title: RCW 71.24.585

text:
(1)(a) The state of Washington declares that substance use disorders are medical conditions. Substance use disorders should be treated in a manner similar to other medical conditions by using interventions that are supported by evidence, including medications approved by the federal food and drug administration for the treatment of opioid use disorder. It is also recognized that many individuals have multiple substance use disorders, as well as histories of trauma, developmental disabilities, or mental health conditions. As such, all individuals experiencing opioid use disorder should be offered evidence-supported treatments to include federal food and drug administration approved medications for the treatment of opioid use disorders and behavioral counseling and social supports to address them. For behavioral health agencies, an effective plan of treatment for most persons with opioid use disorder integrates access to medications and psychosocial counseling and should be consistent with the American society of addiction medicine patient placement criteria. Providers must inform patients with opioid use disorder or substance use disorder of options to access federal food and drug administration approved medications for the treatment of opioid use disorder or substance use disorder. Because some such medications are controlled substances in chapter 69.50 RCW, the state of Washington maintains the legal obligation and right to regulate the uses of these medications in the treatment of opioid use disorder.
(b) The authority must work with other state agencies and stakeholders to develop value-based payment strategies to better support the ongoing care of persons with opioid and other substance use disorders.
(c) The department of corrections shall develop policies to prioritize services based on available grant funding and funds appropriated specifically for opioid use disorder treatment.
(2) The authority must promote the use of medication therapies and other evidence-based strategies to address the opioid epidemic in Washington state. Additionally, by January 1, 2020, the authority must prioritize state resources for the provision of treatment and recovery support services to inpatient and outpatient treatment settings that allow patients to start or maintain their use of medications for opioid use disorder while engaging in services.
(3) The state declares that the main goals of treatment for persons with opioid use disorder are the cessation of unprescribed opioid use, reduced morbidity, and restoration of the ability to lead a productive and fulfilling life.
(4) To achieve the goals in subsection (3) of this section, to promote public health and safety, and to promote the efficient and economic use of funding for the medicaid program under Title XIX of the social security act, the authority may seek, receive, and expend alternative sources of funding to support all aspects of the state's response to the opioid crisis.
(5) The authority must partner with the department of social and health services, the department of corrections, the department of health, the department of children, youth, and families, and any other agencies or entities the authority deems appropriate to develop a statewide approach to leveraging medicaid funding to treat opioid use disorder and provide emergency overdose treatment. Such alternative sources of funding may include:
(a) Seeking a section 1115 demonstration waiver from the federal centers for medicare and medicaid services to fund opioid treatment medications for persons eligible for medicaid at or during the time of incarceration and juvenile detention facilities; and
(b) Soliciting and receiving private funds, grants, and donations from any willing person or entity.
(6)(a) The authority shall work with the department of health to promote coordination between medication-assisted treatment prescribers, federally accredited opioid treatment programs, substance use disorder treatment facilities, and state-certified substance use disorder treatment agencies to:
(i) Increase patient choice in receiving medication and counseling;
(ii) Strengthen relationships between opioid use disorder providers;
(iii) Acknowledge and address the challenges presented for individuals needing treatment for multiple substance use disorders simultaneously; and
(iv) Study and review effective methods to identify and reach out to individuals with opioid use disorder who are at high risk of overdose and not involved in traditional systems of care, such as homeless individuals using syringe service programs, and connect such individuals to appropriate treatment.
(b) The authority must work with stakeholders to develop a set of recommendations to the governor and the legislature that:
(i) Propose, in addition to those required by federal law, a standard set of services needed to support the complex treatment needs of persons with opioid use disorder treated in opioid treatment programs;
(ii) Outline the components of and strategies needed to develop opioid treatment program centers of excellence that provide fully integrated care for persons with opioid use disorder;
(iii) Estimate the costs needed to support these models and recommendations for funding strategies that must be included in the report;
(iv) Outline strategies to increase the number of waivered health care providers approved for prescribing buprenorphine by the substance abuse and mental health services administration; and
(v) Outline strategies to lower the cost of federal food and drug administration approved products for the treatment of opioid use disorder.
(7) State agencies shall review and promote positive outcomes associated with the accountable communities of health funded opioid projects and local law enforcement and human services opioid collaborations as set forth in the Washington state interagency opioid working plan.
(8) The authority must partner with the department and other state agencies to replicate effective approaches for linking individuals who have had a nonfatal overdose with treatment opportunities, with a goal to connect certified peer counselors or certified peer support specialists with individuals who have had a nonfatal overdose.
(9) State agencies must work together to increase outreach and education about opioid overdoses to non-English-speaking communities by developing a plan to conduct outreach and education to non-English-speaking communities. The department must submit a report on the outreach and education plan with recommendations for implementation to the appropriate legislative committees by July 1, 2020.
[ 2025 c 360 s 18; 2019 c 314 s 28; 2017 c 297 s 12; 2016 sp.s. c 29 s 519; 2001 c 242 s 1; 1995 c 321 s 1; 1989 c 270 s 20. Formerly RCW 70.96A.400.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.
Findings—Intent—2017 c 297: See note following RCW 18.22.800.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.

catchline: Opioid and substance use disorder treatment—State response.


doc_type: statute

jurisdiction: wa

title: RCW 71.24.586

text:
(1) The department may apply for approval by the United States department of health and human services to accredit opioid treatment programs pursuant to the requirements in 42 C.F.R. Part 8.
(2) If the department is approved by the United States department of health and human services as an accrediting body under 42 C.F.R. Part 8, the department shall:
(a) Execute its responsibilities as the accrediting body pursuant to policies and procedures approved by the United States department of health and human services; and
(b) Establish accreditation fees in rule.
(3) The department shall set accreditation fees including, but not limited to, an initial accreditation fee and a renewal fee, at levels sufficient to cover the costs associated with the accreditation services it provides under 42 C.F.R. Part 8.
(4) The department may use appropriations from the opioid abatement settlement account to offset the cost to the department of providing accreditation services under 42 C.F.R. Part 8.
[ 2026 c 73 s 1.]

license: public-domain-government-work

rule_set: Revised Code of Washington

code: rcw

unit: section

court: Washington State Legislature


title: RCW 71.24.587

text:
The state declares that a person lawfully possessing or using lawfully prescribed medication for the treatment of opioid use disorder must be treated the same in judicial and administrative proceedings as a person lawfully possessing or using other lawfully prescribed medications.
[ 2017 c 297 s 13.]
Notes:
Findings—Intent—2017 c 297: See note following RCW 18.22.800.

catchline: Opioid use disorder treatment—Possession or use of lawfully prescribed medication—Declaration by state.


title: RCW 71.24.589

text:
(1) Subject to funds appropriated by the legislature, the authority shall administer a grant program for law enforcement assisted diversion which shall adhere to law enforcement assisted diversion core principles recognized by the law enforcement assisted diversion national support bureau, the efficacy of which have been demonstrated in peer-reviewed research studies.
(2) The authority must partner with the law enforcement assisted diversion national support bureau to award contracts, subject to appropriation, for jurisdictions in the state of Washington for law enforcement assisted diversion. Cities, counties, and tribes, subdivisions thereof, public development authorities, and community-based organizations demonstrating support from necessary public partners, may serve as the lead agency applying for funding. Funds may be used to scale existing projects, and to invite additional jurisdictions to launch law enforcement assisted diversion programs.
(3) The program must provide for securing comprehensive technical assistance from law enforcement assisted diversion implementation experts to develop and implement a law enforcement assisted diversion program in a way that ensures fidelity to the research-based law enforcement assisted diversion model. Sufficient funds must be allocated from grant program funds to secure technical assistance for the authority and for the implementing jurisdictions.
(4) The key elements of a law enforcement assisted diversion program must include:
(a) Long-term case management for individuals with substance use disorders;
(b) Facilitation and coordination with community resources focusing on overdose prevention;
(c) Facilitation and coordination with community resources focused on the prevention of infectious disease transmission;
(d) Facilitation and coordination with community resources providing physical and behavioral health services;
(e) Facilitation and coordination with community resources providing medications for the treatment of substance use disorders;
(f) Facilitation and coordination with community resources focusing on housing, employment, and public assistance;
(g) 24 hours per day and seven days per week response to law enforcement for arrest diversions; and
(h) Prosecutorial support for diversion services.
(5) No civil liability may be imposed by any court on the state or its officers or employees, an appointed or elected official, public employee, public agency as defined in RCW 4.24.470, combination of units of government and its employees as provided in RCW 36.28A.010, nonprofit community-based organization, tribal government entity, tribal organization, or urban Indian organization, based on the administration of a law enforcement assisted diversion program or activities carried out within the purview of a grant received under this program except upon proof of bad faith or gross negligence.
[ 2023 sp.s. c 1 s 13; 2019 c 314 s 29.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Law enforcement assisted diversion—Grant program.


title: RCW 71.24.590

text:
(1) When making a decision on an application for licensing or certification of an opioid treatment program, the department shall:
(a) Consult with the county legislative authorities in the area in which an applicant proposes to locate a program and the city legislative authority in any city in which an applicant proposes to locate a program;
(b) License or certify only programs that will be sited in accordance with the appropriate county or city land use ordinances. Counties and cities may require conditional use permits with reasonable conditions for the siting of programs only to the extent that such reasonable conditional use requirements applied to opioid treatment programs are similarly applied to other essential public facilities and health care settings. Pursuant to RCW 36.70A.200, no local comprehensive plan or development regulation may preclude the siting of essential public facilities;
(c) Not discriminate in its licensing or certification decision on the basis of the corporate structure of the applicant;
(d) Consider the size of the population in need of treatment in the area in which the program would be located and license or certify only applicants whose programs meet the necessary treatment needs of that population;
(e) Consider the availability of other certified opioid treatment programs near the area in which the applicant proposes to locate the program;
(f) Consider the transportation systems that would provide service to the program and whether the systems will provide reasonable opportunities to access the program for persons in need of treatment;
(g) Consider whether the applicant has, or has demonstrated in the past, the capability to provide the appropriate services to assist the persons who utilize the program in meeting goals established by the legislature in RCW 71.24.585. The department shall prioritize licensing or certification to applicants who have demonstrated such capability and are able to measure their success in meeting such outcomes;
(h) Provide public notice to all appropriate media outlets in the community in which the facility is proposed to be located that states the applicant is proposing a facility in that community.
(2) No city or county legislative authority may impose a maximum capacity for an opioid treatment program.
(3) A program applying for licensing or certification from the department and a program applying for a contract from a state agency that has been denied the licensing or certification or contract shall be provided with a written notice specifying the rationale and reasons for the denial.
(4) Opioid treatment programs may order, possess, dispense, and administer medications approved by the United States food and drug administration for the treatment of opioid use disorder, alcohol use disorder, tobacco use disorder, and reversal of opioid overdose. For an opioid treatment program to order, possess, and dispense any other legend drug, including controlled substances, the opioid treatment program must obtain additional licensure as required by the department, except for patient-owned medications.
(5) Opioid treatment programs may accept, possess, and administer patient-owned medications.
(6) Registered nurses and licensed practical nurses may dispense up to a 31 day supply of medications approved by the United States food and drug administration for the treatment of opioid use disorder to patients of the opioid treatment program, under an order or prescription and in compliance with 42 C.F.R. Sec. 8.12.
(7) A mobile or fixed-site medication unit may be established as part of a licensed opioid treatment program.
(8) For the purpose of this chapter, "opioid treatment program" means a program that:
(a) Engages in the treatment of opioid use disorder with medications approved by the United States food and drug administration for the treatment of opioid use disorder and reversal of opioid overdose, including methadone; and
(b) Provides a comprehensive range of medical and rehabilitative services.
[ 2023 sp.s. c 1 s 14; 2019 c 314 s 30; 2018 c 201 s 4045; 2017 c 297 s 14; 2001 c 242 s 2; 1995 c 321 s 2; 1989 c 270 s 21. Formerly RCW 70.96A.410.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Contingent effective date—2017 c 297 ss 14 and 16: "Sections 14 and 16 of this act take effect only if neither Substitute House Bill No. 1388 (including any later amendments or substitutes) nor Substitute Senate Bill No. 5259 (including any later amendments or substitutes) is signed into law by the governor by July 23, 2017." [ 2017 c 297 s 18.] Neither Substitute House Bill No. 1388 nor Substitute Senate Bill No. 5259 was signed into law by July 23, 2017.
Findings—Intent—2017 c 297: See note following RCW 18.22.800.

catchline: Opioid treatment—Program licensing or certification by department, department duties—Use of medications by program—Definition.


title: RCW 71.24.593

text:
(1) Recognizing that treatment strategies and modalities for the treatment of individuals with opioid use disorder and their newborns continue to evolve, and that improved health outcomes are seen when birth parents and their infants are allowed to room together, the authority must provide recommendations to the office of financial management by October 1, 2019, to better support the care of individuals who have recently delivered and their newborns.
(2) These recommendations must support:
(a) Successful transition from the early postpartum and newborn period for the birth parent and infant to the next level of care;
(b) Reducing the risk of parental infant separation; and
(c) Increasing the chance of uninterrupted recovery of the parent and foster the development of positive parenting practices.
(3) The authority's recommendations must include:
(a) How these interventions could be supported in hospitals, birthing centers, or other appropriate sites of care and descriptions as to current barriers in providing these interventions;
(b) Estimates of the costs needed to support this enhanced set of services; and
(c) Mechanisms for funding the services.
[ 2019 c 314 s 25.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid use disorder treatment—Care of individuals and their newborns—Authority recommendations required.


title: RCW 71.24.594

text:
(1) For any client presenting with symptoms of an opioid use disorder, or who reports recent use of opioids outside legal authority, all licensed or certified behavioral health agencies that provide individuals treatment for mental health or substance use disorder, withdrawal management, secure withdrawal management, evaluation and treatment, or opioid treatment programs must during the client's intake, discharge, or treatment plan review, as appropriate:
(a) Inform the client about opioid overdose reversal medication and ask whether the client has opioid overdose reversal medication; and
(b) If a client does not possess opioid overdose reversal medication, unless the behavioral health provider determines using clinical and professional judgment that opioid overdose reversal medication is not appropriate, the behavioral health provider must:
(i) Prescribe the client opioid overdose reversal medication or utilize the statewide naloxone standing order; and
(ii) Assist the client in directly obtaining opioid overdose reversal medication as soon as practical by:
(A) Directly dispensing the opioid overdose reversal medication, if authorized by state law;
(B) Partnering with a pharmacy to obtain the opioid overdose reversal medication on the client's behalf and distributing the opioid overdose reversal medication to the client;
(C) Assisting the client in utilizing a mail order pharmacy or pharmacy that mails prescription drugs directly to the behavioral health agency or client and distributing the opioid overdose reversal medication to the client, if necessary;
(D) Obtaining and distributing opioid overdose reversal medication through the bulk purchasing and distribution program established in RCW 70.14.170; or
(E) Using any other resources or means authorized by state law to provide opioid overdose reversal medication.
(2) Until the opioid overdose reversal medication bulk purchasing and distribution program established in RCW 70.14.170 is operational, if a behavioral health agency listed in subsection (1) of this section dispenses, distributes, or otherwise assists the client in directly obtaining the opioid overdose reversal medication such that the agency is the billing entity, the behavioral health agency must:
(a) For clients enrolled in medical assistance under chapter 74.09 RCW, bill the client's medicaid benefit for the client's opioid overdose reversal medication utilizing the appropriate billing codes established by the health care authority;
(b) For clients with available health insurance coverage other than medical assistance under chapter 74.09 RCW, bill the client's health plan for the cost of the opioid overdose reversal medication;
(c) For clients who are not enrolled in medical assistance under chapter 74.09 RCW and do not have any other available health insurance coverage, bill the health care authority for the cost of the client's opioid overdose reversal medication.
(3) A pharmacy that dispenses opioid overdose reversal medication through a partnership or relationship with a behavioral health agency as described in subsection (1) of this section must bill the health care authority for the cost of the client's opioid overdose reversal medication for clients that are not enrolled in medical assistance under chapter 74.09 RCW and do not have any other available health insurance coverage.
(4) The labeling requirements of RCW 69.41.050 and 18.64.246 do not apply to opioid overdose reversal medication dispensed or delivered in accordance with this section.
(5) A person who is provided opioid overdose reversal medication under this section must be provided information and resources about medication for opioid use disorder and harm reduction strategies and services which may be available, such as substance use disorder treatment services and substance use disorder peer counselors. This information should be available in all languages relevant to the communities that the behavioral health agency serves.
(6) The individual or entity that dispenses, distributes, or delivers an opioid overdose reversal medication in accordance with this section shall ensure that the directions for use are provided.
(7) Actions taken in compliance with subsection (1) of this section by an entity that provides only mental health treatment may not be construed as the entity holding itself out as providing or in fact providing substance use disorder diagnosis, treatment, or referral for treatment for purposes of state or federal law.
(8) A behavioral health agency, its employees, and providers are immune from suit in any action, civil or criminal, or from professional or other disciplinary action, for action or inaction in compliance with this section.
(9) For purposes of this section, "opioid overdose reversal medication" has the meaning provided in RCW 69.41.095.
[ 2021 c 273 s 4.]
Notes:
Effective date—2021 c 273 ss 2-4: See note following RCW 70.41.480.
Findings—Intent—2021 c 273: See note following RCW 70.41.480.

catchline: Opioid overdose reversal medications—Education—Distribution—Labeling—Liability.


title: RCW 71.24.595

text:
(1) To achieve more medication options, the authority must work with the department and the authority's medicaid managed care organizations, to eliminate barriers and promote access to effective medications known to address opioid use disorders at state-certified opioid treatment programs. Medications include, but are not limited to: Methadone, buprenorphine, and naltrexone. The authority must encourage the distribution of naloxone to patients who are at risk of an opioid overdose.
(2) The department, in consultation with opioid treatment program service providers and counties and cities, shall establish statewide treatment standards for licensed or certified opioid treatment programs. The department shall enforce these treatment standards. The treatment standards shall include, but not be limited to, reasonable provisions for all appropriate and necessary medical procedures, counseling requirements, urinalysis, and other suitable tests as needed to ensure compliance with this chapter.
(3) The department, in consultation with opioid treatment programs and counties, shall establish statewide operating standards for certified opioid treatment programs. The department shall enforce these operating standards. The operating standards shall include, but not be limited to, reasonable provisions necessary to enable the department and counties to monitor certified or licensed opioid treatment programs for compliance with this chapter and the treatment standards authorized by this chapter and to minimize the impact of the opioid treatment programs upon the business and residential neighborhoods in which the program is located.
(4) The department shall analyze and evaluate the data submitted by each treatment program and take corrective action where necessary to ensure compliance with the goals and standards enumerated under this chapter. Opioid treatment programs are subject to the oversight required for other substance use disorder treatment programs, as described in this chapter.
[ 2019 c 314 s 31; 2018 c 201 s 4046; 2017 c 297 s 16; 2003 c 207 s 6; 2001 c 242 s 3; 1998 c 245 s 135; 1995 c 321 s 3; 1989 c 270 s 22. Formerly RCW 70.96A.420.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Contingent effective date—2017 c 297 ss 14 and 16: See note following RCW 71.24.590.
Findings—Intent—2017 c 297: See note following RCW 18.22.800.

catchline: Statewide treatment and operating standards for opioid treatment programs—Evaluation and report.


title: RCW 71.24.597

text:
By October 1, 2019, the authority must work with the department, the accountable communities of health, and community stakeholders to develop a plan for the coordinated purchasing and distribution of opioid overdose reversal medication across the state of Washington. The plan must be developed in consultation with the University of Washington's alcohol and drug abuse institute and community agencies participating in the federal demonstration grant titled Washington state project to prevent prescription drug or opioid overdose.
[ 2019 c 314 s 32.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid overdose reversal medication—Coordinated purchasing and distribution.


title: RCW 71.24.598

text:
(1) The department, in coordination with the authority, must develop a strategy to rapidly deploy a response team to a local community identified as having a high number of fentanyl-related or other drug overdoses by the local emergency management system, hospital emergency department, local health jurisdiction, law enforcement agency, or surveillance data. The response team must provide technical assistance and other support to the local health jurisdiction, health care clinics, hospital emergency departments, substance use disorder treatment providers, and other community-based organizations, and are expected to increase the local capacity to provide medication-assisted treatment and overdose education.
(2) The department and the authority must reduce barriers and promote medication treatment therapies for opioid use disorder in emergency departments and same-day referrals to opioid treatment programs, substance use disorder treatment facilities, and community-based medication treatment prescribers for individuals experiencing an overdose.
[ 2019 c 314 s 33.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Drug overdose response team.


title: RCW 71.24.599

text:
(1) Subject to funds appropriated by the legislature, or approval of a section 1115 demonstration waiver from the federal centers for medicare and medicaid services, to fund opioid treatment medications for persons eligible for medicaid at or during the time of incarceration and juvenile detention facilities, the authority shall establish a methodology for distributing funds to city and county jails to provide medication for the treatment of opioid use disorder to individuals in the custody of the facility in any status. The authority must prioritize funding for the services required in (a) of this subsection. To the extent that funding is provided, city and county jails must:
(a) Provide medication for the treatment of opioid use disorder to individuals in the custody of the facility, in any status, who were receiving medication for the treatment of opioid use disorder through a legally authorized medical program or by a valid prescription immediately before incarceration; and
(b) Provide medication for the treatment of opioid use disorder to incarcerated individuals not less than thirty days before release when treatment is determined to be medically appropriate by a health care practitioner.
(2) City and county jails must make reasonable efforts to directly connect incarcerated individuals receiving medication for the treatment of opioid use disorder to an appropriate provider or treatment site in the geographic region in which the individual will reside before release. If a connection is not possible, the facility must document its efforts in the individual's record.
[ 2019 c 314 s 34.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid use disorder—City and county jails—Funding.


title: RCW 71.24.600

text:
The authority shall not refuse admission for diagnosis, evaluation, guidance[,] or treatment to any applicant because it is determined that the applicant is financially unable to contribute fully or in part to the cost of any services or facilities available under the community behavioral health program.
For nonmedicaid clients, through its contracts with the behavioral health administrative services organizations, the authority may limit admissions of such applicants or modify its programs in order to ensure that expenditures for services or programs do not exceed amounts appropriated by the legislature and are allocated by the authority for such services or programs. For nonmedicaid clients, the authority may establish admission priorities in the event that the number of eligible applicants exceeds the limits set by the authority.
[ 2019 c 325 s 1041; 2018 c 201 s 4047. Prior: 1989 c 271 s 308; 1959 c 85 s 15. Formerly RCW 70.96A.430, 70.96.150.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Severability—1989 c 271: See note following RCW 9.94A.510.

catchline: Inability to contribute to cost of services no bar to admission—Authority may limit admissions for nonmedicaid clients.


title: RCW 71.24.605

text:
The authority shall contract with the University of Washington fetal alcohol syndrome clinic to provide fetal alcohol exposure screening and assessment services. The University indirect charges shall not exceed ten percent of the total contract amount. The contract shall require the University of Washington fetal alcohol syndrome clinic to provide the following services:
(1) Training for health care staff in community-based fetal alcohol exposure clinics to ensure the accurate diagnosis of individuals with fetal alcohol exposure and the development and implementation of appropriate service referral plans;
(2) Development of written or visual educational materials for the individuals diagnosed with fetal alcohol exposure and their families or caregivers;
(3) Systematic information retrieval from each community clinic to (a) maintain diagnostic accuracy and reliability across all community clinics, (b) facilitate the development of effective and efficient screening tools for population-based identification of individuals with fetal alcohol exposure, (c) facilitate identification of the most clinically efficacious and cost-effective educational, social, vocational, and health service interventions for individuals with fetal alcohol exposure;
(4) Based on available funds, establishment of a network of community-based fetal alcohol exposure clinics across the state to meet the demand for fetal alcohol exposure diagnostic and referral services; and
(5) Preparation of an annual report for submission to the authority, the department of health, the department of social and health services, the department of corrections, and the office of the superintendent of public instruction which includes the information retrieved under subsection (3) of this section.
[ 2018 c 201 s 4048; 1998 c 245 s 136; 1995 c 54 s 2. Formerly RCW 70.96A.500.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Findings—Purpose—1995 c 54: "The legislature finds that fetal alcohol exposure is among the leading known causes of mental retardation in the children of our state. The legislature further finds that individuals with undiagnosed fetal alcohol exposure suffer substantially from secondary disabilities such as child abuse and neglect, separation from families, multiple foster placements, depression, aggression, school failure, juvenile detention, and job instability. These secondary disabilities come at a high cost to the individuals, their family, and society. The legislature finds that these problems can be reduced substantially by early diagnosis and receipt of appropriate, effective intervention.
The purpose of this act is to support current public and private efforts directed at the early identification of and intervention into the problems associated with fetal alcohol exposure through the creation of a fetal alcohol exposure clinical network." [ 1995 c 54 s 1.]

catchline: Fetal alcohol screening and assessment services.


title: RCW 71.24.610

text:
The authority, the department of social and health services, the department, the department of corrections, the department of children, youth, and families, and the office of the superintendent of public instruction shall execute an interagency agreement to ensure the coordination of identification, prevention, and intervention programs for children who have fetal alcohol exposure and other prenatal substance exposures, and for women who are at high risk of having children with fetal alcohol exposure or other prenatal substance exposures.
The interagency agreement shall provide a process for community advocacy groups to participate in the review and development of identification, prevention, and intervention programs administered or contracted for by the agencies executing this agreement.
[ 2023 c 288 s 5; 2018 c 201 s 4049; 1995 c 54 s 3. Formerly RCW 70.96A.510.]
Notes:
Findings—2023 c 288: See note following RCW 41.05.810.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Findings—Purpose—1995 c 54: See note following RCW 71.24.605.

catchline: Interagency agreement on prenatal substance exposure programs.


title: RCW 71.24.612

text:
(1) By June 1, 2024, the authority shall submit to the legislature recommendations on ways to increase access to diagnoses, treatment, services, and supports for children who were exposed to alcohol or other substances during pregnancy and their families and caregivers. In creating the recommendations, the authority shall consult with service providers, medical professionals with expertise in diagnosing and treating prenatal substance exposure, families of children who were exposed to alcohol or other substances during pregnancy, communities affected by prenatal substance exposure, and advocates.
(2) The recommendations adopted under subsection (1) of this section shall, at a minimum, address:
(a) Increasing the availability of evaluation and diagnosis services for children and youth for fetal alcohol spectrum disorders and other prenatal substance disorders, including assuring an adequate payment rate for the interdisciplinary team required for diagnosis and developing sufficient capacity in rural and urban areas so that every child is able to access diagnosis services; and
(b) Increasing the availability of treatment for fetal alcohol spectrum disorders and other prenatal substance disorders for all children and youth including all treatments and services recommended by the federal centers for disease control and prevention. The authority shall review all barriers to accessing treatment and make recommendations on removing those barriers, including recommendations related to the definition of medical necessity, prior authorization requirements for diagnosis and treatment services, and limitations of treatment procedure codes and insurance coverage.
[ 2023 c 288 s 3.]
Notes:
Findings—2023 c 288: See note following RCW 41.05.810.


title: RCW 71.24.614

text:
Subject to the availability of amounts appropriated for this specific purpose, the authority shall contract with a statewide nonprofit entity with expertise in fetal alcohol spectrum disorders and experience in supporting parents and caregivers to offer free support groups for individuals living with fetal alcohol spectrum disorders and their parents and caregivers.
[ 2023 c 288 s 4.]
Notes:
Findings—2023 c 288: See note following RCW 41.05.810.


title: RCW 71.24.615

text:
The authority shall prioritize expenditures for treatment provided under RCW 13.40.165. The authority shall provide funds for inpatient and outpatient treatment providers that are the most successful, using the standards developed by the University of Washington under section 27, chapter 338, Laws of 1997. The authority may consider variations between the nature of the programs provided and clients served but must provide funds first for those programs that demonstrate the greatest success in treatment within categories of treatment and the nature of the persons receiving treatment.
[ 2018 c 201 s 4050; 2003 c 207 s 7; 1997 c 338 s 28. Formerly RCW 70.96A.520.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Finding—Evaluation—Report—1997 c 338: See note following RCW 13.40.0357.
Severability—Effective dates—1997 c 338: See notes following RCW 5.60.060.

catchline: Chemical dependency treatment expenditures—Prioritization.


title: RCW 71.24.618

text:
(1) Beginning January 1, 2021, a managed care organization may not require an enrollee to obtain prior authorization for withdrawal management services or inpatient or residential substance use disorder treatment services in a behavioral health agency licensed or certified under RCW 71.24.037.
(2)(a) Beginning January 1, 2021, a managed care organization must:
(i) Provide coverage for no less than two business days, excluding weekends and holidays, in a behavioral health agency that provides inpatient or residential substance use disorder treatment prior to conducting a utilization review; and
(ii) Provide coverage for no less than three days in a behavioral health agency that provides withdrawal management services prior to conducting a utilization review.
(b)(i) The managed care organization may not require an enrollee to obtain prior authorization for the services specified in (a) of this subsection as a condition for payment of services prior to the times specified in (a) of this subsection.
(ii) Once the times specified in (a) of this subsection have passed, the managed care organization may initiate utilization management review procedures if the behavioral health agency continues to provide services or is in the process of arranging for a seamless transfer to an appropriate facility or lower level of care under subsection (6) of this section. Beginning January 1, 2025, if a managed care organization authorizes inpatient or residential substance use disorder treatment services pursuant to (a)(i) of this subsection following the initial medical necessity review process under (c)(iii) of this subsection, the length of the initial authorization may not be less than 14 days from the date that the patient was admitted to the behavioral health agency. Any subsequent reauthorization that the managed care organization approves after the first 14 days must continue for no less than seven days prior to requiring further reauthorization. Nothing prohibits a managed care organization from requesting information to assist with a seamless transfer under this subsection.
(c)(i) The behavioral health agency under (a) of this subsection must notify an enrollee's managed care organization as soon as practicable after admitting the enrollee, but not later than twenty-four hours after admitting the enrollee. The time of notification does not reduce the requirements established in (a) of this subsection.
(ii) The behavioral health agency under (a) of this subsection must provide the managed care organization with its initial assessment and initial treatment plan for the enrollee within two business days of admission, excluding weekends and holidays, or within three days in the case of a behavioral health agency that provides withdrawal management services.
(iii) After the time period in (a) of this subsection and receipt of the material provided under (c)(ii) of this subsection, the managed care organization may initiate a medical necessity review process. Medical necessity review must be based on the standard set of criteria established under RCW 41.05.528. In a review for inpatient or residential substance use disorder treatment services, a managed care organization may not make a determination that a patient does not meet medical necessity criteria based primarily on the patient's length of abstinence. If the patient's abstinence from substance use was due to incarceration, hospitalization, or inpatient treatment, a managed care organization may not consider the patient's length of abstinence in determining medical necessity. If the health plan determines within one business day from the start of the medical necessity review period and receipt of the material provided under (c)(ii) of this subsection that the admission to the facility was not medically necessary and advises the agency of the decision in writing, the health plan is not required to pay the facility for services delivered after the start of the medical necessity review period, subject to the conclusion of a filed appeal of the adverse benefit determination. If the managed care organization's medical necessity review is completed more than one business day after the start of the medical necessity review period and receipt of the material provided under (c)(ii) of this subsection, the managed care organization must pay for the services delivered from the time of admission until the time at which the medical necessity review is completed and the agency is advised of the decision in writing.
(3)(a) The behavioral health agency shall document to the managed care organization the patient's need for continuing care and justification for level of care placement following the current treatment period, based on the standard set of criteria established under RCW 41.05.528, with documentation recorded in the patient's medical record.
(b) Beginning January 1, 2025, for inpatient or residential substance use disorder treatment services, the managed care organization may not consider the patient's length of stay at the behavioral health agency when making decisions regarding the authorization to continue care at the behavioral health agency.
(4) Nothing in this section prevents a health carrier from denying coverage based on insurance fraud.
(5) If the behavioral health agency under subsection (2)(a) of this section is not in the enrollee's network:
(a) The managed care organization is not responsible for reimbursing the behavioral health agency at a greater rate than would be paid had the agency been in the enrollee's network; and
(b) The behavioral health agency may not balance bill, as defined in RCW 48.43.005.
(6) When the treatment plan approved by the managed care organization involves transfer of the enrollee to a different facility or to a lower level of care, the care coordination unit of the managed care organization shall work with the current agency to make arrangements for a seamless transfer as soon as possible to an appropriate and available facility or level of care. The managed care organization shall pay the agency for the cost of care at the current facility until the seamless transfer to the different facility or lower level of care is complete. A seamless transfer to a lower level of care may include same day or next day appointments for outpatient care, and does not include payment for nontreatment services, such as housing services. If placement with an agency in the managed care organization's network is not available, the managed care organization shall pay the current agency at the service level until a seamless transfer arrangement is made.
(7) The requirements of this section do not apply to treatment provided in out-of-state facilities.
(8) For the purposes of this section "withdrawal management services" means twenty-four hour medically managed or medically monitored detoxification and assessment and treatment referral for adults or adolescents withdrawing from alcohol or drugs, which may include induction on medications for addiction recovery.
[ 2024 c 366 s 8; 2020 c 345 s 4.]
Notes:
Findings—Intent—2024 c 366: See note following RCW 71.24.847.
Findings—Intent—2020 c 345: See note following RCW 41.05.526.

catchline: Withdrawal management services—Substance use disorder treatment services—Prior authorization—Utilization review—Medical necessity review.


title: RCW 71.24.619

text:
When updated versions of the ASAM Criteria, treatment criteria for addictive, substance related, and co-occurring conditions, inclusive of adolescent and transition age youth versions, are published by the American society of addiction medicine, the health care authority and the office of the insurance commissioner shall jointly determine whether to use the updated version, and, if so, the date upon which the updated version must begin to be used by medicaid managed care organizations, carriers, and other relevant entities. Both agencies shall post notice of their decision on their websites. For purposes of the ASAM Criteria, 4th edition, medicaid managed care organizations and carriers shall begin to use the updated criteria no later than January 1, 2028, unless the health care authority and the office of the insurance commissioner jointly determine that it should not be used.
[ 2025 c 335 s 1; 2024 c 366 s 12.]
Notes:
Findings—Intent—2024 c 366: See note following RCW 71.24.847.

catchline: Standard set of criteria—Authority review.


title: RCW 71.24.621

text:
(1) If a behavioral health provider or licensed or certified behavioral health agency that provides withdrawal management services to a patient seeks to discontinue usage or reduce dosage amounts of a medication, including a psychotropic medication, that the patient has been using in accordance with the directions of a prescribing health care provider, the withdrawal management provider shall engage in individualized, patient-centered, shared decision making, using nonjudgmental and compassionate communication and, with the consent of the patient, make a good faith effort to consult the prescribing health care provider. A withdrawal management provider may not, by philosophy or practice, categorically require all patients to discontinue all psychotropic medications, including benzodiazepines and medications for attention deficit hyperactivity disorder.
(2) This section does not apply to hospitals licensed under chapter 70.41 RCW and psychiatric hospitals licensed under chapter 71.12 RCW.
[ 2024 c 366 s 5.]
Notes:
Findings—Intent—2024 c 366: See note following RCW 71.24.847.

catchline: Withdrawal management services—Requirements for limiting medication usage.


title: RCW 71.24.625

text:
The authority shall ensure that the provisions of this chapter are applied by behavioral health administrative services organizations and managed care organizations in a consistent and uniform manner. The authority shall also ensure that, to the extent possible within available funds, the designated crisis responders are specifically trained in adolescent substance use disorder issues, the substance use disorder commitment laws, and the criteria for commitment.
[ 2019 c 325 s 1042; 2018 c 201 s 4052; 2016 sp.s. c 29 s 521; 1992 c 205 s 306. Formerly RCW 70.96A.905.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.
Part headings not law—Severability—1992 c 205: See notes following RCW 13.40.010.

catchline: Uniform application of chapter—Training for designated crisis responders.


title: RCW 71.24.630

text:
(1) The authority shall maintain an integrated and comprehensive screening and assessment process for substance use and mental disorders and co-occurring substance use and mental disorders.
(a) The process adopted shall include, at a minimum:
(i) An initial screening tool that can be used by intake personnel systemwide and which will identify the most common types of co-occurring disorders;
(ii) An assessment process for those cases in which assessment is indicated that provides an appropriate degree of assessment for most situations, which can be expanded for complex situations;
(iii) Identification of triggers in the screening that indicate the need to begin an assessment;
(iv) Identification of triggers after or outside the screening that indicate a need to begin or resume an assessment;
(v) The components of an assessment process and a protocol for determining whether part or all of the assessment is necessary, and at what point; and
(vi) Emphasis that the process adopted under this section is to replace and not to duplicate existing intake, screening, and assessment tools and processes.
(b) The authority shall consider existing models, including those already adopted by other states, and to the extent possible, adopt an established, proven model.
(c) The integrated, comprehensive screening and assessment process shall be implemented statewide by all substance use disorder and mental health treatment providers and designated crisis responders.
(2) The authority shall provide for adequate training to effect statewide implementation and, upon request, shall report the rates of co-occurring disorders [and] the stage of screening or assessment at which the co-occurring disorder was identified to the appropriate committees of the legislature.
(3) The authority shall establish performance-based contracts with managed care organizations and behavioral health administrative services organizations and implement the integrated screening and assessment process.
[ 2019 c 325 s 1043; 2018 c 201 s 4053; 2016 sp.s. c 29 s 513; 2014 c 225 s 77; 2005 c 504 s 601. Formerly RCW 70.96C.010.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date—2014 c 225: See note following RCW 71.24.016.
Findings—Intent—Severability—Application—Construction—Captions, part headings, subheadings not law—Adoption of rules—Effective dates—2005 c 504: See notes following RCW 71.05.027.
Alphabetization—Correction of references—2005 c 504: See note following RCW 71.05.020.

catchline: Integrated, comprehensive screening and assessment process for substance use and mental disorders.


title: RCW 71.24.635

text:
(1) Subject to amounts appropriated for this specific purpose, the health care authority must issue a request for proposal and contract with an entity to develop, implement, test, and evaluate guidance and health interventions for health care providers and patients at risk for developing serious complications due to cannabis consumption who are seeking care in emergency departments, primary care settings, behavioral health settings, other health care facilities, and for use by state poison control and recovery hotlines to promote cannabis use reduction and cessation for the following populations:
(a) Youth and adults at high risk of adverse mental health impacts from use of high THC cannabis;
(b) Youth and adults who have experienced a cannabis-induced first episode psychosis but do not have a diagnosis of a psychotic disorder; and
(c) Youth and adults who have a diagnosed psychotic disorder and use cannabis.
(2) The health care authority must submit a preliminary report to the appropriate committees of the legislature summarizing the progress toward developing and testing health interventions and recruiting patients and health care facilities to participate by December 1, 2025. The health care authority must provide a progress report on initial outcomes of the health interventions for participating patients and health care facilities by July 1, 2027. The health care authority must submit a final report to the appropriate committees of the legislature summarizing the results of the interventions and any recommendations for implementation of health interventions by December 1, 2028.
(3) A contract entered under the authorization in this section must include, in the scope of work, data gathering on adverse health impacts occurring in Washington associated with consumption of high THC cannabis, and data gathered must be included in the reports submitted to the legislature under this section.
(4) This section expires December 31, 2028.
[ 2024 c 360 s 5.]
Notes:
Finding—Intent—2024 c 360: See notes following RCW 69.50.357.

catchline: Cannabis consumption—Health care provider guidance—Promotion of reduction and cessation programs for populations at risk of serious complications—Request for proposal—Report. (Expires December 31, 2028.)


title: RCW 71.24.640

text:
The secretary shall license or certify evaluation and treatment facilities that meet state minimum standards. The standards for certification or licensure of evaluation and treatment facilities by the department must include standards relating to maintenance of good physical and mental health and other services to be afforded persons pursuant to this chapter and chapters 71.05 and 71.34 RCW, and must otherwise assure the effectuation of the purposes of these chapters.
[ 2018 c 201 s 4054; 2016 sp.s. c 29 s 507.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.

catchline: Standards for certification or licensure of evaluation and treatment facilities.


title: RCW 71.24.645

text:
The secretary shall license or certify crisis stabilization units that meet state minimum standards. The standards for certification or licensure of crisis stabilization units by the department must include standards that:
(1) Permit location of the units at a jail facility if the unit is physically separate from the general population of the jail;
(2) Require administration of the unit by mental health professionals who direct the stabilization and rehabilitation efforts; and
(3) Provide an environment affording security appropriate with the alleged criminal behavior and necessary to protect the public safety.
[ 2018 c 201 s 4055; 2016 sp.s. c 29 s 508.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.

catchline: Standards for certification or licensure of crisis stabilization units.


title: RCW 71.24.648

text:
The secretary shall license or certify intensive behavioral health treatment facilities that meet state minimum standards. The secretary must establish rules working with the authority and the department of social and health services to create standards for licensure or certification of intensive behavioral health treatment facilities. The rules, at a minimum, must:
(1) Clearly define clinical eligibility criteria in alignment with how "intensive behavioral health treatment facility" is defined in RCW 71.24.025;
(2) Require twenty-four hour supervision of residents;
(3) Establish staffing requirements that provide an appropriate response to the acuity of the residents, including a clinical team and a high staff to patient ratio;
(4) Establish requirements for the ability to provide services and an appropriate level of care to individuals with intellectual or developmental disabilities. The requirements must include staffing and training;
(5) Require access to regular psychosocial rehabilitation services including, but not limited to, skills training in daily living activities, social interaction, behavior management, impulse control, and self-management of medications;
(6) Establish requirements for the ability to use limited egress;
(7) Limit services to persons at least eighteen years of age; and
(8) Establish resident rights that are substantially similar to the rights of residents in long-term care facilities.
[ 2019 c 324 s 3.]
Notes:
Findings—Intent—2019 c 324: "The legislature finds that there is a need for additional bed capacity and services for individuals with behavioral health needs. The legislature further finds that for many individuals, it is best for them to receive treatment in their communities and in smaller facilities that help them stay closer to home. The legislature further finds that the state hospitals are struggling to keep up with rising demand; there are challenges to finding appropriate placements for patients ready to discharge, and there are a shortage of appropriate facilities for individuals with complex behavioral health needs.
Therefore, the legislature intends to provide more options in the continuum of care for behavioral health clients by creating new facility types and by expanding the capacity of current provider types in the community." [ 2019 c 324 s 1.]
Mental health drop-in center services pilot program—2019 c 324: See note following RCW 71.24.649.
Report—2019 c 324: See note following RCW 70.38.111.
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: See note following RCW 74.39A.030.

catchline: Standards for certification or licensure of intensive behavioral health treatment facilities.


title: RCW 71.24.649

text:
The secretary shall license or certify mental health peer-run respite centers that meet state minimum standards. In consultation with the authority and the department of social and health services, the secretary must:
(1) Establish requirements for licensed and certified community behavioral health agencies to provide mental health peer-run respite center services and establish physical plant and service requirements to provide voluntary, short-term, noncrisis services that focus on recovery and wellness;
(2) Require licensed and certified agencies to partner with the local crisis system including, but not limited to, evaluation and treatment facilities and designated crisis responders;
(3) Establish staffing requirements, including rules to ensure that facilities are peer-run;
(4) Limit services to a maximum of seven days in a month;
(5) Limit services to individuals who are experiencing psychiatric distress, but do not meet legal criteria for involuntary hospitalization under chapter 71.05 RCW; and
(6) Limit services to persons at least eighteen years of age.
[ 2021 c 302 s 403; 2019 c 324 s 5.]
Notes:
Findings—Intent—2021 c 302: See note following RCW 71.24.890.
Mental health drop-in center services pilot program—2019 c 324: "(1) The health care authority shall establish a pilot program to provide mental health drop-in center services. The mental health drop-in center services shall provide a peer-focused recovery model during daytime hours through a community-based, therapeutic, less restrictive alternative to hospitalization for acute psychiatric needs. The program shall assist clients in need of voluntary, short-term, noncrisis services that focus on recovery and wellness. Clients may refer themselves, be brought to the center by law enforcement, be brought to the center by family members, or be referred by an emergency department.
(2) The pilot program shall be conducted in the largest city in a regional service area that has at least nine counties. Funds to support the pilot program shall be distributed through the behavioral health administrative service organization that serves the pilot program.
(3) The pilot program shall begin on January 1, 2020, and conclude July 1, 2022.
(4) By December 1, 2020, the health care authority shall submit a preliminary report to the governor and the appropriate committees of the legislature. The preliminary report shall include a survey of peer mental health programs that are operating in the state, including the location, type of services offered, and number of clients served. By December 1, 2021, the health care authority shall report to the governor and the appropriate committees of the legislature on the results of the pilot program. The report shall include information about the number of clients served, the needs of the clients, the method of referral for the clients, and recommendations on how to expand the program statewide, including any recommendations to account for different needs in urban and rural areas." [ 2019 c 324 s 12.]
Findings—Intent—2019 c 324: See note following RCW 71.24.648.
Report—2019 c 324: See note following RCW 70.38.111.
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: See note following RCW 74.39A.030.

catchline: Standards for certification or licensure of mental health peer-run respite centers.


title: RCW 71.24.650

text:
The secretary shall license or certify clubhouses that meet state minimum standards. The standards for certification or licensure of a clubhouse by the department must at a minimum include:
(1) The facilities may be peer-operated and must be recovery-focused;
(2) Members and employees must work together;
(3) Members must have the opportunity to participate in all the work of the clubhouse, including administration, research, intake and orientation, outreach, hiring, training and evaluation of staff, public relations, advocacy, and evaluation of clubhouse effectiveness;
(4) Members and staff and ultimately the clubhouse director must be responsible for the operation of the clubhouse, central to this responsibility is the engagement of members and staff in all aspects of clubhouse operations;
(5) Clubhouse programs must be comprised of structured activities including but not limited to social skills training, vocational rehabilitation, employment training and job placement, and community resource development;
(6) Clubhouse programs must provide in-house educational programs that significantly utilize the teaching and tutoring skills of members and assist members by helping them to take advantage of adult education opportunities in the community;
(7) Clubhouse programs must focus on strengths, talents, and abilities of its members;
(8) The work-ordered day may not include medication clinics, day treatment, or other therapy programs within the clubhouse.
[ 2018 c 201 s 4057; 2016 sp.s. c 29 s 509.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.
Effective dates—2016 sp.s. c 29: See note following RCW 71.05.760.
Short title—Right of action—2016 sp.s. c 29: See notes following RCW 71.05.010.

catchline: Standards for certification or licensure of a clubhouse.


title: RCW 71.24.657

text:
Subject to the availability of funds appropriated for this specific purpose, the authority shall:
(1) Make sufficient funding available to support establishment of an adequate and equitable stock of recovery residences in each region of the state;
(2) Establish a voucher program to allow accredited recovery housing operators to hold bed space for individuals who are waiting for treatment;
(3) Conduct outreach to underserved and rural areas to support the development of recovery housing, including adequate resources for women, LGBTQIA+ communities, Black, indigenous, and other people of color communities, immigrant communities, and youth; and
(4) Develop a training for housing providers by January 1, 2024, to assist them with providing appropriate service to LGBTQIA+ communities, Black, indigenous, and other people of color communities, and immigrant communities, including consideration of topics like harassment, communication, antiracism, diversity, and gender-affirming behavior, and ensure applicants for grants or loans related to recovery residences receive access to the training.
[ 2023 sp.s. c 1 s 17.]


title: RCW 71.24.660

text:
Beginning January 1, 2023, a licensed or certified service provider may not refer a client who is appropriate for housing in a recovery residence, to support the client's recovery from a substance use disorder, to a recovery residence that is not included in the registry of approved recovery residences maintained by the authority under RCW 41.05.760. This section does not otherwise limit the discharge or referral options available for a person in recovery from a substance use disorder to any other appropriate placements or services.
[ 2019 c 264 s 5.]
Notes:
Findings—2019 c 264: See note following RCW 41.05.760.

catchline: Recovery residences—Referrals by licensed or certified service providers.


title: RCW 71.24.665

text:
(1) The authority shall provide an annual report on psychiatric treatment and evaluation and bed utilization for American Indians and Alaska Natives starting on October 1, 2020. The report shall be available for review by the tribes, urban Indian health programs, and the American Indian health commission for Washington state.
(2) Indian health care providers shall be included in any bed tracking system created by the authority.
[ 2020 c 256 s 307.]

catchline: Psychiatric treatment, evaluation, and bed utilization for American Indians and Alaska Natives—Report by authority.


title: RCW 71.24.670

text:
Any substance use disorder treatment facilities and entities that provide behavioral health services where the department of children, youth, and families is investigating child abuse or neglect, as provided for under RCW 26.44.210, shall share records and any other information that is relevant to the department of children, youth, and families' investigation. Any records or information shared with the department of children, youth, and families retains any confidentiality protections under state or federal law.
[ 2023 c 441 s 5.]
Notes:
Finding—Intent—2023 c 441: See note following RCW 74.15.325.

catchline: Substance use disorder treatment facilities and entities—Record sharing.


title: RCW 71.24.700

text:
(1) The authority and the entities identified in *RCW 71.24.310 and 71.24.380 shall: (a) Work with willing community hospitals licensed under chapters 70.41 and 71.12 RCW and evaluation and treatment facilities licensed or certified under chapter 71.05 RCW to assess their capacity to become licensed or certified to provide long-term inpatient care and to meet the requirements of this chapter; and (b) enter into contracts and payment arrangements with such hospitals and evaluation and treatment facilities choosing to provide long-term mental health placements, to the extent that willing licensed or certified facilities are available.
(2) Nothing in this section requires any community hospital or evaluation and treatment facility to be licensed or certified to provide long-term mental health placements.
[ 2019 c 324 s 6.]
Notes:
*Reviser's note: RCW 71.24.310 was repealed by 2019 c 325 s 6004, effective January 1, 2020.
Findings—Intent—2019 c 324: See note following RCW 71.24.648.
Mental health drop-in center services pilot program—2019 c 324: See note following RCW 71.24.649.
Report—2019 c 324: See note following RCW 70.38.111.
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: See note following RCW 74.39A.030.

catchline: Long-term inpatient care and mental health placements—Contracting with community hospitals and evaluation and treatment facilities.


title: RCW 71.24.710

text:
(1) The authority shall convene a reentry services work group to consider ways to improve reentry services for persons with an identified behavioral health services need. The work group shall:
(a) Advise the authority on its waiver application under RCW 71.24.715;
(b) Develop a plan to assure notifications of the person's release date, current location, and other appropriate information are provided to the person's managed care organization before the person's scheduled release from confinement, or as soon as practicable thereafter, in accordance with RCW 74.09.555;
(c) Consider the value of expanding, replicating, or adapting the essential elements of the reentry community services program under RCW 72.09.370 and 71.24.470 to benefit new populations, such as:
(i) A larger group of incarcerated persons in the department of corrections than those who currently have the opportunity to participate;
(ii) State hospital patients committed under criminal insanity laws under chapter 10.77 RCW;
(iii) Involuntary treatment patients committed under chapter 71.05 RCW;
(iv) Persons committed to juvenile rehabilitation;
(v) Persons confined in jail; and
(vi) Other populations recommended by the work group;
(d) Consider whether modifications should be made to the reentry community services program;
(e) Identify potential costs and savings for the state and local governments which could be realized through the use of telehealth technology to provide behavioral health services, expansion or replication of the reentry community services program, or other reentry programs which are supported by evidence;
(f) Consider the sustainability of reentry or diversion services provided by pilot programs funded by contempt fines in Trueblood, et al., v. Washington State DSHS, No. 15-35462;
(g) Recommend a means of funding expanded reentry services; and
(h) Consider incorporation of peer services into the reentry community services programs.
(2)(a) In addition, the authority shall convene a subcommittee of the work group consisting of a representative of the authority, one representative of each managed care organization contracted with the authority under chapter 74.09 RCW, representatives of the Washington association of sheriffs and police chiefs, representatives of jails, and other members that the work group determines are appropriate to inform the tasks of the work group.
(b) The subcommittee must:
(i) Determine and make progress toward implementing a process for transmitting real-time location information related to incarcerated individuals to the managed care organization in which the individual is enrolled;
(ii) Develop a process to transmit patient health information between jails and managed care organizations to ensure high quality health care for incarcerated individuals enrolled in a managed care organization; and
(iii) Improve collaboration between the authority, the managed care organizations, and the jails as it pertains to care coordination both when an individual enters custody and upon release.
(c) The subcommittee must submit an initial report to the relevant committees of the legislature by December 1, 2021, and a final report by December 1, 2022. The reports shall evaluate the progress of managed care organizations with respect to meeting their contractual obligations regarding clinical coordination when an individual enters custody as well as care coordination and connection to reentry services upon release, including any corrective action taken by the authority against a managed care organization related to noncompliance. The reports shall also identify any barriers to effective care coordination for individuals in jail and recommendations to overcome those barriers.
(3) The authority shall invite participation in the work group by stakeholders including but not limited to representatives from: Disability rights Washington; behavioral health advocacy organizations; behavioral health peers; reentry community services providers; community behavioral health agencies; advocates for persons with developmental disabilities; the department of corrections; the department of children, youth, and families; the Washington association of sheriffs and police chiefs; prosecutors; defense attorneys; the Washington state association of counties; King county behavioral health and recovery division; the department of social and health services; state hospital employees who serve patients committed under chapters 10.77 and 71.05 RCW; the public safety review panel under RCW 10.77.139; managed care organizations; behavioral health administrative services organizations; jail administrators; the Washington statewide reentry council; the Washington state senate; the Washington state house of representatives; and the Washington state institute for public policy.
(4) The work group must provide a progress report to the governor and appropriate committees of the legislature by July 1, 2022, and a final report by December 1, 2023.
[ 2021 c 243 s 9.]
Notes:
Findings—2021 c 243: See note following RCW 74.09.670.

catchline: Reentry services—Work group.


title: RCW 71.24.715

text:
(1) The health care authority shall apply for a waiver allowing the state to provide medicaid services to persons who are confined in a correctional facility as defined in RCW 72.09.015 and 70.48.020, institution or facility operated by the department of children, youth, and families, or a state hospital or other treatment facility up to 30 days prior to the person's release or discharge to the community. The purpose is to create continuity of care and provide reentry services.
(2) The health care authority shall consult with the work group established under RCW 71.24.710 about how to optimize the waiver application and its chance of success, including by limiting its scope if deemed appropriate.
(3) The health care authority shall inform the governor and relevant committees of the legislature in writing when the waiver application is submitted and update them as to progress of the waiver at appropriate points.
(4) No provision of this section may be interpreted to require the health care authority to provide medicaid services to persons who are confined in a correctional facility, state hospital, or other treatment facility up to 30 days prior to the person's release or discharge unless the health care authority obtains final approval for its waiver application from the centers for medicare and medicaid services.
[ 2025 c 12 s 4; 2021 c 243 s 4.]
Notes:
Finding—Conflict with federal requirements—2025 c 12: See notes following RCW 74.09.670.
Findings—2021 c 243: See note following RCW 74.09.670.

catchline: Reentry services—Waiver application.


title: RCW 71.24.720

text:
The authority shall coordinate with the department of social and health services to offer contracts to community behavioral health agencies to support the nonmedicaid costs entailed in fulfilling the agencies' role as transition team members for a person recommended for conditional release to a less restrictive alternative under RCW 10.77.550, or for a person who qualifies for multidisciplinary transition team services under RCW 71.05.320(6)(a)(i). The authority may establish requirements, provide technical assistance, and provide training as appropriate and within available funding.
[ 2021 c 263 s 18.]
Notes:
Application—2021 c 263: See note following RCW 10.77.550.

catchline: Less restrictive alternative treatment—Transition teams.


title: RCW 71.24.845

text:
The authority, in consultation with the established behavioral health administrative services organizations, shall develop a uniform transfer agreement to govern the transfer of clients between behavioral health administrative services organizations, taking into account the needs of the regional service area.
[ 2019 c 325 s 1044; 2014 c 225 s 46; 2013 c 230 s 1.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.
Effective date—2014 c 225: See note following RCW 71.24.016.

catchline: Transfer of clients between behavioral health administrative services organizations—Uniform transfer agreement.


title: RCW 71.24.847

text:
(1)(a) By October 1, 2024, each licensed or certified behavioral health agency providing voluntary inpatient or residential substance use disorder treatment services or withdrawal management services shall submit to the department any policies that the agency maintains regarding the transfer or discharge of a person without the person's consent from a facility providing those services. The policies that agencies must submit include any policies related to situations in which the agency transfers or discharges a person without the person's consent, therapeutic progressive disciplinary processes that the agency maintains, and procedures to assure safe transfers and discharges when a patient is discharged without the patient's consent. Behavioral health agencies that do not maintain such policies must provide an attestation to this effect.
(b) By April 1, 2025, the department shall adopt a model policy for licensed or certified behavioral health agencies providing voluntary inpatient or residential substance use disorder treatment services or withdrawal management services to consider when adopting policies related to the transfer or discharge of a person without the person's consent from a facility providing those services. In developing the model policy, the department shall consider the policies submitted by agencies under (a) of this subsection and establish factors to be used in making a decision to transfer or discharge a person without the person's consent. Factors may include, but are not limited to, the person's medical condition, the clinical determination that the person no longer requires treatment or withdrawal management services at the facility, the risk of physical injury presented by the person to the person's self or to other persons at the facility, the extent to which the person's behavior risks the recovery goals of other persons at the facility, and the extent to which the agency has applied a therapeutic progressive disciplinary process. The model policy must include provisions addressing the use of an appropriate therapeutic progressive disciplinary process and procedures to assure safe transfers and discharges of a patient who is discharged without the patient's consent.
(2)(a) Beginning July 1, 2025, every licensed or certified behavioral health agency providing voluntary inpatient or residential substance use disorder treatment services or withdrawal management services shall submit a report to the department for each instance in which a person receiving services either: (i) Was transferred or discharged from the facility by the agency without the person's consent; or (ii) released the person's self from the facility prior to a clinical determination that the person had completed treatment.
(b) The department shall adopt rules to implement the reporting requirement under (a) of this subsection, using a standard form. The rules must require that the agency provide a description of the circumstances related to the person's departure from the facility, including whether the departure was voluntary or involuntary, the extent to which a therapeutic progressive disciplinary process was applied, the patient's self-reported understanding of the reasons for discharge, efforts that were made to avert the discharge, and efforts that were made to establish a safe discharge plan prior to the patient leaving the facility.
(3) Patient health care information contained in reports submitted under subsection (2) of this section is exempt from disclosure under RCW 42.56.360.
(4) This section does not apply to hospitals licensed under chapter 70.41 RCW and psychiatric hospitals licensed under chapter 71.12 RCW.
[ 2024 c 366 s 2.]
Notes:
Findings—Intent—2024 c 366: "(1) The legislature finds that ensuring that individuals with substance use disorders can enter into and complete residential addiction treatment is an important public policy objective. Substance use disorder providers forcing patients to leave treatment prematurely and insurance authorization barriers both present impediments to realizing this goal.
(2) The legislature further finds that patients with substance use disorders should be provided information regarding and access to the full panoply of treatment options for their condition, as would be the case with any other life-threatening disease. Pharmacotherapies are incredibly effective and severely underutilized tools in the treatment of opioid use disorder and alcohol use disorder. The federal food and drug administration has approved three medications for the treatment of opioid use disorder and three medications for the treatment of alcohol use disorder. Only 37 percent of individuals with opioid use disorder and nine percent of individuals with alcohol use disorder receive medication to treat their condition.
(3) Therefore, it is the intent of the legislature to reduce forced patient discharges from residential addiction treatment, to remove arbitrary insurance authorization barriers to residential addiction treatment, and to ensure that patients with opioid use disorder and alcohol use disorder receive access to care that is consistent with clinical best practices." [ 2024 c 366 s 1.]

catchline: Transfer of clients—Policy and statistic reporting.


title: RCW 71.24.850

text:
(1) By December 1, 2018, the department of social and health services and the authority shall report to the governor and the legislature regarding the preparedness of each regional service area to provide mental health services, chemical dependency services, and medical care services to medicaid clients under a fully integrated managed care health system.
(2) By January 1, 2020, the community behavioral health program must be fully integrated in a managed care health system that provides mental health services, chemical dependency services, and medical care services to medicaid clients.
[ 2018 c 201 s 4060; 2014 c 225 s 8.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.

catchline: Regional service areas—Report—Managed care integration.


title: RCW 71.24.852

text:
By December 1, 2019, the secretary of health, in consultation with the department of social and health services, the department of commerce, the long-term care ombuds, and relevant stakeholders must provide recommendations to the governor and the appropriate committees of the legislature on providing resident rights and access to ombuds services to the residents of the intensive behavioral health treatment facilities.
[ 2019 c 324 s 4.]
Notes:
Findings—Intent—2019 c 324: See note following RCW 71.24.648.
Mental health drop-in center services pilot program—2019 c 324: See note following RCW 71.24.649.
Report—2019 c 324: See note following RCW 70.38.111.
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: See note following RCW 74.39A.030.

catchline: Intensive behavioral health treatment facilities—Resident rights and access to ombuds services—Recommendations to governor and legislature.


title: RCW 71.24.855

text:
The legislature finds that the growing demand for state hospital beds has strained the state's capacity to meet the demand while providing for a sufficient workforce to operate the state hospitals safely. It is the intent of the legislature that the executive and legislative branches work collaboratively to maximize access to, safety of, and the therapeutic role of the state hospitals to best serve patients while ensuring the safety of patients and employees.
[ 2016 sp.s. c 37 s 1.]

catchline: Finding—Intent—State hospitals.


title: RCW 71.24.861

text:
(1) The legislature finds that ongoing coordination between state agencies, the counties, and the behavioral health administrative services organizations is necessary to coordinate the behavioral health system. To this end, the authority shall establish a committee to meet quarterly to address systemic issues, including but not limited to the data-sharing needs of behavioral health system partners.
(2) The committee established in subsection (1) of this section must be convened by the authority, meet quarterly, and include representatives from:
(a) The authority;
(b) The department of social and health services;
(c) The department;
(d) The office of the governor;
(e) One representative from the behavioral health administrative services organization per regional service area; and
(f) One county representative per regional service area.
[ 2023 c 292 s 3; 2019 c 325 s 1047.]
Notes:
Findings—Intent—2023 c 292: See note following RCW 74.09.871.
Effective date—2019 c 325: See note following RCW 71.24.011.

catchline: Behavioral health system coordination committee.


title: RCW 71.24.870

text:
(1) Rules adopted by the department relating to the provision of behavioral health services must:
(a) Identify areas in which duplicative or inefficient documentation requirements can be eliminated or streamlined for providers;
(b) Limit prescriptive requirements for individual initial assessments to allow clinicians to exercise professional judgment to conduct age-appropriate, strength-based psychosocial assessments, including current needs and relevant history according to current best practices;
(c) Exempt providers from duplicative state documentation requirements when the provider is following documentation requirements of an evidence-based, research-based, or state-mandated program that provides adequate protection for patient safety; and
(d) Be clear and not unduly burdensome in order to maximize the time available for the provision of care.
(2) Subject to the availability of amounts appropriated for this specific purpose, audits conducted by the department relating to provision of behavioral health services must:
(a) Rely on a sampling methodology to conduct reviews of personnel files and clinical records based on written guidelines established by the department that are consistent with the standards of other licensing and accrediting bodies;
(b) Treat organizations with multiple locations as a single entity. The department must not require annual visits at all locations operated by a single entity when a sample of records may be reviewed from a centralized location;
(c) Share audit results with behavioral health administrative services organizations and managed care organizations to assist with their review process and, when appropriate, take steps to coordinate and combine audit activities;
(d) Not require information to be provided in particular documents or locations when the same information is included or demonstrated elsewhere in the clinical file, except where required by federal law; and
(e) Ensure that audits involving manualized programs such as wraparound with intensive services or other evidence or research-based programs are conducted to the extent practicable by personnel familiar with the program model and in a manner consistent with the documentation requirements of the program.
[ 2019 c 325 s 1045; 2017 c 207 s 2.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.
Contingent effective date—2017 c 207 s 2: "Section 2 of this act takes effect only if neither Substitute House Bill No. 1388 (including any later amendments or substitutes) nor Substitute Senate Bill No. 5259 (including any later amendments or substitutes) is signed into law by the governor by July 23, 2017." [ 2017 c 207 s 5.] Neither Substitute House Bill No. 1388 nor Substitute Senate Bill No. 5259 was signed into law by July 23, 2017.
Findings—Intent—2017 c 207: "The legislature finds that a prioritized recommendation of the children's mental health work group, as reported in December 2016, is to reduce burdensome and duplicative paperwork requirements for providers of children's mental health services. This recommendation is consistent with the recommendations of the behavioral health workforce assessment of the workforce training and education coordinating board to reduce time-consuming documentation requirements and the behavioral and primary health regulatory alignment task force to streamline regulations and reduce the time spent responding to inefficient and excessive audits.
The legislature further finds that duplicative and overly prescriptive documentation and audit requirements negatively impact the adequacy of the provider network by reducing workforce morale and limiting the time available for patient care. Such requirements create costly barriers to the efficient provision of services for children and their families. The legislature also finds that current state regulations are often duplicative or conflicting with research-based models and other state-mandated treatment models intended to improve the quality of services and ensure positive outcomes. These barriers can be reduced while creating a greater emphasis on quality, outcomes, and safety.
The legislature further finds that social workers serving children are encumbered by burdensome paperwork requirements which can interfere with the effective delivery of services.
Therefore, the legislature intends to require the department of social and health services to take steps to reduce paperwork, documentation, and audit requirements that are inefficient or duplicative for social workers who serve children and for providers of mental health services to children and families, and to encourage the use of effective treatment models to improve the quality of services." [ 2017 c 207 s 1.]

catchline: Behavioral health services—Adoption of rules—Audit.


title: RCW 71.24.872

text:
(1) The legislature finds that behavioral health integration requires parity in the approach to regulation between primary care providers and behavioral health agencies.
(2) Neither the authority nor the department may provide initial documentation requirements for patients receiving care in a behavioral health agency, either in contract or rule, which are substantially more administratively burdensome to complete than initial documentation requirements in primary care settings, unless such documentation is required by federal law or to receive federal funds.
[ 2019 c 325 s 5032.]
Notes:
Effective date—2019 c 325: See note following RCW 71.24.011.

catchline: Regulatory parity between primary care and behavioral health care settings—Initial documentation requirements for patients—Administrative burdensomeness.


title: RCW 71.24.880

text:
(1) The authority shall, upon the request of a county authority or authorities within a regional service area, collaborate with counties to create an interlocal leadership structure that includes participation from counties and the managed health care systems serving that regional service area. The interlocal leadership structure must include representation from physical and behavioral health care providers, tribes, and other entities serving the regional service area as necessary.
(2) The interlocal leadership structure regional organization must be chaired by the counties and jointly administered by the authority, managed health care systems, and counties. It must design and implement the fully integrated managed care model for that regional service area to assure clients are at the center of care delivery and support integrated delivery of physical and behavioral health care at the provider level.
(3) The interlocal leadership structure may address, but is not limited to addressing, the following topics:
(a) Alignment of contracting, administrative functions, and other processes to minimize administrative burden at the provider level to achieve outcomes;
(b) Monitoring implementation of fully integrated managed care in the regional service area, including design of an early warning system to monitor ongoing success to achieve better outcomes and to make adjustments to the system as necessary;
(c) Developing regional coordination processes for capital infrastructure requests, local capacity building, and other community investments;
(d) Identifying, using, and building on measures and data consistent with, but not limited to, RCW 70.320.030 and 41.05.690, for tracking and maintaining regional accountability for delivery system performance; and
(e) Discussing whether the managed health care systems awarded the contract by the authority for a regional service area should subcontract with a county-based administrative service organization or other local organization, which may include and determine, in partnership with that organization, which value-add services will best support a bidirectional system of care.
(4) To ensure an optimal transition, regional service areas that enter as mid-adopters must be allowed a transition period of up to one year during which the interlocal leadership structure develops and implements a local plan, including measurable milestones, to transition to fully integrated managed care. The transition plan may include provisions for the counties' organization to maintain existing contracts during some or all of the transition period if the managed care design begins during 2017 to 2018, with the mid-adopter transition year occurring in 2019.
(5) Nothing in this section may be used to compel contracts between a provider, integrated managed health care system, or administrative service organization.
(6) The interlocal leadership group expires December 1, 2021, unless the interlocal leadership group decides locally to extend it.
[ 2018 c 201 s 4062.]
Notes:
Findings—Intent—Effective date—2018 c 201: See notes following RCW 41.05.018.

catchline: Interlocal leadership structure—Transition to fully integrated managed care within a regional service area.


title: RCW 71.24.885

text:
(1) It is the intent of the legislature that behavioral health medicaid rate increases be grounded with the rate-setting process for the provider type or practice setting.
(2) In implementing a rate increase funded by the legislature, including rate increases provided through managed care organizations, the authority must work with the actuaries responsible for establishing medicaid rates for behavioral health services and managed care organizations responsible for distributing funds to behavioral health services to assure that appropriate adjustments are made to the wraparound with intensive services case rate, as well as any other behavioral health services in which a case rate is used.
(3)(a) The authority shall establish a process for verifying that funds appropriated in the omnibus operating appropriations act for targeted behavioral health provider rate increases, including rate increases provided through managed care organizations, are used for the objectives stated in the appropriation.
(b) The process must: (i) Establish which behavioral health provider types the funds are intended for; (ii) include transparency and accountability mechanisms to demonstrate that appropriated funds for targeted behavioral health provider rate increases are passed through, in the manner intended, to the behavioral health providers who are the subject of the funds appropriated for targeted behavioral health provider rate increases; (iii) include actuarial information provided to managed care organizations to ensure the funds directed to behavioral health providers have been appropriately allocated and accounted for; and (iv) include the participation of managed care organizations, behavioral health administrative services organizations, providers, and provider networks that are the subject of the targeted behavioral health provider rate increases. The process must include a method for determining if the funds have increased access to the behavioral health services offered by the behavioral health providers who are the subject of the targeted provider rate increases.
(c) The process may:
(i) Include a quantitative method for determining if the funds have increased access to behavioral health services offered by the behavioral health providers who received the targeted provider rate increases;
(ii) Ensure the viability of pass-through payments in a capitated rate methodology; and
(iii) Ensure that medicaid rate increases account for the impact of value-based contracting on provider reimbursements and implementations of pass-through payments.
(4) By November 1st of each year, the authority shall report to the committees of the legislature with jurisdiction over behavioral health issues and fiscal matters regarding the established process for each appropriation for a targeted behavioral health provider rate increase, whether the funds were passed through in accordance with the appropriation language, and any information about increased access to behavioral health services associated with the appropriation. The reporting requirement for each appropriation for a targeted behavioral health provider rate increase shall continue for two years following the specific appropriation.
[ 2020 c 285 s 1.]

catchline: Medicaid rate increases—Review authority—Reporting.