BHT Board supports mid-adoption of FIMC

In 2014 the Washington state legislature passed 2SSB 6312 that requires integration of behavioral health benefits into the Apple Health managed care program by 2020. Additionally, this provided a road map for integration, that included the transition from a Regional Service Network to Behavioral Health Organizations. Spokane County serves as our region’s Behavioral Health Organization and has done a tremendous job integrating our mental health and substance abuse services through Adams, Lincoln, Stevens, Pend Oreille, Ferry, and Spokane Additionally, Okanogan county selected to receive BHO services from Spokane but will ultimately be transitioned to North Central no later than January 1, 2020.

Additionally, the legislation provided a provision for early and mid-adopter regions. Southwest, comprised of Clark and Skamania counties, were the only region in the state to select to be an early adopter. This region launched fully integrated managed care in April 2016 after a RFP process that selected Molina and Community Health Plan of Washington.

Late in 2016, North Central, comprised of Chelan, Douglas and Grant counties, announced their intention to be mid-adopters. North Central is currently in their RFP process, all 5 Managed Care plans are applying and we expect to have an announcement in mid-May of the selected 2-3 plans.

On April 10, the HCA released new incentive information for region’s willing to be mid-adopters. For our region, this would mean $8.7 million dollars for investment in providers to prepare for fully integrated managed care (FIMC). In order to trigger the investment, step one is for each county’s Commissioners to submit a binding letter of intent by September 1, 2017.

There is current legislative movement occurring, in which the Spokane BHO is active, to shift the integration deadline beyond 2020, carve out a specific role for BHOs moving forward, and provide a mechanism for BHOs to have a right of first refusal for the Behavioral Health Administrative Role that will deliver crises services, administer certain non-Medicaid funding sources and other negotiable regional functions. Additionally, the state legislature still needs to adopt a policy to move current funding from DSHS to Health Care Authority. This is currently still active legislation.

BHT Board Decision

As noted above, this is a decision for each of our region’s County Commissioners to make. BHT could adopt a policy and direct BHT staff to provide information and advocacy to partners and Commissioners to assist in encouraging our region to be a mid-adopter of FIMC.


To actively support moving the BHT ACH region to FIMC by 2019 in order to trigger a $8.7-million-dollar investment and accelerate our efforts to move to whole person care.