AN ACT Relating to expanding treatment for individuals at risk of suicide by promoting training in evidence-based practices; amending RCW 28B.115.050, 28B.115.070, 28B.115.080, and 28B.115.120; and adding a new section to chapter 28B.20 RCW.

Subject to the availability of amounts appropriated for this specific purpose, the University of Washington shall establish certificate programs to educate behavioral health care professionals in evidence-based practices. The certificate programs must be established as follows:

(1)(a) The University of Washington school of social work, in collaboration with the University of Washington department of psychology, shall establish a certificate program in evidence-based dialectical behavior therapy practices that have been shown to be effective in treating patients with mental health disorders and those who are at risk of suicide.

(2)(a) The University of Washington department of psychiatry and behavioral sciences division of public behavioral health and justice policy shall establish a certificate program in evidence-based dialectical behavior therapy practices that have been shown to be effective in treating patients with mental health disorders and those who are at risk of suicide.

(b) The certificate program must be designed for licensed behavioral health care professionals who wish to receive additional education in evidence-based dialectical behavior therapy practices.

The office shall establish a planning committee to assist it in developing criteria for the selection of participants. The office shall include on the planning committee representatives of the department, the department of social and health services, appropriate representatives from health care facilities, provider groups, consumers, the state board for community and technical colleges, the superintendent of public instruction, and other appropriate public and private agencies and organizations. The criteria may require that some of the participants meet the definition of "needy student" under RCW 28B.92.030. The criteria must also include whether a credentialed health care professional has a certificate in dialectical behavior therapy.

(a) Determine eligible credentialed health care professions for the purposes of the loan repayment and scholarship program authorized by this chapter. Eligibility shall be based upon an assessment that determines that there is a shortage or insufficient availability of a credentialed profession so as to jeopardize patient care and pose a threat to the public health and safety. The department shall consider the relative degree of shortages among professions when determining eligibility. The department may add or remove professions from eligibility based upon the determination that a profession is no longer in shortage. Should a profession no longer be eligible, participants or eligible students who have received scholarships shall be eligible to continue to receive scholarships or loan repayments until they are no longer eligible or until their service obligation has been completed;

(2) ((For the 2017-2019 fiscal biennium, consideration for eligibility shall also be given to registered nursing students who have been accepted into an eligible nursing education program and have declared an intention to teach nursing upon completion of the nursing education program.))(3) Beginning with the 2020 award cycle, the planning committee established under RCW 28B.115.050 shall devote fifty percent of the loan repayment awards to credentialed health care professionals who are employed in a designated health professional shortage area and are providing behavioral health services. The planning committee may devote less than fifty percent of the loan repayment awards if there are not enough qualified applicants providing behavioral health services in any given award cycle.

(((1)))(a) Establish the annual award amount for each credentialed health care profession which shall be based upon an assessment of reasonable annual eligible expenses involved in training and education for each credentialed health care profession. The annual award amount may be established at a level less than annual eligible expenses. The annual award amount shall be established by the office for each eligible health profession. The awards shall not be paid for more than a maximum of five years per individual;

(((2)))(b) Determine any scholarship awards for prospective physicians in such a manner to require the recipients declare an interest in serving in rural areas of the state of Washington. Preference for scholarships shall be given to students who reside in a rural physician shortage area or a nonshortage rural area of the state prior to admission to the eligible education and training program in medicine. Highest preference shall be given to students seeking admission who are recommended by sponsoring communities and who declare the intent of serving as a physician in a rural area. The office may require the sponsoring community located in a nonshortage rural area to financially contribute to the eligible expenses of a medical student if the student will serve in the nonshortage rural area;

(((3)))(c) Establish the required service obligation for each credentialed health care profession, which shall be no less than three years or no more than five years. The required service obligation may be based upon the amount of the scholarship or loan repayment award such that higher awards involve longer service obligations on behalf of the participant;

(((5)))(e) Honor loan repayment and scholarship contract terms negotiated between the office and participants prior to May 21, 1991, concerning loan repayment and scholarship award amounts and service obligations authorized under this chapter or chapter ((28B.115, 28B.104, or)) 70.180 RCW.

(2) Subject to the availability of amounts appropriated for this specific purpose and beginning with the 2020-21 academic year, the office, in consultation with an organization that certifies health care professionals in dialectical behavior therapy, shall award conditional scholarships to graduate students and credentialed health care professionals enrolled in evidence-based dialectical behavior therapy certificate programs established under section 1 of this act. The office shall determine the amount of the conditional scholarship.

(1)(a) Participants in the health professional loan repayment and scholarship program who are awarded scholarships under RCW 28B.115.080(1) incur an obligation to repay the scholarship, with penalty and interest, unless they serve the required service obligation in a health professional shortage area in the state of Washington.

(b) Participants who receive a conditional scholarship under RCW 28B.115.080(2) incur an obligation to repay the scholarship, with penalty and interest, unless they serve for three years at a public behavioral health site, to be determined by the office in consultation with the department.

(3) The period for repayment shall coincide with the required service obligation, with payments of principal and interest commencing no later than six months from the date the participant completes or discontinues the course of study or completes or discontinues the required postgraduate training. Provisions for deferral of payment shall be determined by the office.

(4) The entire principal and interest of each payment shall be forgiven for each payment period in which the participant serves in a health professional shortage area until the entire repayment obligation is satisfied or the borrower ceases to so serve. Should the participant cease to serve in a health professional shortage area or a public behavioral health site of this state before the participant's repayment obligation is completed, payment of the unsatisfied portion of the principal and interest is due and payable immediately.

(5)(a) In addition to the amount determined in subsection (4) of this section, except for circumstances beyond their control, participants who received a scholarship under RCW 28B.115.080(1) and who serve less than the required service obligation shall be obliged to pay a penalty of an amount equal to twice the unsatisfied portion of the principal.

(b) In addition to the amount determined under subsection (4) of this section, except for circumstances beyond their control, participants who received a conditional scholarship under RCW 28B.115.080(2) and who serve less than the required service obligation shall be obligated to pay a penalty of an amount equal to the unsatisfied portion of the principal.

(6) Participants who are unable to pay the full amount due shall enter into a payment arrangement with the office for repayment including interest. The maximum period for repayment is ten years.

(7) The office is responsible for collection of repayments made under this section and shall exercise due diligence in such collection, maintaining all necessary records to ensure that maximum repayments are made. Collection and servicing of repayments under this section shall be pursued using the full extent of the law, including wage garnishment if necessary, and shall be performed by entities approved for such servicing by the Washington student loan guaranty association or its successor agency. The office is responsible to forgive all or parts of such repayments under the criteria established in this section and shall maintain all necessary records of forgiven payments.

(8) Receipts from the payment of principal or interest or any other subsidies to which the office as administrator is entitled, which are paid by or on behalf of participants under this section, shall be deposited with the office and shall be used to cover the costs of granting the scholarships, maintaining necessary records, and making collections under subsection (7) of this section. The office shall maintain accurate records of these costs, and all receipts beyond those necessary to pay such costs shall be used to grant scholarships to eligible students.

(9) Sponsoring communities who financially contribute to the eligible financial expenses of eligible medical students may enter into agreements with the student to require repayment should the student not serve the required service obligation in the community as a primary care physician. The office may develop criteria for the content of such agreements with respect to reasonable provisions and obligations between communities and eligible students.

(10) The office may make exceptions to the conditions for participation and repayment obligations should circumstances beyond the control of individual participants warrant such exceptions. The office shall establish an appeal process by rule.