Behavioral health was a significant priority for the 2023 legislative session

In 2023 the legislature prioritized improvements to behavioral health resources across the state. For cities, the most impactful bills were HB 1134, SB 5120, and SB 5440.

The first two, HB 1134 and SB 5120 improve the 988 and crisis behavioral health systems. HB 1134 expands and updates the 988 system to provide a more robust response when an individual calls 988 in a mental or behavioral health crisis. This bill establishes liability protection for several entities and personnel for activities related to the dispatching decisions of the hotline and the transfer of calls between 911 and 988. The bill also creates an endorsement for 988 rapid response crisis teams that meet standards and a grant program to support them. AWC supports expansion of the 988-line to provide cities with a more robust service for their residents.

Similarly, SB 5120 creates a new framework for 23-hour crisis stabilization facilities. The goal is to eventually ensure that there is always someplace that an individual can go when experiencing a mental or behavioral health crisis. The centers are intended to function like an emergency room for mental and behavioral health crisis; people can come from a variety of referral sources including walk-ins, law enforcement, and 988, and will be triaged, stabilized, and then a plan of care established for their next steps. 23-hour crisis relief centers would be open 24 hours per day, seven days a week and accept anyone in a behavioral health crisis who walks in the door, are brought in by first responders, or are referred through the 988 behavioral health crisis system. The bill eliminates triage facilities as a behavioral health category and converts those existing triage facilities into crisis stabilization units. AWC supported this important step to expanding crisis behavioral health treatment services.

Related to this issue is the question of how the state provides for individuals charged with a crime when their mental and behavioral health concerns raise to the level of questioning their constitutional competency to stand trial. SB 5440 modifies the competency restoration system as follows:

• Requires a court to determine if there is a genuine doubt about a defendant’s competency before ordering an evaluation.
• Requires jails to allow clinical intervention specialists to provide direct services and consultation for defendants waiting for competency services, allowing them to stand trial.
• Prohibits jails from substituting or discontinuing medication for a serious mental health disorder.
• Requires courts to dismiss nonfelony charges and refer defendants for services if the court finds that the defendant is amenable to services and can safely receive services in the community. This would be overseen by a forensic navigator.
• Eliminates criminal trespass in the first and second degrees from the list of per-se serious offenses in RCW 10.77.092.

In addition to the above policy improvements, the legislature also made substantial budgetary investments in behavioral health. You can read more here.