wa-law.org > bill > 2023-24 > SB 6251 > Second Substitute
Behavioral health administrative services organizations shall use their authorities under RCW 71.24.045 to establish coordination within the behavioral health crisis response system in each regional service area including, but not limited to, establishing comprehensive protocols for dispatching mobile rapid response crisis teams and community-based crisis teams. In furtherance of this:
The behavioral health administrative services organization may convene regional behavioral health crisis response system partners and stakeholders within available resources for the purpose of establishing clear regional protocols which memorialize expectations, understandings, lines of communication, and strategies for optimizing crisis response in the regional service area. The regional protocols must describe how crisis response partners will share information consistent with data-sharing requirements under RCW 71.24.890, which should promote real-time information sharing between 988 contact hubs, regional crisis lines, or their successors, to create a seamless delivery system that is person-centered;
Behavioral health administrative services organizations shall submit regional protocols to the authority for approval. If the authority does not respond within 90 days of submission, the regional protocols shall be considered approved until such time as the behavioral health administrative services organization and the authority agree to updated protocols. A behavioral health administrative services organization must notify the authority by January 1, 2025, if it does not intend to develop and submit regional protocols;
A behavioral health administrative services organization may recommend the 988 contact hub or hubs which it determines to be the best fit for partnership and implementation of regional protocols in its regional service area among candidates which are able to meet necessary state and federal certification requirements. The 988 contact hub or hubs recommended by the behavioral health administrative services organization in each regional service area must be able to connect to the culturally appropriate behavioral health crisis response services established under this chapter;
The department may designate additional 988 contact hubs which have been recommended by a behavioral health administrative services organization and are able to meet state and federal certification requirements within available resources and when the addition of more hubs is consistent with the rules adopted under RCW 71.24.890 and a need identified in regional protocols. If the department declines to designate a 988 contact hub that has been recommended by a behavioral health administrative services organization, the department shall provide a written explanation of its reasons to the behavioral health administrative services organization;
The department and the authority shall provide support to the behavioral health administrative services organization in the development of protocols under subsection (1) of this section as requested by the behavioral health administrative services organization;
Protocols established under subsection (1) of this section must be in writing and copies shall be provided to the department, authority, and state 911 coordination office. The protocol for each regional service area which creates one should be updated as needed and at intervals of no longer than three years; and
For the purpose of subsection (1) of this section, partners and stakeholders in the coordinated regional behavioral health crisis response system include but are not limited to regional crisis lines, 988 contact hubs, certified public safety telecommunicators, local governments, tribal governments, first responders, co-response teams, hospitals, organizations representing persons with lived experience, and behavioral health agencies.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
The behavioral health administrative services organization contracted with the authority pursuant to RCW 71.24.381 shall:
Administer crisis services for the assigned regional service area. Such services must include:
A behavioral health crisis hotline for its assigned regional service area;
Crisis response services twenty-four hours a day, seven days a week, three hundred sixty-five days a year;
Services related to involuntary commitments under chapters 71.05 and 71.34 RCW;
Tracking of less restrictive alternative orders issued within the region by superior courts, and providing notification to a managed care organization in the region when one of its enrollees receives a less restrictive alternative order so that the managed care organization may ensure that the person is connected to services and that the requirements of RCW 71.05.585 are complied with. If the person receives a less restrictive alternative order and is returning to another region, the behavioral health administrative services organization shall notify the behavioral health administrative services organization in the home region of the less restrictive alternative order so that the home behavioral health administrative services organization may notify the person's managed care organization or provide services if the person is not enrolled in medicaid and does not have other insurance which can pay for those services;
Additional noncrisis behavioral health services, within available resources, to individuals who meet certain criteria set by the authority in its contracts with the behavioral health administrative services organization. These services may include services provided through federal grant funds, provisos, and general fund state appropriations;
Care coordination, diversion services, and discharge planning for nonmedicaid individuals transitioning from state hospitals or inpatient settings to reduce rehospitalization and utilization of crisis services, as required by the authority in contract;
Regional coordination, cross-system and cross-jurisdiction coordination with tribal governments, and capacity building efforts, such as supporting the behavioral health advisory board and efforts to support access to services or to improve the behavioral health system; and
Duties under section 1 of this act;
Administer and provide for the availability of an adequate network of evaluation and treatment services to ensure access to treatment, investigation, transportation, court-related, and other services provided as required under chapter 71.05 RCW;
Coordinate services for individuals under RCW 71.05.365;
Administer and provide for the availability of resource management services, residential services, and community support services as required under its contract with the authority;
Contract with a sufficient number, as determined by the authority, of licensed or certified providers for crisis services and other behavioral health services required by the authority;
Maintain adequate reserves or secure a bond as required by its contract with the authority;
Establish and maintain quality assurance processes;
Meet established limitations on administrative costs for agencies that contract with the behavioral health administrative services organization; and
The behavioral health administrative services organization must collaborate with the authority and its contracted managed care organizations to develop and implement strategies to coordinate care with tribes and community behavioral health providers for individuals with a history of frequent crisis system utilization.
The behavioral health administrative services organization shall:
Assure that the special needs of minorities, older adults, individuals with disabilities, children, and low-income persons are met;
Collaborate with local government entities to ensure that policies do not result in an adverse shift of persons with mental illness into state and local correctional facilities; and
Work with the authority to expedite the enrollment or reenrollment of eligible persons leaving state or local correctional facilities and institutions for mental diseases.
The behavioral health administrative services organization shall employ an assisted outpatient treatment program coordinator to oversee system coordination and legal compliance for assisted outpatient treatment under RCW 71.05.148 and 71.34.815.
(1) Establishing the state designated 988 contact hubs and enhancing the crisis response system will require collaborative work between the department and, the authority, and regional system partners within their respective roles. The department shall have primary responsibility for establishing and designating the designated 988 contact hubs upon the recommendation of behavioral health administrative services organizations. The authority shall have primary responsibility for developing and, implementing, and facilitating coordination of the crisis response system and services to support the work of the designated 988 contact hubs, regional crisis lines, and other coordinated regional behavioral health crisis response system partners. In any instance in which one agency is identified as the lead, the expectation is that agency will be communicating and collaborating communicate and collaborate with the other to ensure seamless, continuous, and effective service delivery within the statewide crisis response system.