S-4054.1

SUBSTITUTE SENATE BILL 5894

State of Washington
67th Legislature
2022 Regular Session
BySenate Behavioral Health Subcommittee to Health & Long Term Care (originally sponsored by Senators Frockt, Conway, Hasegawa, Nguyen, Nobles, Robinson, and C. Wilson)
READ FIRST TIME 01/31/22.
AN ACT Relating to integrating means for payment of community health workers into primary care; adding new sections to chapter 41.05 RCW; and creating new sections.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION.  Sec. 1. The legislature finds that in 2021, over 44 percent of middle school students and 57 percent of high school students reported feeling depressed most days. One in five mothers suffer from mood disorders after birth while only 16 percent receive treatment. Meanwhile, 78 percent of primary care doctors who refer kids for behavioral health care receive no further information or coordination after the referral. The unique relationship between pediatric primary care providers and their patients makes primary care well-positioned for investment in services and supports by community health workers. These workers drive connectivity to other parts of the delivery system, address social determinants of health, and lower the total cost of care while freeing up licensed health care professionals to practice at the top of their scope of license, improving patient outcomes.
NEW SECTION.  Sec. 2. A new section is added to chapter 41.05 RCW to read as follows:
Subject to the availability of amounts appropriated for this specific purpose, by January 1, 2023, the authority shall establish a pediatric community health worker program for reimbursement of services to patients up to age 18 provided by community health workers in primary care clinics whose patients are significantly comprised of pediatric patients enrolled in medical assistance under chapter 74.09 RCW. Community health workers funded under this section may provide outreach, informal counseling, and social supports for health-related social needs.
NEW SECTION.  Sec. 3. A new section is added to chapter 41.05 RCW to read as follows:
(1) The authority shall work with stakeholders to develop a multipayer primary care transformation model to improve access to and quality of services covered by medicaid, public employees' benefits board, and school employees' benefits board programs and begin phasing in value-based payment and accountability for primary care clinics starting January 1, 2023.
(2) The multipayer primary care transformation model shall, among other components, explore sustainable reimbursement options for integration of community health workers in primary care to address the health-related social needs of families.
NEW SECTION.  Sec. 4. The department of health shall contract with an organization that represents pediatric primary care needs in Washington state to convene community-based organizations dedicated to children's mental health in order to establish and implement an equity-focused curriculum by January 1, 2023, with the goal to prepare community health workers to meet the unique needs of children, adolescents, and their families.
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