The 2019 Washington State Legislative Session saw the first every AIHC Tribal and Urban Indian Health Program Legislative Day held on January 16, 2019. Representatives from 12 Tribes, both UIHP and AIHC staff and consultants visited 50 legislators to ask them support for our Legislative Priorities for 2019.
2019 Priorities and results:
The Washington Indian Health Improvement
- Recognizes the United States trust responsibility to provide “quality health care and allied health services to American Indians and Alaska Natives, including those individuals who are residents of this state”; and implement the national policies of Indian self-determination with the goal of reducing health inequities for American Indians.”
2. Establishes the Governor’s Indian Health Advisory Council that will:
- a. Adopt a biennial Indian health improvement advisory plan, developed by the Indian Health Improvement Reinvestment Committee;
- b. Address issues with tribal implications that are not able to be resolved at the agency level; and
- c. Provide oversight of the Indian Health Improvement Reinvestment Account;
3. Establishes the Indian Health Improvement Reinvestment Account Committee to develop the biennial Indian Health Improvement Plan
4. Establishes the Indian Health Improvement Reinvestment Account where new savings created by “100% FMAP received through a Tribal Facility” savings will be deposited beginning November 1, 2019.
Senator John McCoy was the main sponsor of SB 5415. Other sponsors were: Senators Rivers, Cleveland, Saldaña, Van De Wege, Billig, Conway, Frockt, Kuderer, Nguyen, and Rolfes. The bill passed through all committees and both chambers unanimously in each case. Not a single legislator voted “no.”
A companion bill, HB 1365 was primarily sponsored by Representative Steve Tharinger. Other sponsors were: Reps. Harris, Chapman, Appleton, Dolan, Fitzgibbon, Jinkins, Riccelli, Stanford, Robinson, Kloba, Doglio, Pollet, Levitt, Santos, Ormsby, Ortiz-Self. This bill did not make it to a vote in the House Health Committee in recognition that the Senate bill would be the vehicle to get the act passed.
The Washington Indian Health Care Improvement Act was signed into law by Governor Inslee on Tuesday, May 7th, 2019.
Washington State Behavioral Health Crisis Care Act
This bill was not introduced during the session. The Senate and House agreed to incorporate the work needed on this bill into the work of the Governor’s Indian Health Advisory Committee. Over the next year, this bill will go through the same process that the Washington Indian Health Improvement Act went through, it will be reviewed by the Tribe, UIHP, State Legislative and Agency representatives on the council, pared down to what is needed to be in legislation and worked through any operational or programmatic changes that need to be made.
For the 2019 Legislative Session, the purpose of this bill was to address long-standing issues in the Behavioral Health Crisis Care system that are causing access barriers for American Indians and Alaska Natives needing inpatient behavioral health services. These issues have been ongoing since the implementation of the Regional Support Networks (RSN) and, more recently, the Behavioral Health Organizations (BHO), as the “gatekeepers” for inpatient mental and behavioral health services. More information on the legislation can be found here:
Funding to Continue Tribal Evaluation and Treatment Facility Workgroup:
The Washington State Legislature funded $150,000 over the next biennium to continue the work of this committee. Beginning in July, this workgroup will be moving to become the board or Tribal consortium to oversee the rollout of Tribal Evaluation and Treatment or Secure Detox facilities and lease agreements across the State. If you are interested in more information about this workgroup, you can find it on our website here:
Foundation Public Health Services Policy Bill and Funding Request:
The Foundational Public Health Services Policy bill passed the legislature and was signed into law by the Governor on April 3rd. The law:
- Requires the Department of Health, federally recognized Indian tribes, a state association representing local health jurisdictions, and the State Board of Health to agree to the distribution and use of funds appropriated for foundational public health services in order for the funds to be distributed.
- Defines foundational public health services.
- Repeals statutes related to the public health services improvement plan.
Full funding of Foundational Public Health Services in Washington State was determined by the Foundational Public Health Services Steering Committee to be $496 million per year. The Steering Committee asked for $296 million for the first year, the Governor funded $22 million in his budget and that is the amount that passed the legislator.
Over the next year, AIHC will be working with Tribes and UIHPs to define Tribal Foundation Public Health Services in Washington State. The Northwest Tribal Epidemiology Center and the Urban Indian Health Institute will work with Tribes, UIHPs and Local Health Jurisdictions (LHJs) to provide information on prevention and control of communicable diseases across jurisdictions, identify assets in Indian Health delivery system for prevention and control of communicable disease, and ensure disease surveillance, investigation, and control.
In the next legislative session, AIHC will continue to support full funding of Foundational Public Health Services in our State.
Add Tribal Representation on the Washington State Emergency Management Council
The requested was language was to be incorporated into SB 5106- Concerning the creation of a work group to study and make recommendations on natural disaster mitigation and resiliency activities. Because the scope of the bill being about the workgroup, the legislation that passed incorporated Tribal representation onto the workgroup. We will continue to work next year to get Tribal representation for the Washington State Emergency Management Council.
Together we can educate, influence, and help the legislature partner with us to strengthen and redesign our Indian Health system of care into one that reflects our indigenous values.