"NEW SECTION.  Sec. 1   (1) The legislature finds that the state of Washington has an opportunity to transform its health care delivery system.
     (2) The state health care innovation plan establishes the following primary drivers of health transformation, each with individual key actions that are necessary to achieve the objective:
     (a) Improve health overall by stressing prevention and early detection of disease and integration of behavioral health;
     (b) Developing linkages between the health care delivery system and community; and
     (c) Supporting regional collaboratives for communities and populations, improve health care quality, and lower costs.

NEW SECTION.  Sec. 2   (1) The health care authority is responsible for coordination, implementation, and administration of interagency efforts and local collaborations of public and private organizations to implement the state health care innovation plan.
     (2) Prior to the authority submitting a grant application for innovation plan funding, the authority must consult a neutral actuarial firm not currently contracted with the agency to review the estimated savings with the innovation plan prior to application submission. The plan and the actuarial information must be presented to the joint select committee on health care oversight, including the scope and details of the grant application and any request for proposal, prior to an application submission. The joint committee must approve the application prior to submission.
     (3) The grant application cannot commit the state to any financial
obligations beyond the actual grant award amount.
     (4) In the event a grant is awarded, the agency must come before the joint committee and seek approval for the implementation of the plan included in the grant application. The agency must provide quarterly updates and status reports on the implementation effort to the joint committee.
     (5) All required federal reporting related to a grant award must be shared with the joint committee at the same time it is submitted to the federal government.
     (6) By January 1, 2015, and January 1st of each year through January 1, 2019, the health care authority shall coordinate and submit a status report to the appropriate committees of the legislature regarding implementation of the innovation plan. The report must summarize any actions taken to implement the innovation plan, progress toward achieving the aims of the innovation plan, and anticipated future implementation efforts. In addition, the health care authority shall submit any recommendations for legislation necessary to implement the innovation plan.

NEW SECTION.  Sec. 3   (1) The joint select committee on health care oversight is established in statute, continuing the committee created in Engrossed Substitute Senate Concurrent Resolution No. 8401 passed in 2013.
     (2) The membership of the joint select committee on health care oversight must consist of the following: (a) The chairs of the health care committees of the senate and the house of representatives, who must serve as cochairs; (b) four additional members of the senate, two each appointed by the leadership of the two largest political parties in the senate; and (c) four additional members of the house of representatives, two each appointed by the leadership of the two largest political parties in the house of representatives. The governor must be invited to appoint, as a liaison to the joint select committee, a person who must be a nonvoting member.
     (3) The joint select committee on health care oversight must provide oversight between the health care authority, health benefit exchange, the office of the insurance commissioner, the department of health, and the department of social and health services. The goal must be to ensure that these entities are not duplicating their efforts and are working toward a goal of increased quality of services which will lead to reduced costs to the health care consumer.
     (4) The joint select committee on health care oversight must, as necessary, propose legislation to the health care committees and budget recommendations to the ways and means committees of the legislature that aids in their coordination of activities and that leads to better quality and cost savings.
     (5) The joint select committee on health care oversight expires on December 31, 2022.

NEW SECTION.  Sec. 4   A new section is added to chapter 41.05 RCW to read as follows:
     (1) A community of health is a regionally based, voluntary collaborative. The purpose of the collaborative is to align actions to achieve healthy communities and populations, improve health care quality, and lower costs. "Communities of health" is a term used to recognize entities that are currently active and those that may become active that perform the functions described in this section. This term is used only to assist in directing funding or other support that may be available to these local entities. The designation of an entity as a community of health is not intended to create an additional government entity.
     (2) By September 1, 2014, the authority shall establish boundaries for up to nine regions for accountable collaboratives for health as provided in this subsection. Counties, through the Washington state association of counties, must be given the opportunity to propose the boundaries of the regions. The boundaries must be based on county borders and must be consistent with medicaid procurement regions.
     (3) The authority shall develop a process for designating an entity as a community of health. An entity seeking designation is eligible if:
     (a) It is a nonprofit or public-private partnership;
     (b) Its membership is broad and incorporates key stakeholders, such as the long-term care system, the health care delivery system, behavioral health, social supports and services, primary care and specialty providers, hospitals, consumers, small and large employers, health plans, and public health, with no single entity or organizational cohort serving in a majority capacity; and
     (c) It demonstrates an ongoing capacity to:
     (i) Lead health improvement activities within the region with other local systems to improve health outcomes and the overall health of the community, improve health care quality, and lower costs; and
     (ii) Distribute tools and resources from the health extension program created in section 7 of this act.
     (4) The authority may designate more than one community of health in any region that consists of more than one county, but the community of health may not cross the regional boundaries defined by the authority or overlap with another community of health.
     (5) An entity designated by the authority as a community of health must convene key stakeholders to:
     (a) Review existing data, including data collected through the community health assessment process;
     (b) Assess the region's capacity to address chronic care needs;
     (c) Review available funding and resources; and
     (d) Identify and prioritize or reaffirm regional health care needs and prevention strategies and develop a plan or use an existing plan to address those needs.
     (6) For purposes of this section and section 5 of this act, the authority may only adopt rules that are necessary to implement this section and section 5 of this act.

NEW SECTION.  Sec. 5   A new section is added to chapter 41.05 RCW to read as follows:
     (1) The authority shall, subject to the availability of amounts appropriated or grants received for this specific purpose, award grants to support the development of a community of health. Grants may only be used for start-up costs.
     (2) An entity may be eligible for a grant under this section once designated in section 4 of this act. A grant application must, at a minimum:
     (a) Identify the geographic region served by the applicant;
     (b) Demonstrate how the applicant's structure and operation; and
     (c) Indicate the size of the grant being requested and describe how the money will be spent.
     (3) In awarding grants under this section, the authority shall consider the extent to which the applicant will:
     (a) Base decisions on public input and an active collaboration among key community partners, including, but not limited to, local governments, housing providers, school districts, early learning regional coalitions, large and small businesses, labor organizations, health and human service organizations, tribal governments, health carriers, providers, hospitals, public health agencies, and consumers;
     (b) Match the grant funding with funds from other sources; and
     (c) Demonstrate capability for sustainability without reliance on state general fund appropriations.
     (4) The authority may prioritize applications that commit to providing at least one dollar in matching funds for each grant dollar awarded.
     (5) Before grant funds are disbursed, the authority and the applicant must agree on performance requirements.

NEW SECTION.  Sec. 6   A new section is added to chapter 41.05 RCW to read as follows:
     Any entity designated as a community of health pursuant to sections 4 and 5 of this act shall submit a report to the appropriate committees of the legislature and the authority beginning December 1, 2015, and December 1st of each year through December 1, 2019. The report must:
     (1) Describe the regional health care needs identified by the entity and key stakeholders including the plan to address needs, actions taken by the plan, and any measurable progress toward meeting those needs;
     (2) Identify any grant funds received by the entity pursuant to section 5 of this act; and
     (3) For the final report, demonstrate the entity's capability for sustainability without reliance on state general fund appropriations.

NEW SECTION.  Sec. 7   A new section is added to chapter 43.70 RCW to read as follows:
     (1) Subject to the availability of amounts appropriated for this specific purpose, the department shall establish a health extension program to provide training, tools, and technical assistance to primary care, behavioral health, and other providers. The program must emphasize high quality preventive, chronic disease, and behavioral health care that is comprehensive and evidence-based.
     (2) The health extension program must coordinate dissemination of evidence-based tools and resources that promote:
     (a) Integration of physical and behavioral health;
     (b) Clinical decision support to promote evidence-based care;
     (c) Methods of formal assessment;
     (d) Support for patients managing their own conditions; and
     (e) Identification and use of resources that are available in the community for patients and their families, including community health workers.
     (3) The department may adopt rules necessary to implement this section, but may not adopt rules, policies, or procedures beyond the scope of authority granted in this section.

NEW SECTION.  Sec. 8   A new section is added to chapter 74.09 RCW to read as follows:
     (1) The authority and the department shall restructure medicaid procurement of health care services and agreements with managed care systems on a phased basis to better support integrated physical health, mental health, and chemical dependency treatment. By January 1, 2019, medicaid services provided under this chapter and chapters 71.24, 71.36, and 70.96A RCW may be fully integrated in a managed health care system that provides mental health, chemical dependency, and medical care services to medicaid clients. The authority and the department may develop and utilize innovative mechanisms to promote and sustain integrated clinical models of physical and behavioral health care.
     (2) The authority and the department may incorporate the following principles into future medicaid procurement efforts aimed at integrating the delivery of physical and behavioral health services:
     (a) Medicaid purchasing must support delivery of integrated, person-centered care that addresses the spectrum of individuals' health needs in the context of the communities in which they live and with the availability of care continuity as their health needs change;
     (b) Accountability for the client outcomes established in RCW 43.20A.895 and 71.36.025 and performance measures linked to those outcomes;     
     (c) Medicaid benefit design must recognize that adequate preventive care, crisis intervention, and support services promote a recovery-focused approach;
     (d) Evidence-based care interventions and continuous quality improvement must be enforced through contract specifications and performance measures that provide meaningful integration at the patient care level with broadly distributed accountability for results;
     (e) Active purchasing and oversight of medicaid managed care contracts is a state responsibility;
     (f) A deliberate and flexible system change plan with identified benchmarks to promote system stability, provide continuity of treatment for patients, and protect essential existing behavioral health system infrastructure and capacity; and
     (g) Community and organizational readiness are key determinants of implementation timing; a phased approach is therefore desirable.
     (3) The principles identified in subsection (2) of this section are not intended to create an individual entitlement to services.

NEW SECTION.  Sec. 9   Section 3 of this act constitutes a new chapter in Title 44 RCW.

NEW SECTION.  Sec. 10   Sections 4 through 6 of this act expire July 1, 2020."