Peer support specialists

AN ACT Relating to certified peer support specialists; amending 1
RCW 74.09.871, 18.420.005, 18.420.010, 18.420.020, 18.420.030, 2
18.420.040, 18.420.050, 18.420.060, 18.420.090, 18.420.800, 3
43.70.250, 48.43.825, 71.24.585, 71.24.903, 71.24.920, 71.24.922, 4
71.24.924, 71.40.040, and 71.40.090; reenacting and amending RCW 5
18.130.040, 18.130.175, 71.24.025, and 71.24.890; adding a new 6
section to chapter 41.05 RCW; adding a new section to chapter 18.420 7
RCW; and adding a new section to chapter 43.280 RCW.8
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:9
Sec. 1. RCW 74.09.871 and 2023 c 292 s 2 are each amended to 10
read as follows: 11
(1) Any agreement or contract by the authority to provide 12
behavioral health services as defined under RCW 71.24.025 to persons 13
eligible for benefits under medicaid, Title XIX of the social 14
security act, and to persons not eligible for medicaid must include 15
the following: 16
(a) Contractual provisions consistent with the intent expressed 17
in RCW 71.24.015 and 71.36.005; 18
(b) Standards regarding the quality of services to be provided, 19
including increased use of evidence-based, research-based, and 20
promising practices, as defined in RCW 71.24.025; 21
H-0538.1
HOUSE BILL 1427
State of Washington 69th Legislature 2025 Regular Session
By Representatives Davis, Caldier, Obras, Eslick, Lekanoff, Ramel,
Ormsby, and Santos
Read first time 01/20/25. Referred to Committee on Health Care &
Wellness.
p. 1 HB 1427
(c) Accountability for the client outcomes established in RCW 1
71.24.435, 70.320.020, and 71.36.025 and performance measures linked 2
to those outcomes; 3
(d) Standards requiring behavioral health administrative services 4
organizations and managed care organizations to maintain a network of 5
appropriate providers that is supported by written agreements 6
sufficient to provide adequate access to all services covered under 7
the contract with the authority and to protect essential behavioral 8
health system infrastructure and capacity, including a continuum of 9
substance use disorder services; 10
(e) Provisions to require that medically necessary substance use 11
disorder and mental health treatment services be available to 12
clients; 13
(f) Standards requiring the use of behavioral health service 14
provider reimbursement methods that incentivize improved performance 15
with respect to the client outcomes established in RCW 71.24.435 and 16
71.36.025, integration of behavioral health and primary care services 17
at the clinical level, and improved care coordination for individuals 18
with complex care needs; 19
(g) Standards related to the financial integrity of the 20
contracting entity. This subsection does not limit the authority of 21
the authority to take action under a contract upon finding that a 22
contracting entity's financial status jeopardizes the contracting 23
entity's ability to meet its contractual obligations;24
(h) Mechanisms for monitoring performance under the contract and 25
remedies for failure to substantially comply with the requirements of 26
the contract including, but not limited to, financial deductions, 27
termination of the contract, receivership, reprocurement of the 28
contract, and injunctive remedies; 29
(i) Provisions to maintain the decision-making independence of 30
designated crisis responders; and 31
(j) Provisions stating that public funds appropriated by the 32
legislature may not be used to promote or deter, encourage, or 33
discourage employees from exercising their rights under Title 29, 34
chapter 7, subchapter II, United States Code or chapter 41.56 RCW.35
(2) At least six months prior to releasing a medicaid integrated 36
managed care procurement, but no later than January 1, 2025, the 37
authority shall adopt statewide network adequacy standards that are 38
assessed on a regional basis for the behavioral health provider 39
networks maintained by managed care organizations pursuant to 40
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subsection (1)(d) of this section. The standards shall require a 1
network that ensures access to appropriate and timely behavioral 2
health services for the enrollees of the managed care organization 3
who live within the regional service area. At a minimum, these 4
standards must address each behavioral health services type covered 5
by the medicaid integrated managed care contract. This includes, but 6
is not limited to: Outpatient, inpatient, and residential levels of 7
care for adults and youth with a mental health disorder; outpatient, 8
inpatient, and residential levels of care for adults and youth with a 9
substance use disorder; crisis and stabilization services; providers 10
of medication for opioid use disorders; specialty care; other 11
facility-based services; and other providers as determined by the 12
authority through this process. The authority shall apply the 13
standards regionally and shall incorporate behavioral health system 14
needs and considerations as follows: 15
(a) Include a process for an annual review of the network 16
adequacy standards; 17
(b) Provide for participation from counties and behavioral health 18
providers in both initial development and subsequent updates;19
(c) Account for the regional service area's population; 20
prevalence of behavioral health conditions; types of minimum 21
behavioral health services and service capacity offered by providers 22
in the regional service area; number and geographic proximity of 23
providers in the regional service area; an assessment of the needs or 24
gaps in the region; and availability of culturally specific services 25
and providers in the regional service area to address the needs of 26
communities that experience cultural barriers to health care 27
including but not limited to communities of color and the LGBTQ+ 28
community; 29
(d) Include a structure for monitoring compliance with provider 30
network standards and timely access to the services;31
(e) Consider how statewide services, such as residential 32
treatment facilities, are utilized cross-regionally; and33
(f) Consider how the standards would impact requirements for 34
behavioral health administrative service organizations.35
(3) Before releasing a medicaid integrated managed care 36
procurement, the authority shall identify options that minimize 37
provider administrative burden, including the potential to limit the 38
number of managed care organizations that operate in a regional 39
service area. 40
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(4) The following factors must be given significant weight in any 1
medicaid integrated managed care procurement process under this 2
section: 3
(a) Demonstrated commitment and experience in serving low-income 4
populations; 5
(b) Demonstrated commitment and experience serving persons who 6
have mental illness, substance use disorders, or co-occurring 7
disorders; 8
(c) Demonstrated commitment to and experience with partnerships 9
with county and municipal criminal justice systems, housing services, 10
and other critical support services necessary to achieve the outcomes 11
established in RCW 71.24.435, 70.320.020, and 71.36.025;12
(d) The ability to provide for the crisis service needs of 13
medicaid enrollees, consistent with the degree to which such services 14
are funded; 15
(e) Recognition that meeting enrollees' physical and behavioral 16
health care needs is a shared responsibility of contracted behavioral 17
health administrative services organizations, managed care 18
organizations, service providers, the state, and communities;19
(f) Consideration of past and current performance and 20
participation in other state or federal behavioral health programs as 21
a contractor; 22
(g) The ability to meet requirements established by the 23
authority; 24
(h) The extent to which a managed care organization's approach to 25
contracting simplifies billing and contracting burdens for community 26
behavioral health provider agencies, which may include but is not 27
limited to a delegation arrangement with a provider network that 28
leverages local, federal, or philanthropic funding to enhance the 29
effectiveness of medicaid-funded integrated care services and promote 30
medicaid clients' access to a system of services that addresses 31
additional social support services and social determinants of health 32
as defined in RCW 43.20.025; 33
(i) Demonstrated prior national or in-state experience with a 34
full continuum of behavioral health services that are substantially 35
similar to the behavioral health services covered under the 36
Washington medicaid state plan, including evidence through past and 37
current data on performance, quality, and outcomes; ((and))38
(j) Demonstrated commitment by managed care organizations to the 39
use of alternative pricing and payment structures between a managed 40
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care organization and its behavioral health services providers, 1
including provider networks described in subsection (b) of this 2
section, and between a managed care organization and a behavioral 3
administrative service organization, in any of their agreements or 4
contracts under this section, which may include but are not limited 5
to: 6
(i) Value-based purchasing efforts consistent with the 7
authority's value-based purchasing strategy, such as capitated 8
payment arrangements, comprehensive population-based payment 9
arrangements, or case rate arrangements; or 10
(ii) Payment methods that secure a sufficient amount of ready and 11
available capacity for levels of care that require staffing 24 hours 12
per day, 365 days per year, to serve anyone in the regional service 13
area with a demonstrated need for the service at all times, 14
regardless of fluctuating utilization; and15
(k) The accessibility of peer services, as demonstrated in the 16
application through a required comprehensive analysis of access to 17
peer services in the managed care organization's network. The 18
analysis must evaluate the availability of certified peer counselors 19
and peer support specialists certified under chapter 18.420 RCW who 20
are:21
(i) Adults in recovery from a mental health condition;22
(ii) Adults in recovery from a substance use disorder;23
(iii) Youth and young adults in recovery from a mental condition;24
(iv) Youth and young adults in recovery from a substance use 25
disorder; and26
(v) The parent or legal guardian of a youth who is receiving or 27
has received behavioral health services. 28
(5) The authority may use existing cross-system outcome data such 29
as the outcomes and related measures under subsection (4)(c) of this 30
section and chapter 338, Laws of 2013, to determine that the 31
alternative pricing and payment structures referenced in subsection 32
(4)(j) of this section have advanced community behavioral health 33
system outcomes more effectively than a fee-for-service model may 34
have been expected to deliver. 35
(6)(a) The authority shall urge managed care organizations to 36
establish, continue, or expand delegation arrangements with a 37
provider network that exists on July 23, 2023, and that leverages 38
local, federal, or philanthropic funding to enhance the effectiveness 39
of medicaid-funded integrated care services and promote medicaid 40
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clients' access to a system of services that addresses additional 1
social support services and social determinants of health as defined 2
in RCW 43.20.025. Such delegation arrangements must meet the 3
requirements of the integrated managed care contract and the national 4
committee for quality assurance accreditation standards.5
(b) The authority shall recognize and support, and may not limit 6
or restrict, a delegation arrangement that a managed care 7
organization and a provider network described in (a) of this 8
subsection have agreed upon, provided such arrangement meets the 9
requirements of the integrated managed care contract and the national 10
committee for quality assurance accreditation standards. The 11
authority may periodically review such arrangements for effectiveness 12
according to the requirements of the integrated managed care contract 13
and the national committee for quality assurance accreditation 14
standards. 15
(c) Managed care organizations and the authority may evaluate 16
whether to establish or support future delegation arrangements with 17
any additional provider networks that may be created after July 23, 18
2023, based on the requirements of the integrated managed care 19
contract and the national committee for quality assurance 20
accreditation standards. 21
(7) The authority shall expand the types of behavioral health 22
crisis services that can be funded with medicaid to the maximum 23
extent allowable under federal law, including seeking approval from 24
the centers for medicare and medicaid services for amendments to the 25
medicaid state plan or medicaid state directed payments that support 26
the 24 hours per day, 365 days per year capacity of the crisis 27
delivery system when necessary to achieve this expansion.28
(8) The authority shall, in consultation with managed care 29
organizations, review reports and recommendations of the involuntary 30
treatment act work group established pursuant to section 103, chapter 31
302, Laws of 2020 and develop a plan for adding contract provisions 32
that increase managed care organizations' accountability when their 33
enrollees require long-term involuntary inpatient behavioral health 34
treatment and shall explore opportunities to maximize medicaid 35
funding as appropriate. 36
(9) In recognition of the value of community input and consistent 37
with past procurement practices, the authority shall include county 38
and behavioral health provider representatives in the development of 39
any medicaid integrated managed care procurement process. This shall 40
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include, at a minimum, two representatives identified by the 1
association of county human services and two representatives 2
identified by the Washington council for behavioral health to 3
participate in the review and development of procurement documents.4
(10) For purposes of purchasing behavioral health services and 5
medical care services for persons eligible for benefits under 6
medicaid, Title XIX of the social security act and for persons not 7
eligible for medicaid, the authority must use regional service areas. 8
The regional service areas must be established by the authority as 9
provided in RCW 74.09.870. 10
(11) Consideration must be given to using multiple-biennia 11
contracting periods. 12
(12) Each behavioral health administrative services organization 13
operating pursuant to a contract issued under this section shall 14
serve clients within its regional service area who meet the 15
authority's eligibility criteria for mental health and substance use 16
disorder services within available resources. 17
NEW SECTION. Sec. 2. A new section is added to chapter 41.05 18
RCW to read as follows: 19
(1) The authority shall contract with one or more external 20
entities to expand access to peer support services.21
(2) Beginning October 1, 2025, the entity or entities shall:22
(a) Provide technical assistance to support primary care clinics, 23
urgent care clinics, and hospitals to integrate certified peer 24
support specialists into their clinical care models and bill health 25
insurance carriers for those services; 26
(b) Develop detailed and innovative proposals to create low 27
barrier and cost-effective opportunities for: 28
(i) Community-based agencies, including peer-run agencies and 29
organizations that are not currently licensed as behavioral health 30
agencies under chapter 71.24 RCW, to bill health carriers for peer 31
support services; 32
(ii) Service providers to bill health carriers for behavioral 33
health services that are currently funded by the state general fund, 34
including the law enforcement assisted diversion program established 35
under RCW 71.24.589, the recovery navigator program established under 36
RCW 71.24.115, the arrest and jail alternatives program established 37
under RCW 36.28A.450, and the homeless outreach stabilization 38
transition program established under RCW 71.24.145; and39
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(iii) Community-based victim services agencies, including 1
agencies that support domestic violence, sexual assault, and human 2
trafficking victims, to bill health carriers for peer support 3
services provided to victims of gender-based violence;4
(c) Develop a proposal to establish the concept of, and billing 5
mechanisms for, substance use disorder peer-run respite centers that 6
are modeled after the mental health peer-run respite centers 7
established under RCW 71.24.649; and 8
(d) Explore options for health carriers to pay for peer support 9
services through capitated payment arrangements rather than on a fee-10
for-service basis. 11
(3) By November 1, 2026, the contracted entity or entities shall 12
submit reports to the authority to describe the type and quantity of 13
technical assistance that have been provided, the proposals that have 14
been developed, and the trends in health carriers providing payment 15
for peer support services, and any policy or budget recommendations 16
to encourage health carriers to reimburse providers for peer support 17
services. 18
NEW SECTION. Sec. 3. A new section is added to chapter 18.420 19
RCW to read as follows: 20
(1) The secretary shall issue an endorsement to the certification 21
of a certified peer support specialist in the following categories of 22
practice areas upon demonstrating the following requirements:23
(a) Domestic violence peer support services: 24
(i) Submission of an attestation to the department that the 25
applicant self-identifies as a survivor of domestic violence; and26
(ii) Successful completion of the domestic violence peer support 27
services endorsement education course developed by the office of 28
crime victims advocacy under section 4 of this act.29
(b) Sexual assault peer support services: 30
(i) Submission of an attestation to the department that the 31
applicant self-identifies as a survivor of sexual assault; and32
(ii) Successful completion of the sexual assault peer support 33
services endorsement education course developed by the office of 34
crime victims advocacy under section 4 of this act.35
(c) Human trafficking peer support services: 36
(i) Submission of an attestation to the department that the 37
applicant self-identifies as a survivor of human trafficking; and38
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(ii) Successful completion of the human trafficking peer support 1
services endorsement education course developed by the office of 2
crime victims advocacy under section 4 of this act.3
(2)(a) Except as provided in (b) of this subsection, obtaining an 4
endorsement under this section is voluntary. 5
(b) A certified peer support specialist must hold an endorsement 6
in a category under subsection (1) of this section if:7
(i) The certified peer support specialist is employed by a victim 8
services agency; 9
(ii) The certified peer support specialist is providing peer 10
support services to a client of the victim services agency who has 11
experienced domestic violence, sexual assault, or human trafficking; 12
and 13
(iii) The victim services agency seeks to bill a medical 14
assistance program under chapter 74.09 RCW or a health carrier for 15
the certified peer support specialist's services to the client.16
(c) A victim services agency may only bill for peer support 17
services if the certified peer support specialist holds an 18
endorsement in a category that is relevant to the client's experience 19
with domestic violence, sexual assault, or human trafficking. A 20
certified peer support specialist is not required to hold an 21
endorsement to provide peer support services to the client of a 22
victim services agency if the victim services agency does not seek 23
reimbursement for the peer support services. 24
(3) As used in this section, the term "victim services agency" 25
means a nonprofit program or organization that provides, as its 26
primary purpose, assistance and advocacy for persons who have 27
experienced domestic violence, sexual assault, or human trafficking. 28
Services may include crisis intervention, individual and group 29
support, information, referrals, and safety planning.30
NEW SECTION. Sec. 4. A new section is added to chapter 43.280 31
RCW to read as follows: 32
(1) By July 1, 2026, the office of crime victims advocacy 33
established under RCW 43.280.080 shall develop courses of instruction 34
for certified peer support specialists to receive an endorsement in 35
any of the three categories of practice areas under section 3 of this 36
act. The courses must supplement the instruction received by 37
certified peer support specialists under RCW 71.24.920 with an 38
emphasis on the application of the skills taught in the certification 39
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training to providing peer support services to persons who have 1
experienced domestic violence, sexual assault, or human trafficking, 2
as applicable. The courses must also incorporate competencies that 3
are typically taught in training programs for victim advocates, 4
including safety planning, a foundational understanding of domestic 5
violence, sexual assault, or human trafficking, as applicable, and 6
advocacy across legal, medical, social services, and other systems. 7
The office shall consult with the department of health to determine 8
the appropriate length and content of the courses. 9
(2) The office shall offer the courses on a regular basis or 10
contract with an entity or entities to offer the courses. The courses 11
must be available to certified peer support specialists at no cost.12
(3) The office shall collaborate with the department of health to 13
develop a process to verify to the department that the certified peer 14
support specialist has completed the training. 15
Sec. 5. RCW 18.130.040 and 2024 c 362 s 8, 2024 c 217 s 7, and 16
2024 c 50 s 5 are each reenacted and amended to read as follows:17
(1) This chapter applies only to the secretary and the boards and 18
commissions having jurisdiction in relation to the professions 19
licensed under the chapters specified in this section. This chapter 20
does not apply to any business or profession not licensed under the 21
chapters specified in this section. 22
(2)(a) The secretary has authority under this chapter in relation 23
to the following professions: 24
(i) Dispensing opticians licensed and designated apprentices 25
under chapter 18.34 RCW; 26
(ii) Midwives licensed under chapter 18.50 RCW;27
(iii) Ocularists licensed under chapter 18.55 RCW;28
(iv) Massage therapists and businesses licensed under chapter 29
18.108 RCW; 30
(v) Dental hygienists licensed under chapter 18.29 RCW;31
(vi) Acupuncturists or acupuncture and Eastern medicine 32
practitioners licensed under chapter 18.06 RCW; 33
(vii) Radiologic technologists certified and X-ray technicians 34
registered under chapter 18.84 RCW; 35
(viii) Respiratory care practitioners licensed under chapter 36
18.89 RCW; 37
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(ix) Hypnotherapists registered, agency affiliated counselors 1
registered, certified, or licensed, and advisors and counselors 2
certified under chapter 18.19 RCW; 3
(x) Persons licensed as mental health counselors, mental health 4
counselor associates, marriage and family therapists, marriage and 5
family therapist associates, social workers, social work associates — 6
advanced, and social work associates — independent clinical under 7
chapter 18.225 RCW; 8
(xi) Persons registered as nursing pool operators under chapter 9
18.52C RCW; 10
(xii) Nursing assistants registered or certified or medication 11
assistants endorsed under chapter 18.88A RCW; 12
(xiii) Dietitians and nutritionists certified under chapter 13
18.138 RCW; 14
(xiv) Substance use disorder professionals, substance use 15
disorder professional trainees, or co-occurring disorder specialists 16
certified under chapter 18.205 RCW; 17
(xv) Sex offender treatment providers and certified affiliate sex 18
offender treatment providers certified under chapter 18.155 RCW;19
(xvi) Persons licensed and certified under chapter 18.73 RCW or 20
RCW 18.71.205; 21
(xvii) Orthotists and prosthetists licensed under chapter 18.200 22
RCW; 23
(xviii) Surgical technologists registered under chapter 18.215 24
RCW; 25
(xix) Recreational therapists under chapter 18.230 RCW;26
(xx) Animal massage therapists certified under chapter 18.240 27
RCW; 28
(xxi) Athletic trainers licensed under chapter 18.250 RCW;29
(xxii) Home care aides certified under chapter 18.88B RCW;30
(xxiii) Genetic counselors licensed under chapter 18.290 RCW;31
(xxiv) Reflexologists certified under chapter 18.108 RCW;32
(xxv) Medical assistants-certified, medical assistants-33
hemodialysis technician, medical assistants-phlebotomist, forensic 34
phlebotomist, medical assistant-EMT, and medical assistants-35
registered certified and registered under chapter 18.360 RCW;36
(xxvi) Behavior analysts, assistant behavior analysts, and 37
behavior technicians under chapter 18.380 RCW; 38
(xxvii) Birth doulas certified under chapter 18.47 RCW;39
(xxviii) Music therapists licensed under chapter 18.233 RCW;40
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(xxix) Behavioral health support specialists certified under 1
chapter 18.227 RCW; and 2
(xxx) Certified peer support specialists and certified peer 3
support specialist trainees under chapter 18.420 RCW.4
(b) The boards and commissions having authority under this 5
chapter are as follows: 6
(i) The podiatric medical board as established in chapter 18.22 7
RCW; 8
(ii) The chiropractic quality assurance commission as established 9
in chapter 18.25 RCW; 10
(iii) The dental quality assurance commission as established in 11
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW, 12
licenses and registrations issued under chapter 18.260 RCW, licenses 13
issued under chapter 18.265 RCW, and certifications issued under 14
chapter 18.350 RCW; 15
(iv) The board of hearing and speech as established in chapter 16
18.35 RCW; 17
(v) The board of examiners for nursing home administrators as 18
established in chapter 18.52 RCW; 19
(vi) The optometry board as established in chapter 18.54 RCW 20
governing licenses issued under chapter 18.53 RCW;21
(vii) The board of osteopathic medicine and surgery as 22
established in chapter 18.57 RCW governing licenses issued under 23
chapter 18.57 RCW; 24
(viii) The pharmacy quality assurance commission as established 25
in chapter 18.64 RCW governing licenses issued under chapters 18.64 26
and 18.64A RCW; 27
(ix) The Washington medical commission as established in chapter 28
18.71 RCW governing licenses and registrations issued under chapters 29
18.71, 18.71A, and 18.71D RCW; 30
(x) The board of physical therapy as established in chapter 18.74 31
RCW; 32
(xi) The board of occupational therapy practice as established in 33
chapter 18.59 RCW; 34
(xii) The board of nursing as established in chapter 18.79 RCW 35
governing licenses and registrations issued under that chapter and 36
under chapter 18.80 RCW; 37
(xiii) The examining board of psychology and its disciplinary 38
committee as established in chapter 18.83 RCW; 39
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(xiv) The veterinary board of governors as established in chapter 1
18.92 RCW; 2
(xv) The board of naturopathy established in chapter 18.36A RCW, 3
governing licenses and certifications issued under that chapter; and4
(xvi) The board of denturists established in chapter 18.30 RCW.5
(3) In addition to the authority to discipline license holders, 6
the disciplining authority has the authority to grant or deny 7
licenses. The disciplining authority may also grant a license subject 8
to conditions, which must be in compliance with chapter 18.415 RCW.9
(4) All disciplining authorities shall adopt procedures to ensure 10
substantially consistent application of this chapter, the uniform 11
disciplinary act, among the disciplining authorities listed in 12
subsection (2) of this section. 13
Sec. 6. RCW 18.130.175 and 2023 c 469 s 19 and 2023 c 425 s 25 14
are each reenacted and amended to read as follows:15
(1) In lieu of disciplinary action under RCW 18.130.160 and if 16
the disciplining authority determines that the unprofessional conduct 17
may be the result of an applicable impairing or potentially impairing 18
health condition, the disciplining authority may refer the license 19
holder to a physician health program or a voluntary substance use 20
disorder monitoring program approved by the disciplining authority.21
The cost of evaluation and treatment shall be the responsibility 22
of the license holder, but the responsibility does not preclude 23
payment by an employer, existing insurance coverage, or other 24
sources. Evaluation and treatment shall be provided by providers 25
approved by the entity or the commission. The disciplining authority 26
may also approve the use of out-of-state programs. Referral of the 27
license holder to the physician health program or voluntary substance 28
use disorder monitoring program shall be done only with the consent 29
of the license holder. Referral to the physician health program or 30
voluntary substance use disorder monitoring program may also include 31
probationary conditions for a designated period of time. If the 32
license holder does not consent to be referred to the program or does 33
not successfully complete the program, the disciplining authority may 34
take appropriate action under RCW 18.130.160 which includes 35
suspension of the license unless or until the disciplining authority, 36
in consultation with the director of the applicable program, 37
determines the license holder is able to practice safely. The 38
secretary shall adopt uniform rules for the evaluation by the 39
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disciplining authority of return to substance use or program 1
violation on the part of a license holder in the program. The 2
evaluation shall encourage program participation with additional 3
conditions, in lieu of disciplinary action, when the disciplining 4
authority determines that the license holder is able to continue to 5
practice with reasonable skill and safety. 6
(2) In addition to approving the physician health program or the 7
voluntary substance use disorder monitoring program that may receive 8
referrals from the disciplining authority, the disciplining authority 9
may establish by rule requirements for participation of license 10
holders who are not being investigated or monitored by the 11
disciplining authority. License holders voluntarily participating in 12
the approved programs without being referred by the disciplining 13
authority shall not be subject to disciplinary action under RCW 14
18.130.160 for their impairing or potentially impairing health 15
condition, and shall not have their participation made known to the 16
disciplining authority, if they meet the requirements of this section 17
and the program in which they are participating. 18
(3) The license holder shall sign a waiver allowing the program 19
to release information to the disciplining authority if the licensee 20
does not comply with the requirements of this section or is unable to 21
practice with reasonable skill or safety. The physician health 22
program or voluntary substance use disorder program shall report to 23
the disciplining authority any license holder who fails to comply 24
with the requirements of this section or the program or who, in the 25
opinion of the program, is unable to practice with reasonable skill 26
or safety. License holders shall report to the disciplining authority 27
if they fail to comply with this section or do not complete the 28
program's requirements. License holders may, upon the agreement of 29
the program and disciplining authority, reenter the program if they 30
have previously failed to comply with this section.31
(4) Program records including, but not limited to, case notes, 32
progress notes, laboratory reports, evaluation and treatment records, 33
electronic and written correspondence within the program, and between 34
the program and the participant or other involved entities including, 35
but not limited to, employers, credentialing bodies, referents, or 36
other collateral sources, relating to license holders referred to or 37
voluntarily participating in approved programs are confidential and 38
exempt from disclosure under chapter 42.56 RCW and shall not be 39
subject to discovery by subpoena or admissible as evidence except:40
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(a) To defend any civil action by a license holder regarding the 1
restriction or revocation of that individual's clinical or staff 2
privileges, or termination of a license holder's employment. In such 3
an action, the program will, upon subpoena issued by either party to 4
the action, and upon the requesting party seeking a protective order 5
for the requested disclosure, provide to both parties of the action 6
written disclosure that includes the following information:7
(i) Verification of a health care professional's participation in 8
the physician health program or voluntary substance use disorder 9
monitoring program as it relates to aspects of program involvement at 10
issue in the civil action; 11
(ii) The dates of participation; 12
(iii) Whether or not the program identified an impairing or 13
potentially impairing health condition; 14
(iv) Whether the health care professional was compliant with the 15
requirements of the physician health program or voluntary substance 16
use disorder monitoring program; and 17
(v) Whether the health care professional successfully completed 18
the physician health program or voluntary substance use disorder 19
monitoring program; and 20
(b) Records provided to the disciplining authority for cause as 21
described in subsection (3) of this section. Program records relating 22
to license holders mandated to the program, through order or by 23
stipulation, by the disciplining authority or relating to license 24
holders reported to the disciplining authority by the program for 25
cause, must be released to the disciplining authority at the request 26
of the disciplining authority. Records held by the disciplining 27
authority under this section are exempt from chapter 42.56 RCW and 28
are not subject to discovery by subpoena except by the license 29
holder. 30
(5) This section does not affect an employer's right or ability 31
to make employment-related decisions regarding a license holder. This 32
section does not restrict the authority of the disciplining authority 33
to take disciplinary action for any other unprofessional conduct.34
(6) A person who, in good faith, reports information or takes 35
action in connection with this section is immune from civil liability 36
for reporting information or taking the action. 37
(a) The immunity from civil liability provided by this section 38
shall be liberally construed to accomplish the purposes of this 39
section, and applies to both license holders and students and 40
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trainees when students and trainees of the applicable professions are 1
served by the program. The persons entitled to immunity shall 2
include: 3
(i) An approved physician health program or voluntary substance 4
use disorder monitoring program; 5
(ii) The professional association affiliated with the program;6
(iii) Members, employees, or agents of the program or 7
associations; 8
(iv) Persons reporting a license holder as being possibly 9
impaired or providing information about the license holder's 10
impairment; and 11
(v) Professionals supervising or monitoring the course of the 12
program participant's treatment or rehabilitation.13
(b) The courts are strongly encouraged to impose sanctions on 14
program participants and their attorneys whose allegations under this 15
subsection are not made in good faith and are without either 16
reasonable objective, substantive grounds, or both.17
(c) The immunity provided in this section is in addition to any 18
other immunity provided by law. 19
(7) In the case of a person who is applying to be a substance use 20
disorder professional or substance use disorder professional trainee 21
certified under chapter 18.205 RCW, an agency affiliated counselor 22
registered under chapter 18.19 RCW, or a peer support specialist or 23
peer support specialist trainee certified under chapter 18.420 RCW, 24
if the person is: 25
(a) Less than one year in recovery from a substance use disorder, 26
the duration of time that the person may be required to participate 27
in an approved substance use disorder monitoring program may not 28
exceed the amount of time necessary for the person to achieve one 29
year in recovery; or 30
(b) At least one year in recovery from a substance use disorder, 31
the person may not be required to participate in the approved 32
substance use disorder monitoring program. 33
(8) The provisions of subsection (7) of this section apply to any 34
person employed as a peer support specialist as of July 1, 2025, 35
participating in a program under this section as of July 1, 2025, and 36
applying to become a certified peer support specialist under RCW 37
18.420.050, regardless of when the person's participation in a 38
program began. To this extent, subsection (7) of this section applies 39
retroactively, but in all other respects it applies prospectively.40
p. 16 HB 1427
Sec. 7. RCW 18.420.005 and 2023 c 469 s 1 are each amended to 1
read as follows: 2
(1) The legislature finds that peers play a critical role along 3
the behavioral health continuum of care, from outreach to treatment 4
to recovery support. Peers deal in the currency of hope and 5
motivation. Peers bring hope to individuals receiving services and 6
are incredibly adept at supporting people with behavioral health 7
challenges on their recovery journeys. Peers represent the only 8
segment of the behavioral health workforce where there is not a 9
shortage, but a surplus of willing workers. Peers, however, are 10
presently limited to serving only medicaid recipients and working 11
only in community behavioral health agencies. As a result, youth and 12
adults with commercial insurance have no access to peer services. 13
Furthermore, peers who work in other settings, such as emergency 14
departments and behavioral health urgent care, cannot bill insurance 15
for their services. 16
(2) Therefore, it is the intent of the legislature to address the 17
behavioral health workforce crisis, expand access to peer services, 18
eliminate financial barriers to professional licensing, and honor the 19
contributions of the peer profession by creating the profession of 20
certified peer support specialists. 21
Sec. 8. RCW 18.420.010 and 2023 c 469 s 2 are each amended to 22
read as follows: 23
The definitions in this section apply throughout this chapter 24
unless the context clearly requires otherwise. 25
(1) (("Advisory committee" means the Washington state certified 26
peer specialist advisory committee established under section 4 of 27
this act.28
(2))) "Approved supervisor" means: 29
(a) Until July 1, 2028, a behavioral health provider, as defined 30
in RCW 71.24.025 with at least two years of experience working in a 31
behavioral health practice that employs peer support specialists or 32
certified peer counselors as part of treatment teams; or33
(b) A certified peer support specialist who has completed:34
(i) At least 1,500 hours of work as a fully certified peer 35
support specialist engaged in the practice of peer support services, 36
with at least 500 hours attained through the joint supervision of 37
peers in conjunction with another approved supervisor; and38
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(ii) The training developed by the health care authority under 1
RCW 71.24.920. 2
(((3))) (2) "Certified peer support specialist" means a person 3
certified under this chapter to engage in the practice of peer 4
support services. 5
(((4))) (3) "Certified peer support specialist trainee" means an 6
individual working toward the supervised experience and written 7
examination requirements to become a certified peer support 8
specialist under this chapter. 9
(((5))) (4) "Department" means the department of health.10
(((6))) (5) "Practice of peer support services" means the 11
provision of interventions by a peer who is either a person in 12
recovery from a mental health condition or substance use disorder, or 13
both, or the parent or legal guardian of a youth who is receiving or 14
has received behavioral health services ((. The client receiving the 15
interventions receives them from a person )), to a person with a 16
similar lived experience ((as either a person in recovery from a 17
mental health condition or substance use disorder, or both, or the 18
parent or legal guardian of a youth who is receiving or has received 19
behavioral health services )). The ((person)) peer provides the 20
interventions through the use of shared experiences to assist ((a 21
client)) the participant in the acquisition and exercise of skills 22
needed to support the ((client's)) participant's recovery. 23
Interventions may include activities that assist ((clients)) 24
participants in accessing or engaging in treatment and in symptom 25
management; promote social connection, recovery, and self-advocacy; 26
provide guidance in the development of natural community supports and 27
basic daily living skills; and support ((clients)) participants in 28
engagement, motivation, and maintenance related to achieving and 29
maintaining health and wellness goals. 30
(((7))) (6) "Secretary" means the secretary of health.31
Sec. 9. RCW 18.420.020 and 2023 c 469 s 3 are each amended to 32
read as follows: 33
In addition to any other authority, the secretary has the 34
authority to: 35
(1) Adopt rules under chapter 34.05 RCW necessary to implement 36
this chapter; 37
p. 18 HB 1427
(2) Establish all certification, examination, and renewal fees 1
for certified peer support specialists in accordance with RCW 2
43.70.110 and 43.70.250; 3
(3) Establish forms and procedures necessary to administer this 4
chapter; 5
(4) Issue certificates to applicants who have met the education, 6
training, and examination requirements for obtaining a certificate 7
and to deny a certificate to applicants who do not meet the 8
requirements; 9
(5) Coordinate with the health care authority to confirm an 10
applicants' successful completion of the certified peer support 11
specialist education course offered by the health care authority 12
under RCW 71.24.920 and successful passage of the associated oral 13
examination as proof of eligibility to take a qualifying written 14
examination for applicants for obtaining a certificate;15
(6) Establish practice parameters consistent with the definition 16
of the practice of peer support services; 17
(7) ((Provide staffing and administrative support to the advisory 18
committee;19
(8))) Determine which states have credentialing requirements 20
equivalent to those of this state, and issue certificates to 21
applicants credentialed in those states without examination;22
(((9))) (8) Define and approve any supervised experience 23
requirements for certification; 24
(((10) Assist the advisory committee with the review of peer 25
counselor apprenticeship program applications in the process of being 26
approved and registered under chapter 49.04 RCW;27
(11))) (9) Adopt rules implementing a continuing competency 28
program; and 29
(((12))) (10) Establish by rule the procedures for an appeal of 30
an examination failure. 31
Sec. 10. RCW 18.420.030 and 2023 c 469 s 5 are each amended to 32
read as follows: 33
Beginning July 1, 2025, except as provided in RCW 71.24.920, the 34
decision of a person practicing peer support services to become 35
certified under this chapter is voluntary. A person may not use the 36
title certified peer support specialist unless the person holds a 37
credential under this chapter. 38
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Sec. 11. RCW 18.420.040 and 2023 c 469 s 6 are each amended to 1
read as follows: 2
Nothing in this chapter may be construed to prohibit or restrict:3
(1) An individual who holds a credential issued by this state, 4
other than as a certified peer support specialist or certified peer 5
support specialist trainee, to engage in the practice of an 6
occupation or profession without obtaining an additional credential 7
from the state. The individual may not use the title certified peer 8
support specialist unless the individual holds a credential under 9
this chapter; or 10
(2) The practice of peer support services by a person who is 11
employed by the government of the United States while engaged in the 12
performance of duties prescribed by the laws of the United States.13
Sec. 12. RCW 18.420.050 and 2023 c 469 s 7 are each amended to 14
read as follows: 15
(1) Beginning July 1, 2025, except as provided in subsections (2) 16
and (3) of this section, the secretary shall issue a certificate to 17
practice as a certified peer support specialist to any applicant who 18
demonstrates to the satisfaction of the secretary that the applicant 19
meets the following requirements: 20
(a) Submission of an attestation to the department that the 21
applicant self-identifies as: 22
(i) A person with one or more years of recovery from a mental 23
health condition, substance use disorder, or both; or24
(ii) The parent or legal guardian of a youth who is receiving or 25
has received behavioral health services; 26
(b) Successful completion of the education course developed and 27
offered by the health care authority under RCW 71.24.920;28
(c) Successful passage of an oral examination administered by the 29
health care authority upon completion of the education course offered 30
by the health care authority under RCW 71.24.920; 31
(d) Successful passage of a written examination administered by 32
the health care authority upon completion of the education course 33
offered by the health care authority under RCW 71.24.920;34
(e) Successful completion of an experience requirement of at 35
least 1,000 supervised hours as a certified peer support specialist 36
trainee engaged in the volunteer or paid practice of peer support 37
services, in accordance with the standards in RCW 18.420.060; and38
(f) Payment of the appropriate fee required under this chapter.39
p. 20 HB 1427
(2) The secretary ((, with the recommendation of the advisory 1
committee,)) shall establish criteria for the issuance of a 2
certificate to engage in the practice of peer support services based 3
on prior experience as a peer specialist attained before July 1, 4
2025. The criteria shall establish equivalency standards necessary to 5
be deemed to have met the requirements of subsection (1) of this 6
section. An applicant under this subsection shall have until July 1, 7
2026, to complete any standards in which the applicant is determined 8
to be deficient. 9
(3) The secretary ((, with the recommendation of the advisory 10
committee,)) shall issue a certificate to engage in the practice of 11
peer support services based on completion of an apprenticeship 12
program registered and approved under chapter 49.04 RCW ((and 13
reviewed by the advisory committee under RCW 18.420.020)).14
(4) A certificate to engage in the practice of peer support 15
services is valid for two years. A certificate may be renewed upon 16
demonstrating to the department that the certified peer support 17
specialist has successfully completed 30 hours of continuing 18
education approved by the department. As part of the continuing 19
education requirement, every six years the applicant must submit 20
proof of successful completion of at least three hours of suicide 21
prevention training and at least six hours of coursework in 22
professional ethics and law, which may include topics under RCW 23
18.130.180. 24
Sec. 13. RCW 18.420.060 and 2023 c 469 s 8 are each amended to 25
read as follows: 26
(1) Beginning July 1, 2025, the secretary shall issue a 27
certificate to practice as a certified peer support specialist 28
trainee to any applicant who demonstrates to the satisfaction of the 29
secretary that: 30
(a) The applicant meets the requirements of RCW 18.420.050 31
(1)(a), (b), (c), (d), and (4) and is working toward the supervised 32
experience requirements to become a certified peer support specialist 33
under this chapter; or 34
(b) The applicant is enrolled in an apprenticeship program 35
registered and approved under chapter 49.04 RCW and approved by the 36
secretary under RCW 18.420.020. 37
(2) An applicant seeking to become a certified peer support 38
specialist trainee under this section shall submit to the secretary 39
p. 21 HB 1427
for approval an attestation, in accordance with rules adopted by the 1
department, that the certified peer support specialist trainee is 2
actively pursuing the supervised experience requirements of RCW 3
18.420.050(1)(((d))) (e). This attestation must be updated with the 4
trainee's annual renewal. 5
(3) A certified peer support specialist trainee certified under 6
this section may practice only under the supervision of an approved 7
supervisor. Supervision may be provided through distance supervision. 8
Supervision may be provided by an approved supervisor who is employed 9
by the same employer that employs the certified peer support 10
specialist trainee or by an arrangement made with a third-party 11
approved supervisor to provide supervision, or a combination of both 12
types of approved supervisors. 13
(4) A certified peer support specialist trainee certificate is 14
valid for one year and may only be renewed four times.15
Sec. 14. RCW 18.420.090 and 2023 c 469 s 12 are each amended to 16
read as follows: 17
The uniform disciplinary act, chapter 18.130 RCW, governs 18
uncertified practice of peer support services, the issuance and 19
denial of certificates, and the discipline of certified peer support 20
specialists and certified peer support specialist trainees under this 21
chapter. 22
Sec. 15. RCW 18.420.800 and 2023 c 469 s 11 are each amended to 23
read as follows: 24
(1) The department ((, in consultation with the advisory 25
committee,)) shall conduct an assessment and submit a report to the 26
governor and the committees of the legislature with jurisdiction over 27
health policy issues by December 1, 2027. 28
(2) The report in subsection (1) of this section shall provide:29
(a) An analysis of the adequacy of the supply of certified peer 30
support specialists serving as approved supervisors pursuant to RCW 31
18.420.010(((2))) (1)(b) with respect to the ability to meet the 32
anticipated supervision needs of certified peer support specialist 33
trainees upon the expiration of behavioral health providers serving 34
as approved supervisors pursuant to RCW 18.420.010(((2))) (1)(a);35
(b) An assessment of whether or not it is necessary to extend the 36
expiration of behavioral health providers serving as approved 37
supervisors pursuant to RCW 18.420.010(((2))) (1)(a) in order to meet 38
p. 22 HB 1427
the anticipated supervision needs of certified peer support 1
specialist trainees; 2
(c) Recommendations for increasing the supply of certified peer 3
support specialists serving as approved supervisors pursuant to RCW 4
18.420.010(((2))) (1)(b), including any potential modifications to 5
the requirements to become an approved supervisor; and6
(d) Recommendations for alternative methods of providing 7
supervision to certified peer support specialist trainees, including 8
options for team-based supervision that incorporate supervision from 9
both behavioral health providers serving as approved supervisors 10
pursuant to RCW 18.420.010(((2))) (1)(a) and certified peer support 11
specialists serving as approved supervisors pursuant to RCW 12
18.420.010(((2))) (1)(b). 13
Sec. 16. RCW 43.70.250 and 2024 c 366 s 14 are each amended to 14
read as follows: 15
(1) It shall be the policy of the state of Washington that the 16
cost of each professional, occupational, or business licensing 17
program be fully borne by the members of that profession, occupation, 18
or business. 19
(2) The secretary shall from time to time establish the amount of 20
all application fees, license fees, registration fees, examination 21
fees, permit fees, renewal fees, and any other fee associated with 22
licensing or regulation of professions, occupations, or businesses 23
administered by the department. Any and all fees or assessments, or 24
both, levied on the state to cover the costs of the operations and 25
activities of the interstate health professions licensure compacts 26
with participating authorities listed under chapter 18.130 RCW shall 27
be borne by the persons who hold licenses issued pursuant to the 28
authority and procedures established under the compacts. In fixing 29
said fees, the secretary shall set the fees for each program at a 30
sufficient level to defray the costs of administering that program 31
and the cost of regulating licensed volunteer medical workers in 32
accordance with RCW 18.130.360, except as provided in RCW 18.79.202. 33
In no case may the secretary impose any certification, examination, 34
or renewal fee upon a person seeking certification as a certified 35
peer support specialist trainee under chapter 18.420 RCW or, between 36
July 1, 2025, and July 1, 2030, impose a certification, examination, 37
or renewal fee of more than $100 upon any person seeking 38
certification as a certified peer support specialist under chapter 39
p. 23 HB 1427
18.420 RCW. Subject to amounts appropriated for this specific 1
purpose, between July 1, 2024, and July 1, 2029, the secretary may 2
not impose any certification or certification renewal fee on a person 3
seeking certification as a substance use disorder professional or 4
substance use disorder professional trainee under chapter 18.205 RCW 5
of more than $100. 6
(3) All such fees shall be fixed by rule adopted by the secretary 7
in accordance with the provisions of the administrative procedure 8
act, chapter 34.05 RCW. 9
Sec. 17. RCW 48.43.825 and 2023 c 469 s 16 are each amended to 10
read as follows: 11
By July 1, 2026, each carrier shall provide access to services 12
provided by certified peer support specialists and certified peer 13
support specialist trainees in a manner sufficient to meet the 14
network access standards set forth in rules established by the office 15
of the insurance commissioner. 16
Sec. 18. RCW 71.24.025 and 2024 c 368 s 2, 2024 c 367 s 1, and 17
2024 c 121 s 25 are each reenacted and amended to read as follows:18
Unless the context clearly requires otherwise, the definitions in 19
this section apply throughout this chapter. 20
(1) "23-hour crisis relief center" means a community-based 21
facility or portion of a facility which is licensed or certified by 22
the department of health and open 24 hours a day, seven days a week, 23
offering access to mental health and substance use care for no more 24
than 23 hours and 59 minutes at a time per patient, and which accepts 25
all behavioral health crisis walk-ins drop-offs from first 26
responders, and individuals referred through the 988 system 27
regardless of behavioral health acuity, and meets the requirements 28
under RCW 71.24.916. 29
(2) "988 crisis hotline" means the universal telephone number 30
within the United States designated for the purpose of the national 31
suicide prevention and mental health crisis hotline system operating 32
through the national suicide prevention lifeline. 33
(3) "Acutely mentally ill" means a condition which is limited to 34
a short-term severe crisis episode of: 35
(a) A mental disorder as defined in RCW 71.05.020 or, in the case 36
of a child, as defined in RCW 71.34.020; 37
p. 24 HB 1427
(b) Being gravely disabled as defined in RCW 71.05.020 or, in the 1
case of a child, a gravely disabled minor as defined in RCW 2
71.34.020; or 3
(c) Presenting a likelihood of serious harm as defined in RCW 4
71.05.020 or, in the case of a child, as defined in RCW 71.34.020.5
(4) "Alcoholism" means a disease, characterized by a dependency 6
on alcoholic beverages, loss of control over the amount and 7
circumstances of use, symptoms of tolerance, physiological or 8
psychological withdrawal, or both, if use is reduced or discontinued, 9
and impairment of health or disruption of social or economic 10
functioning. 11
(5) "Approved substance use disorder treatment program" means a 12
program for persons with a substance use disorder provided by a 13
treatment program licensed or certified by the department as meeting 14
standards adopted under this chapter. 15
(6) "Authority" means the Washington state health care authority.16
(7) "Available resources" means funds appropriated for the 17
purpose of providing community behavioral health programs, federal 18
funds, except those provided according to Title XIX of the Social 19
Security Act, and state funds appropriated under this chapter or 20
chapter 71.05 RCW by the legislature during any biennium for the 21
purpose of providing residential services, resource management 22
services, community support services, and other behavioral health 23
services. This does not include funds appropriated for the purpose of 24
operating and administering the state psychiatric hospitals.25
(8) "Behavioral health administrative services organization" 26
means an entity contracted with the authority to administer 27
behavioral health services and programs under RCW 71.24.381, 28
including crisis services and administration of chapter 71.05 RCW, 29
the involuntary treatment act, for all individuals in a defined 30
regional service area. 31
(9) "Behavioral health aide" means a counselor, health educator, 32
and advocate who helps address individual and community-based 33
behavioral health needs, including those related to alcohol, drug, 34
and tobacco abuse as well as mental health problems such as grief, 35
depression, suicide, and related issues and is certified by a 36
community health aide program of the Indian health service or one or 37
more tribes or tribal organizations consistent with the provisions of 38
25 U.S.C. Sec. 1616l and RCW 43.71B.010 (7) and (8).39
p. 25 HB 1427
(10) "Behavioral health provider" means a person licensed under 1
chapter 18.57, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79 RCW, as 2
it applies to registered nurses and advanced practice registered 3
((nurse practitioners)) nurses. 4
(11) "Behavioral health services" means mental health services, 5
substance use disorder treatment services, and co-occurring disorder 6
treatment services as described in this chapter and chapter 71.36 RCW 7
that, depending on the type of service, are provided by licensed or 8
certified behavioral health agencies, behavioral health providers, or 9
integrated into other health care providers. 10
(12) "Child" means a person under the age of 18 years.11
(13) "Chronically mentally ill adult" or "adult who is 12
chronically mentally ill" means an adult who has a mental disorder 13
and meets at least one of the following criteria: 14
(a) Has undergone two or more episodes of hospital care for a 15
mental disorder within the preceding two years; or16
(b) Has experienced a continuous behavioral health 17
hospitalization or residential treatment exceeding six months' 18
duration within the preceding year; or 19
(c) Has been unable to engage in any substantial gainful activity 20
by reason of any mental disorder which has lasted for a continuous 21
period of not less than 12 months. "Substantial gainful activity" 22
shall be defined by the authority by rule consistent with Public Law 23
92-603, as amended. 24
(14) "Clubhouse" means a community-based program that provides 25
rehabilitation services and is licensed or certified by the 26
department. 27
(15) "Community behavioral health program" means all 28
expenditures, services, activities, or programs, including reasonable 29
administration and overhead, designed and conducted to prevent or 30
treat substance use disorder, mental illness, or both in the 31
community behavioral health system. 32
(16) "Community behavioral health service delivery system" means 33
public, private, or tribal agencies that provide services 34
specifically to persons with mental disorders, substance use 35
disorders, or both, as defined under RCW 71.05.020 and receive 36
funding from public sources. 37
(17) "Community support services" means services authorized, 38
planned, and coordinated through resource management services 39
including, at a minimum, assessment, diagnosis, emergency crisis 40
p. 26 HB 1427
intervention available 24 hours, seven days a week, prescreening 1
determinations for persons who are mentally ill being considered for 2
placement in nursing homes as required by federal law, screening for 3
patients being considered for admission to residential services, 4
diagnosis and treatment for children who are acutely mentally ill or 5
severely emotionally or behaviorally disturbed discovered under 6
screening through the federal Title XIX early and periodic screening, 7
diagnosis, and treatment program, investigation, legal, and other 8
nonresidential services under chapter 71.05 RCW, case management 9
services, psychiatric treatment including medication supervision, 10
counseling, psychotherapy, assuring transfer of relevant patient 11
information between service providers, recovery services, and other 12
services determined by behavioral health administrative services 13
organizations. 14
(18) "Community-based crisis team" means a team that is part of 15
an emergency medical services agency, a fire service agency, a public 16
health agency, a medical facility, a nonprofit crisis response 17
provider, or a city or county government entity, other than a law 18
enforcement agency, that provides the on-site community-based 19
interventions of a mobile rapid response crisis team for individuals 20
who are experiencing a behavioral health crisis. 21
(19) "Consensus-based" means a program or practice that has 22
general support among treatment providers and experts, based on 23
experience or professional literature, and may have anecdotal or case 24
study support, or that is agreed but not possible to perform studies 25
with random assignment and controlled groups. 26
(20) "Coordinated regional behavioral health crisis response 27
system" means the coordinated operation of 988 call centers, regional 28
crisis lines, certified public safety telecommunicators, and other 29
behavioral health crisis system partners within each regional service 30
area. 31
(21) "County authority" means the board of county commissioners, 32
county council, or county executive having authority to establish a 33
behavioral health administrative services organization, or two or 34
more of the county authorities specified in this subsection which 35
have entered into an agreement to establish a behavioral health 36
administrative services organization. 37
(22) "Crisis stabilization services" means services such as 23-38
hour crisis relief centers, crisis stabilization units, short-term 39
respite facilities, peer-run respite services, and same-day walk-in 40
p. 27 HB 1427
behavioral health services, including within the overall crisis 1
system components that operate like hospital emergency departments 2
that accept all walk-ins, and ambulance, fire, and police drop-offs, 3
or determine the need for involuntary hospitalization of an 4
individual. 5
(23) "Crisis stabilization unit" has the same meaning as under 6
RCW 71.05.020. 7
(24) "Department" means the department of health.8
(25) "Designated 988 contact hub" or "988 contact hub" means a 9
state-designated contact center that streamlines clinical 10
interventions and access to resources for people experiencing a 11
behavioral health crisis and participates in the national suicide 12
prevention lifeline network to respond to statewide or regional 988 13
contacts that meets the requirements of RCW 71.24.890.14
(26) "Designated crisis responder" has the same meaning as in RCW 15
71.05.020. 16
(27) "Director" means the director of the authority.17
(28) "Drug addiction" means a disease characterized by a 18
dependency on psychoactive chemicals, loss of control over the amount 19
and circumstances of use, symptoms of tolerance, physiological or 20
psychological withdrawal, or both, if use is reduced or discontinued, 21
and impairment of health or disruption of social or economic 22
functioning. 23
(29) "Early adopter" means a regional service area for which all 24
of the county authorities have requested that the authority purchase 25
medical and behavioral health services through a managed care health 26
system as defined under RCW 71.24.380(7). 27
(30) "Emerging best practice" or "promising practice" means a 28
program or practice that, based on statistical analyses or a well 29
established theory of change, shows potential for meeting the 30
evidence-based or research-based criteria, which may include the use 31
of a program that is evidence-based for outcomes other than those 32
listed in subsection (31) of this section. 33
(31) "Evidence-based" means a program or practice that has been 34
tested in heterogeneous or intended populations with multiple 35
randomized, or statistically controlled evaluations, or both; or one 36
large multiple site randomized, or statistically controlled 37
evaluation, or both, where the weight of the evidence from a systemic 38
review demonstrates sustained improvements in at least one outcome. 39
"Evidence-based" also means a program or practice that can be 40
p. 28 HB 1427
implemented with a set of procedures to allow successful replication 1
in Washington and, when possible, is determined to be cost-2
beneficial. 3
(32) "First responders" includes ambulance, fire, mobile rapid 4
response crisis team, coresponder team, designated crisis responder, 5
fire department mobile integrated health team, community assistance 6
referral and education services program under RCW 35.21.930, and law 7
enforcement personnel. 8
(33) "Immediate jeopardy" means a situation in which the licensed 9
or certified behavioral health agency's noncompliance with one or 10
more statutory or regulatory requirements has placed the health and 11
safety of patients in its care at risk for serious injury, serious 12
harm, serious impairment, or death. 13
(34) "Indian health care provider" means a health care program 14
operated by the Indian health service or by a tribe, tribal 15
organization, or urban Indian organization as those terms are defined 16
in the Indian health care improvement act (25 U.S.C. Sec. 1603).17
(35) "Intensive behavioral health treatment facility" means a 18
community-based specialized residential treatment facility for 19
individuals with behavioral health conditions, including individuals 20
discharging from or being diverted from state and local hospitals, 21
whose impairment or behaviors do not meet, or no longer meet, 22
criteria for involuntary inpatient commitment under chapter 71.05 23
RCW, but whose care needs cannot be met in other community-based 24
placement settings. 25
(36) "Licensed or certified behavioral health agency" means:26
(a) An entity licensed or certified according to this chapter or 27
chapter 71.05 RCW; 28
(b) An entity deemed to meet state minimum standards as a result 29
of accreditation by a recognized behavioral health accrediting body 30
recognized and having a current agreement with the department; or31
(c) An entity with a tribal attestation that it meets state 32
minimum standards for a licensed or certified behavioral health 33
agency. 34
(37) "Licensed physician" means a person licensed to practice 35
medicine or osteopathic medicine and surgery in the state of 36
Washington. 37
(38) "Long-term inpatient care" means inpatient services for 38
persons committed for, or voluntarily receiving intensive treatment 39
for, periods of ninety days or greater under chapter 71.05 RCW. 40
p. 29 HB 1427
"Long-term inpatient care" as used in this chapter does not include: 1
(a) Services for individuals committed under chapter 71.05 RCW who 2
are receiving services pursuant to a conditional release or a court-3
ordered less restrictive alternative to detention; or (b) services 4
for individuals voluntarily receiving less restrictive alternative 5
treatment on the grounds of the state hospital. 6
(39) "Managed care organization" means an organization, having a 7
certificate of authority or certificate of registration from the 8
office of the insurance commissioner, that contracts with the 9
authority under a comprehensive risk contract to provide prepaid 10
health care services to enrollees under the authority's managed care 11
programs under chapter 74.09 RCW. 12
(40) "Mental health peer-run respite center" means a peer-run 13
program to serve individuals in need of voluntary, short-term, 14
noncrisis services that focus on recovery and wellness.15
(41) Mental health "treatment records" include registration and 16
all other records concerning persons who are receiving or who at any 17
time have received services for mental illness, which are maintained 18
by the department of social and health services or the authority, by 19
behavioral health administrative services organizations and their 20
staffs, by managed care organizations and their staffs, or by 21
treatment facilities. "Treatment records" do not include notes or 22
records maintained for personal use by a person providing treatment 23
services for the entities listed in this subsection, or a treatment 24
facility if the notes or records are not available to others.25
(42) "Mentally ill persons," "persons who are mentally ill," and 26
"the mentally ill" mean persons and conditions defined in subsections 27
(3), (13), (51), and (52) of this section. 28
(43) "Mobile rapid response crisis team" means a team that 29
provides professional on-site community-based intervention such as 30
outreach, de-escalation, stabilization, resource connection, and 31
follow-up support for individuals who are experiencing a behavioral 32
health crisis, that shall include certified peer counselors or 33
certified peer support specialists as a best practice to the extent 34
practicable based on workforce availability, and that meets standards 35
for response times established by the authority. 36
(44) "Recovery" means a process of change through which 37
individuals improve their health and wellness, live a self-directed 38
life, and strive to reach their full potential. 39
p. 30 HB 1427
(45) "Regional crisis line" means the behavioral health crisis 1
hotline in each regional service area which provides crisis response 2
services 24 hours a day, seven days a week, 365 days a year including 3
but not limited to dispatch of mobile rapid response crisis teams, 4
community-based crisis teams, and designated crisis responders.5
(46) "Research-based" means a program or practice that has been 6
tested with a single randomized, or statistically controlled 7
evaluation, or both, demonstrating sustained desirable outcomes; or 8
where the weight of the evidence from a systemic review supports 9
sustained outcomes as described in subsection (31) of this section 10
but does not meet the full criteria for evidence-based.11
(47) "Residential services" means a complete range of residences 12
and supports authorized by resource management services and which may 13
involve a facility, a distinct part thereof, or services which 14
support community living, for persons who are acutely mentally ill, 15
adults who are chronically mentally ill, children who are severely 16
emotionally disturbed, or adults who are seriously disturbed and 17
determined by the behavioral health administrative services 18
organization or managed care organization to be at risk of becoming 19
acutely or chronically mentally ill. The services shall include at 20
least evaluation and treatment services as defined in chapter 71.05 21
RCW, acute crisis respite care, long-term adaptive and rehabilitative 22
care, and supervised and supported living services, and shall also 23
include any residential services developed to service persons who are 24
mentally ill in nursing homes, residential treatment facilities, 25
assisted living facilities, and adult family homes, and may include 26
outpatient services provided as an element in a package of services 27
in a supported housing model. Residential services for children in 28
out-of-home placements related to their mental disorder shall not 29
include the costs of food and shelter, except for children's long-30
term residential facilities existing prior to January 1, 1991.31
(48) "Resilience" means the personal and community qualities that 32
enable individuals to rebound from adversity, trauma, tragedy, 33
threats, or other stresses, and to live productive lives.34
(49) "Resource management services" mean the planning, 35
coordination, and authorization of residential services and community 36
support services administered pursuant to an individual service plan 37
for: (a) Adults and children who are acutely mentally ill; (b) adults 38
who are chronically mentally ill; (c) children who are severely 39
emotionally disturbed; or (d) adults who are seriously disturbed and 40
p. 31 HB 1427
determined by a behavioral health administrative services 1
organization or managed care organization to be at risk of becoming 2
acutely or chronically mentally ill. Such planning, coordination, and 3
authorization shall include mental health screening for children 4
eligible under the federal Title XIX early and periodic screening, 5
diagnosis, and treatment program. Resource management services 6
include seven day a week, 24 hour a day availability of information 7
regarding enrollment of adults and children who are mentally ill in 8
services and their individual service plan to designated crisis 9
responders, evaluation and treatment facilities, and others as 10
determined by the behavioral health administrative services 11
organization or managed care organization, as applicable.12
(50) "Secretary" means the secretary of the department of health.13
(51) "Seriously disturbed person" means a person who:14
(a) Is gravely disabled or presents a likelihood of serious harm 15
to himself or herself or others, or to the property of others, as a 16
result of a mental disorder as defined in chapter 71.05 RCW;17
(b) Has been on conditional release status, or under a less 18
restrictive alternative order, at some time during the preceding two 19
years from an evaluation and treatment facility or a state mental 20
health hospital; 21
(c) Has a mental disorder which causes major impairment in 22
several areas of daily living; 23
(d) Exhibits suicidal preoccupation or attempts; or24
(e) Is a child diagnosed by a mental health professional, as 25
defined in chapter 71.34 RCW, as experiencing a mental disorder which 26
is clearly interfering with the child's functioning in family or 27
school or with peers or is clearly interfering with the child's 28
personality development and learning. 29
(52) "Severely emotionally disturbed child" or "child who is 30
severely emotionally disturbed" means a child who has been determined 31
by the behavioral health administrative services organization or 32
managed care organization, if applicable, to be experiencing a mental 33
disorder as defined in chapter 71.34 RCW, including those mental 34
disorders that result in a behavioral or conduct disorder, that is 35
clearly interfering with the child's functioning in family or school 36
or with peers and who meets at least one of the following criteria:37
(a) Has undergone inpatient treatment or placement outside of the 38
home related to a mental disorder within the last two years;39
p. 32 HB 1427
(b) Has undergone involuntary treatment under chapter 71.34 RCW 1
within the last two years; 2
(c) Is currently served by at least one of the following child-3
serving systems: Juvenile justice, child-protection/welfare, special 4
education, or developmental disabilities; 5
(d) Is at risk of escalating maladjustment due to:6
(i) Chronic family dysfunction involving a caretaker who is 7
mentally ill or inadequate; 8
(ii) Changes in custodial adult; 9
(iii) Going to, residing in, or returning from any placement 10
outside of the home, for example, behavioral health hospital, short-11
term inpatient, residential treatment, group or foster home, or a 12
correctional facility; 13
(iv) Subject to repeated physical abuse or neglect;14
(v) Drug or alcohol abuse; or 15
(vi) Homelessness. 16
(53) "State minimum standards" means minimum requirements 17
established by rules adopted and necessary to implement this chapter 18
by: 19
(a) The authority for: 20
(i) Delivery of mental health and substance use disorder 21
services; and 22
(ii) Community support services and resource management services;23
(b) The department of health for: 24
(i) Licensed or certified behavioral health agencies for the 25
purpose of providing mental health or substance use disorder programs 26
and services, or both; 27
(ii) Licensed behavioral health providers for the provision of 28
mental health or substance use disorder services, or both; and29
(iii) Residential services. 30
(54) "Substance use disorder" means a cluster of cognitive, 31
behavioral, and physiological symptoms indicating that an individual 32
continues using the substance despite significant substance-related 33
problems. The diagnosis of a substance use disorder is based on a 34
pathological pattern of behaviors related to the use of the 35
substances. 36
(55) "Tribe," for the purposes of this section, means a federally 37
recognized Indian tribe. 38
p. 33 HB 1427
Sec. 19. RCW 71.24.585 and 2019 c 314 s 28 are each amended to 1
read as follows: 2
(1)(a) The state of Washington declares that substance use 3
disorders are medical conditions. Substance use disorders should be 4
treated in a manner similar to other medical conditions by using 5
interventions that are supported by evidence, including medications 6
approved by the federal food and drug administration for the 7
treatment of opioid use disorder. It is also recognized that many 8
individuals have multiple substance use disorders, as well as 9
histories of trauma, developmental disabilities, or mental health 10
conditions. As such, all individuals experiencing opioid use disorder 11
should be offered evidence-supported treatments to include federal 12
food and drug administration approved medications for the treatment 13
of opioid use disorders and behavioral counseling and social supports 14
to address them. For behavioral health agencies, an effective plan of 15
treatment for most persons with opioid use disorder integrates access 16
to medications and psychosocial counseling and should be consistent 17
with the American society of addiction medicine patient placement 18
criteria. Providers must inform patients with opioid use disorder or 19
substance use disorder of options to access federal food and drug 20
administration approved medications for the treatment of opioid use 21
disorder or substance use disorder. Because some such medications are 22
controlled substances in chapter 69.50 RCW, the state of Washington 23
maintains the legal obligation and right to regulate the uses of 24
these medications in the treatment of opioid use disorder.25
(b) The authority must work with other state agencies and 26
stakeholders to develop value-based payment strategies to better 27
support the ongoing care of persons with opioid and other substance 28
use disorders. 29
(c) The department of corrections shall develop policies to 30
prioritize services based on available grant funding and funds 31
appropriated specifically for opioid use disorder treatment.32
(2) The authority must promote the use of medication therapies 33
and other evidence-based strategies to address the opioid epidemic in 34
Washington state. Additionally, by January 1, 2020, the authority 35
must prioritize state resources for the provision of treatment and 36
recovery support services to inpatient and outpatient treatment 37
settings that allow patients to start or maintain their use of 38
medications for opioid use disorder while engaging in services.39
p. 34 HB 1427
(3) The state declares that the main goals of treatment for 1
persons with opioid use disorder are the cessation of unprescribed 2
opioid use, reduced morbidity, and restoration of the ability to lead 3
a productive and fulfilling life. 4
(4) To achieve the goals in subsection (3) of this section, to 5
promote public health and safety, and to promote the efficient and 6
economic use of funding for the medicaid program under Title XIX of 7
the social security act, the authority may seek, receive, and expend 8
alternative sources of funding to support all aspects of the state's 9
response to the opioid crisis. 10
(5) The authority must partner with the department of social and 11
health services, the department of corrections, the department of 12
health, the department of children, youth, and families, and any 13
other agencies or entities the authority deems appropriate to develop 14
a statewide approach to leveraging medicaid funding to treat opioid 15
use disorder and provide emergency overdose treatment. Such 16
alternative sources of funding may include: 17
(a) Seeking a section 1115 demonstration waiver from the federal 18
centers for medicare and medicaid services to fund opioid treatment 19
medications for persons eligible for medicaid at or during the time 20
of incarceration and juvenile detention facilities; and21
(b) Soliciting and receiving private funds, grants, and donations 22
from any willing person or entity. 23
(6)(a) The authority shall work with the department of health to 24
promote coordination between medication-assisted treatment 25
prescribers, federally accredited opioid treatment programs, 26
substance use disorder treatment facilities, and state-certified 27
substance use disorder treatment agencies to: 28
(i) Increase patient choice in receiving medication and 29
counseling; 30
(ii) Strengthen relationships between opioid use disorder 31
providers; 32
(iii) Acknowledge and address the challenges presented for 33
individuals needing treatment for multiple substance use disorders 34
simultaneously; and 35
(iv) Study and review effective methods to identify and reach out 36
to individuals with opioid use disorder who are at high risk of 37
overdose and not involved in traditional systems of care, such as 38
homeless individuals using syringe service programs, and connect such 39
individuals to appropriate treatment. 40
p. 35 HB 1427
(b) The authority must work with stakeholders to develop a set of 1
recommendations to the governor and the legislature that:2
(i) Propose, in addition to those required by federal law, a 3
standard set of services needed to support the complex treatment 4
needs of persons with opioid use disorder treated in opioid treatment 5
programs; 6
(ii) Outline the components of and strategies needed to develop 7
opioid treatment program centers of excellence that provide fully 8
integrated care for persons with opioid use disorder;9
(iii) Estimate the costs needed to support these models and 10
recommendations for funding strategies that must be included in the 11
report; 12
(iv) Outline strategies to increase the number of waivered health 13
care providers approved for prescribing buprenorphine by the 14
substance abuse and mental health services administration; and15
(v) Outline strategies to lower the cost of federal food and drug 16
administration approved products for the treatment of opioid use 17
disorder. 18
(7) State agencies shall review and promote positive outcomes 19
associated with the accountable communities of health funded opioid 20
projects and local law enforcement and human services opioid 21
collaborations as set forth in the Washington state interagency 22
opioid working plan. 23
(8) The authority must partner with the department and other 24
state agencies to replicate effective approaches for linking 25
individuals who have had a nonfatal overdose with treatment 26
opportunities, with a goal to connect certified peer counselors or 27
certified peer support specialists with individuals who have had a 28
nonfatal overdose. 29
(9) State agencies must work together to increase outreach and 30
education about opioid overdoses to non-English-speaking communities 31
by developing a plan to conduct outreach and education to non-32
English-speaking communities. The department must submit a report on 33
the outreach and education plan with recommendations for 34
implementation to the appropriate legislative committees by July 1, 35
2020. 36
Sec. 20. RCW 71.24.890 and 2024 c 368 s 4 and 2024 c 364 s 1 are 37
each reenacted and amended to read as follows: 38
p. 36 HB 1427
(1) Establishing the state designated 988 contact hubs and 1
enhancing the crisis response system will require collaborative work 2
between the department, the authority, and regional system partners 3
within their respective roles. The department shall have primary 4
responsibility for designating 988 contact hubs, and shall seek 5
recommendations from the behavioral health administrative services 6
organizations to determine which 988 contact hubs best meet regional 7
needs. The authority shall have primary responsibility for 8
developing, implementing, and facilitating coordination of the crisis 9
response system and services to support the work of the designated 10
988 contact hubs, regional crisis lines, and other coordinated 11
regional behavioral health crisis response system partners. In any 12
instance in which one agency is identified as the lead, the 13
expectation is that agency will communicate and collaborate with the 14
other to ensure seamless, continuous, and effective service delivery 15
within the statewide crisis response system. 16
(2) The department shall provide adequate funding for the state's 17
crisis call centers to meet an expected increase in the use of the 18
988 contact hubs based on the implementation of the 988 crisis 19
hotline. The funding level shall be established at a level 20
anticipated to achieve an in-state call response rate of at least 90 21
percent by July 22, 2022. The funding level shall be determined by 22
considering standards and cost per call predictions provided by the 23
administrator of the national suicide prevention lifeline, call 24
volume predictions, guidance on crisis call center performance 25
metrics, and necessary technology upgrades. Contracts with the 988 26
contact hubs: 27
(a) May provide funding to support designated 988 contact hubs to 28
enter into limited partnerships with the public safety answering 29
point to increase the coordination and transfer of behavioral health 30
calls received by certified public safety telecommunicators that are 31
better addressed by clinic interventions provided by the 988 system. 32
Tax revenue may be used to support partnerships. These partnerships 33
with 988 and public safety may be expanded to include regional crisis 34
lines administered by behavioral health administrative services 35
organizations; 36
(b) Shall require that 988 contact hubs enter into data-sharing 37
agreements, when appropriate, with the department, the authority, 38
regional crisis lines, and applicable regional behavioral health 39
administrative services organizations to provide reports and client 40
p. 37 HB 1427
level data regarding 988 contact hub calls, as allowed by and in 1
compliance with existing federal and state law governing the sharing 2
and use of protected health information. Data-sharing agreements with 3
regional crisis lines must include real-time information sharing. All 4
coordinated regional behavioral health crisis response system 5
partners must share dispatch time, arrival time, and disposition for 6
behavioral health calls referred for outreach by each region 7
consistent with any regional protocols developed under RCW 71.24.432. 8
The department and the authority shall establish requirements for 988 9
contact hubs to report data to regional behavioral health 10
administrative services organizations for the purposes of maximizing 11
medicaid reimbursement, as appropriate, and implementing this chapter 12
and chapters 71.05 and 71.34 RCW. The behavioral health 13
administrative services organization may use information received 14
from the 988 contact hubs in administering crisis services for the 15
assigned regional service area, contracting with a sufficient number 16
of licensed or certified providers for crisis services, establishing 17
and maintaining quality assurance processes, maintaining patient 18
tracking, and developing and implementing strategies to coordinate 19
care for individuals with a history of frequent crisis system 20
utilization. 21
(3) The department shall adopt rules by January 1, 2025, to 22
establish standards for designation of crisis call centers as 23
designated 988 contact hubs. The department shall collaborate with 24
the authority, other agencies, and coordinated regional behavioral 25
health crisis response system partners to assure coordination and 26
availability of services, and shall consider national guidelines for 27
behavioral health crisis care as determined by the federal substance 28
abuse and mental health services administration, national behavioral 29
health accrediting bodies, and national behavioral health provider 30
associations to the extent they are appropriate, and recommendations 31
from behavioral health administrative services organizations and the 32
crisis response improvement strategy committee created in RCW 33
71.24.892. 34
(4) The department shall designate 988 contact hubs considering 35
the recommendations of behavioral health administrative services 36
organizations by January 1, 2026. The designated 988 contact hubs 37
shall provide connections to crisis intervention services, triage, 38
care coordination, and referrals for individuals contacting the 988 39
contact hubs from any jurisdiction within Washington 24 hours a day, 40
p. 38 HB 1427
seven days a week, using the system platform developed under 1
subsection (5) of this section. The department may not designate more 2
than a total of four 988 contact hubs without legislative approval.3
(a) To be designated as a 988 contact hub, the applicant must 4
demonstrate to the department the ability to comply with the 5
requirements of this section and to contract to provide 988 contact 6
hub services. If a 988 contact hub fails to substantially comply with 7
the contract, data-sharing requirements, or approved regional 8
protocols developed under RCW 71.24.432, the department may revoke 9
the designation of the 988 contact hub and, after consulting with the 10
affected behavioral health administrative services organization, may 11
designate a 988 contact hub recommended by a behavioral health 12
administrative services organization which is able to meet necessary 13
state and federal requirements. 14
(b) The contracts entered shall require designated 988 contact 15
hubs to: 16
(i) Have an active agreement with the administrator of the 17
national suicide prevention lifeline for participation within its 18
network; 19
(ii) Meet the requirements for operational and clinical standards 20
established by the department and based upon the national suicide 21
prevention lifeline best practices guidelines and other recognized 22
best practices; 23
(iii) Employ highly qualified, skilled, and trained clinical 24
staff who have sufficient training and resources to provide empathy 25
to callers in acute distress, de-escalate crises, assess behavioral 26
health disorders and suicide risk, triage to system partners for 27
callers that need additional clinical interventions, and provide case 28
management and documentation. Call center staff shall be trained to 29
make every effort to resolve cases in the least restrictive 30
environment and without law enforcement involvement whenever 31
possible. Call center staff shall coordinate with certified peer 32
counselors or certified peer support specialists to provide follow-up 33
and outreach to callers in distress as available. It is intended for 34
transition planning to include a pathway for continued employment and 35
skill advancement as needed for experienced crisis call center 36
employees; 37
(iv) Train employees on agricultural community cultural 38
competencies for suicide prevention, which may include sharing 39
resources with callers that are specific to members from the 40
p. 39 HB 1427
agricultural community. The training must prepare staff to provide 1
appropriate assessments, interventions, and resources to members of 2
the agricultural community. Employees may make warm transfers and 3
referrals to a crisis hotline that specializes in working with 4
members from the agricultural community, provided that no person 5
contacting 988 shall be transferred or referred to another service if 6
they are currently in crisis and in need of emotional support;7
(v) Prominently display 988 crisis hotline information on their 8
websites and social media, including a description of what the caller 9
should expect when contacting the crisis call center and a 10
description of the various options available to the caller, including 11
call lines specialized in the behavioral health needs of veterans, 12
American Indian and Alaska Native persons, Spanish-speaking persons, 13
and LGBTQ populations. The website may also include resources for 14
programs and services related to suicide prevention for the 15
agricultural community; 16
(vi) Collaborate with the authority, the national suicide 17
prevention lifeline, and veterans crisis line networks to assure 18
consistency of public messaging about the 988 crisis hotline;19
(vii) Collaborate with coordinated regional behavioral health 20
crisis response system partners within the 988 contact hub's regional 21
service area to develop protocols under RCW 71.24.432, including 22
protocols related to the dispatching of mobile rapid response crisis 23
teams and community-based crisis teams endorsed under RCW 71.24.903;24
(viii) Provide data and reports and participate in evaluations 25
and related quality improvement activities, according to standards 26
established by the department in collaboration with the authority; 27
and 28
(ix) Enter into data-sharing agreements with the department, the 29
authority, regional crisis lines, and applicable behavioral health 30
administrative services organizations to provide reports and client 31
level data regarding 988 contact hub calls, as allowed by and in 32
compliance with existing federal and state law governing the sharing 33
and use of protected health information, which shall include sharing 34
real-time information with regional crisis lines. The department and 35
the authority shall establish requirements that the designated 988 36
contact hubs report data to regional behavioral health administrative 37
services organizations for the purposes of maximizing medicaid 38
reimbursement, as appropriate, and implementing this chapter and 39
chapters 71.05 and 71.34 RCW including, but not limited to, 40
p. 40 HB 1427
administering crisis services for the assigned regional service area, 1
contracting with a sufficient number of licensed or certified 2
providers for crisis services, establishing and maintaining quality 3
assurance processes, maintaining patient tracking, and developing and 4
implementing strategies to coordinate care for individuals with a 5
history of frequent crisis system utilization. 6
(c) The department and the authority shall incorporate 7
recommendations from the crisis response improvement strategy 8
committee created under RCW 71.24.892 in its agreements with 9
designated 988 contact hubs, as appropriate. 10
(5) The department and authority must coordinate to develop the 11
technology and platforms necessary to manage and operate the 12
behavioral health crisis response and suicide prevention system. The 13
department and the authority must include designated 988 contact 14
hubs, regional crisis lines, and behavioral health administrative 15
services organizations in the decision-making process for selecting 16
any technology platforms that will be used to operate the system. No 17
decisions made by the department or the authority shall interfere 18
with the routing of the 988 contact hubs calls, texts, or chat as 19
part of Washington's active agreement with the administrator of the 20
national suicide prevention lifeline or 988 administrator that routes 21
988 contacts into Washington's system. The technologies developed 22
must include: 23
(a) A new technologically advanced behavioral health and suicide 24
prevention crisis call center system platform for use in 988 contact 25
hubs designated by the department under subsection (4) of this 26
section. This platform, which shall be implemented as soon as 27
possible and fully funded by January 1, 2026, shall be developed by 28
the department and must include the capacity to receive crisis 29
assistance requests through phone calls, texts, chats, and other 30
similar methods of communication that may be developed in the future 31
that promote access to the behavioral health crisis system; and32
(b) A behavioral health integrated client referral system capable 33
of providing system coordination information to designated 988 34
contact hubs and the other entities involved in behavioral health 35
care. This system shall be developed by the authority.36
(6) In developing the new technologies under subsection (5) of 37
this section, the department and the authority must coordinate to 38
designate a primary technology system to provide each of the 39
following: 40
p. 41 HB 1427
(a) Access to real-time information relevant to the coordination 1
of behavioral health crisis response and suicide prevention services, 2
including: 3
(i) Real-time bed availability for all behavioral health bed 4
types and recliner chairs, including but not limited to crisis 5
stabilization services, 23-hour crisis relief centers, psychiatric 6
inpatient, substance use disorder inpatient, withdrawal management, 7
peer-run respite centers, and crisis respite services, inclusive of 8
both voluntary and involuntary beds, for use by crisis response 9
workers, first responders, health care providers, emergency 10
departments, and individuals in crisis; and 11
(ii) Real-time information relevant to the coordination of 12
behavioral health crisis response and suicide prevention services for 13
a person, including the means to access: 14
(A) Information about any less restrictive alternative treatment 15
orders or mental health advance directives related to the person; and16
(B) Information necessary to enable the designated 988 contact 17
hubs to actively collaborate with regional crisis lines, emergency 18
departments, primary care providers and behavioral health providers 19
within managed care organizations, behavioral health administrative 20
services organizations, and other health care payers to establish a 21
safety plan for the person in accordance with best practices and 22
provide the next steps for the person's transition to follow-up 23
noncrisis care. To establish information-sharing guidelines that 24
fulfill the intent of this section the authority shall consider input 25
from the confidential information compliance and coordination 26
subcommittee established under RCW 71.24.892; 27
(b) The means to track the outcome of the 988 call to enable 28
appropriate follow-up, cross-system coordination, and accountability, 29
including as appropriate: (i) Any immediate services dispatched and 30
reports generated from the encounter; (ii) the validation of a safety 31
plan established for the caller in accordance with best practices; 32
(iii) the next steps for the caller to follow in transition to 33
noncrisis follow-up care, including a next-day appointment for 34
callers experiencing urgent, symptomatic behavioral health care 35
needs; and (iv) the means to verify and document whether the caller 36
was successful in making the transition to appropriate noncrisis 37
follow-up care indicated in the safety plan for the person, to be 38
completed either by the care coordinator provided through the 39
person's managed care organization, health plan, or behavioral health 40
p. 42 HB 1427
administrative services organization, or if such a care coordinator 1
is not available or does not follow through, by the staff of the 2
designated 988 contact hub; 3
(c) A means to facilitate actions to verify and document whether 4
the person's transition to follow-up noncrisis care was completed and 5
services offered, to be performed by a care coordinator provided 6
through the person's managed care organization, health plan, or 7
behavioral health administrative services organization, or if such a 8
care coordinator is not available or does not follow through, by the 9
staff of the designated 988 contact hub; 10
(d) The means to provide geographically, culturally, and 11
linguistically appropriate services to persons who are part of high-12
risk populations or otherwise have need of specialized services or 13
accommodations, and to document these services or accommodations; and14
(e) When appropriate, consultation with tribal governments to 15
ensure coordinated care in government-to-government relationships, 16
and access to dedicated services to tribal members.17
(7) The authority shall: 18
(a) Collaborate with county authorities and behavioral health 19
administrative services organizations to develop procedures to 20
dispatch behavioral health crisis services in coordination with 21
designated 988 contact hubs to effectuate the intent of this section;22
(b) Establish formal agreements with managed care organizations 23
and behavioral health administrative services organizations by 24
January 1, 2023, to provide for the services, capacities, and 25
coordination necessary to effectuate the intent of this section, 26
which shall include a requirement to arrange next-day appointments 27
for persons contacting the 988 contact hub or a regional crisis line 28
experiencing urgent, symptomatic behavioral health care needs with 29
geographically, culturally, and linguistically appropriate primary 30
care or behavioral health providers within the person's provider 31
network, or, if uninsured, through the person's behavioral health 32
administrative services organization; 33
(c) Create best practices guidelines by July 1, 2023, for 34
deployment of appropriate and available crisis response services by 35
behavioral health administrative services organizations in 36
coordination with designated 988 contact hubs to assist 988 hotline 37
callers to minimize nonessential reliance on emergency room services 38
and the use of law enforcement, considering input from relevant 39
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stakeholders and recommendations made by the crisis response 1
improvement strategy committee created under RCW 71.24.892;2
(d) Develop procedures to allow appropriate information sharing 3
and communication between and across crisis and emergency response 4
systems for the purpose of real-time crisis care coordination 5
including, but not limited to, deployment of crisis and outgoing 6
services, follow-up care, and linked, flexible services specific to 7
crisis response; and 8
(e) Establish guidelines to appropriately serve high-risk 9
populations who request crisis services. The authority shall design 10
these guidelines to promote behavioral health equity for all 11
populations with attention to circumstances of race, ethnicity, 12
gender, socioeconomic status, sexual orientation, and geographic 13
location, and include components such as training requirements for 14
call response workers, policies for transferring such callers to an 15
appropriate specialized center or subnetwork within or external to 16
the national suicide prevention lifeline network, and procedures for 17
referring persons who access the 988 contact hubs to linguistically 18
and culturally competent care. 19
(8) The department shall monitor trends in 988 crisis hotline 20
caller data, as reported by designated 988 contact hubs under 21
subsection (4)(b)(ix) of this section, and submit an annual report to 22
the governor and the appropriate committees of the legislature 23
summarizing the data and trends beginning December 1, 2027.24
(9) Subject to authorization by the national 988 administrator 25
and the availability of amounts appropriated for this specific 26
purpose, any Washington state subnetwork of the 988 crisis hotline 27
dedicated to the crisis assistance needs of American Indian and 28
Alaska Native persons shall offer services by text, chat, and other 29
similar methods of communication to the same extent as does the 30
general 988 crisis hotline. The department shall coordinate with the 31
substance abuse and mental health services administration for the 32
authorization. 33
Sec. 21. RCW 71.24.903 and 2023 c 454 s 9 are each amended to 34
read as follows: 35
(1) By April 1, 2024, the authority shall establish standards for 36
issuing an endorsement to any mobile rapid response crisis team or 37
community-based crisis team that meets the criteria under either 38
subsection (2) or (3) of this section, as applicable. The endorsement 39
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is a voluntary credential that a mobile rapid response crisis team or 1
community-based crisis team may obtain to signify that it maintains 2
the capacity to respond to persons who are experiencing a significant 3
behavioral health emergency requiring an urgent, in-person response. 4
The attainment of an endorsement allows the mobile rapid response 5
crisis team or community-based crisis team to become eligible for 6
performance payments as provided in subsection (10) of this section.7
(2) The authority's standards for issuing an endorsement to a 8
mobile rapid response crisis team or a community-based crisis team 9
must consider: 10
(a) Minimum staffing requirements to effectively respond in-11
person to individuals experiencing a significant behavioral health 12
emergency. Except as provided in subsection (3) of this section, the 13
team must include appropriately credentialed and supervised staff 14
employed by a licensed or certified behavioral health agency and may 15
include other personnel from participating entities listed in 16
subsection (3) of this section. The team shall include certified peer 17
counselors or certified peer support specialists as a best practice 18
to the extent practicable based on workforce availability. The team 19
may include fire departments, emergency medical services, public 20
health, medical facilities, nonprofit organizations, and city or 21
county governments. The team may not include law enforcement 22
personnel; 23
(b) Capabilities for transporting an individual experiencing a 24
significant behavioral health emergency to a location providing 25
appropriate level crisis stabilization services, as determined by 26
regional transportation procedures, such as crisis receiving centers, 27
crisis stabilization units, and triage facilities. The standards must 28
include vehicle and equipment requirements, including minimum 29
requirements for vehicles and equipment to be able to safely 30
transport the individual, as well as communication equipment 31
standards. The vehicle standards must allow for an ambulance or aid 32
vehicle licensed under chapter 18.73 RCW to be deemed to meet the 33
standards; and 34
(c) Standards for the initial and ongoing training of personnel 35
and for providing clinical supervision to personnel.36
(3) The authority must adjust the standards for issuing an 37
endorsement to a community-based crisis team under subsection (2) of 38
this section if the team is comprised solely of an emergency medical 39
services agency, whether it is part of a fire service agency or a 40
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private entity, that is located in a rural county in eastern 1
Washington with a population of less than 60,000 residents. Under the 2
adjusted standards, until January 1, 2030, the authority shall exempt 3
a team from the personnel standards under subsection (2)(a) of this 4
section and issue an endorsement to a team if: 5
(a) The personnel assigned to the team have met training 6
requirements established by the authority under subsection (2)(c) of 7
this section, as those requirements apply to emergency medical 8
service and fire service personnel, including completion of the 9
three-hour training in suicide assessment, treatment, and management 10
under RCW 43.70.442; 11
(b) The team operates under a memorandum of understanding with a 12
licensed or certified behavioral health agency to provide direct, 13
real-time consultation through a behavioral health provider employed 14
by a licensed or certified behavioral health agency while the team is 15
responding to a call. The consultation may be provided by telephone, 16
through remote technologies, or, if circumstances allow, in person; 17
and 18
(c) The team does not include law enforcement personnel.19
(4) Prior to issuing an initial endorsement or renewing an 20
endorsement, the authority shall conduct an on-site survey of the 21
applicant's operation. 22
(5) An endorsement must be renewed every three years.23
(6) The authority shall establish forms and procedures for 24
issuing and renewing an endorsement. 25
(7) The authority shall establish procedures for the denial, 26
suspension, or revocation of an endorsement. 27
(8)(a) The decision of a mobile rapid response crisis team or 28
community-based crisis team to seek endorsement is voluntary and does 29
not prohibit a nonendorsed team from participating in the crisis 30
response system when (i) responding to individuals who are not 31
experiencing a significant behavioral health emergency that requires 32
an urgent in-person response or (ii) responding to individuals who 33
are experiencing a significant behavioral health emergency that 34
requires an urgent in-person response when there is not an endorsed 35
team available. 36
(b) The decision of a mobile rapid response crisis team not to 37
pursue an endorsement under this section does not affect its 38
obligation to comply with any standards adopted by the authority with 39
respect to mobile rapid response crisis teams. 40
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(c) The decision of a mobile rapid response crisis team not to 1
pursue an endorsement under this section does not affect its 2
responsibilities and reimbursement for services as they may be 3
defined in contracts with managed care organizations or behavioral 4
health administrative services organizations. 5
(9) The costs associated with endorsement activities shall be 6
supported with funding from the statewide 988 behavioral health 7
crisis response and suicide prevention line account established in 8
RCW 82.86.050. 9
(10) The authority shall establish an endorsed mobile rapid 10
response crisis team and community-based crisis team performance 11
program with receipts from the statewide 988 behavioral health crisis 12
response and suicide prevention line account. 13
(a) Subject to funding provided for this specific purpose, the 14
performance program shall: 15
(i) Issue establishment grants to support mobile rapid response 16
crisis teams and community-based crisis teams seeking to meet the 17
elements necessary to become endorsed under either subsection (2) or 18
(3) of this section; 19
(ii) Issue performance payments in the form of an enhanced case 20
rate to mobile rapid response crisis teams and community-based crisis 21
teams that have received an endorsement from the authority under 22
either subsection (2) or (3) of this section; and 23
(iii) Issue supplemental performance payments in the form of an 24
enhanced case rate higher than that available in (a)(ii) of this 25
subsection (10) to mobile rapid response crisis teams and community-26
based crisis teams that have received an endorsement from the 27
authority under either subsection (2) or (3) of this section and 28
demonstrate to the authority that for the previous three months they 29
met the following response time and in route time standards:30
(A) Between January 1, 2025, through December 31, 2026:31
(I) Arrive to the individual's location within 30 minutes of 32
being dispatched by the designated 988 contact hub, at least 80 33
percent of the time in urban areas; 34
(II) Arrive to the individual's location within 40 minutes of 35
being dispatched by the designated 988 contact hub, at least 80 36
percent of the time in suburban areas; and 37
(III) Be in route within 15 minutes of being dispatched by the 38
designated 988 contact hub, at least 80 percent of the time in rural 39
areas; and 40
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(B) On and after January 1, 2027: 1
(I) Arrive to the individual's location within 20 minutes of 2
being dispatched by the designated 988 contact hub, at least 80 3
percent of the time in urban areas; 4
(II) Arrive to the individual's location within 30 minutes of 5
being dispatched by the designated 988 contact hub, at least 80 6
percent of the time in suburban areas; and 7
(III) Be in route within 10 minutes of being dispatched by the 8
designated 988 contact hub, at least 80 percent of the time in rural 9
areas. 10
(b) The authority shall design the program in a manner that 11
maximizes the state's ability to receive federal matching funds.12
(11) The authority shall contract with the actuaries responsible 13
for development of medicaid managed care rates to conduct an analysis 14
and develop options for payment mechanisms and levels for rate 15
enhancements under subsection (10) of this section. The authority 16
shall consult with staff from the office of financial management and 17
the fiscal committees of the legislature in conducting this analysis. 18
The payment mechanisms must be developed to maximize leverage of 19
allowable federal medicaid match. The analysis must clearly identify 20
assumptions, include cost projections for the rate level options 21
broken out by fund source, and summarize data used for the cost 22
analysis. The cost projections must be based on Washington state 23
specific utilization and cost data. The analysis must identify low, 24
medium, and high ranges of projected costs associated for each option 25
accounting for varying scenarios regarding the numbers of teams 26
estimated to qualify for the enhanced case rates and supplemental 27
performance payments. The analysis must identify costs for both 28
medicaid clients, and for state-funded nonmedicaid clients paid 29
through contracts with behavioral health administrative services 30
organizations. The analysis must account for phasing in of the number 31
of teams that meet endorsement criteria over time and project annual 32
costs for a four-year period associated with each of the scenarios. 33
The authority shall submit a report summarizing the analysis, payment 34
mechanism options, enhanced performance payment and supplemental 35
performance payment rate level options, and related cost estimates to 36
the office of financial management and the appropriate committees of 37
the legislature by December 1, 2023. 38
(12) The authority shall conduct a review of the endorsed 39
community-based crisis teams established under subsection (3) of this 40
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section and report to the governor and the health policy committees 1
of the legislature by December 1, 2028. The report shall provide 2
information about the engagement of the community-based crisis teams 3
receiving an endorsement under subsection (3) of this section and 4
their ability to provide a timely and appropriate response to persons 5
experiencing a behavioral health crisis and any recommended changes 6
to the teams to better meet the needs of the community including 7
personnel requirements, training standards, and behavioral health 8
provider consultation. 9
Sec. 22. RCW 71.24.920 and 2023 c 469 s 13 are each amended to 10
read as follows: 11
(1)(a) By January 1, 2025, the authority must develop a course of 12
instruction to become a certified peer support specialist under 13
chapter 18.420 RCW. The course must be approximately 80 hours in 14
duration and based upon the curriculum offered by the authority in 15
its peer counselor training as of July 23, 2023, as well as 16
additional instruction in the principles of recovery coaching and 17
suicide prevention. The authority shall establish a peer engagement 18
process to receive suggestions regarding subjects to be covered in 19
the 80-hour curriculum beyond those addressed in the peer counselor 20
training curriculum and recovery coaching and suicide prevention 21
curricula, including the cultural appropriateness of the 80-hour 22
training. The education course must be taught by certified peer 23
support specialists. The education course must be offered by the 24
authority with sufficient frequency to accommodate the demand for 25
training and the needs of the workforce. The authority must establish 26
multiple configurations for offering the education course, including 27
offering the course as an uninterrupted course with longer class 28
hours held on consecutive days for students seeking accelerated 29
completion of the course and as an extended course with reduced daily 30
class hours, possibly with multiple days between classes, to 31
accommodate students with other commitments. Upon completion of the 32
education course, the student must pass an oral examination 33
administered by the course trainer. 34
(b) The authority shall develop an expedited course of 35
instruction that consists of only those portions of the curriculum 36
required under (a) of this subsection that exceed the authority's 37
certified peer counselor training curriculum as it exists on July 23, 38
2023. The expedited training shall focus on assisting persons who 39
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completed the authority's certified peer counselor training as it 1
exists on July 23, 2023, to meet the education requirements for 2
certification under RCW 18.420.050. 3
(2) By January 1, 2025, the authority must develop a training 4
course for certified peer support specialists providing supervision 5
to certified peer support specialist trainees under RCW 18.420.060.6
(3)(a) By July 1, 2025, the authority shall offer a 40-hour 7
specialized training course in peer crisis response services for 8
individuals employed as peers who work with individuals who may be 9
experiencing a behavioral health crisis. When offering the training 10
course, priority for enrollment must be given to certified peer 11
support specialists employed in a crisis-related setting, including 12
entities identified in (b) of this subsection. The training shall 13
incorporate best practices for responding to 988 behavioral health 14
crisis line calls, as well as processes for co-response with law 15
enforcement when necessary. 16
(b) Beginning July 1, 2025, any entity that uses certified peer 17
support specialists as peer crisis responders, may only use certified 18
peer support specialists who have completed the training course 19
established by (a) of this subsection. A behavioral health agency 20
that uses certified peer support specialists to work as peer crisis 21
responders must maintain the records of the completion of the 22
training course for those certified peer support specialists who 23
provide these services and make the records available to the state 24
agency for auditing or certification purposes. 25
(4) By July 1, 2025, the authority shall offer a course designed 26
to inform licensed or certified behavioral health agencies of the 27
benefits of incorporating certified peer support specialists and 28
certified peer support specialist trainees into their clinical staff 29
and best practices for incorporating their services. The authority 30
shall encourage entities that hire certified peer support specialists 31
and certified peer support specialist trainees, including licensed or 32
certified behavioral health agencies, hospitals, primary care 33
offices, and other entities, to have appropriate staff attend the 34
training by making it available in multiple formats.35
(5) The authority shall: 36
(a) Hire clerical, administrative, investigative, and other staff 37
as needed to implement this section to serve as examiners for any 38
practical oral or written examination and assure that the examiners 39
are trained to administer examinations in a culturally appropriate 40
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manner and represent the diversity of applicants being tested. The 1
authority shall adopt procedures to allow for appropriate 2
accommodations for persons with a learning disability, other 3
disabilities, and other needs and assure that staff involved in the 4
administration of examinations are trained on those procedures;5
(b) Develop oral and written examinations required under this 6
section. The initial examinations shall be adapted from those used by 7
the authority as of July 23, 2023 ((, and modified pursuant to input 8
and comments from the Washington state peer specialist advisory 9
committee)). The authority shall assure that the examinations are 10
culturally appropriate; 11
(c) Prepare, grade, and administer, or supervise the grading and 12
administration of written examinations for obtaining a certificate;13
(d) Approve entities to provide the educational courses required 14
by this section and approve entities to prepare, grade, and 15
administer written examinations for the educational courses required 16
by this section ((. In establishing approval criteria, the authority 17
shall consider the recommendations of the Washington state peer 18
specialist advisory committee)); 19
(e) Develop examination preparation materials and make them 20
available to students enrolled in the courses established under this 21
section in multiple formats, including specialized examination 22
preparation support for students with higher barriers to passing the 23
written examination; and 24
(f) ((The authority shall administer )) Administer, through 25
contract, a program to link eligible persons in recovery from 26
behavioral health challenges who are seeking employment as peers with 27
employers seeking to hire peers, including certified peer support 28
specialists. The authority must contract for this program with an 29
organization that provides peer workforce development, peer coaching, 30
and other peer supportive services. The contract must require the 31
organization to create and maintain a statewide database which is 32
easily accessible to eligible persons in recovery who are seeking 33
employment as peers and potential employers seeking to hire peers, 34
including certified peer support specialists. The program must be 35
fully implemented by July 1, 2024. 36
(6) For the purposes of this section, the term "peer crisis 37
responder" means a peer support specialist certified under chapter 38
18.420 RCW who has completed the training under subsection (3) of 39
this section whose job involves responding to behavioral health 40
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emergencies, including those dispatched through a 988 crisis hotline 1
or the 911 system. 2
Sec. 23. RCW 71.24.922 and 2023 c 469 s 14 are each amended to 3
read as follows: 4
Behavioral health agencies must reduce the caseload for approved 5
supervisors who are providing supervision to certified peer support 6
specialist trainees seeking certification under chapter 18.420 RCW((, 7
in accordance with standards established by the Washington state 8
certified peer specialist advisory committee)). 9
Sec. 24. RCW 71.24.924 and 2023 c 469 s 15 are each amended to 10
read as follows: 11
(1) Beginning January 1, 2027, a person who engages in the 12
practice of peer support services and who bills a health carrier or 13
medical assistance or whose employer bills a health carrier or 14
medical assistance for those services must hold an active credential 15
as a certified peer support specialist or certified peer support 16
specialist trainee under chapter 18.420 RCW. 17
(2) A person who is registered as an agency affiliated counselor 18
under chapter 18.19 RCW who engages in the practice of peer support 19
services and whose agency, as defined in RCW 18.19.020, bills medical 20
assistance for those services must hold a certificate as a certified 21
peer support specialist or certified peer support specialist trainee 22
under chapter 18.420 RCW no later than January 1, 2027.23
Sec. 25. RCW 71.40.040 and 2022 c 134 s 4 are each amended to 24
read as follows: 25
The state office of behavioral health consumer advocacy shall 26
assure performance of the following activities, as authorized in 27
contract: 28
(1) Selection of a name for the contracting advocacy organization 29
to use for the advocacy program that it operates pursuant to contract 30
with the office. The name must be selected by the statewide advisory 31
council established in this section and must be separate and 32
distinguishable from that of the office; 33
(2) Certification of behavioral health consumer advocates by 34
October 1, 2022, and coordination of the activities of the behavioral 35
health consumer advocates throughout the state according to standards 36
adopted by the office; 37
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(3) Provision of training regarding appropriate access by 1
behavioral health consumer advocates to behavioral health providers 2
or facilities according to standards adopted by the office;3
(4) Establishment of a toll-free telephone number, website, and 4
other appropriate technology to facilitate access to contracting 5
advocacy organization services for patients, residents, and clients 6
of behavioral health providers or facilities; 7
(5) Establishment of a statewide uniform reporting system to 8
collect and analyze data relating to complaints and conditions 9
provided by behavioral health providers or facilities for the purpose 10
of identifying and resolving significant problems, with permission to 11
submit the data to all appropriate state agencies on a regular basis;12
(6) Establishment of procedures consistent with the standards 13
adopted by the office to protect the confidentiality of the office's 14
records, including the records of patients, residents, clients, 15
providers, and complainants; 16
(7) Establishment of a statewide advisory council, a majority of 17
which must be composed of people with lived experience, that shall 18
include: 19
(a) Individuals with a history of mental illness including one or 20
more members from the black community, the indigenous community, or a 21
community of color; 22
(b) Individuals with a history of substance use disorder 23
including one or more members from the black community, the 24
indigenous community, or a community of color; 25
(c) Family members of individuals with behavioral health needs 26
including one or more members from the black community, the 27
indigenous community, or a community of color; 28
(d) One or more representatives of an organization representing 29
consumers of behavioral health services; 30
(e) Representatives of behavioral health providers and 31
facilities, including representatives of facilities offering 32
inpatient and residential behavioral health services;33
(f) One or more certified peer support specialists;34
(g) One or more medical clinicians serving individuals with 35
behavioral health needs; 36
(h) One or more nonmedical providers serving individuals with 37
behavioral health needs; 38
(i) One representative from a behavioral health administrative 39
services organization; 40
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(j) Two parents or caregivers of a child who received behavioral 1
health services, including one parent or caregiver of a child who 2
received complex, multisystem behavioral health services, one parent 3
or caregiver of a child ages one through 12, or one parent or 4
caregiver of a child ages 13 through 17; 5
(k) Two representatives of medicaid managed care organizations, 6
one of which must provide managed care to children and youth 7
receiving child welfare services; 8
(l) Other community representatives, as determined by the office; 9
and 10
(m) One representative from a labor union representing workers 11
who work in settings serving individuals with behavioral health 12
conditions; 13
(8) Monitoring the development of and recommend improvements in 14
the implementation of federal, state, and local laws, rules, 15
regulations, and policies with respect to the provision of behavioral 16
health services in the state and advocate for consumers;17
(9) Development and delivery of educational programs and 18
information statewide to patients, residents, and clients of 19
behavioral health providers or facilities, and their families on 20
topics including, but not limited to, the execution of mental health 21
advance directives, wellness recovery action plans, crisis services 22
and contacts, peer services and supports, family advocacy and rights, 23
family-initiated treatment and other behavioral health service 24
options for minors, and involuntary treatment; and25
(10) Reporting to the office, the legislature, and all 26
appropriate public agencies regarding the quality of services, 27
complaints, problems for individuals receiving services from 28
behavioral health providers or facilities, and any recommendations 29
for improved services for behavioral health consumers.30
Sec. 26. RCW 71.40.090 and 2022 c 134 s 5 are each amended to 31
read as follows: 32
The contracting advocacy organization shall develop and submit, 33
for approval by the office, a process to train and certify all 34
behavioral health consumer advocates, whether paid or volunteer, 35
authorized by this chapter as follows: 36
(1) Certified behavioral health consumer advocates must have 37
training or experience in the following areas: 38
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(a) Behavioral health and other related social services programs, 1
including behavioral health services for minors; 2
(b) The legal system, including differences in state or federal 3
law between voluntary and involuntary patients, residents, or 4
clients; 5
(c) Advocacy and supporting self-advocacy; 6
(d) Dispute or problem resolution techniques, including 7
investigation, mediation, and negotiation; and 8
(e) All applicable patient, resident, and client rights 9
established by either state or federal law. 10
(2) A certified behavioral health consumer advocate may not have 11
been employed by any behavioral health provider or facility within 12
the previous twelve months, except as a certified peer support 13
specialist or where prior to July 25, 2021, the person has been 14
employed by a regional behavioral health consumer advocate.15
(3) No certified behavioral health consumer advocate or any 16
member of a certified behavioral health consumer advocate's family 17
may have, or have had, within the previous twelve months, any 18
significant ownership or financial interest in the provision of 19
behavioral health services. 20
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