 5894. Differences between bills include requiring DSHS to contract with long-term involuntary treatment facilities to provide treatment instead of requiring BHOs to contract with the facilities, requiring DSHS to establish rules for certification of such facilities, and providing authority for the entity responsible for the cost of care to designate an available facility for treatment.

EFFECT OF 2ND FLOOR STRIKER:
Updates underlying statutory language to reflect statutory changes that were enacted in the regular session.

SENATE COMMITTEE (Human Services & Corrections) STRIKER AMENDMENT
EFFECT: 1. Requires the health care authority (HCA) to develop a psychiatric managed care capitation risk model, taking into account the recommendations derived from the PCG Washington Mental Health System Assessment: Final Alternative Options and Recommendations Report and the Inpatient Psychiatric Care Risk Model Report, that integrates long-term inpatient risk for long-term involuntary civil treatment provided by state hospitals, and submit a final draft to the Legislature by December 1, 2020. 2. Requires HCA to integrate long-term inpatient risk for longterm involuntary civil treatment provided by state hospitals into managed care contracts by July 1, 2021. 3. Requires HCA to request legislation, as appropriate, extending institution for mental health diseases disproportionate share hospital payments to community hospitals as an option to maximize any reductions brought on by changes in the forensic to civil ratio for the state hospital population. 4. Requires the department of social and health services (DSHS) to collaborate with HCA and invite appropriate and interested stakeholders to develop a detailed transition plan to move the cost of state hospital civil treatment into managed care, taking into account the recommendations derived from the PCG Washington Mental Health System Assessment: Final Alternative Options and Recommendations Report and the Inpatient Psychiatric Care Risk Model Report. 5. Removes the review of the DSHS draft transition plan by the select committee on quality improvement in state hospitals and clarifies that DSHS must consider the input of the relevant committees of the Legislature and external stakeholders before submitting a final transition plan. Adds that the final transition plan is due to the Legislature by December 30, 2019. 6. Clarifies that stakeholders must include, but not be limited to, interested members of the Legislature, the Washington state Code Rev/CL:jcm 24 S-5381.2/18 2nd draft hospital association, the association of Washington healthcare plans, each of the five contracted apple health managed care organizations or administrative services organizations if applicable, the Washington council for behavioral health, and the Washington state association of counties. 7. Declares the intent to purchase part of the State's capacity for 90/180-day treatment in willing community facilities that come to the table to contract with the state. 8. Specifies which data must be measured and collected pursuant to contracts in language worked out and vetted with Washington State Hospital Association, and adds January 1, 2024, for the data reporting end date. 9. Clarifies that the state contracts with facilities and allocates a mix of state hospital and community beds to the BHOs/ FIMCOs. 10. Includes that the state must develop rules to certify 90/180- day facilities, and must consult with WSHA to determine what shortterm rules are inappropriate to long-term facilities. 11. Subject to funding language incorporated for 90/180-day contracts. 12. Courts must remand to the custody of department or designee, not a specific facility. The payer (BHO/FIMCO/state) must designate patient placement, provided they must place in an open bed if available. Prior authorization prohibited for ITA placement. 13. Updates language to reflect the behavioral health organizations includes successor entities as contracted by the Authority under RCW 71.24.850(2).

Hearing Date: Tuesday, February 20, 2018 -- 1:30 pm

WA State Legislature Link:
http://app.leg.wa.gov/billsummary?BillNumber=2107&Year=2017    (opens a new browser tab)