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HCA outlines work groups, timelines for House Bill 1813 crisis services; state and regions flag funding and rural access concerns
Summary
The Washington Health Care Authority outlined work groups and timelines to implement House Bill 1813, which requires MCOs to expand delegated crisis services to BHASOs by July 1, 2026, while state and regional officials flagged funding and rural access as major implementation risks.
Health Care Authority officials described a multistage implementation process for House Bill 1813 that will expand crisis services delegated to Behavioral Health Administrative Service Organizations (BHASOs) and set a July 1, 2026 deadline for Managed Care Organizations to include crisis stabilization facilities and crisis relief centers in delegated services.
"By 07/01/2026, Managed Care Organizations will expand the current crisis allegation services, which currently are phone, mobile crisis and in home crisis stabilization services. So expand what they currently have to the BHASOs to include crisis stabilization facilities and crisis relief centers," said Martha (HCA), who is leading the HB 1813 implementation work.
HCA said it has organized four fall work groups to prepare: a clinical pathways group (to define how people flow through the system and when communications must happen between BHASOs, crisis providers and MCOs); a delegation agreement oversight group (to define monitoring and contract changes); a care coordination group (to define roles and responsibilities), and a quality-monitoring group (to identify outcome measures).
Why this matters: HB 1813 expands the set of crisis services BHASOs will coordinate or oversee. HCA and DBHR officials said the work groups will produce guardrails and monitoring approaches to support MCO–BHASO delegation agreements and to smooth contracting and service delivery.
Funding and access concerns: Tisha Kirschbaum, director of the Division of Behavioral Health and Recovery at the Health Care Authority, and deputy director Teresa Kleekamp said funding is a major outstanding issue, particularly for non‑Medicaid populations. Kleekamp noted that crisis stabilization has historically been funded on an "available resources" basis for the non‑Medicaid population and that new crisis relief centers, which aim to be no‑refusal front‑door facilities, create a financial entitlement pressure on non‑Medicaid funding streams.
Regional perspectives: Justin from the Spokane Regional BH-ASO and Frontier Behavioral Health representatives said their region has invested in vertical integration, mobile response and a new relief center, but they cautioned that rural counties may not see immediate capacity increases. Justin said workforce and travel distances constrain how quickly stabilization beds and mobile teams can meet needs in frontier counties.
Next steps: HCA said ASOs and MCOs will work in the four work groups and that clinical pathways for regions are due in the near term. HCA also said it is coordinating with the Office of the Insurance Commissioner to ensure private insurers participate in paying for stabilization and relief center care where statutory language requires private plan coverage.
Ending: HCA officials said the work groups will continue through the fall to produce operational expectations and contract language ahead of contracting and implementation activity in 2025–2026.
