Health Policy/Government Relations Committee March 2017 Update
AAPPN encourages its members to learn about the issues and share their opinions with their Congressional delegation on both the federal and state level. Advanced Practice Psychiatric Nurses are also encouraged to join our advocacy listserv to keep abreast of the changing legislative landscape. To join the advocacy listserv eGroup, please email Chris Crosser at .
United States Bills
The American Health Care Act (AHCA) was introduced in the House. It is anticipated to have far-reaching impacts for our profession. A large part of the AHCA is making cuts to the federal funding of Medicaid. Currently, 17% of federal Medicaid spending is for seniors, 40% is for people with disabilities, and 25% is for children.
- Nearly 30% of Medicaid expansion enrollees have a mental health or substance use disorder. Without Medicaid, they will be without access to critical services.
- This bill undermines efforts to address our national crisis of opioid overdose deaths by leaving consumers without access to critical care or life-saving overdose medicine.
Many people exiting the criminal justice system have untreated mental health and substance use disorders. Expanded Medicaid eligibility and access to treatment for these conditions helps them become and stay healthy and return to their communities and to the workforce.
There are many resources available to help you evaluate the AHCA.
- American Psychiatric Nurses Association position paper at: http://www.apna.org/i4a/pages/index.cfm?pageID=6214&utm_source=takeaction&utm_campaign=2017MHStand&utm_medium=homepage
- Kaiser Family Foundations’ comparison tool for ACA replacement proposals: http://kff.org/interactive/proposals-to-replace-the-affordable-care-act/
- American Medical Association’s Vision on Health Reform webpage: https://www.ama-assn.org/ama-health-reform-vision
- AARP statement: http://www.aarp.org/about-aarp/press-center/info-02-2017/AARP-Opposes-Special-Interest-Health-Care-Bill.html
Washington State Bills
For each of the bills listed below, AAPPN committee volunteers are working with our lobbyist, Jennifer Muhm, to determine when AAPPN member action is needed. Please be on the lookout for Action Alerts through the listserv or the monthly eNews. We will try to provide the resources for you to find contact information for your legislator and talking points to share with them. Thank you for helping to protect our profession!
Volk vs Demeerleer decision
Concerning obligations of mental health professionals – House Bill 1810 Sponsors: Cody, Graves, Macri / Senate Bill 5800 Sponsor: Baumgartner
Both of these bills retain the standard for mandatory reporting that is currently in place in RCW 71.05.120, essentially the “Tarasoff” standard that requires us to notify anyone who is named as someone a patient intends to harm. These bills mitigate the potential damage of the Volk decision.
- HB 1810 did not make it out of committee. No further action needed.
- SB 5800 passed the Senate and its current version, ESB 5800, is in the House Judiciary Committee.
Senate Bill 5706 – Workgroup Volunteer Opportunity
Addressing parent-initiated behavioral health treatment for children aged thirteen to seventeen years old. Sponsors: Becker, Rivers, Bailey, Brown, O’Ban, Fortunato, Warnick
- AAPPN members are invited to volunteer for the workgroup for Senate Bill 5706. This bill addresses parent-initiated behavioral health treatment for children ages thirteen to seventeen years old. If you serve children in your practice or have an interest this would be a good opportunity to contribute to the decision making re: future services. If you or one of your clients would like to participate in this work group, please contact Matt Tremble, Staff Counsel WA Senate Majority Coalition Caucus, at or by phone at (360) 786-7891 (office) or (425) 283-2369 (cell).
Senate Bill 5782 – Monitor/Support
Restricting the use of step therapy by public and private insurers for drugs used in mental health treatment. Sponsors: Rivers, Mullet
- This bill appears to place limits on the insurance industry in Washington State in terms of what restrictions they can place on approval of medications that prescribers have ordered.
- Its current version, 1st Substitute – SSB 5782, is in the Senate Ways and Means Committee.
House Bills 1413 and 1477 – Monitor/Support
- HB 1477 – Concerning disclosure of health-related information with persons with a close relationship with a patient. Sponsors: Kilduff, Muri, Lytton, Stambaugh, Orwall, McDonald, Robinson, Lovick, Goodman, Sells, Appleton, Fey
If passed, this bill would bring Washington State’s restrictions on the sharing of protected health information more in line with the requirements of HIPAA.
Its current version, 1st Substitute – SHB 1477, has passed the House and was introduced in the Senate where it was referred to the Senate Human Services, Mental Health & Housing.
It is scheduled for public hearing in the Senate Committee on Human Services, Mental Health & Housing on March 21, at 1:30 PM. (Subject to change)
- HB 1413 – Specifying to whom information and records related to mental health services may be disclosed for the purposes of care coordination and treatment. Sponsors: Cody, Schmick, Macri, Harris, Jinkins, Appleton, Springer
If passed, this bill appears to broaden the allowances for sharing PHI in a different way, but this bill is specific to mental health care. Its purpose appears to be to ensure that records can be shared for coordination of care without requiring an ROI.
Its current version, 1st Substitute – SHB 1413, passed the House and was introduced in the Senate where it was referred to the Senate Human Services, Mental Health & Housing.
House Bill 1259 – Support
Concerning standards for detention of persons with mental disorders or chemical dependency. Sponsors: Klippert, Goodman, Rodne, Hayes
- This bill concerns the standard used for detaining people on an emergency basis for the purpose of treatment of a mental illness. It would change the threshold from “imminent risk” to “substantial likelihood.” This is a significant change and will allow many more of our patients who need hospitalization to receive it.
- It has been referred to the House Judiciary Committee.
House Bill 1427 – Support
Concerning opioid treatment programs. Sponsors: Cody, Jinkins, Peterson, Pollet
- This bill concerns opioid treatment and loosens the state’s restrictions on approving new treatment facilities for individuals with opioid use disorders (though they will subsequently be monitored just the same as other substance use disorder programs are). The bill also officially recognizes certain treatments (the treatments recognized by the UW’s Alcohol and Drug Abuse Institute as well as FDA-approved drugs) as evidence-based.
- Its current version, 1st Substitute – ESHB 1427, passed the House and was introduced into the Senate where it was referred to the Senate Health Care Committee.
- It is scheduled for a public hearing in the Senate Committee on Health Care at on March 21, at 10:00 AM. (Subject to change)
House Bill 1788 – Support
Concerning no required psychotropic medication use for students. Sponsors: Hargrove, Muri, McCaslin, Volz
- This is an interesting bill, which, if passed, would require each school district to create a policy ensuring students are not taken into police custody or restricted from accessing district programs or services on the basis of a caregiver (parent/guardian) not giving a psychotropic medication the school district feels is necessary/appropriate. Students will also not be compelled to undergo psychological evaluation without prior parent/guardian consent.
- It was referred to the House Education Committee.
House Bill 1546 – Support, with concerns
Concerning the addition of services for long-term placement of mental health patients in community hospitals that voluntarily contract and are certified by the department of social and health services. Sponsors: Schmick, Cody
- This bill seeks to shift long-term care of severely/chronically mentally ill individuals out of the centralized state-run hospitals and into community-based hospitals. While this sounds like an acceptable idea, we are concerned about the ability of smaller, community-based hospitals to appropriately manage the needs of this difficult population. There are also concerns about whether this is cost-effective and whether it would actually result in any improvement in care over simply improving the care already provided at our state hospitals.
- It is currently in the House Health Care & Wellness Committee.
Health Professional Loan Repayment program.
Advanced Practice Psychiatric Nurse Practiced are encourage to communicate their support for the Health Professional Loan Repayment program. This programs helps to address Washington’s shortage of healthcare providers by providing educational loan repayment for providers working in rural communities or with underserved populations.
These awards support Advanced Registered Nurse Practitioners, registered nurses, dentists, physicians, pharmacists, hygienists, and midwives, as well as non-prescribing mental health providers including clinical psychologists, marriage and family therapists, licensed social workers, and mental health counselors.
To learn more, visit the Washington State Nurses Association website at: https://www.wsna.org