SSB 6558 -
By Committee on Early Learning & Human Services
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1 The legislature finds that services for
low-income children in Washington with serious mental health needs
should be improved so that children can be served in their community,
rather than in out-of-home placements, in order to receive the help
they need. Entering a state institution, foster home, or other out-of-home placement may create additional hardship on the child and the
family by forcing a child into an unfamiliar living situation and
separating them from their family, friends, school, community, and
natural supports. The legislature intends to expand access to
intensive home and community-based children's services so that these
services will be implemented statewide on a phased-in basis to children
with serious mental health needs.
Sec. 2 RCW 71.24.065 and 2007 c 359 s 10 are each amended to read
as follows:
((To the extent funds are specifically appropriated for this
purpose,)) (1) The department of social and health services shall
((contract for implementation of a wraparound model of integrated
children's mental health services delivery in up to four regional
support network regions in Washington state in which wraparound
programs are not currently operating, and in up to two regional support
network regions in which wraparound programs are currently operating.
Contracts in regions with existing wraparound programs shall be for the
purpose of expanding the number of children served.)) implement statewide intensive home and community-based
services for children, funded through medicaid. This set of services
is known as wraparound with intensive services, and shall include the
following core medicaid covered mental health services: (a) Intensive
care coordination, (b) intensive home and community-based services, and
(c) mobile crisis intervention and stabilization services. In order to
ensure consistency statewide, the department shall develop standards,
policies and protocols to direct the implementation and provision of
care under this section beginning July 1, 2014. The services must be
phased in as rapidly as feasible and according to a schedule that
prioritizes infrastructure availability and local provider readiness.
(1) Funding provided may be expended for: Costs associated with a
request for proposal and contracting process; administrative costs
associated with successful bidders' operation of the wraparound model;
the evaluation under subsection (5) of this section; and funding for
services needed by children enrolled in wraparound model sites that are
not otherwise covered under existing state programs. The services
provided through the wraparound model sites shall include, but not be
limited to, services covered under the medicaid program. The
department shall maximize the use of medicaid and other existing state-funded programs as a funding source. However, state funds provided may
be used to develop a broader service package to meet needs identified
in a child's care plan. Amounts provided shall supplement, and not
supplant, state, local, or other funding for services that a child
being served through a wraparound site would otherwise be eligible to
receive
(2) The wraparound ((model sites)) with intensive services program
funded through medicaid shall serve children ((with serious emotional
or behavioral disturbances who are at high risk of residential or
correctional placement or psychiatric hospitalization, and who have
been referred for services from the department, a county juvenile
court, a tribal court, a school, or a licensed mental health provider
or agency)) and youth under the age of twenty-one with a mental illness
or condition and who have a functional impairment which substantially
interferes with or substantially limits the ability to function in the
family, school or community setting, and for whom intensive home and
community-based services have been recommended by a licensed
practitioner to correct or ameliorate the mental illness or condition.
(((3) Through a request for proposal process, the department shall
contract, with regional support networks, alone or in partnership with
either educational service districts or entities licensed to provide
mental health services to children with serious emotional or behavioral
disturbances, to operate the wraparound model sites. The contractor
shall provide care coordination and facilitate the delivery of services
and other supports to families using a strength-based, highly
individualized wraparound process. The request for proposal shall
require that:)) Referral to services may include, but is not limited to:
(a) The regional support network agree to use its medicaid revenues
to fund services included in the existing regional support network's
benefit package that a medicaid-eligible child participating in the
wraparound model site is determined to need;
(b) The contractor provide evidence of commitments from at least
the following entities to participate in wraparound care plan
development and service provision when appropriate: Community mental
health agencies, schools, the department of social and health services
children's administration, juvenile courts, the department of social
and health services juvenile rehabilitation administration, and managed
health care systems contracting with the department under RCW
74.09.522; and
(c) The contractor will operate the wraparound model site in a
manner that maintains fidelity to the wraparound process as defined in
RCW 71.36.010.
(4) Contracts for operation of the wraparound model sites shall be
executed on or before April 1, 2008, with enrollment and service
delivery beginning on or before July 1, 2008.
(5) The evidence-based practice institute established in RCW
71.24.061 shall evaluate the wraparound model sites, measuring outcomes
for children served. Outcomes measured shall include, but are not
limited to
(a) A self-referral from the child or the child's family;
(b) Regional support networks;
(c) Mental health or medical providers;
(d) Tribes or tribal courts;
(e) Health care authority;
(f) The department of social and health services;
(g) County juvenile courts;
(h) Schools; and
(i) Local law enforcement.
(3) The department shall track, monitor, and report on measures
such as:
(a) Decreased out-of-home placement, ((including residential,
group, and foster care, and increased stability of such placements,
school attendance, school performance, recidivism,)) as well as
decreased length of stay in such placements;
(b) Emergency room utilization((,));
(c) Involvement with the juvenile justice system((, decreased));
(d) Use of psychotropic medication((,)); and ((decreased))
(e) Hospitalization between baseline and postimplementation
periods.
(((6) The evidence-based practice institute shall provide a report
and recommendations to the appropriate committees of the legislature by
December 1, 2010.))
NEW SECTION. Sec. 3 For the duration of the implementation
process of the wraparound with intensive services, the department of
social and health services shall provide annual implementation reports
to the office of financial management and the appropriate legislative
committees on or before December 1st each year. Throughout the
implementation process, and as services are phased in, the department
shall seek input from local stakeholders to include families and youth,
local government, tribal partners, and service providers on:
(1) The adequacy and availability of core services required for
wraparound with intensive services within provider networks and shall
engage in problem-solving around shortages or lack of quality core
service availability;
(2) Performance measures, outcomes, and quality improvement
relevant to children's behavioral health in Washington state; and
(3) Recommendations for participants in a local collaborative body
to ensure that children, families, and other stakeholders have a clear
pathway to receive intensive home and community-based wraparound
services.
NEW SECTION. Sec. 4 Beginning July 1, 2014, funding provided for
the wraparound pilot programs must be repurposed toward the costs of
phasing in an implementation of wraparound with intensive services.
The department of social and health services shall prioritize service
areas based on provider readiness and develop a schedule for phase-in
by county."
Correct the title.
EFFECT: The striking amendment makes the following changes to the
underlying bill:
Specifies that the Wraparound with Intensive Services (WISe)
includes intensive care coordination, intensive home and community-
based services, and mobile crisis intervention and stabilization
services.
Requires DSHS to develop standards, policies and protocols to
direct the implementation of WISe.
Specifies that DSHS will prioritize service areas based on provider
readiness and develop a schedule for phase-in by county.