In 2021, the Legislature directed the Department of Health (DOH) to convene a task force focused on developing a parks Rx health and wellness pilot program.  The Washington Parks Rx Legislative Task Force (Task Force) was required to provide recommendations on a three-region pilot program, in the Puget Sound, Eastern Washington, and Southwest Washington regions, and create three regional advisory committees (RACs) to represent each region.  The Task Force was directed to develop:

• a process to establish a pilot program with an emphasis on diverse communities and where systemic inequities and discrimination have negatively affected health outcomes;
• model agreements that would enable insurers to offer incentives to public, nonprofit, and private employers to create wellness programs that offer employees a discount on health insurance in exchange for a certain usage level of outdoor parks and trails for recreation and physical activity; and
• recommendations on ways in which a public-private partnership approach may be used to fund implementation of the pilot program.

The Task Force convened between August 2021 and June 2022, and the three RACs convened between January 2022 and June 2022.  The Task Force recommended:

• two parks Rx program frameworks;
• a focus on equity throughout all phases of the pilot program;
• support by a statewide leadership committee;
• pilot project site selection from a request for application process;
• the Legislature should appropriate funds in the 2023-2025 biennium budget bill for the initial pilot program phase starting in 2023;
• two options for collaboratively working with health insurance carriers in the pilot program phase; and
• actions by organizations and individuals interested in the Task Force while awaiting legislative action.

DOH reported findings and recommendations from the Task Force to the Governor and Legislature in September 2022.

• DOH must create an advisory committee for the parks Rx health and wellness pilot programs.  The membership of the committee shall include communities that have been historically marginalized in access to parks. Subject to the availability of amounts appropriated for this specific purpose, DOH in collaboration with the advisory committee must:
• by February 1, 2025 , develop a competitive request for proposal process and create evaluation criteria that focuses on:
  1. identifying populations experiencing the greatest health care disparities;
  2. forming partnerships with health and wellness providers;
  3. working with leaders of disadvantaged communities to bring lived experience perspectives;
  4. conducting outreach to local governments and organizations that can provide fitness spaces, trails, community centers, and other similar facilities for usage; and
  5. developing a data gathering and measuring system to evaluate the program's effectiveness and impact on the health and well-being of individual and communities;
• by August 1, 2025 , select a minimum of three pilot programs located in each of the following regions of Washington State?Puget Sound, Eastern Washington, and Southwest Washington; and
• by July 1, 2028 , submit a report to the Governor and Legislature that includes:
  1. an assessment of the performance for each pilot program during the two-year period;
  2. an impact assessment of the three-region pilot programs on community and individual health and well-being;
  3. an analysis of the pilot program that identifies the resources and tools needed to ensure the long-term sustainability of the program; and
  4. recommendations on potential funding and resource options.

• Extends the dates in the bill for implementing and reporting on the Parks Rx pilot projects by one year

PRO: Prescribing outdoor experiences could be another tool to address mental health challenges, and increase physical activity. These parks Rx pilot programs are a really good asset and opportunity to invest in the community and to see the return in that investment. This would provide an opportunity for employers and insurers to offer outdoor incentives so that their employees can earn wellness points, providing an opportunity to lower the cost of health care in the long run. Last year we received wonderful recommendations back from the Task Force. The Task Force was successful through collaborating with local communities, gathering information from other states, and developing recommendations for the pilot program phase. This is really exciting work and has incredible potential to show us an innovative way to make a health impact in our communities.

PRO: Parks RX could provide health providers the option to prescribe access to nature to help address an underlying health condition. This is a low-cost way to improve health outcomes, especially for underserved lower income and historically marginalized populations.

The committee recommended a different version of the bill than what was heard. PRO:  The bill is meant to increase opportunities for outdoor activities to support mental health. This bill would increase access to outdoor activities for underserved and lower income communities. The task force researched existing programs and determined that initial public investment is essential for success. All of the pilots will be designed to address equity and will include a process to track health outcomes.