And there is inherent tension, I think, between
the tennis and the pickleball people. There is.
Right. The pickleball people are taking over
the courts. And the tennis people are not happy.
Welcome to County Connection, the official podcast
of the Washington State Association of Counties,
where we dive into the legislative issues shaping
the future of our communities. From budgets to
public safety, infrastructure to elections, we'll
break down what's happening in Olympia and how
it impacts counties from across the Evergreen
State. Stay informed, stay engaged, and join
us as we amplify the voice of Washington's 39
counties. Welcome back, everybody, to the County
Connection podcast. I'm Paul Jewell. government
relations director with the Washington State
Association of Counties, and your host. And I'm
back in the studio on this same Tuesday afternoon,
another bright, sunny, shining day here in Olympia
by March standards. And today I've got Brad Banks,
our contract lobbyist handling behavioral health
and human services, as well as law and justice
issues for us. Good to see you, Brad. Great to
see you, Paul. Thanks for coming back. No, no,
I'm delighted to be here. So I've been talking
with everybody else for the last couple of podcasts
about last week and Cut Off. Yeah. big day on
Wednesday. It's kind of the really marks the
halfway point process wise for all of us here
in Olympia. And it's always a bit of a day of
celebration. I know for that reason and because
our workloads get a lot smaller. That's right.
We get to focus a little more. Yeah. It's not
so scattershot, but yeah. Yeah. And no one has
really been shy about celebrating the demise
of several pills. I wasn't too sad to see a few
of them go. Let me put it that way. Yeah. Are
there any in particular that you feel deserve
some honorable mention here? You know, is that
a good idea? Should we be calling those out publicly?
I don't know if that actually is in our interest.
It probably is a bad idea. So why don't we we
can we can move on. I mean, yes, there were definitely
some that. I just sat and watched as they sat
in rules or sat on the floor. And you weren't
sad to see them. I was not. I was not. And as
that minute hand clicked towards 5 p .m., I was
like, yeah, I'm not going to have to sign in
or testify. Just get to zero, please. Just get
to zero. And whatever you do, don't. don't make
it unnecessary to implement the budget well of
course yeah those are the magic bills right the
ones which is what you have more success on than
sometimes no that's impressive yeah sometimes
so you know that five o 'clock that five o 'clock
hour yeah on um cutoff day is a big deal yep
a lot of us are you know very anxiously kind
of awaiting that yeah Both for not just to see
bad bills kind of go the way of the dodo, right?
Right. But also because we are oftentimes running
up against that clock. That's right. To try to
get to our own stuff. Yeah, it's our own stuff.
Keeping our own stuff from dying. Right. And
that's easier said than done, right? It is. I
was talking with Brian just a few hours ago.
Yeah. And we were talking about the process and
how it's actually designed for you to fail. Yeah.
And how much easier it is to kill bills than
it is to pass bills. Yep. And the one thing you
definitely want to do is do everything you can
to get rid of the bad bills. But at this point
in the session, you also don't want to look around
and go, wait a minute, all the good stuff I was
trying to work on is dead too. Is also dead now
too. And I've got really nothing going on. Yeah.
That's kind of the death knell for a lobbyist.
Totally. And yeah, I would agree. I think I like
that analogy or that summary that it's designed,
it is designed to... to kill bills. Ultimately.
I think that is the way the system is designed
to keep, to keep the deluge from continuing on.
Right. And yeah, even if you're the majority
party, a hundred percent, you gotta make, you
gotta have self controls. Right. And that's what
this is. It's a, it's a, all these cutoffs are
control mechanisms, right? It's a way to kind
of, you know, silo in and consolidate where really
the priorities need to be for session and what,
what they feel like they can handle as it relates
to the budget and, you know, any of the other
pieces to that. So, yeah, I mean, and I, I agree.
I mean, in some ways, you know, keeping, and
there are so many, so many little things that
can hang a bill up. Oh, we were talking about
that too. I mean, it's just like. Yeah. Even
a good bill. A good, yeah. With nothing that
gets out of committees unanimously. I know. And
then it just, it takes one thing to just totally,
and at the pace of at which things are moving,
that's all it takes. All of a sudden you get
blown by, by five other bills that now are, you
know, somebody else's attention. And you can
do everything right. everything right and just
watch it wither and die right in front of your
eyes exactly yeah you know it's a little demoralizing
you can have everything lined up you can get
you know and the the panic yeah the panic that
sets in yeah i mean unless you do this work like
that panic of watching your bill the days sort
of you know all of a sudden the days of sessions
really slow down right and it's like why can't
this get out of rules why can't i get this on
an order of consider why i can't yeah and it
just becomes you're Processing over it every
second. Yes, it's just a nightmarish process.
What else can I do? What haven't I done? Who
can I talk to? Who can help me? Should I leave?
Would it be better if I just left the hill? Because
me being here seems to not be helping. So maybe
if I just walk away, this bill will have a better
chance. We'll talk about sweating it. Yeah. 1813.
Yeah, that was one that caused a little perspiration
for me. So that's our priority bill. We've talked
about that here on the podcast before. That's
our behavioral health priority bill. Yeah. That
one. ultimately passed. So it's alive, but you,
you were sweating it pretty good. It was both
at the, at the cutoff for rules to get it out
of rules. Right. As well as kind of that, you
know, floor cutoff. You were cutting it pretty
close. We were. Yeah. Tell us what happened.
Yeah. So yeah, no, it was. And again, it was
one of the, I mean, this bill has not been without
tension. Yeah. So remind everybody. Yeah, sure.
So, so house bill 1813, uh, it is our priority
legislation and really what it's designed to
do is sort of two things. Um, When the bill initially
was drafted, it... Called for a re -procurement
of our managed care companies that operate here,
the Apple Health MCOs, as they're sometimes called.
MCOs are managed care organizations. Managed
care organizations, right. They're kind of the
insurance companies that handle all the folks
on Medicaid. Right. And then really try to make
some improvements through what we were calling
a carve -out for our crisis system, right? So
for the Medicaid dollars and the folks that were
accessing the crisis system who were on Medicaid,
currently that's not in the - county sort of
book of business, right? I mean, we work and
we provide crisis services for those folks, but
that is still sort of managed and sort of financially
responsible. The responsibility sits at the MCO
level, the managed care organizations. We felt
like it made more sense to sort of shift, realign
that and shift those folks. back over to the
counties through the BHA SOs, the behavioral
health administrative services organizations
that are responsible for the crisis side. As
this bill went through the process, obviously,
you know, the managed care organizations had
a lot to say, the state agencies had a lot to
say. And as we worked through it, it's gotten
to a point now where the re -procurement language
is pretty toned down. It still requires some
pieces from HCA, from the healthcare authority,
sorry. That's a very acronym heavy space. It
is. Everything in county government. That's right.
We love it. For them to continue to... prepare
and take stakeholder feedback as they work towards
a re -procurement. I think we've talked about
before on this podcast, it's been like 14 plus
years since the state has done a re -procurement.
So we're definitely way overdue. And I imagine
if you're an MCO, you know, you like the fact
that it's been 14 years. You haven't had to change
a thing. No need to see a re -procurement anytime
soon. Right. No new standards to meet. Exactly.
No new expectations, anything like that. It's
just kind of status quo. That's right. And yeah,
status quo is working. And I think that was really
our, you know, works for. that works for them
that's been our the biggest pushback from our
end is that - It hasn't been working for us.
It hasn't been working for us. And that really,
we're the only ones arguing for that are, at
least in our estimation at this point, are the
managed care companies. That really the status
quo is meeting their needs, but it's not meeting
our needs. Well, let's be honest. They're the
ones who profit from the system the way that
it is right now. They do. And the profit is pretty
modest. I mean, I don't want to say that, but
it is, they wouldn't be here if they weren't
making money, right? I mean, that's the whole
point. And I think, back to the re -procurement
point, right? I mean, we have five managed care
companies that operate in - in Washington State
through our managed care process. If it were
to go to re -procurement, there are a number
of companies out there, national, large national
companies that I think would love to get in on.
get in on it. Right. And so that could displace
one of the current companies, for example. And
so. Yeah. But from for us and for from a service
model and an efficiency model, competition is
a good thing. We want to encourage that. Right.
And really, we don't care who I mean, I think
from the county standpoint, it's not our we're
not interested who the managed care companies
are. We're not interested in any of that bidding
process. What we're interested in is making sure
that there's a clear expectation of what the
responsibilities are. If you're going to provide.
contracted services in this state for our Medicaid
eligible folks, and that we're matching the right
managed care organizations with the right populations
in our regions, right? So it's also about, you
know, it's about efficiencies, it's about service,
but it's also about getting services in the right
places, right? And making sure that there aren't
deserts. That's right. And there are right now.
Yeah. And that's something we're dealing with.
Well, when you talk about it, it's been 14 years
since a re -procurement was required. I'm trying
to remember when the whole behavioral health,
physical health, you know, collaboration. Yeah.
The whole integration process. Because when I
was a county commissioner back. in ancient times,
right? Way back in 2008, 2009, it was a whole
different system. It was. And it was only, you
know, a few years into, I think my first or second
term where this, well, it was essentially, it
started under the Inslee administration, right?
This was one of his signature issues was to integrate
the physical health and mental health side, behavioral
health side. And that must've been right around.
12 or 13 years ago. It was. So there hasn't been
a re -procurement since that whole process began?
No. And in fact, when this system went, you know
- That's actually hard to believe. It's pretty
amazing, right? And when you consider that, you
know, they did this initial procurement, right,
14 years ago, everything that has happened since
then, including going fully live. So when we
did that procurement as a state, we hadn't fully
integrated at that point, right? So our integrated
managed care plan hadn't really been put into
place. That didn't really go live until 2020.
So there's no way that the current system of
services in any way matches that full integration
process. That's right. And you think about all
the things that have changed between when that
happened and where we are here now in 2025 and
the demands on the system, whether it's on the
criminal justice side or in the behavioral health
side or the intersect in between. Right. I mean,
the need and the. the outcry for services in
communities, which county commissioners and council
members are hearing all the time because they're
in the communities hearing these needs, it continues
to grow in the crisis side of the system. And
so for us, we see this as something needs to
happen, and that's why we're here. So I don't
mean to be controversial, and I don't mean to
morning quarterback this thing, but the more
we talk about this, it's a great education for
me because even though I was an elected official
for a while and I was part of this association
as a member, I never really understood that much
about behavioral health. And I certainly don't
have the same knowledge base that you do. And
I'm sure our listeners, many of our listeners
don't as well, although we have some members
who are really up to speed on this. But again,
not to be too controversial and not to Monday
morning quarterback this too much, but if this
were such an important issue. and such an important
cause for the previous administration. How did
this much time go by without a re -procurement,
number one? That seems at best to be a major
oversight, at worst, almost negligent, number
one. And number two, how is it that we're now
the ones who are pushing this? Yeah, I think
both of those are great questions, frankly. And
I think there's a few things to that, right?
I mean, we did this initial re -procurement.
or initial procurement. And then in 2020, when
we went live on the integrated managed care model,
where we set up. these two types of new systems
where we got rid of the old model, the old BHOs,
behavioral health organizations, if you recall,
which even before then were, what were they?
Regional service networks, right? The RSNs. RSNs,
yeah. That's what they were called. That's right,
yeah. We called them behavioral health service
networks or whatever, but they were still called
RSNs. Right, they were RSNs, yeah. And then,
so when we did this shift, this sort of... full
-on shift in 2020 where we had the managed care
organizations now responsible for all the Medicaid
folks in the state, including those Medicaid
folks as they're accessing crisis. And then we
set up the behavioral health administrative services
organizations to do just the crisis side of the
system, right? So just the crisis side, non -Medicaid,
state general fund dollar, local dollar, responding
to need within the community. It's been a real
challenge, I think, that at least from our perspective
at the local level, how little attention has
been been paid to that side of the system over
the last five plus years, right? That since we
sort of went live or flipped the switch on this,
it's been disheartening. And I think what we've
seen is the legislature, to their credit, has
tried to respond, right? They have tried to respond
with bills and provisos and funding increases
and rate increases for our providers and a variety
of things. But the reality is, and I think if
we're just going to all lay the cards on the
table, it's been really frustrating to not see
much of a statewide vision. being presented by
our agencies, right? To really say, this is where
we're going to work towards as a state and as
a system. And so it's really been left to individual
counties, regions, like I said, legislators to
try to come up and do stop gaps, right? So here
we are. And here we are. And here we are with
this piece of legislation, which is designed
to try to move some of this forward in a way
that it needed to and provide some meaningful
change. Okay. Well, that catches us up. to kind
of where the bill is now. Yeah. Getting back
to the process and kind of how you were sweating
bullets there at the end. I was hoping we had
moved on from that part. No, no. Yeah, no, we
were sweating it because, like I said, it wasn't
a bill that didn't have a lot of, I mean, it
wasn't without controversy. On a podcast, you
never get away without giving away the gritty
details. I know, I know. So, you know, the bill
certainly, obviously, we had a lot of negotiations
happening between the managed care organizations
as well as the BHASOs, the state agencies. The
governor's office were also involved in these
negotiations. I think when the bill – one of
the issues that came up later, which really did
slow the bill down, was inclusion with our partners
in the tribes. It was our tribal partners. They
did not – the tribes did not integrate in the
same way that the rest of the state did as it
relates to behavioral health. They have a slightly
separate system that they negotiate directly
with the state. At the ASO level, at the local
BHA ASO level and the county level, level, we
interact with our tribal partners all the time.
And it's a big part of the work that we do is
a lot of cross coordination and collaboration.
But they also had some frustrations, frankly,
in the way that the system was working, and I
think some warranted ones. And so they felt like
this was a vehicle that they could try to get
some input in. But by doing so kind of late in
the game, it really slowed the bill down. We
had to pause so that we could try to figure out
how to negotiate that in a way that made sense
and make sure that what some of the concerns
that they were trying to build in a fit within
the bill, the scope of the bill, but also could
move the ball forward for them as well. So you
had some kind of late hour negotiations. So we
did. And so that, that created, and that's one
of those things like we were just talking about.
It's like. once you have one of those little
hiccups, all of a sudden your bill is now not
the priority, right? Your bill is now not on
the track that it was because it's off to the
side being worked on and everything else is moving
along and clicking along. And then you've got
to find your way back to that conveyor belt.
Right, you've got to bring yourself back into
the stream, right? And so once we got that done,
then we also did learn that there were some concerns
being raised by the MCOs on the floor that were
ultimately those amendments didn't get offered
by the - by the sponsor who had them drafted
up. But it, it was a, that's yet another negotiation
that takes time. That's exactly. And, and ultimately
it created, you know, I think we use the term
sometimes that there was a member with their
foot on it. So we had a member that had their
foot on it while the, while we were kind of working
this out. And, and ultimately we got to a good
place. The, the prime sponsor did some really
excellent work with that particular member who
was, who was. expressing some concerns. And they
got to a good place. They got to an agreement
and were able to get it released and pulled.
I think I want to say we were one of the last.
Yeah. One of the last rules polls. I think you
were the last rules poll. You were on that last
list. I was glad to see it on there. Yeah, me
too. Believe me. And then, yeah, we had a couple
of late nights and then we ended up passing it.
I think it passed out at like 11 p .m. on that.
tuesday night so it was the day before um but
it came out it came out yeah it was it was But
yeah, it came out with a good vote, nice bipartisan
vote, strong bipartisan vote. And so now it's
over the House and we're, or I'm sorry, over
in the Senate and we're working it now. And in
fact, I've got some stakeholder meetings with
senators on this tomorrow. So congratulations
on getting it this far. No, and credit to our
membership who has, you know, whether they were
testifying or talking to members or working members,
it's really been a push by the association to
keep this moving. Yeah, it's not easy to get
it even halfway through the system. That's right.
The good news is, is once you get it halfway,
way your odds of getting it all the way through
go way up obviously right so we're feeling a
little bit like the winds that are back at the
moment but there's still a bottleneck at the
end that you're gonna have to fight to get in
line with you know and whenever you move from
one chamber to the other i mean they are completely
different animals right i mean i think some people
assume it's like oh you move from the house of
the senator senator to the house and it's just
the same old thing and they are just that's you
know as well as i that's they operate on totally
different planes well and this year the senate
is so different than what we've seen the last
several years right very much so um So it'll
be interesting to see kind of how things work
out. Now, your bill was in the Senate. No, our
bill was a House bill. Okay, it was in the House.
That's right. It was 1813 is the number. So it's
in the Senate now. Has it been scheduled for
a hearing? No. We expect it to be scheduled probably
next week is what we're thinking. Like I said,
there's some stakeholder meetings happening this
week with the committee chairs. Well, committee
chair and... uh, ranking member. We're trying
to bring everybody in to kind of have a conversation
and make sure everybody's comfortable with where
it's at. Um, and, and see what we can do to kind
of move this forward. I anticipate, obviously
it'll go through a policy committee first and
then have to go to a fiscal committee as well.
So the clock is ticking, but you got some time
we do. And I feel good that we're at least we're,
you know, we've got it lined up to where we can
get it heard relatively soon. And yeah, our next
committee cutoff or next policy cutoff isn't
until April 2nd. Exactly. Two weeks? Yeah, two
weeks. I'm feeling pretty good that we'll have
this at least out of the policy committee. Good,
good. Well, congratulations on that. Thanks.
We have a couple minutes left. Any other important
pieces that made it through so far that you are
following that are important to our members?
Yeah, I think, you know, interestingly, I know
we've talked before on this podcast about House
Bill 1218, which dealt with competency evaluations.
This was a bill that we had some significant
concerns about when it came. It came up initially
just before session, particularly the components
around essentially penalizing or fining counties
that were being. determined to have too many
comments evaluation requests. So we've had to
do a ton of work to get this bill to a place
where we feel comfortable with it. I won't say
it's a perfect bill because it's not, but I think
we feel at the moment that by removing, we were
successful in getting the penalty components
removed from the bill. So they're completely
gone. They're completely gone. So that is good.
That was a big win for us. And I do think we
shared some of the problem statement in the bill.
We shared that the concerns that the sponsor
I do believe that will have a harder path in
the Senate. than it did in the House, and it
didn't have a totally easy run in the House.
You know, that bill is an interesting one. It's
kind of a lesson in what I think are some of
the fundamental misconceptions about how county
government actually operates, right? You know,
county government has a separation of powers.
unlike any other government system that's out
there. You know, we have, what, eight or nine
independently elected officials plus several
agencies that all have individual responsibilities.
And there is no clear executive versus legislative
versus judicial branch. I mean, there is in some
ways, but for instance, the county commissioners
actually have executive. judicial and legislative
powers. So it's just this kind of weird animal.
I started calling it the shadow government in
Washington state that no one ever really fully
understands until you're part of it. It's like
skull and bones. You have to be a member before
they give you the secrets to how things actually
operate. But I can't remember who I was talking
to. It wasn't very long ago, but they were saying,
that they'd been in politics for years, studied
it, you know, went to school for political science,
were in elective office, et cetera. And, you
know, they could never remember through all their
studies and everything that they'd been through
anyone ever giving them a lesson on how county
governments actually worked. And I think that's
probably why we spend all of our time up here
trying to fix things. Right, right. And 1218,
I think, is a really good example. It is a great
example of that. Yeah. And not only just in terms
of how things work at the county level but there
are other players involved that that aren't counties
at all. Right. I mean, their cities are a part
of this work, our judicial system. I mean, the
judges. So not just the not just the prosecutors,
the public defenders. Right. Which are a whole
other independent group. And so, yeah, they're
all independent, all independent and all have
a different and different interest and a different
interaction authority and authority in this and
responsibility in space. And many in, for instance,
the county commissioners can't tell the prosecutor
what to do. They can't public defense. The prosecutor
can't tell her. city exactly none of those entities
can tell anybody what to do exactly once they're
elected and they're in those positions they have
full authority to make those decisions the only
check that's on them at all other than the law
is that is the voters that's right is the taxpayers
that's right and 12 18 right that had a bunch
of penalties that that i think assumed that county
commissioners would be able to control right
that we could just flip a switch or turn a dial
and all of a sudden it would be fine right and
it took a lot of work to try to explain that
that was just that's that's not how it works
and that we don't as i appreciate them thinking
we had that much power right but but that we
don't and that this really is a lot of independent
individuals or independent entities making this
part of the system work or not work frankly um
so yeah it was a challenge but i think we got
to a good place on it i feel good about it uh
and we'll continue to engage on it in the senate
as it works through Well, that's great, and that's
good news to hear that the penalties are gone
off of that bill. I think our members will really...
appreciate that. So good work, Brad. Well, thanks.
Appreciate it. Appreciate the support on it.
Yeah. Well, that's all the time we've got. Um,
I want you to come back to chat about, uh, what's
been going on with the law and justice. Yeah.
There's plenty going on there. Yep. Uh, after
cutoff and, uh, juvenile rehabilitation, maybe
a little bit. Yeah. I think we need to talk about
those things too. So, um, let's schedule another
podcast. I'm sure that our listenership will
be eagerly waiting for sure. They just, yeah,
they're going off. When's Brad going to be back?
No, thanks. ball though yeah look forward to
it we'll talk to you all right bye thanks for
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