An attempt to capture the scope of work currently underway in the state of Washington and under the purview of the Children and Youth Behavioral Health Care Work Group

1. Family, Children, and Youth
Behavioral Healthcare Work Group
Washington State’s Expanded System of Care

2. HB 2737
Children & Youth Behavioral Health Work Group
• Identify barriers to and opportunities for accessing behavioral health
services for
• children, youth and young adults (prenatal to 25 years old) and their
families
• that are accessible, effective, timely, culturally and linguistically
relevant, supported by evidence, and incorporate tailored innovations
as needed;
• and to advise the legislature on statewide behavioral health services
and supports for this population.

3. Structure Proposal
• Support Washington State COVID-19 Recovery efforts
• Build upon existing committees, workgroups, and individuals with deep
subject matter expertise across the state.
• Identify barriers and opportunities for service access across silos, including
our school behavioral health system serving IEP and ELL students.
• Level up our behavioral health safety net delivery system to catch up with
new reforms and direction.
• Ensure enacted laws are implemented and communities held accountable.
• Use technology to increase equitable access to information and payment
sources
• Expanded SOC:

4. COVID-19
Recovery &
Vision Beyond
System Reboot
Behavioral Heathcare System COVID response
evaluation
Workforce | Rates career pathways | onboarding | retention
# for Standards of Care/ACH/OIC HIPAA/43CFR2 virtual
ex: CLIP beds/100k
the severely disregulated child
PPALS referral assist address 24/7 crisis triage (UT)
payment pathways CLIP | HCA (MCO) } Private Pay | OSPI (NPA) | DCYF [DD, JR, BRS]
Ombuds | complaint process
System of Care:
strategic
implementation
& responsive
accountability
FYSPRT System of Care WISe Implementation See expanded detail
Challenge & Solutions see expanded detail
CLIP-IT see expanded detail
Residential Options see expanded detail
0-5 social determinents of health
early screening & prevention
primary care coordination
adoption & foster care support
Build Upon
Safety Net
Reforms |
Leveling Up
DCYF Strategic Plan
BRS Ryther/Kitsap closings
JJ & JR | DD | ARY/CHINS | BRS Respite
ITA Reform 13-17
18-25
Family centered systems
Transition Housing 6560
School Safety,
Wellness,
Suicide, BH
MTSS
Restraint, disturbed child, school
refusal, etc.
IEP care coordination, payment, BH delivery
Non-academic professionals
SEL | BH Literacy | SUD prevention SEAC
8-12 early intervention signs Parenting Wisely

5. WISe
Implementation
24/7 crisis support needs
Data Quality Team CANS screening accuracy & appeals
Consistency in the availability of
intensive home and community-
based mental health treatment for
Medicaid youth.
BRS WISe
Increasing the number of transition
aged youth that get help early when
facing onset of psychosis
Timely peer training and onboarding

6. FYSPRT
Challenge
&
Solutions
Non-core waiver respite for hours of time not necessarily
beds, sub-acute care needs survey
Non-Medicaid WISe
Data Quality Team
Parent supports
Access: 1874/2883 Implementation
Youth Move grant
Zero Youth Detention

7. Children’s
Long-term
Inpatient
Program
Improvement
Team (CLIP-IT)
Challenge & Solution: intake & discharge process
improvements
Changing how residential treatment is used as part
of our continuum of care.
Implementing Washington Children’s Mental Health
principles (based on SOC values) in service delivery.
Reducing length of stay in out-of-home treatment.
More fully integrating residential and community
based resources
DCYF recommendation

8. Residential
Options
Wilderness Licensing
Medical Necessity
conduct disorder | truancy | class C felonies
and below | violence
SUD co-occurring
Transitional facilities
Transport
boarding schools with high exercise, peer
interactions, and therapeutic adventure
teen recovery support group homes a group of peers with… eating disorders, obesity, self-
harm, vaping, porn, addictive gaming, gambling, et al.
evaluative/holding facilities
long-term care for emotional regulation
attachment disorder | Fetal toxic stress or
other in utero chemical imbalance | autism

9. Footnotes

10. Public Behavioral Health Mandate
Additional services are available
for those with
no insurance or private coverage
if they are in crisis

11. Children's Behavioral Health Services:
Systems of Care Governance
• The Washington State System of Care (SOC) grant funded (SAMHSA, Substance Abuse
and Mental Health Services Administration) project expands systems of care statewide
with family-driven, youth-guided core values fully integrated in all parts of the SOC
Governance Structure: the Statewide Family, Youth and System Partners Round Table -
FYSPRT.
• The FYSPRT Governance structure has been adopted as the infrastructure for Children's
Behavioral Health and is comprised of ten regional FYSPRTs, the statewide FYSPRT, and
the FYSPRT Leadership team.
• Each FYSPRT reviews and approves policy, program and practice changes at the local,
regional or state levels.
• Our SOC prioritizes expanding services to youth ages 13-18 with serious emotional
disturbances - SED, out-of-home placement, or juvenile justice/child welfare histories.

12. System of Care Values
• Infuse these SOC values in all child-serving systems:
• Family driven and youth guided, with the strengths and needs of the youth
and family determining the types and mix of services and supports that best
fit their needs.
• Community based, with services and the management of those services
resting within a supportive framework at the community level.
• Culturally and linguistically competent, with programs and services that
reflect the culture and language of the population served.
• Ensure access to services based on each youth and their family’s unique
needs and eliminate gaps in services.
Ref: https://www.hca.wa.gov/assets/program/govdelivery-system-of-care-faq-fysprt-final.pdf

13. System of Care Goals
• Infuse SOC values in all child-serving systems.
• Expand and sustain effective leadership roles for families, youth, and
system partners.
• Establish an appropriate array of services and resources statewide,
including home and community-based services.
• Develop and strengthen a workforce that will operationalize SOC values.
• Build a strong data management system to inform decision-making and
track outcomes.
• Develop sustainable financing and align funding to ensure services are
seamless for children, youth, and families.

14. SOC Oversight & Reports
• Oversight: Centers for Medicare & Medicaid Services & Governing bodies
outlined in the T.R. Settlement Agreement (inc. FYSPRT)
• Behavioral Health Certification and Licensing for Community Mental Health
Agencies (CBOs) through the Department of Health
• Reports will be developed through a collaborative effort between DBHR
and RDA and include both programmatic and administrative data. The
Children's Behavioral Health System of Care Data Quality Team,
comprised of representatives of DSHS child serving systems, is developing
Measures of Statewide Performance to provide a monitoring and
evaluation framework for the System of Care. This outcomes-based report
is intended to be relevant to all children and youth with emotional and
behavioral health needs and their families served by DSHS and HCA.

15. Primary Partners
• Washington State Health Care Authority Division of Behavioral Health
Recovery
• Washington State Department of Children, Youth and Families
• Rehabilitation Administration
• Developmental Disabilities Administration
• OSPI
• Juvenile Justice & Juvenile Rehabilitation
• Foster care and BRS
• Community based organizations, higher education, workforce
• Tribal consultation, planning, and communication are ongoing

16. WA Washington State Common Measure Set,
2019 Behavioral Health (all ages)

17. System of Care Legislation
• SSHB 1088 passed in 2007 and codified as – 71.36 RCW, development
of Children’s Behavioral Health Measures of Statewide Performance.
• ESSHB 2536 passed in 2012 and codified as 43.20C.020 RCW,
regarding the increased use of evidence/researched-based and
promising practices.

18. Prepared April 12, 2020
Peggy Dolane, peggy.dolane@gmail.com
206-865-8619