NEW SECTION. Sec. 23. A new section is added to chapter
43.216 RCW to read as follows:
(1) The health care authority in consultation with the department shall develop a training for parents of children and transition age youth with substance use disorders by June 30, 2024, addressing the following:
(a) Science and education related to substance use disorders;
(b) Adaptive and functional communication strategies for communication with a loved one about their substance use disorder, including positive communication skills and strategies to influence motivation and behavioral change;
(c) Self-care and means of obtaining support; and
(d) Means to obtain opioid overdose reversal medication when appropriate and instruction on proper use.
(2) The health care authority and the department shall make this training publicly available and the department must promote the training to licensed foster parents and caregivers, including any tribally licensed foster parents and tribal caregivers.
NEW SECTION. Sec. 24. A new section is added to chapter
43.216 RCW to read as follows:
The department must make opioid overdose reversal medication available for use by caseworkers or employees that may come in contact with individuals experiencing overdose and must make appropriate training available.
Part VIII – Data Support for Recovery Navigator Programs
NEW SECTION. Sec. 25. To support recovery navigator programs, the health care authority must develop and implement a data integration platform by June 30, 2024, to serve as a common database for diversion efforts across the state, to serve as a data collection and management tool for practitioners, and to assist in standardizing definitions and practices. If possible, the health care authority must leverage and interact with existing platforms already in use in efforts funded by the authority. The health care authority must establish a quality assurance process for behavioral health administrative services organizations, and employ data validation for fields in the data collection workbook.
NEW SECTION. Sec. 26. A new section is added to chapter
71.24 RCW to read as follows:
(1) The authority shall contract with the Washington state institute for public policy to conduct a study of the long-term effectiveness of the recovery navigator program under RCW
71.24.115 with reports due by June 30th in the years 2028, 2033, and 2038. The Washington state institute for public policy shall collaborate with the authority and substance use recovery services advisory committee under RCW
71.24.546 on the topic of data collection and to determine the parameters of the report, which shall include recommendations, if any, for modification and improvement of the recovery navigator program. The authority shall cooperate with the Washington state institute for public policy to provide data for this report.
(2) The authority shall establish an expedited preapproval process by August 1, 2023, which allows requests for the use of data to be forwarded to the Washington state institutional review board without delay when the request is made by the Washington state institute for public policy for the purpose of completing a study that has been directed by the legislature.
Part IX – Establishing Rules and Payment Structures for Health Engagement Hubs
NEW SECTION. Sec. 27. A new section is added to chapter
71.24 RCW to read as follows:
(1) The authority shall develop payment structures for health engagement hubs by January 1, 2025.
(2) A health engagement hub:
(a) Serves as an all-in-one location where people who use drugs can access a range of medical, harm reduction, treatment, and social services. A health engagement hub may not provide supervised injection services;
(b) May be affiliated with existing syringe service programs, federally qualified health centers, community health centers, overdose prevention sites, safe consumption sites, patient-centered medical homes, tribal behavioral health programs, peer run organizations such as clubhouses, services for unhoused people, supportive housing, and opioid treatment programs including mobile and fixed-site medication units established under an opioid treatment program, or other appropriate entity;
(c) Provides referrals or access to methadone and other medications for opioid addiction;
(d) Functions as a patient-centered medical home by offering high-quality, cost-effective patient-centered care, including wound care;
(e) Provides harm reduction services and supplies;
(f) Provides linkage to housing, transportation, and other support services; and
(g) Is open to youth as well as adults.
(3) To the extent allowed under federal law, the authority shall direct medicaid managed care organizations to adopt a value-based bundled payment methodology in contracts with health engagement hubs and other opioid treatment providers.
(4) The authority shall make sufficient funding available to ensure that a health engagement hub is available within a two-hour drive for all communities and that there is at least one health engagement hub available per 200,000 residents in Washington state.
Part X – Education and Employment Pathways
NEW SECTION. Sec. 28. A new section is added to chapter
71.24 RCW to read as follows:
Subject to funding provided for this specific purpose, the authority shall establish a grant program for providers of employment, education, training, certification, and other supportive programs designed to provide persons recovering from a substance use disorder with employment opportunities. The grant program shall employ a low-barrier application and give priority to programs that engage with black, indigenous, persons of color, and other historically underserved communities.
Part XI – Providing a Statewide Directory of Recovery Services
NEW SECTION. Sec. 29. A new section is added to chapter
71.24 RCW to read as follows:
Subject to funding provided for this specific purpose, the authority must collaborate with the department and the department of social and health services to expand the Washington recovery helpline and the recovery readiness asset tool to provide a dynamically updated statewide behavioral health treatment and recovery support services mapping tool that includes a robust resource database for those seeking services and a referral system to be incorporated within the locator tool to help facilitate the connection between an individual and a facility that is currently accepting new referrals. The tool must include dual interface capability, one for public access and one for internal use and management.
Part XII – Investing Adequately in Statewide Diversion Services
NEW SECTION. Sec. 30. (1) It is the intent of the legislature to increase investments in the 2023-2025 biennium substantially over baseline levels established in the 2021-2023 operating and capital budgets to increase the provision of evidence-based prearrest and prefiling diversion programs in all regions of the state. Services which shall be increased and included in every health purchasing region include crisis stabilization units, 23-hour crisis relief centers, mobile crisis response services for youth and adults, recovery navigator programs, and law enforcement assisted diversion.
(2) The appropriations in this subsection are provided to the state health care authority and are subject to the following conditions and limitations:
(a) The following sums, or so much thereof as may be necessary, are each appropriated: $18,114,000 from the state general fund for the fiscal year ending June 30, 2024; and $16,437,000 from the state general fund for the fiscal year ending June 30, 2025. The amounts in this subsection are provided solely for the authority to continue and expand efforts to provide opioid use disorder medication in city, county, regional, and tribal jails.
(b) The following sums, or so much thereof as may be necessary, are each appropriated: $3,500,000 from the state general fund for the fiscal year ending June 30, 2024; and $3,500,000 from the state general fund for the fiscal year ending June 30, 2025. The amounts in this subsection are provided solely for the authority to provide support funds to new and established clubhouses throughout the state.
(c) The following sums, or so much thereof as may be necessary, are each appropriated: $1,583,000 from the state general fund for the fiscal year ending June 30, 2024; and $1,583,000 from the state general fund for the fiscal year ending June 30, 2025. The amounts in this subsection are provided solely for the authority to award grants to crisis services providers to establish and expand 23-hour crisis relief center capacity. It is the intent of the legislature that grants are awarded to an equivalent number of providers to the west and the east of the Cascade mountains. The authority must consider the geographic distribution of proposed grant applicants and the regional need for 23-hour crisis relief centers when awarding grant funds.
(d) The following sums, or so much thereof as may be necessary, are each appropriated: $900,000 from the state general fund for the fiscal year ending June 30, 2024; $900,000 from the state general fund for the fiscal year ending June 30, 2025; and $1,800,000 from the state general fund
—federal for the fiscal biennium ending June 30, 2025. The amounts in this subsection are provided solely for the authority to maintain a memorandum of understanding with the criminal justice training commission to provide ongoing funding for community grants pursuant to RCW
36.28A.450.
(e) The following sums, or so much thereof as may be necessary, are each appropriated: $1,250,000 from the state general fund for the fiscal year ending June 30, 2024; $1,250,000 from the state general fund for the fiscal year ending June 30, 2025; and $2,500,000 from the state general fund
—federal for the fiscal biennium ending June 30, 2025. The amounts in this subsection are provided solely for the authority to provide ongoing grants to law enforcement assistant diversion programs under RCW
71.24.590.
Part XIII – Streamlining Substance Use Disorder Treatment Intakes
NEW SECTION. Sec. 31. A new section is added to chapter
71.24 RCW to read as follows:
(1) The authority shall convene a work group to recommend changes to systems, policies, and processes related to intake, screening, and assessment for substance use disorder services, with the goal to broaden the workforce capable of processing intakes and to make the intake process as brief as possible, including only what is necessary to manage utilization and initiate care. The intake shall be low barrier, person-centered, and amenable to administration in diverse health care settings and by a range of health care professionals. The intake assessment shall consider the person's self-identified needs and preferences when evaluating direction of treatment and may include different components based on the setting, context, and past experience with the client.
(2) The work group must include care providers, payors, people who use drugs, and other individuals recommended by the authority. The work group shall present its recommendations to the governor and appropriate committees of the legislature by December 1, 2024.
Part XIV - Miscellaneous Provisions
Sec. 32. 2021 c 311 s 29 (uncodified) is amended to read as follows:
Sections 8 through 10((,))and 12((, 15, and 16)) of this act expire July 1, 2023.
NEW SECTION. Sec. 33. Sections 2 through 12 and 32 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and take effect July 1, 2023."
2SSB 5536 - S AMD 154
By Senator Robinson
ADOPTED AS AMENDED 03/03/2023
On page 1, line 4 of the title, after "paraphernalia;" strike the remainder of the title and insert "amending RCW
69.50.4011,
69.50.4013,
69.50.4014,
69.41.030,
69.50.509,
69.50.4121,
9.96.060,
36.70A.200,
71.24.589,
71.24.590,
10.31.110, and
84.36.043; amending 2021 c 311 s 29 (uncodified); adding a new section to chapter
43.43 RCW; adding new sections to chapter
69.50 RCW; adding a new section to chapter
43.330 RCW; adding a new section to chapter
26.12 RCW; adding new sections to chapter
71.24 RCW; adding new sections to chapter
43.216 RCW; creating new sections; repealing RCW
10.31.115; prescribing penalties; making appropriations; providing an effective date; and declaring an emergency."
EFFECT: (1) Provides guidance that the Washington state patrol should aim to complete the necessary analysis of suspected drugs in possession cases within 45 days of receipt of the request for analysis, and provides that the Washington state patrol's failure to meet the 45 day timeline does not constitute grounds to dismiss a criminal case.
(2) Requires the state to make resources available to assist defendants in obtaining a substance use disorder evaluation within 7 days of the defendant's agreement to participate in the pretrial diversion program.
(3) Requires the state to reimburse local courts for costs associated with travel related to obtaining a substance use disorder evaluation.
(4) Removes the direction to the court to avoid discussing circumstances, history, or diagnoses that could be embarrassing to the defendant.
(5) Requires defendants to substantially comply with, rather than meaningfully engage with, recommended treatment in order to successfully complete pretrial diversion.
(6) Provides that the prosecutor may make a motion for termination of pretrial diversion if the defendant is charged with simple possession subsequent to acceptance into pretrial diversion.
(7) Removes the requirement that the postconviction diagnostic evaluation and treatment recommendation be prepared under the direction of the court.
(8) Requires the postconviction diagnostic evaluation and treatment recommendations be filed with the court under seal.
(9) Permits agencies providing treatment to report any noncompliance with treatment in accordance with the agency's standard practices.
(10) Removes the requirement that courts notify the department of health of any failure by an agency to report noncompliance and the associated fine.
(11) Provides that courts may not sanction an individual for failing to comply with recommended treatment if the individual has made reasonable efforts to comply but cannot, either due to a lack of available treatment or, if the individual is indigent, due to a lack of funding for treatment.
(12) Restores requirement for the Department of Health to hold a hearing in the community before approval of the siting of an opioid treatment program.
(13) Prohibits a health engagement hub from providing supervised injection services.
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