National Suicide Prevention Hotline. In October 2020, Congress passed the National Suicide Hotline Designation Act of 2020 (Act) which designates the number 988 as the universal telephone number within the United States for the purpose of accessing the National Suicide Prevention and Mental Health Crisis Hotline system maintained by the National Suicide Prevention Lifeline and the Veterans Crisis Line. The Department of Health must provide adequate funding for use of the state's crisis lifeline call centers once the 988 hotline number is established. The funding must be established at a level anticipated to achieve an in-state call response rate of at least 90 percent. The level of funding must be determined by considering call volume predictions, cost per call predictions provided by the National Suicide Prevention Lifeline (Lifeline), guidance on call center performance metrics, and necessary call center upgrades.

Statewide 988 Behavioral Health Crisis Response and Suicide Prevention Line Tax. In 2021, HB 1477 was enacted which established several changes to the behavioral health crisis system in response to the adoption of 988 as the phone number for the National Suicide Prevention and Mental Health Crisis Hotline. The bill established crisis call center hubs to provide crisis intervention services, case management, referrals, and connection to crisis system participants beginning July 1, 2024. The bill also charged the state with developing a new technology platform for managing communications with the 988 hotline and imposed a tax upon phone lines to support the activities. The Statewide 988 Behavioral Health Crisis Response and Suicide Prevention Line Tax (988 Tax) is imposed on all radio access lines, interconnected voice over Internet protocol (VoIP) service lines, and switched access lines.

A radio access line is a telephone number assigned to or used by a subscriber for two-way local wireless voice service from a radio communications company, including cellular telephone service, personal communications services, and network radio access lines. A VoIP service line is a service that enables real-time, two way voice communications using a broadband connection. Switched access line means the telephone service line that connects a subscriber's main telephone or equivalent main telephone to the local exchange company's switching office. The 988 Tax amount for each of these lines is phased in so that the tax was increased from $0.23 per line per month to $0.40 per line per month beginning January 1, 2023. 

Proceeds from the 988 Tax are deposited into the 988 Account, an appropriated account in the State Treasury. Money from the 988 Account may only be used for the routing of calls from the 988 Crisis Hotline to an appropriate crisis hotline center and for personnel and the provision of acute behavioral health, crisis outreach, stabilization services and follow-up case management. Cities and counties are prohibited from imposing a tax on radio access lines, VoIP service lines, or switched access lines for the purpose of routing calls made to the 988 Crisis Hotline to a crisis hotline center or crisis call center hub or for responding to 988 Crisis Hotline calls. 

The line tax for the Behavioral Health Crisis Response and Suicide Prevention Account is increased from $0.40 per line per month to $0.60 per line per month beginning July 1, 2026.

The line tax for the Behavioral Health Crisis Response and Suicide Prevention Account is increased from $0.60 per line per month to $0.80 per line per month beginning July 1, 2027. 

Expenditures from the 988 Account must be prioritized to fully fund 988 call centers so that they maintain required answer rates.

PRO: Behavioral health organizations are engaged in the rollout of 988, and it is a key tool for individuals who need help. The services coordinated with 988 are extremely complex. This bill would ensure call centers have the support needed to maintain response rates. Being a counselor in these positions is difficult. The volume of the work increases and response rates need to be met, so call centers need to remain resourced.

CON: This doubles the tax on services after a recent increase. This bill would triple the original tax less than five years after implementation. More than 30 states have explored approaches to implementation, and only nine have used a new tax. One state has a higher tax rate than Washington and after this bill Washington would have the highest rate. There is a budget crisis and the Legislature needs to review expenditures before providing new money. The hotline provides a valuable serivce, but the benefit of the program is questionable. The tax earns $100 million per biennium, and should not need to be raised so soon after the program has started operating. Funding for anything other than the call centers should not be funded with the tax. There is a lack of data to support the success of the 988 line. Children are able to use this line and access mental health services without parent consent. They are often taken to emergency rooms or mental health hospitals. This is another tax increase and should be considered with all of the additional tax increases being proposed this year. Washington is the fourth least affordable state in the nation, and this would make Washington even more expensive.