This year’s state Legislature, which adjourned Sunday, was marked by tax increases and a budget shortfall as well as a rent cap and a new gun permit system.
Among the approvals were several mental health-related bills, which range from clarifying insurance coverage for behavioral health care to closing a facility once used to house people with disabilities.
The budget shortfall this session included significant cuts to behavioral health services statewide and limited new action on them. For example, some lawmakers said they’d like to push for improvements to the state’s civil commitment system but held off because of the costs. Funding for short-term behavioral health housing subsidies was also cut by 20%.
But the budget did include some capital improvements for mental and behavioral health, such as funding to finish the new building at Western State Hospital. The budget also allocated $130 million in grants that would expand capacity for behavioral health care in community settings. That includes funding for support services for youth in crisis, behavioral health programs for children and youth up to age 24 and navigator programs for people recovering from substance use disorders.
Outside of the budget, here are some of the key mental health-related bills passed this session. They still need to be signed by the governor before they become law:
Closing the Rainier School residential facility
After a wind-down period, Senate Bill 5393 would eventually close the Rainier School, a state-run facility for people with intellectual and developmental disabilities. The Pierce County residential habilitation center is run by the state’s Department of Social and Health Services.
People with disabilities and advocates had pointed to the facility’s history of safety violations and said people could receive better care in community settings, rather than large institutions. But families and employees said if the facility was closed, the people living there would be displaced, and there isn’t adequate care elsewhere in the community.
An amendment to the bill, added by House Republicans, slowed down the process from the original deadline of June 2027, giving no closure date.
Instead, if signed into law, it would wind down new admissions, and the facility must close once there are no more long-term residents. Patients could return to the center within one year of leaving.
A companion bill to immediately close the Yakima Valley School, another residential facility in Selah, failed to make it out of committee.
Expanding public defense options for patients
Late last year, a newly opened University of Washington behavioral health hospital that was meant to serve the state’s civil commitment population — people who aren’t charged with crimes but have severe mental illness — stopped taking patients. It cited a lack of public defenders to represent these patients in their court cases, stemming from a dispute with the King County Department of Public Defense, which said it was too overwhelmed to keep taking new cases.
Senate Bill 5745 allows county public defense departments to contract with outside entities to represent patients. Counties could contract with the state’s office of public defense or seek help from private, third-party law firms.
Standardizing mental health insurance coverage
House Bill 1432 requires all insurers in Washington to follow a generally accepted set of standards for covering mental health, one that is recommended by doctors and is publicly available. The bill would also allow the office of the insurance commissioner to put additional pressure on insurance companies if they don’t adequately cover mental health.
The public criteria, proponents say, increases transparency around claims that have been denied. They also hope it will push insurers to use doctor-recommended guidelines for approving or denying claims, which is not always the case now.
The bill attempts to improve mental health parity, or covering mental health conditions in a way that is comparable to physical health coverage. Despite recent laws to improve services, mental health coverage often still lags.
Realigning billing for crisis services
House Bill 1813 would simplify contracting with Medicaid for crisis care centers. Some new crisis centers in Washington have struggled to attract or retain operators because the operators say the funding models don’t make them financially viable. Among other things, this bill aims to help address that by reducing the administrative burden for providers.
A few other mental health-related bills did not make it to the end of the session. One would have limited the number of patients each county can send to the state psychiatric hospital for competency restoration — or treatment that enables them to attend court hearings. Another would have increased the statewide tax to pay for the 988 behavioral health and suicide prevention crisis line.
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