Human Services & Housing
Staff Contact:  Julie Murray

Mental Health
Counties, under the name Regional Support Networks (RSNs), are responsible for administering inpatient and outpatient community mental health services according to the provisions of 71.24 RCW, the Community Mental Health Services Act. In addition, they are responsible for administering the provisions of the adult and children’s involuntary treatment act (ITA), sometimes known as civil commitment, under 71.05 and 71.34 RCW respectively. In coordination with the criminal justice system and its duties to care for the mentally ill offender, the RSN also is involved in the criminal insanity statutes, 10.77 RCW, as it utilizes the designated mental health professional and overlaps the civil commitment process. As RSNs, counties are responsible for collaborating and coordinating with all other health and social services systems, the tribes through Memorandum 7.01, local and state criminal justice systems, the courts, the schools, and other agencies and organizations to ensure the most appropriate care for the mentally ill. (Note: Pierce County has opted out of being a RSN and the state has taken the program over, per statute, and is contracting with Pierce County Human Services to continue to provide some of the inpatient and involuntary treatment act functions. Other services are contracted directly between the provider and the state)

There continue to be stresses placed on both long-term and short-term inpatient capacity both in the community and at the state hospital. It will continue to be necessary for the state to increase funding for community residential options and diversionary types of service such as PACT teams to more effectively treat persons with mental illness in the most appropriate setting. Both children’s mental health and state-only funded programs and clients continue to need additional funding for services throughout the continuum of care. The state and legislature continue an interest in more efficiently serving persons with mental illness by linking them with primary care services through a variety of Medicaid integration pilot projects.

WSAC Policy:
Counties support full state funding of all mental health services the state requires counties to provide whether in state statute, WAC, waiver, or contract, as well as for any additional state mandates and shifts in priority populations. Counties support state funding for additional administrative responsibilities mandated by the state and the federal government. Counties call for a concerted effort from the state to reduce process requirements in favor of research-based outcome measures. Counties support the increase of residential resources statewide. Counties only support the continued reduction of inpatient resources at the state level if the necessary resources are provided up-front to increase local residential capacity and provide programs to appropriately serve those persons discharged from the state hospitals. Counties support additional state funding for non-Medicaid adults and children and/or non-Medicaid services provided to Medicaid eligible persons.

In addition, counties advocate sound policy decisions regarding the provision of appropriate care to the mentally ill based upon the best judgment of county mental health professionals and administrators, taking into consideration local political choices and requirements. Counties support Medicaid rates that accurately reflect the true cost of care for all clients which are provided sufficient state match funds to pull down all available federal funds without use of state-only funds or local dollars. Counties support the integration of the recovery and resilience model of care into the current system. Counties support efforts to more efficiently provide services of all types including mental health, substance abuse and primary care as long as these efforts are supported within the local community and contain sound evaluation components that are completed and accepted by the community before any expansion of such integrated and coordinated programs. Counties oppose any cuts to the total public mental health system budget but would support additional efficiencies in running the system which result in serving additional consumers and do not diminish county authority or increase county responsibility.