ENGROSSED SECOND SUBSTITUTE SENATE BILL 5884

State of Washington

67th Legislature

2022 Regular Session

BySenate Ways & Means (originally sponsored by Senators Trudeau, Dhingra, Hasegawa, Kuderer, Lovick, Nguyen, Nobles, Saldaña, and C. Wilson)

READ FIRST TIME 02/07/22.

AN ACT Relating to establishing behavioral health support specialists; amending RCW 18.130.040 and 18.130.040; adding a new section to chapter 48.43 RCW; adding a new chapter to Title 18 RCW; providing an effective date; and providing expiration dates.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds that the behavioral health support specialist is a new service delivery model in Washington state based on improving access to psychological therapies (IAPT), an evidence-based model developed by the national health service in England. IAPT services are characterized by evidenced-based psychological therapies, delivered by trained and accredited practitioners with training matched to the intensity and expected duration of the mental health problem. The model features routine outcome monitoring and regular, outcome-focused supervision. Use of behavioral health support specialists in Washington is expected to improve access to behavioral health services and ease workforce shortages while helping behavioral health professionals work at the top of their scope of practice.

NEW SECTION. Sec. 2. The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

(1) "Applicant" means a person who completes the required application, pays the required fee, is at least 18 years of age, and meets any background check requirements and uniform disciplinary act requirements.

(2) "Behavioral health support specialist" means a trained paraprofessional certified under this chapter to deliver low-intensity, evidence-based behavioral health interventions for adults with mild-to-moderate behavioral health conditions in a stepped care model in ongoing partnership with a licensed health care provider whose scope of practice includes behavioral health, including at a licensed community behavioral health agency. A behavioral health support specialist does not have within their scope the ability to make diagnoses but does track and monitor treatment response and outcomes using measurement-based care.

(3) "Department" means the department of health.

(4) "Secretary" means the secretary of health or the secretary's designee.

NEW SECTION. Sec. 3. The department shall partner with the University of Washington department of psychiatry and behavioral sciences and consult with other stakeholders including the Washington state council on behavioral health to develop rules to implement this chapter by January 1, 2024, which shall be consistent with the evidence-based improving access to psychological therapies model, and shall include appropriate standards for accreditation of educational programs for behavioral health support specialists, which shall include a practicum component and may be integrated into a bachelor's degree program or structured as a continuing education program.

NEW SECTION. Sec. 4. A person may not represent themself as a behavioral health support specialist without being certified by the department.

NEW SECTION. Sec. 5. Nothing in this chapter shall be construed to prohibit or restrict delivery of behavioral health interventions by an individual otherwise regulated under this title and performing services within their authorized scope of practice.

NEW SECTION. Sec. 6. In addition to any other authority provided by law, the secretary has the authority to:

(1) Adopt rules under chapter 34.05 RCW necessary to implement this chapter. Any rules adopted shall be in consultation with the University of Washington;

(2) Establish all certification, examination, and renewal fees in accordance with RCW 43.70.250;

(3) Establish forms and procedures necessary to administer this chapter;

(4) Issue certifications to applicants who have met the education, practicum, and examination requirements for certification and to deny a certification to applicants who do not meet the requirements;

(5) Develop, administer, and supervise the grading and taking of an examination for applicants for certification;

(6) Adopt rules implementing a continuing education program in consultation with the University of Washington;

(7) Maintain the official record of all applicants and certification holders; and

(8) Establish by rule the procedures for an appeal of an examination failure.

NEW SECTION. Sec. 7. The uniform disciplinary act, chapter 18.130 RCW, governs uncertified practice, the issuance and denial of certification, and the discipline of persons certified under this chapter. The secretary shall be the disciplinary authority under this chapter.

NEW SECTION. Sec. 8. The secretary shall issue a certification to any applicant who demonstrates to the satisfaction of the secretary that the applicant meets the following requirements:

(1) Graduation from a bachelor's degree program;

(2) Successful completion of a behavioral health support specialist program that is accredited to meet standards consistent with the evidence-based program improving access to psychological treatment, including a supervised clinical practicum with demonstrated clinical skills in core competencies;

(3) Successful completion of an approved examination; and

(4) Ongoing partnership with a licensed health care provider whose scope of practice includes behavioral health, including at a licensed community behavioral health agency.

NEW SECTION. Sec. 9. (1) The date and location of examinations shall be established by the secretary. Applicants who have been found by the secretary to meet the other requirements for certification shall be scheduled for the next examination following the filing of the application. The secretary shall establish by rule the examination application deadline.

(2) The secretary or the secretary's designee shall examine each applicant, by means determined to be most effective, on subjects appropriate to the scope of practice, as applicable. Such examinations shall be limited to the purpose of determining whether the applicant possesses the minimum skill and knowledge necessary to practice competently.

(3) The examination papers, all grading of the papers, and the grading of any practical work shall be preserved for a period of not less than one year after the secretary has made and published the decisions. All examinations shall be conducted using fair and wholly impartial methods.

(4) The secretary may approve an examination prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the certification requirements.

NEW SECTION. Sec. 10. Applications for certification shall be submitted on forms provided by the secretary. The secretary may require any information and documentation which reasonably relates to the need to determine whether the applicant meets the criteria for certification provided for in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the secretary under RCW 43.70.250. The fee shall accompany the application.

NEW SECTION. Sec. 11. The health care authority shall take any steps which are necessary and proper to ensure that the services of behavioral health support specialists are covered under the state medicaid program by January 1, 2024. A behavioral health support specialist must be eligible to bill for behavioral health service delivery, including psychotherapy codes.

NEW SECTION. Sec. 12. A new section is added to chapter 48.43 RCW to read as follows:

By July 1, 2024, the office of the insurance commissioner shall integrate behavioral health support specialists into its network access standards through enforcement of every category of health care provider provision in RCW 48.43.045.

Sec. 13. RCW 18.130.040 and 2021 c 179 s 6 are each amended to read as follows:

(1) This chapter applies only to the secretary and the boards and commissions having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.

(2)(a) The secretary has authority under this chapter in relation to the following professions:

(i) Dispensing opticians licensed and designated apprentices under chapter 18.34 RCW;

(ii) Midwives licensed under chapter 18.50 RCW;

(iii) Ocularists licensed under chapter 18.55 RCW;

(iv) Massage therapists and businesses licensed under chapter 18.108 RCW;

(v) Dental hygienists licensed under chapter 18.29 RCW;

(vi) Acupuncturists or acupuncture and Eastern medicine practitioners licensed under chapter 18.06 RCW;

(vii) Radiologic technologists certified and X-ray technicians registered under chapter 18.84 RCW;

(viii) Respiratory care practitioners licensed under chapter 18.89 RCW;

(ix) Hypnotherapists and agency affiliated counselors registered and advisors and counselors certified under chapter 18.19 RCW;

(x) Persons licensed as mental health counselors, mental health counselor associates, marriage and family therapists, marriage and family therapist associates, social workers, social work associates—advanced, and social work associates—independent clinical under chapter 18.225 RCW;

(xi) Persons registered as nursing pool operators under chapter 18.52C RCW;

(xii) Nursing assistants registered or certified or medication assistants endorsed under chapter 18.88A RCW;

(xiii) Dietitians and nutritionists certified under chapter 18.138 RCW;

(xiv) Substance use disorder professionals, substance use disorder professional trainees, or co-occurring disorder specialists certified under chapter 18.205 RCW;

(xv) Sex offender treatment providers and certified affiliate sex offender treatment providers certified under chapter 18.155 RCW;

(xvi) Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;

(xvii) Orthotists and prosthetists licensed under chapter 18.200 RCW;

(xviii) Surgical technologists registered under chapter 18.215 RCW;

(xix) Recreational therapists under chapter 18.230 RCW;

(xx) Animal massage therapists certified under chapter 18.240 RCW;

(xxi) Athletic trainers licensed under chapter 18.250 RCW;

(xxii) Home care aides certified under chapter 18.88B RCW;

(xxiii) Genetic counselors licensed under chapter 18.290 RCW;

(xxiv) Reflexologists certified under chapter 18.108 RCW;

(xxv) Medical assistants-certified, medical assistants-hemodialysis technician, medical assistants-phlebotomist, forensic phlebotomist, and medical assistants-registered certified and registered under chapter 18.360 RCW; ((and))

(xxvi) Behavior analysts, assistant behavior analysts, and behavior technicians under chapter 18.380 RCW; and

(xxvii) Behavioral health support specialists certified under chapter 18.--- RCW (the new chapter created in section 15 of this act).

(b) The boards and commissions having authority under this chapter are as follows:

(i) The podiatric medical board as established in chapter 18.22 RCW;

(ii) The chiropractic quality assurance commission as established in chapter 18.25 RCW;

(iii) The dental quality assurance commission as established in chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW, licenses and registrations issued under chapter 18.260 RCW, and certifications issued under chapter 18.350 RCW;

(iv) The board of hearing and speech as established in chapter 18.35 RCW;

(v) The board of examiners for nursing home administrators as established in chapter 18.52 RCW;

(vi) The optometry board as established in chapter 18.54 RCW governing licenses issued under chapter 18.53 RCW;

(vii) The board of osteopathic medicine and surgery as established in chapter 18.57 RCW governing licenses issued under chapters 18.57 and 18.57A RCW;

(viii) The pharmacy quality assurance commission as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;

(ix) The Washington medical commission as established in chapter 18.71 RCW governing licenses and registrations issued under chapters 18.71 and 18.71A RCW;

(x) The board of physical therapy as established in chapter 18.74 RCW;

(xi) The board of occupational therapy practice as established in chapter 18.59 RCW;

(xii) The nursing care quality assurance commission as established in chapter 18.79 RCW governing licenses and registrations issued under that chapter;

(xiii) The examining board of psychology and its disciplinary committee as established in chapter 18.83 RCW;

(xiv) The veterinary board of governors as established in chapter 18.92 RCW;

(xv) The board of naturopathy established in chapter 18.36A RCW, governing licenses and certifications issued under that chapter; and

(xvi) The board of denturists established in chapter 18.30 RCW.

(3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses. The disciplining authority may also grant a license subject to conditions.

(4) All disciplining authorities shall adopt procedures to ensure substantially consistent application of this chapter, the uniform disciplinary act, among the disciplining authorities listed in subsection (2) of this section.

Sec. 14. RCW 18.130.040 and 2021 c 179 s 7 are each amended to read as follows: