Behavioral health policy to expect in Washington’s 2022 legislative session


Aaron Kunkler


Addressing problems facing the behavioral health workforce will be a top priority for the Washington State legislature when it convenes in January. 

Legislative committees began meeting in earnest this week ahead of the session, and on Nov. 16, the state’s Behavioral Health Advisory Council presented some of its policy recommendations to the Senate Behavioral Health Subcommittee, ahead of a full report due to the legislature and governor on Dec. 1. These recommendations include high-priority recommendations like increasing Medicaid reimbursement rates, and increasing financial support for students and workers to bolster the workforce. The report recommends increasing Medicaid reimbursement rates to community behavioral health agencies by 7%, at a minimum, to help make the work more competitive for employees. 


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The problems facing the behavioral health system in Washington State are issues that Sen. Manka Dhingra, chair of the Senate Behavioral Health Subcommittee, has been working on. 

During the committee meeting, and in previous coverage, Dhingra said that even though more funding is available to the behavioral health system, a significant number of workers have left the field due to low wages and high turnover, which is limiting what can be done. 

Ann Christian, CEO of the Washington Council for Behavioral Health, said according to an October report, crisis contacts increased by 200% from March 2020 to July 2021, and ongoing treatment demand increased by 34%. 

“At the same time we are losing, on a daily basis, capacity to provide care in our community system,” Christian said. 

Christian said of the behavioral health providers they surveyed, 52% had to close or limit admissions due to workforce shortages. It’s a situation she hasn’t seen before in four decades working in behavioral health. 

“We have never closed the front door in all of those years,” Christian said. “It is terrible to have to turn people away, but agencies have felt that they could not in good conscious take on clients for whom they do not have the workers to provide the care.” 

Christian said they’re asking that the 7% Medicaid rate increase for all outpatient behavioral health services become effective this January, instead of July, due to the need. She estimated that this would require $44.8 million from state general funds, and $99.6 million in federal matching dollars. 

“This would be a big step in the right direction to help us stem the tide of departing physicians,” Christian said. 

Other recommendations include increasing the ability of behavioral health agencies to accept students and trainees by incentivizing and supporting clinical and registered apprenticeship training sites. Further, the recommendations include creating a funding mechanism that supports community behavioral health agencies for performing significant training for workers. 

Reissuing policy that allows a greater number of behavioral health workers to receive loan support, and to increase the number of workers able to receive loan repayment per profession type, per site, from two to at least three. 

Dhingra is planning on introducing several bills in the upcoming session that will address these and other issues in the behavioral health system. These include legislation or updates to allow assisted outpatient treatment before hospitalization, finding ways to allow certified peers to provide more services, and increasing apprenticeship opportunities.