ANALYSIS OF HOUSE BILL 2358

  Establishing provisions for managed mental health care.

Health Care Committee                           20 January 1998

Washington State House of Representatives

SPONSORS:  Representatives Dyer and Cody.

PURPOSE:

To set forth principles for publicly-funded managed mental health services and establish a related task force.

BACKGROUND:

Publicly-funded mental health services are administered at the state level by the Mental Health Division of the Department of Social & Health Services (DSHS). The 1989 Mental Health Reform Act reorganized mental health services locally among 14 regional support networks (RSNs). In an effort to improve efficiency, the Division has moved to expand the use of managed care.

The proponents of this measure believe that a thorough study of the use of managed care in mental health is needed before the Division proceeds further.

SUMMARY:

Sets forth the following managed public mental health care principles:

Collaboration among consumers, providers, and payers;

Services directed by the consumers' needs and desires, whenever possible;

     Adequacy to meet the needs of the covered population;

     Reasonable operating margins for service organizations;

Clear consumer rights and responsibilities, including a grievance procedure;

     Emphasis on community-based care;

     Consistent, reliable, and valid outcome measures;

Adequate authority and flexibility for service organizations assuming capitated risk; and

     Clarity of public agency roles in the service delivery system.

A task force to the Legislature on managed public mental health care is created with appointments and composition as follows:

Appointed by the Governor:

  6 members representing:Service providers; regional support networks; managed care agencies; and the public;

  1 member representing the Governor;

  1 member representing the DSHS.

Appointed by the Senate President:

  1 Democratic Senator

  1 Republican Senator

Appointed by the Speaker of the House:

  1 Republican Representative

  1 Democratic Representative

The appointed members shall select a chair of the Task Force.

The Task Force is terminated  June 30, 1999.

The Task Force shall make recommendations relating to the design and implementation of managed public mental health care services and must review:  The experiences of other states; research on the cost effectiveness of various financing models, including full and partial capitation; and issues relating to rural communities.

The Task Force shall report to the Legislature and Governor by December 1, 1998.

$50,00 is appropriated for the study.

The Act takes effect immediately upon enactment.