HOUSE BILL REPORT
ESSB 5583
As Passed House ‑ Amended:
April 6, 2001
Title: An act relating to the implementation of recommendations of the joint legislative audit and review committee's performance audit of the public mental health system.
Brief Description: Implementing recommendations of the joint legislative audit and review committee's performance audit of the public mental health system.
Sponsors: By Senate Committee on Human Services & Corrections (originally sponsored by Senators Long, Hargrove, Stevens, Costa, Carlson, Hewitt, Kohl‑Welles, Franklin, Kastama, Winsley and Regala).
Brief History:
Committee Activity:
Health Care: 3/23/01, 3/29/01 [DPA];
Appropriations: 3/31/01, 4/2/01 [DPA(APP w/o HC)s].
Floor Activity:
Passed House ‑ Amended: 4/6/01, 92-0.
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Brief Summary of Engrossed Substitute Bill (As Amended by House)
$Focuses the community mental health delivery system on outcomes and provides the Department of Social and Health Services greater flexibility to achieve positive outcomes for clients.
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HOUSE COMMITTEE ON HEALTH CARE
Majority Report: Do pass as amended. Signed by 14 members: Representatives Campbell, Republican Co‑Chair; Cody, Democratic Co‑Chair; Schual‑Berke, Democratic Vice Chair; Skinner, Republican Vice Chair; Alexander, Ballasiotes, Conway, Darneille, Edmonds, Edwards, Marine, McMorris, Pennington and Ruderman.
Staff: Dave Knutson (786‑7146).
HOUSE COMMITTEE ON APPROPRIATIONS
Majority Report: Do pass as amended by Committee on Appropriations and without amendment by Committee on Health Care. Signed by 31 members: Representatives Sehlin, Republican Co‑Chair; H. Sommers, Democratic Co‑Chair; Barlean, Republican Vice Chair; Doumit, Democratic Vice Chair; Lisk, Republican Vice Chair; Alexander, Benson, Boldt, Buck, Clements, Cody, Cox, Dunshee, Fromhold, Grant, Kagi, Keiser, Kenney, Kessler, Lambert, Linville, Mastin, McIntire, Mulliken, Pearson, Pflug, Ruderman, D. Schmidt, Schual‑Berke, Talcott and Tokuda.
Staff: Amy Hanson (786‑7118).
Background:
The Joint Legislative Audit and Review Committee (JLARC) recently conducted an audit of the community mental health delivery system. The audit found that services to mental health clients were not well-coordinated, system accountability activities focus on processes rather than outcomes of care, data collected for accountability purposes is not consistent, geographic allocation of funding is inequitable; leading to disparities in service, and a wide range of operating practices and costs made it impossible to identify best practices across the service delivery system.
The audit recommends 14 improvements. They include: (1) Improve coordination of services for clients with multiple needs; (2) require Regional Support Networks to collaborate with allied service providers; (3) ensure timely hospital discharge and community placements; (4) the mental health division should streamline and reduce process-oriented accountability activities; (5) specify in statute that the delivery system should operate efficiently and effectively; (6) improve the consistency of fiscal data collected; (7) change fiscal accountability standard to include all system costs; (8) develop uniform definitions for reporting of client and service data; (9) the mental health division should use outcome information to manage the system; (10) the mental health division should implement an outcome-based performance system consistent with the JLARC consultant's report; (11) reduce the complexity of and disparity in rates paid to regional support networks, and allocate state hospital funding to regional support networks; (12) conduct periodic prevalence studies to ensure continued relationship between payments to regional support networks and the prevalence of mental illness; (13) limit regional support network fund balances to 10 percent of annual revenue; and (14) use outcome information to identify and reward best practices.
Summary of Amended Bill:
The Department of Social and Health Services (DSHS) is given the flexibility to utilize federal and state funds for mental health services between department divisions and administrations to improve outcomes for clients. The community mental health service delivery system will be evaluated based on outcome and performance measures. The outcome and performance measures will be developed jointly by the department and representatives of consumers, service providers, and regional support networks. The department will use the outcome measure information to manage the community mental health service delivery system. The department is required to deem compliance with state minimum standards for individuals and organizations accredited by recognized accrediting bodies.
Appropriation: None.
Fiscal Note: Available.
Effective Date of Amended Bill: The bill contains an emergency clause and takes effect immediately.
Testimony For: (Health Care) The Joint Legislative Audit and Review Committee recently released their audit of the community mental health system. They developed several recommendations which the Legislature should support.
Testimony For: (Appropriations) We support this bill. One of the findings of the JLARC study was that there are vast differences in spending on clients by the Regional Support Networks. We need outcome information to manage our system. It might be best to wait on the 2 percent reward system until outcome measures are actually in place.
Testimony Against: (Health Care) None.
Testimony Against: (Appropriations) None.
Testified: (Health Care) Senator Long, prime sponsor; Sgt. Fred Ibuki, Seattle Police Department; Shanon Dolittle, Community Action Partnership; Donald Lachman, CPI Institute; Cathy Gaylord, Washington Community Mental Health Council; Jean Wessman, Washington Association of Counties; Steven Pearce, Citizens' Commission on Human Rights; Tom Richardson, National Alliance for the Mentally Ill; and Richard Onizuka, Department of Social and Health Services.
Testified: (Appropriations) Lonnie Johns-Brown, National Association of Social Workers; and Richard Warner, Citizens Commission on Human Rights.