Legislative
Priorities 2024

Fund recovery housing in the capital budget

Living in recovery housing for six months post-treatment increases the chances of sustained substance use disorder recovery by as much as ten times. Unfortunately, the demand for recovery housing in Washington far outpaces supply. While the state has made significant investments to expand access to recovery housing under the operating budget (e.g. short-term housing vouchers for people exiting inpatient treatment), there has been no investment in recovery housing using the state capital budget. Most recovery residences are owned by private landlords and rented by recovery housing providers. This priority proposes to use the capital budget to fund the acquisition of properties for recovery housing so that financial equity can be built and used to purchase more properties for this purpose.

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HB 2319: Expand access to inpatient addiction treatment and treatment medications

This bill would facilitate access to inpatient substance use disorder (SUD) treatment by prohibiting insurance companies from: denying inpatient care based on patient length of abstinence, denying continued care based on patient length of stay in treatment, and requiring insurance re-authorization prior to standard inpatient program completion (28 days). HB 2319 also seeks to curtail the practice of inpatient SUD providers kicking patients out of treatment for “rule violations” by requiring DOH reporting of forced discharges. Finally, it requires SUD providers to offer patient education on available medication treatment options for opioid use disorder and alcohol use disorder.

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HB 2469: Amend Ricky's Law to ease roadblocks that hinder the utilization of

involuntary commitment for substance use disorder

There have been many challenges reported around using Ricky’s Law to involuntarily commit individuals with life-threatening SUD to receive treatment services. Passed in 2016, Ricky's Law created a non-criminal legal intervention for people with severe,

untreated SUD who are otherwise unwilling or unable to accept help. It has been incredibly effective for individuals who have accessed it. However, half of available Ricky’s Law (secure withdrawal management and stabilization) beds remain empty on any given night. This bill seeks to address systemic bottlenecks to increase utilization of this treatment modality by: ensuring hospital emergency departments summon Designated Crisis Responders (DCRs) when appropriate, ensuring that patients who agree to voluntary treatment are likely to follow through, designing a non-ambulance transportation system for civilly committed patients, working to make the involuntary treatment process more patient-centered and trauma-informed, and expanding eligible petitioners under Joel’s Law.

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SB 5804: Requires all school districts, charter schools, and state-tribal education compact schools, not just those with 2000 or more students, to obtain and maintain at least one set of opioid overdose reversal medication doses in each of the public schools and to adopt a related policy.

This state is in a drug crisis, especially with fentanyl, and schools are not immune to this crisis. Deaths related to drug overdoses are rising, and many involve fentanyl. Teenagers encounter opioids everywhere including at school. Narcan is needed in all schools, not just those with more than 2,000 students. Narcan is easy to use and works in minutes. All students

need to be protected and get a second chance at life. This medication will bring peace of mind to families, staff, and students. The cost for this medication is nominal. This bill was passed out of the Senate with unanimous support and is moving through the House.

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SB 5660: Directs the Health Care Authority to convene a work group to make recommendations concerning a mental health advance directive (MHAD) statewide repository, and to develop trainings related to MHADs.

The bill is a culmination of years of work and trying to identify the most meaningful way to increase the use of Mental Health Directives in WA. The bill would fund the Health Care Authority to convene stakeholders to develop training for individuals, peers, and care providers and would also identify a solution for storing and accessing mental health advance directives.

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Close pharmaceutical warehouse distributor tax preference

Pharmaceutical warehouse distributors (companies that sell large batches of drugs, including opioids, to pharmacies) are given special treatment in our tax code. That tax break increases the profits of these multi-billion dollar companies, while the state loses nearly $20 million each year in potential funding for much-needed behavioral health services. The economic reason that led to the creation of this tax preference is no longer valid. Specifically, the increased revenue from closing this tax preference would be allocated to addiction recovery services that are not reimbursable by Medicaid or commercial insurance—the outreach services that help get people into treatment and the recovery support services that help people remain in long-term recovery after treatment.

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Levy an opioid impact fee

This would involve a per milligram fee charged to pharmaceutical manufacturers (e.g. Purdue Pharma) who sell opioids within WA's borders. Applies to all opioid manufacturers in the state. Medications for opioid use disorder would be exempt from

the fee. The funding produced from the levy will go to supporting substance use disorder services.

 

Amend the certified peer specialist statute established in SB 5555 to re-add section 4 to create a Peer Advisory Committee that was vetoed by the Governor

SB 5555 focused on creating the profession of certified peer specialists and was adopted during the last legislative session, but the Governor vetoed section 4, which sought to establish a Peer Advisory Committee led by peers to oversee this new

profession. We seek to amend the certified peer specialist statute established in SB 5555 to re-add the entirety of section 4 from the original legislation so that peers are able to have a voice and decision-making authority around their own profession.

 

Amend the harm reduction language enacted under SB 5536 to address concerns with siting issues and legal protections for harm reduction providers

SB 5536, also known as the Blake Bill, gives cities and counties the ability to regulate harm reduction services as they see fit, which can include banning certain services. By amending the harm reduction language, we can ensure that harm reduction service providers are legally protected and ensure these lifesaving programs are able to operate.

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Designating and funding a lead agency for school-based behavioral health

Designate a statewide leadership authority for student behavioral health and well-being, with a mandate to ensure student access to a continuum of effective behavioral health services in school and interconnected community settings. Provide funding to the leadership authority to act on that mandate. For a more detailed breakdown of this recommendation, please see the link here.

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Finance behavioral health care coordination as performed by community health workers

Fund care coordination activities performed by Community Health Workers (CHWs) under the supervision of licensed providers to address the behavioral, emotional, social, and developmental needs of children on Apple Health (Medicaid). Approximately 43% of children with mental health conditions require coordination beyond what occurs during their visits to ensure they successfully navigate from screening to services, carry out the care plan, and adjust the care plan as needs change. Almost half of these needs are currently going unmet. Primary care providers and behavioral health professionals are straining to coordinate care for the kids who need it, which compromises the care delivered. CHWs, who bring a wealth of community experience and for whom no professional degree is required, can do much of this work and be a tremendous help to

overwhelmed primary care providers and behavioral health professionals. By providing a sustainable source of funding for CHWs, the state could increase capacity and ensure that children are receiving care that is culturally appropriate and responsive to their needs. For a more detailed breakdown of this recommendation, please see the link here.

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