SENATE BILL REPORT

SB 5947

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Majority Report: That Substitute Senate Bill No. 5947 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

Signed by Senators Becker, Chair; Dammeier, Vice Chair; Frockt, Ranking Minority Member; Angel, Bailey, Brown, Cleveland, Conway, Jayapal, Keiser, Parlette and Rivers.

Background: Integrated or Collaborative Care Psychiatry. The American Psychiatric Association defines integrated or collaborative care as the coordination of care for patients who have psychiatric disorders, which includes substance use disorder and general medical illness. There is a higher rate of psychiatric illness in patients with chronic medical illness, and a higher rate of chronic medical illness among patients with psychiatric illness, especially with serious and persistent mental illness. Patients with these conditions have increased morbidity and mortality rates.

In integrated care, mental health professionals support primary care providers and other health professionals in familiar settings, bringing mental health treatment to to where people feel comfortable receiving care.

University of Washington (UW) Integrated Care Psychiatry. The UW School of Medicine has a division of integrated care and public health. The programs supported by the division are patient centered, collaborative, population and public health focused, evidence based, and integrated with other health and social services. The program has developed a collaborative care model that has been used by the advancing integrated mental health solution center to train over 6000 clinicians. This model of integrated care is used in primary care to treat persistent mental health conditions like depression and anxiety that require systematic follow-up.

The UW Department of Psychiatry and Behavioral Sciences offers an integrated care pathway, psychiatry in medical settings program. The program is a career development pathway focused on developing resident experiences and fostering interests in evidence-based practice at the interface of psychiatry and other medical settings.

Summary of Bill (Recommended Substitute): The Washington Department of Health and the Department of Psychiatry and Behavioral Sciences at UW must develop and operate a training program in integrated care psychiatry. The training program must:

offer a specialized track in integrated behavioral health care to five UW psychiatry residents in their third and fourth years of residency training each year, to include a minimum of 12 months of training in settings where integrated behavioral health services are provided under the supervision of experienced psychiatric consultants;
establish a one-year clinical fellowship program for psychiatrists who seek additional specialty training in integrated care; and
annually offer continuing medical education courses and supervision in evidence-based integrated care to up to ten psychiatrists who are interested in integrated care in Washington.

UW may partner with nursing and social work programs at UW, Washington State University, and Eastern Washington University.

Subject to the availability of amounts appropriated, the Health Care Authority (HCA) must expand the Partnership Access Line Plus service (PAL) by selecting a predominantly rural region of the state where approximately one-fifth of the state's total Medicaid population lives, and offering this region an additional level of service.

The PAL must initially be targeted to serve 12–18 year olds with Medicaid coverage and a depressive or anxiety disorder, who are receiving treatment from their primary care provider. HCA must monitor PAL outcomes and evaluate the viability of a statewide PAL program.

Staff Summary of Public Testimony on Original Bill: PRO: Washington State ranks 48th out of 50 for access to mental health care. The best way to help train more psychiatrists is to partner with primary care providers. This bill proposes to train 15 to 20 psychiatrists per year in the integrated care model. This would allow patients to get access to mental health care through their primary care physicians, where they otherwise would not. It was also suggested that advanced registered nurse practitioners be included in the integrated care model.