Authored by Melanie Smith, Registered Lobbyist and Julia Kocian LICSW, MPH, Legislative Chair
The 2019 legislative session made massive and transformative changes in the behavioral health system in Washington State. The legislature’s enthusiasm and attention to the challenges in behavioral health was long overdue, and likely will continue at least through 2020. Below are some of the major pieces of legislation that passed this year and had WSSCSW’s endorsement.
Adolescent Behavioral Health
HB1874 – Implementing the recommendations of the Parent Initiated Treatment work group.
The 2018 children’s mental health bill created a stakeholder group to evaluate the parent-initiated treatment (PIT) process and make recommendations about how to better serve youth ages 13-17 including recommendations about changing the age of consent. That (laborious!) work group met 23 times throughout the summer of 2018 and arrived at a series of recommendations. In part, due to the advocacy of WSSCSW, the work group ultimately did not recommend raising the age of consent, but instead made recommendations that would give parents more tools to access treatment for their youth, without changing the current access youth have to initiate their own treatment. We participated in the stakeholder process and supported the final recommendations of the work group and the legislation.
This bill makes substantial changes to family involvement with adolescent behavioral health. Here are some of them:
- · Allows for parents to consent to limited out-patient visits on behalf of the adolescent. Parents can consent to 12 out-patient visits within 3 months.
- · Clarifies Washington’s existing laws on information sharing limits with regards to adolescents’ treatment, and allows clinicians to exercise discretion and release limited information to parents to balance protecting the health of the adolescent and involving helpful social supports
- · Provides liability protections for clinicians with regards to their decision to share, or not share, information with families
- · Expands in-patient options for families beyond just in-patient hospitalization to include partial hospitalization and long-term residential treatment
- · Provides training and resources for clinicians to serve families and educate them on the new statute.
Confidentiality in Insurance Documentation
We want our sensitive information to remain our own; insurance communications is one way that confidentiality can be breeched, especially for minors.
SB5999 – Requires that insurance companies must maintain confidentiality in their insurance communications and their explanation of benefits. For example, if an adult, or minor is a covered dependent of the primary enrollee on an insurance plan, and they accessed “sensitive health care services” (eg. reproductive health/mental health), the insurance company must work to protect privacy in communications regarding those services.
In-Patient and Forensic Mental Health
We have a lot of work to do in reshaping our inpatient mental health facilities and addressing the intersectionality of mental health and our criminal justice system. These bills tackle a few of the issues.
HB 1593 – Creates a new psychiatric teaching hospital at the University of Washington. This will be the first psychiatric teaching hospital in the country. Although this is part of the School of Medicine, it will open many opportunities for social workers as well. This will both increase capacity, and build our workforce.
HB1874- Creates a new classification of facility called an “intensive behavioral health treatment facility” to better serve individuals in either state or community hospitals who no longer need in-patient services, but who cannot be appropriately placed in the community with minimal outpatient support. This should free up capacity in hospitals and smooth transitions down in level of care.
SB5444 (Trueblood Legal Settlement)– This bill is meant to address the long-term failure of the state to provide timely competency evaluations in our jails, and to create a process to divert many individuals into treatment rather than incarceration. It names a new position, the “forensic navigator”, who will assist individuals deemed incompetent in getting the treatment and services they need.
Ever feel overworked and underpaid? Have you had trouble transferring your license from out of state? Have you seen clients run into problems getting all of their care in one place? These are all issues with workforce in WA state. These bills aim to make it easier to succeed and operate in our profession because the world needs more social workers!
HB1768 (Dual Credentialing)– Creates a license endorsement for mental health licenses to treat and bill for substance abuse disorders within certified agencies, which will be called a “co-occurring disorder specialist”. This endorsement requires 60 (clock) hours of training, an exam, and either 40 or 80 hours of supervision depending on amount of prior experience. The current “alternative path” requires at least 15 semester hours, and 1000 hours of supervision for a social worker to obtain a CDP certificate. HB1768 is an improvement on that path to licensure in that it lowers these additional requirements, however, the effort to streamline co-occurring treatment and expand access to substance abuse services was and is politically challenging and controversial. The framework of the endorsement is a beginning, but there are significant practice restrictions on the endorsement that must be addressed in future sessions. Our work on this important issue will certainly continue.
HB1668 – Creates a specific loan repayment program specifically for behavioral health professionals modeled after other similar programs for health professionals. Provides a framework to include the costs of supervision hours in the loan repayment program.
SB 5054(Reciprocity) – Tasks the Department of Health with studying licensing and credentialing and ultimately, with developing a more streamlined reciprocity system for all mental health licenses. It also requests that DOH examine access to supervision and CEU hours and consider how to address barriers to these.
If you would like to be more involved in setting WSSCSW’s legislative agenda for this year or advocating for change, please reach out! (Julia.firstname.lastname@example.org)