Gov. Jay Inslee waiting for feds on mental health privatization

Staff writerJanuary 20, 2014 

Gov. Jay Inslee's mental health proposal was introduced Monday in the Legislature, and it would align mental health care with drug treatment when it comes to public health care for the poor.

What the proposal does not do is give private insurance companies a chance to compete with counties for the care.

Inslee had proposed opening up bidding to the private sector in response to a federal mandate to rebid mental-health services. And his budget, in fact, assumes that will happen. But that's not part of the bill.

Inslee policy advisor Andi Smith told House members on Monday that's because the state is waiting to hear back from the federal Centers on Medicare and Medicaid Services.

The agency is the one that told Washington to begin with that it needed to change how it pays for mental health services -- putting at risk up to $550 million in federal funding.

But state attorneys have questioned that directive, and Smith said the Inslee administration has now has heard informally from lower-level federal officials that its legal arguments may be having some effect.

"It may be we don't have to do a competitive procurement with counties competing against private entities," she told lawmakers. 

But Smith cautioned that Washington is still waiting for the official word from the top of CMS. "The proverbial fat lady has not sung," she said. After getting that word, she said, Inslee would decide whether to seek changes to the proposal.

Regardless, Inslee wants to do joint bidding for mental-health and drug treatment. He called for $2 million in his budget proposal for that purpose.

It's a step toward Inslee's goal of eventually combining both of those services with primary medical care. In the short term, the bill would align the regional map for medical care and mental-health care.

The bill would also lay down some requirements for whatever public or private agencies end up doing mental-health and drug treatment in each region. A task force would be assigned to work out the particulars.

The measure, Senate Bill 6312, is sponsored by Tacoma Sen. Jeannie Darneille and other Democrats who are in the minority in the Senate.

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