Community behavioral health moves to HCA on July 1

Wednesday, June 6, 2018

HCA will welcome about 120 employees from the Department of Social and Health Services (DSHS) on July 1, as we take on responsibility for the state’s community behavioral health system. This includes community-based mental health services and substance use disorder prevention and treatment.

Why is this change happening?

Gov. Jay Inslee requested this move in House Bill 1388, which aligns the state’s resources to best support integration of physical and behavioral health services statewide for Apple Health (Medicaid) clients. HB 1388 passed the Legislature during the 2018 session, and was signed into law.

The bill better aligns the functions of three state agencies to improve services so consumers and providers can more effectively and efficiently navigate the system. The goal is achieving better coordinated, quality and cost-effective care.

What specifically is changing?

The bill:

  • Designates HCA as the state mental health authority, including for the administration of the involuntary treatment act. DSHS will continue to administer the state Western and Eastern mental health hospitals.
  • Transfers the substance use prevention services currently at DSHS to HCA because these program funds are closely tied to the treatment dollars.
  • Moves licensing and certification of behavioral health providers and facilities to the Department of Health (DOH), including licensing behavioral health agencies and the certification of mental health, substance use disorder, and problem gambling services offered by behavioral health agencies. This transfer will reduce the administrative burdens of licensing and certification of behavioral health providers and facilities.

What do these changes mean for me?

  • Apple Health (Medicaid) clients: Continue accessing health services as you currently are.
  • Providers: While contracts are shifting to HCA, providers should expect to continue to work with primarily the same staff members after July 1 as you have before.
  • Licensed agencies: While the licensing function is moving to DOH, expect to continue to work with primarily the same licensing staff members after July 1 as you have before. There is more information on DOH’s website.

What does it mean to integrate physical and behavioral health services?

Per Senate Bill 6312, passed in 2014, Washington is transforming how it delivers behavioral health services. We are doing this by integrating the financing and delivery of physical and behavioral health care for Apple Health (Medicaid) by 2020. Behavioral health includes mental health and substance use disorder treatment.

Apple Health clients have had to navigate separate systems in order to access the physical and behavioral health services they needed to stay healthy. The physical health, mental health, and substance use disorder delivery systems often didn’t communicate about clients’ care, which led to duplication of services, poorly coordinated care, lower health outcomes, and a frustrating experience for Apple Health clients and the providers who serve them.

Integration will help provide a whole-person approach to care in one system, through an integrated network of providers.

Two of nine Apple Health purchasing areas have already moved to integration:

  • Southwest Washington (which includes Clark and Skamania counties) integrated in April 2016.
  • North Central Washington (which includes Chelan, Douglas and Grant counties) integrated in January 2018.