See, I'm not a big apple pie guy.
I know. I know. An American.
Whoa. But I'm not sure I would go.
I know. But I would go Apple over over all day long.
Yeah, all day long. Yeah.
Welcome to County Connection, the official podcast of the Washington
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OK, welcome back, everybody, to the County Connections podcast.
I'm Paul Jewell, government relations director for Wasack,
and I'm here with Brad Banks.
Brad, it's good to see you. Thanks for joining us today.
Brad is a new contractor with Wasack, former employee, actually.
Brad, why don't you introduce yourself?
No, great. Thanks, Paul. I'm delighted to be on the County Connection.
Yeah. So former Wasack employee
for many years worked with the public health folks during that time.
And now since 2016, been off doing contract work,
but still kind of staying in the in the county family,
doing a lot of behavioral health work, working with the BHA SOs,
really trying to stay engaged on a lot of the local health
and behavioral health issues out there.
But had a really great opportunity
to come back on board with the departure of Juliana, who was
a stalwart in this space for a long time, but happy to kind of be following
her coattails and be back on staff and working with you all again this session.
Yeah. Well, it's great to see you. I'm glad that you're here.
We're lucky to have you.
For most of our legislative steering committee members, you're not a new face.
No. They've seen you around.
And them not for me. Right. Right.
And you and I, we go way.
We do. Back to even LSE days.
Yeah. When you were an LSE member.
That's right. That's right.
That's right. We have we have a lot of baggage between the two of us here.
And I don't know what that means moving forward, but hopefully it's a good thing.
Yeah. Well, Brad, we're here talking in our first episode,
just kind of about, you know, what to expect this session.
There's a lot of stuff going on in Olympia this year.
I mean, today by itself is Inauguration Day.
So there's a ton going on.
There's a whole new slate of legislators of leadership.
You know, there's some big budget deficits that folks are facing.
You know, what we want to talk about with you is, you know,
what are you expecting to be the big issues?
In your policy areas now, you handle behavioral health,
law and justice and public safety and human services for.
Yeah, kind of that larger human services umbrella. Yeah.
So what do you think are going to be the big hot topic items this year
that you're hearing about that you're looking out for? Sure. No, thanks.
And, you know, I think well, and, you know, we're on day three here
and we're already, I think, get jumping into some of those already
in terms of seeing what some of these themes are coming in.
I would say, you know, as we were entering into session,
I had some pretty clear expectations that I think, you know,
obviously behavioral health, community behavioral health in particular
is going to remain a focal point for the legislature.
It is not an area that
problems are decreasing.
There are the need.
The demand is still continuing to grow and counties are going to continue
to play a central role in the delivery of those services.
So every year we kind of come back into a new a new flavor
of what the focus wants to be for behavioral health.
I do think more youth focused approach this year
will be something we see out of the legislature.
So that'll be interesting.
That's definitely an area where there are a lot of deserts,
for lack of a better term around the state in terms of youth
behavioral health facilities and services.
So that'll be something we're going to watch.
And I think that the counties are going to play an interesting role in.
Yeah. Youth seems like a huge opportunity in the behavioral health sphere.
Yeah, definitely. I mean, I think when we talk about behavioral health, right?
I mean, we really want to the key to it a lot like public health, right?
Is that sort of early downstream or upstream?
I forget which what's what's used to be upstream.
It would be upstream. Right.
Yeah. The earlier you get those early intervention services, that's that's where I'm going.
Right. Yeah.
And so youth is really a place to do that engagement with the schools,
engagement with, you know, other types of youth, youth type
engagement programs that allow allow for issues to be addressed
or or interacted with prior to them turning into something worse.
And then and then they enter into our our criminal justice or public safety arena,
which is not where we want to have these conversations.
Well, we had some major issues between last session and this session in the juvenile.
That's right. Justice system and rehabilitation with the state.
Are you expecting anything to come out of that?
Are there going to be any new proposals that will affect counties?
Yeah, that's a great point.
I mean, we we actually well, we've got a new secretary coming into
Department of Youth and Family Services.
No, the Department of Children, Children, Youth and Families.
Sorry. Yeah. DCYF. DCYF.
I should just use the acronym. I try to spell it out.
Yeah. I mean, new secretary secretary, Tana Sen.
I think that's going to be really exciting.
I think she's going to be great in terms of of kind of understanding
that perspective from a local level.
Former legislator, former legislator and pretty engaged in that youth
behavioral health space.
And so I think there's a great nexus there.
And yeah, and I think the county association, you know, we've been working
really diligently with our partners over at DCYF to talk about
the juvenile rehabilitation issues that have been going on,
that there's, you know, there's overcrowding.
We've got population issues at the at these facilities.
And there's going to be, I think, a lot of attention this session.
But I think a lot of debate, too, by legislators in terms of where
their priorities are going to be on what they're going to want to fund.
And I do think we're going to have to see
how that ebbs and flows throughout session.
And we may need to be more on the defensive or offensive,
depending on where we see the legislature lean in solving these problems.
Yeah, that's that's really going to be interesting.
You know, Brad, one thing that I think about when I'm thinking about
this legislative session and the changes in leadership
from the very beginning and from the very beginning,
I mean, 12 years ago with the Inslee administration, you know, behavioral health
and reshaping behavioral health, right?
And and combining behavioral health with physical health and
and looking at the whole person was a major focus of the Inslee administration,
really from start to finish all the way until today.
Do you think it's going to be the same level of focus
from the Ferguson administration or you think he's got different ideas?
That's a great question. Yeah.
I mean, I think you're exactly right.
We've been it's we've been in the last, you know, at least the last five,
you could argue at least the last 10, a really intense
behavioral health sort of environment, right?
There's been a lot of focus on it.
It seems to be touching all parts of of in some form or another
local government type activities and state government activities, frankly.
Yeah, I think that's a little bit of a question mark, honestly, on the new administration.
I do think they have some I think they've got some interest.
I think they are dabbling around with some ideas around what they can do in this space.
I did have some good conversations today with former Senator Fracht,
who's coming in and going to be, I think, a little bit.
It was now going to be on the governor's the new governor's policy team
is going to be in this space, kind of sharing it with another another individual.
He indicated that they really want to, I think, try to be
make sure they're not coming in and messing anything up.
But at the same time, hearing and trying to listen to stakeholders,
see where there's opportunities for improvement and figure out
how they can build that into their to their priorities that they want to look at,
both for policy and and budget.
But I think they're an administration that's going to be
open to kind of hearing where they ought to be looking in this space.
Interesting. Well, we have a behavioral health priority, too, as the loss act this year, right?
Our legislative steering committee went through a whole process during the spring, summer and fall.
We identified behavioral health as one of our major legislative efforts.
Why don't you talk about that just a little bit?
Yeah, I'd be delighted to.
And I think it's a I think it's a real, a really thoughtful proposal
that is coming from a place of, hey, you know, as you mentioned earlier, Paul, right, we're we're
we've been so focused on behavioral health over the last 10 years.
We've gone through we're now five years into integrated managed care as the primary
the primary way folks are accessing behavioral health services, at least outside of the criminal justice system.
And we're really at a point now where we've had a good sense of what's working and what's not working right where the shortfalls,
all shortfalls are both from a funding standpoint as well as from a policy standpoint and
wassack members, I think coming, identifying and saying, hey, what we're feeling really is missing
from this conversation is this more direct county involvement, county voice at the table to really influence what
the expectations are for all the for all the stakeholders who are doing this work, particularly in the community level.
Right. So whether you're a managed care organization or behavioral health administrative services organization, a provider,
a state agency, really trying to pull all those players together, figure out, OK, now that we've had this five years to live in this
integrated managed care environment, what do we need to work on for the next five years?
What how do we set ourselves up to be successful in those next five years? And I think that's really what we're trying to do with this
county priority. It is going to involve some some difficult conversations around
reprocurement of managed Medicaid managed care, which is always a complex issue.
And it does extend beyond behavioral health.
You explain reprocurement.
Yeah, happy to. Yeah, I almost didn't say the word because I thought we knew we'd have to talk about.
Yeah, so podcasts are particularly that's right.
That's right. We can we can flow with it.
So the the really what what happens is every every so often the state comes in and it's usually the the health care authority in our in our in our state
contracts out with private insurance companies to provide Medicaid services for individuals in the community.
That happens both in the health care space, but it also happens in the behavioral health space.
So normally most states go through some type of reprocurement where they sort of go out to bid again, because that's essentially what a reprocurement is.
Right. Go out to bid again and have these managed care companies bid.
And does this happen at regular intervals?
That's what I was just going to get to.
Yes. And normally it should.
In most states, it's it's kind of like an every other year thing or some states even do it every year.
Washington hasn't done it in over 12 years.
So yeah, so we're in a really big interval, for lack of a better term.
Right. So.
I mean, really, since the start of the Inslee administration.
That's exactly right. Yeah.
And so we're we're really ready, I think, for that next level of conversation.
And I think that's a big part of why WSAC wants to push this this legislation this year is to say, OK, 12 years, that's that's long enough.
It's time for a refresh.
It's time for a renewed conversation and a time to sort of revamp the contracts that are used between the state and the locals, as well as with the managed care organizations to figure out who serves who.
Well, if we haven't done this, reprocurement process is a rebidding process for services.
And when you're talking about Medicaid clients, you're not talking about private pay clients.
No, no, that's a separate group.
You're talking about clients that qualify for Medicaid services for Medicaid benefits.
So these are this is a different class of client potentially.
Right. That's right.
And so you've got to have service providers in certain areas.
And you do. And you got to have the service providers that you need.
That's right.
Well, it's it's really hard to believe that if we haven't done this in 20 years, we're going to be able to do it.
And I think that's the thing about this is that we've been doing this in 12 years and thinking about all the change that has happened in the behavioral health industry and the system here in Washington, that the current the current contracts line up very meeting the need.
Yeah.
The needs that have been established in the new program.
That's right.
And so we've been working with the federal legislation here at Wasack. It was House Bill 1515. I think that was in the 2023 legislative session really to address exactly that issue, which was this network adequacy is the term we use.
Right.
Really what that was designed to talk about and to stress was are we in it?
Do we have standards in place that really are ensuring we have the right level, the right number of providers, the right type of providers to really get folks the type of services they need as quickly as possible.
The right things in the right place.
At the right time.
Right. And so, you know, I think we felt like we were making progress there and thought that that would perhaps be a catalyst for a re procurement to happen at the state level.
But we've seen since then is is not a lot of desire to do that.
And so I think what we're trying to do with this legislation this year really is kind of light a fire under that a little bit to kind of take the forward momentum that we got from that previous bill and add on to it and make it a little more holistic.
And I think that's what we're trying to do with this go around with some with some tangible dates and expectations.
OK, interesting.
All right.
Well, Brad, is there anything else that our members need to know as they look forward to the rest of the session?
Like you said, we're only in day three.
Yeah, only in day three.
Yeah, I mean, I think there is going to be quite a bit of conversation in the crossover in the criminal justice and behavioral health space.
Right.
We had this morning on a new True Blood bill that was dropped by the outgoing administration and that we're going to we're going to have to, I think, deal with this session.
This is a short podcast, so we don't have a lot of time.
No, yeah, it's a long bill.
We could do several several installments.
You need to know what True Blood is.
Just Google.
Just Google it.
You'll you'll there's plenty on there.
There's an old HBO show, but that's not.
No, well, that might be good, too.
But yeah, so yeah, there'll be plenty to do this session.
I look forward to keeping folks up to date as as often as I can.
Yeah, great.
Well, we're glad you're here.
I'm delighted to be here.
Pleased to have you part of the team, Brad.
You always help me understand the behavioral health system in a way that I never would be able to understand it.
I don't know how you sift through it the way that you know, we all have our niche.
I mean, we could sit down and you could start talking land use and I'd immediately just start thinking about the pies.
Maybe we were talking about before we went on air.
So sometimes when you talk about behavioral health, I just want to go to my pie.
Right. I mean, that's where we go on these things.
I do notice you're a little grayer on the side.
So don't get me started this year.
I know.
Yeah.
Well, thanks, Brad.
No, thanks.
All the time.
Appreciate it.
We'll be we'll we'll be back in touch shortly.
Yeah, look forward to it.
All right.
Thanks.
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