H-1518.1

SECOND SUBSTITUTE HOUSE BILL 1580

ByHouse Appropriations (originally sponsored by Representatives Callan, Harris, Senn, Eslick, Dent, Ortiz-Self, Simmons, Leavitt, Ryu, Berry, Taylor, Walen, Bateman, Bronoske, Goodman, Ormsby, Schmidt, Orwall, Gregerson, Thai, Doglio, Lekanoff, Ramel, Rule, Reed, Pollet, Timmons, and Macri)

AN ACT Relating to creating a system to support children in crisis; adding a new section to chapter 43.06 RCW; creating a new section; providing an expiration date; and declaring an emergency.

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

NEW SECTION.  Sec. 1. A new section is added to chapter 43.06 RCW to read as follows:

(1) The governor must maintain a children and youth multisystem care coordinator to serve as a state lead on addressing complex cases of children in crisis. The children and youth multisystem care coordinator must:

(a) Direct:

(i) The appropriate use of state and other resources to a child in crisis, and that child's family, if appropriate; and

(ii) Appropriate and timely action by state agencies to serve children in crisis;

(b) Have access to flexible funds to support:

(i) The safe discharge of children in crisis from hospitals; and

(ii) Long-term, appropriate placement for children in crisis who are dependent under chapter 13.34 RCW; and

(c) Coordinate with:

(i) The rapid response team established under RCW 43.216.205 to make sure that resources are effectively identified and mobilized for people who meet the definition of child in crisis and a youth or young adult exiting a publicly funded system of care; and

(ii) Youth behavioral health and inpatient navigator teams to efficiently and effectively mobilize services for a child in crisis.

(2) The children and youth multisystem care coordinator created under this section, in coordination with the department of children, youth, and families, the health care authority, the office of financial management, and the department of social and health services, shall develop and implement a rapid care team for the purpose of supporting and identifying appropriate services and living arrangements for a child in crisis, and that child's family, if appropriate. The rapid care team created under this section must be implemented as soon as possible, but no later than January 1, 2024.

(3) In creating the rapid care team required under this section, the children and youth multisystem care coordinator created under this section shall develop and implement a system for:

(a) Identifying children in crisis who should be served by the rapid care team;

(b) Initiating the rapid care team in a timely manner that reduces the time a child in crisis spends in a hospital without a medical need;

(c) Locating services and connecting youth and families with the appropriate services to allow the child in crisis to safely discharge from a hospital;

(d) Screening referrals for a child in crisis; and

(e) Determining when it would be appropriate for the department of children, youth, and families to provide services to a child in crisis as the:

(i) Youth meets the definition of a "child who is a candidate for foster care" under RCW 74.13.020;

(ii) Youth meets the definition of "dependent child" under RCW 13.34.030(6)(a) based on the child being abandoned; or

(iii) Family should be offered a voluntary placement agreement.

(4) The rapid care team under this section may provide assistance and support to a child in crisis, or the family of a child in crisis.

(5) The following individuals may refer a child in crisis to the rapid care team:

(a) A child in crisis themselves;

(b) A family member of the child in crisis;

(c) An advocate for the child in crisis;

(d) An educator;

(e) A law enforcement officer;

(f) An employee of the department of children, youth, and families;

(g) An employee of the department of social and health services;

(h) An employee of the health care authority;

(i) A service provider contracting with the department of children, youth, and families;

(j) A service provider contracting with the department of social and health services;

(k) A behavioral health service provider;

(l) A representative of a managed care organization;

(m) A representative from a youth behavioral health or inpatient navigator team;

(n) A person providing health care services to the child in crisis; or

(o) A hospital employee.

(6) By November 1, 2023, the governor shall provide an initial report to the legislature describing the process of developing and implementing the rapid care team created under this section, and must include a projection of when the rapid care team process will be implemented. By November 1, 2024, the governor shall provide a final report to the legislature including data and recommendations related to the rapid care team created in this section. The report required under this subsection must be submitted in compliance with RCW 43.01.036. The report required under this subsection must include the following:

(a) The number of children in crisis referred to the rapid care team and the types of people making referrals to the rapid care team;

(b) The demographic data of the children in crisis served by the rapid care team;

(c) The types of services and living arrangements identified by the rapid care team;

(d) The availability of the services and living arrangements identified as needed for the children in crisis served by the rapid care team;

(e) Any barriers that are preventing children in crisis from safely exiting the hospital setting when there is not a medical need for that hospital stay;

(f) Any barriers that are preventing children in crisis who are dependent under chapter 13.34 RCW from maintaining an appropriate and stable placement;

(g) Recommendations for earlier intervention to prevent children from becoming children in crisis;

(h) Discussion regarding the implementation of youth behavioral health and inpatient navigator programs and their role in serving children in crisis; and

(i) Recommendations for systemic changes that could replace the rapid care team in addressing complex cases involving a child in crisis.

(7) The following definitions apply to this section:

(a) "Child in crisis" means a person under age 18 who is:

(i) At risk of remaining in a hospital without medical necessity, without the ability to return to the care of a parent, and not dependent under chapter 13.34 RCW;

(ii) Staying in a hospital without medical necessity and who is unable to return to the care of a parent but is not dependent under chapter 13.34 RCW; or

(iii) Dependent under chapter 13.34 RCW, experiencing placement instability, and referred to the rapid care team by the department of children, youth, and families.

(b) "Rapid care team" means a team, whose work is managed and directed by the children and youth multisystem care coordinator created under this section, working to quickly identify the appropriate services and living arrangements for a child in crisis. A rapid care team must include:

(i) One designee from the health care authority;

(ii) One designee from the department of social and health services;

(iii) One designee from the office of financial management;

(iv) One designee from the developmental disabilities administration of the department of social and health services;

(v) One designee from the department of children, youth, and families; and

(vi) Any other entities, including governmental entities and managed care organizations, or individuals, including clinicians and other service providers, that the children and youth multisystem care coordinator deems appropriate to support a child in crisis.

(8) This section expires June 30, 2025.

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