The 2022 Washington State Legislative session concluded in mid-March, after a whirlwind 60-day session. This was a historic session for many reasons, especially for child and youth behavioral health.  There has been a growing focus on the national youth mental health crisis over the past year, and we are thrilled at the investment and commitment demonstrated in the legislature. 

Mental and behavioral health for children and youth has been long-time focus of Seattle Children’s advocacy. In late March, Washington State Governor Jay Inslee signed two top Seattle Children’s advocacy priorities into law – both of which have the potential to significantly improve access to and quality of children and youth mental and behavioral health care. The Governor also approved the state operating budget, which includes numerous significant investments that will also move the needle for kids in need of mental and behavioral health services. 

Senate Bill 5736 requires coverage for partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) mental health services for youth insured by Apple Health for Kids (Medicaid) starting Jan. 1, 2024. 

Coverage of these programs under Apple Health for Kids has been a focus of Seattle Children’s state advocacy over the past five years. IOPs and PHPs can serve as a “step-up” in care for youth who need more intensive services than weekly outpatient therapy and may not need inpatient admission. They can also serve as a “step-down” in care for youth discharging from inpatient psychiatric care to support them in returning safely to community care. 

“We are deeply grateful to Senator David Frockt for his leadership and championship of SB 5736, as well as to the Washington State Legislature for their unanimous passage of the bill,” said Hugh Ewart, Senior Director of State and Federal Government Affairs, Seattle Children’s. “SB 5736 will enable youth state-wide to access intensive services more equitably, thus filling a gap in the continuum of behavioral health care in WA state.” 

In addition to increasing equity in access to intensive services – these programs also provide relief to our inpatient Psychiatry and Behavioral Medicine Unit (PBMU) and may prevent some youth from boarding in our Emergency Department (ED) where they wait for available and appropriate services, sometimes for days. 

In previous legislative sessions, the WA Legislature had funded pilot programs for PHP and IOP at Seattle Children’s and Sacred Heart; this session, Mary Bridge was added as a third pilot site. We are thankful for the opportunity to be able to continue and expand these programs as we await full implementation, and we look forward to our continued collaboration with community partners in this work. 

House Bill 1890 creates a state-wide child and youth behavioral health strategic plan as part of the Children and Youth Behavioral Health Workgroup (CYBHWG). This bill allows the legislatively-created CYBHWG to form a strategic advisory group to: 

  • Examine WA’s current child and youth behavioral health landscape – identifying what’s working, what isn’t and where there are gaps currently. 
  • Articulate a vision for the behavioral health system we want in WA from perinatal phase to transition to adulthood. 
  • Create an intentional strategic plan to fill the gaps, solve some of the issues we’re currently experiencing and maximize federal investment. 

 The co-chairs of the CYBHWG, including State Representative Lisa Callan, will be leading these efforts, and calling on many stakeholders to be involved, including those with lived experience, state agencies and behavioral health experts. 

 This bill gives WA state the ability to intentionally and proactively build the system we need for children and youth rather than reacting to crises on a case-by-case basis.  

In addition to passage of these two bills, the legislature also approved a supplemental operating budget with new investments in several items important to Seattle Children’s and to pediatric behavioral health overall. A sampling of some of these items, plus related important approved legislation, is below: 

  • Investments to start a 32-bed short-term residential crisis stabilization program for youth. 
  • 7% increase in community behavioral health rates under Medicaid. 
  • HB 1800 funds a new parent portal to provide caregivers with information and resources. 
  • HB 1905 provides funds and supports to prevent youth from exiting publicly-funded systems of care into homelessness. 
  • Department of Children, Youth, and Family received funding to increase rates for therapeutic foster care providers and behavioral rehabilitation services as well as a new 30-bed BRS facility to open in FY2023. 
  • Support for behavioral health in primary care by providing start-up funds for integration and funding non-licensed providers (such as Community Health Workers) in primary care. 
  • Funding for expanded grants to establish new school-based health centers and add behavioral health capacity to existing school-based health centers. 
  • HB 1268 adds WA state to the psychologist interstate licensure compact, an initiative that will improve access to behavioral health services across state lines. 

 “At Seattle Children’s, we know our services are part of a broader continuum of care and that children and youth need support from multiple parts of the community, including primary care providers, schools, youth recreation and caring adults. These legislative wins, which were made possible by the strong collaboration across the community to advocate for them, will propel child and adolescent health forward across the entire state, paving the way for transformational improvements for all kids,” said Ewart. 

Child Health Always Includes Mental Health 

Seattle Children’s has made a long-term commitment to mental and behavioral health as an inextricable part of child health. To that end, we’re building a coalition to reimagine pediatric mental health care so that all children, teens and families can live their healthiest and most fulfilling lives possible. This means every child would have access to the support and resources they need to succeed and to be happy, safe and well within their family, school and community. Turning this vision into a reality will involve ongoing organization-wide collaboration, community partnerships, legislative advocacy and the continued support of our generous community.