Health Care & Human Services

Expanding behavioral health care capacity: The supplemental budget continued the state’s expansion of behavioral health services Since 2020, the state has added hundreds of new state-operated beds. At least 550 more will open by 2029. For the first time, wait times for court-ordered competency restoration are within the requirements of the 2014 Trueblood settlement.

Helping Tribes defeat the scourge of opioids: SB 6099 created the state’s first ever fund dedicated specifically to addressing the opioid crisis in Tribal communities. Tribal communities have bene acutely afflicted by the rise of opioid related substance use disorders, with a death rate that is more than four times the state average.

Capping medication costs: Gov. Inslee signed legislation that capped the cost of inhalers used to treat asthma, and epinephrine, which is used to treat severe allergic reactions, at $35 for a 30-day supply.  

Refugee & immigrant assistance: The governor approved $30 million in new spending to help address the increasing number of asylum-seekers and refugees arriving in Washington. HB 2368 directs DSHS to coordinate statewide efforts to support the economic, social and essential needs of these individuals who have resettled in Washington, many of whom are ineligible for federally funded services. 

Resolving encampments and providing emergency shelter: Since its launch in the spring of 2022, the governor’s encampment resolution program has resolved a total of 48 encampments. Nearly 1200 people have been brought inside through this program. Recipients are access to health care, case management services, and job training.

• In response to the U.S. Supreme Court’s Dobbs decision that overturned Roe v. Wade, the governor acted on a number of bills to protect abortion access and gender-affirming care in the state, including legislation to protect consumer health data collected by apps and other organizations; a shield law protecting patients and providers from out-of-state prosecutions; and the elimination of cost-sharing for abortions to increase equitable access to services.
• At the direction of the governor, the state Department of Corrections purchased a three-year supply of the abortion pill mifepristone in anticipation of a federal court ruling that would effectively ban the sale of this common and safe abortion medication. The Legislature acted by authorizing the DOC to distribute the medication to providers and clinics.
• At the governor’s request, the Legislature put nearly $1 billion in new funding toward housing and homelessness programs in Washington state, one of the single largest investments ever.
• The Legislature passed governor-request legislation that enacts several reforms to the state’s behavioral health system for competency services. The bill creates a diversion program for misdemeanor defendants with certain developmental issues instead of putting them in the criminal justice system. It creates a clinical intervention specialist program to help more defendants receive treatment and oversight while waiting for jail competency services.
• To address health care staffing shortages, the governor signed a safe staffing bill that requires hospitals submit staffing plans to the state Department of Health. If a hospital is less than 80% compliant with its staffing plan, DOH and the Department of Labor & Industries can require corrective action or issue penalties.
• The governor signed legislation capping the price of insulin at $35 a month, helping Washingtonians with diabetes avoid outrageous costs for this life-saving medication. The governor also signed legislation increasing access to HIV medication through the Department of Health’s early intervention program, which provides crucial financial assistance and other services to Washingtonians living with HIV.
• The state successfully won a federal waiver and secured coverage in the budget to expand Apple Health coverage to immigrants who lack access to federal or state coverage programs, with enrollment beginning July 1, 2024.
• At the request of the Department of Children, Youth and Families, the Legislature made permanent and expanded the Child Welfare Housing Assistance Program to shorten the amount of time foster children spend in out of home care.

• The Legislature created more opportunities for health care workforce development by funding more slots in nursing programs, grants to nurses supervising students, loan repayments for nurse educators and expediting licensing for nurses.
• HB 1761 expanded the types of health care providers who may administer opioid overdose reversal medication in hospital emergency departments, removing potential barriers to access when someone needs this life-saving medication immediately.
• The Legislature created the Office of Apple Health & Homes under the Department of Commerce to increase the capacity, quality and sustainability of permanent supportive housing units for people experiencing chronic homelessness. The office brings together several programs to increase housing capacity, supportive services, rent assistance and operations and maintenance funding to sustain permanent supportive housing units throughout Washington.
• The Legislature established a Prescription Drug Affordability Board, making Washington one of just a handful of states with this tool to curb excessive drug costs. The board has the authority to set upper payment limits on prescription medicines.
• The Legislature funded the governor’s Right of Way Initiative to remove encampments from dangerous public rights of way by finding individuals experiencing homelessness the supportive housing services they need to get back into permanent housing. This collaborative effort between state and local agencies has closed more than two dozen encampments and connected hundreds to housing services, with more to come.
• The Legislature repealed parental cost obligations to pay a portion of the cost of their child’s support, treatment and confinement in DCYF residential facilities. The legislation also terminated any outstanding efforts to recover similar debts owed prior to the law’s passage.

• Reduce homelessness. Combined capital and operating budgets for the 2021-23 biennium include historic new funding for things like rapid capital housing, a new state program that will allow communities to purchase or update facilities like hotels and turn them into supportive housing units. The funding also supports crisis stabilization facilities, right-of-way outreach, and supportive behavioral health services.
• Improve funding for public health. The Legislature approved $175 million for foundational public health services to strengthen and support the government’s public health system infrastructure, which provides necessary services and health education to Washingtonians at the state, local and Tribal levels.
• Prevent evictions and foreclosures. The Legislature earmarked more than $1 billion in federal and state funds to help households impacted by the pandemic keep up with rent and utility payments, and avoid foreclosure. This includes funding for a new state rental and utility assistance program aimed at assisting individuals most at risk of becoming homeless or suffering severe health consequences due to eviction.
• Protect frontline workers during public health emergencies. The COVID-19 pandemic highlighted the need for increased protections for frontline workers during a public health emergency. The governor acted on a number of bills passed during the 2021 legislative session to bolster protections for workers, especially in times of crisis.
• Support families and businesses impacted by COVID-19. HB 1368 directed $2.2 billion of federal COVID relief funding to support K-12 schools, provide assistance for rental and utility bills, assist child care providers, and bolster food banks. The bill also provided funding for business assistance grants and income relief for immigrants who don’t qualify for traditional unemployment.

• Combat COVID-19. Inslee signed a package of five bills that support various aspects of the state’s response to COVID-19. It includes legislation to improve surge capacity in the health care system, provide funding to local governments, and assist businesses with unemployment impacts.
• Dismantle poverty and inequality in Washington state. The Poverty Reduction Work Group launched by Gov. Inslee in 2017 released its 10-year strategic plan for reducing poverty and inequality. The work group includes several members with lived experience and expertise in issues related to poverty. The strategic plan is already providing value to legislators and state agency decision-makers as a reference for developing legislative proposals.
• Reduce insulin costs. HB 2662 directs health plans to cap the total amount a patient has to pay for a 30-day supply of insulin to no more than $100. The bill also creates a task force to further review ways to reduce insulin costs.

• Public option and guaranteed consumer protections. Inslee signed the first-in-the-nation public option legislation, known as Cascade Care, to combat attempts by President Trump and congressional Republicans to undermine the Affordable Care Act (ACA). The bill will ensure affordable insurance options for every Washingtonian through the state’s Health Benefits Exchange. Inslee signed another bill that reinforces several consumer protections in the ACA, including the much-discussed right that no person will be denied health coverage because they have a pre-existing medical condition. This ensures that even if the federal government rolls back the ACA, those protections will remain in place for Washington consumers.
• First-in-the-nation long-term care benefits. Another first-in-the-nation bill signed by Inslee creates a long-term care benefit, similar to a Social Security or Medicare benefit. Because Medicare doesn’t cover long-term care, the benefit will be crucial for the growing numbers of workers and families who do not have long-term care insurance and find themselves unable to pay for necessary health and care services.
• Transformation of Washington’s mental and behavioral health system. Transforming Washington’s struggling behavioral health system has been one of Inslee’s top budget priorities. The budget and various policy bills signed by the governor will emphasize community-based care for civil patients and state hospitals for forensic patients. Funding will secure approximately 600 placements in community facilities and approximately 120 beds in community hospitals and evaluation and treatment centers. The budget also supports the construction of 60 additional forensic beds at the state hospitals and a new forensic hospital. A new teaching hospital at the University of Washington will serve patients while also expanding training to fill the state and national shortage of behavioral health workers.
• Youth smoking and vaping. Inslee signed legislation increasing the tobacco and vaping purchasing age from 18 to 21. The new policy is based on compelling data showing 90 percent of daily smokers report they first started smoking when they were 19, and a dramatic rise in youth vaping rates in recent years.
• Stronger vaccine protections. Following a measles outbreak in Washington state that infected dozens of people, legislators approved a policy that removes the philosophical or personal objection exemption for the measles, mumps and rubella vaccine.
• Opioid treatment and prevention. To address the opioid epidemic, the governor requested and signed legislation that provides comprehensive opioid prevention and treatment options. This includes innovative approaches such as electronic prescribing and expanded treatment options, with a focus on pregnant and parenting programs. The bill also directs the state Department of Health to create a standing order for naloxone, making access to the life-saving overdose reversal drug a lot easier. The governor issued an executive order and a multi-year state plan to address opioids in 2016.
• More affordable housing. Additional funding for the state’s Housing Trust Fund will build up to 4,100 new affordable housing units and preserve as many as 500 aging affordable housing units for a broad spectrum of vulnerable populations, including those with chronic mental illness, homeless families, youth and individuals, veterans, farmworkers, seniors and individuals with special needs. Local governments and homeless service providers will be able to provide rent assistance to about 1,000 additional vulnerable individuals, and about 135 additional families will receive permanent supportive housing services from the state.

• Juvenile rehabilitation work. The Department of Children, Youth and Families integrated the juvenile rehabilitation work that has long been housed at the Department of Social and Health Services. The transition of juvenile rehabilitation programs into DCYF is a significant next step to ensuring youth get the support they need.

• Reforming behavioral health care. To help Medicaid clients navigate the health care system, Gov. Inslee signed legislation to combine and better coordinate physical health services, mental health services and addiction treatment. He also approved funding for strategies to fight the state’s opioid epidemic and money to expand behavioral health services in local communities.
• Tackling the opioid crisis. Washington expanded the hub-and-spoke treatment model across the state to help people with opioid substance use disorder find help. The state has also reduced opioid prescribing, taken legal action against opioid prescription manufacturers, and has seen a decline in unintentional opioid overdose deaths and the percentage of minors abusing painkillers.
• Reproductive Parity Act. Gov. Inslee signed SB 6219, requiring reproductive parity in all health insurance plans in Washington. This means plans that offer maternity coverage must also cover contraception and abortions.
• Breakfast After the Bell. In high-need schools, Breakfast After the Bell programs allow students to eat breakfast during instructional time, accommodating hungry students who can’t make it to school for breakfast before class begins. Following a five-year effort, the governor signed HB 1508, establishing Breakfast After the Bell in Washington.
• Health care transparency. Washington has launched HealthCareCompare, an online tool for the public that shares information from the state’s All-Payer Claims Database about expected costs of common medical procedures, as well as health care quality ratings. Landmark legislation requested by the governor in 2015 requires commercial health insurance companies to disclose information for the database.
• Modernize the state’s mental and behavioral health system. The governor announced a five-year plan to transition our mental health system away from large institutions to smaller, community-based facilities to treat patients more effectively and closer to friends and family.
• Help at-risk children and families thrive from the start. In 2016, the governor convened a Blue Ribbon Commission on Children and Families, a group of experts who recommended bringing together early learning and family support services under one agency. As a result, the Department of Children, Youth, and Families launched in July 2018 with a focus on preventive family interventions, as well as equity for all Washington children. The agency provides all services previously housed in the Department of Early Learning and some services previously provided by the Department of Social and Health Services.

• Improving services for children and families. Gov. Inslee signed HB 1661, establishing the new Department of Children, Youth, and Families. The department brings together services previously scattered across other agencies, including early learning, child welfare and juvenile justice programs, better equipping the state and its many partners to protect children and youth from harm and promote healthy development.
• Progress on helping homeless youth. Gov. Inslee issued Directive 17-01, creating an interagency workgroup on youth homelessness led by the Office of Youth Homelessness.
• Investing in mental health care. The 2017-2019 budget included $66 million in state funds to expand capacity at community-based mental health facilities for patients ordered into commitment by a court.
• Dismantle the root causes of poverty. The governor created a Poverty Reduction Work Group tasked with creating a strategic plan for reducing poverty and helping more families access housing, health care, jobs and education. The work group will rely on the lived experiences and expertise of people who have personally experienced poverty.
• Improve behavioral health care. At the governor’s request, the Legislature passed HB 1388 to support integrating physical services and behavioral health services, such as addiction treatment and mental health care, statewide for Apple Health (Medicaid) clients. The bill better aligns the functions of three state agencies to help consumers navigate the system more effectively and to receive better coordinated, quality and cost-effective care.

• Protecting minors against harmful products. Gov. Inslee signed SB 6328 to strengthen protections for minors against the sale and use of e-cigarettes and vapor products. The bill is part of the governor’s Healthiest Next Generation efforts.
• Reducing lead exposure. Gov. Inslee issued a directive to the state Department of Health and partner agencies to assist local communities with lead testing and take steps aimed at reducing lead exposure in Washington.
• Investments in behavioral health workforce. One of the key health care reforms underway in Washington state is the improved integration of mental health with primary care and chemical dependency treatment. This new behavioral health approach will require additional health care workers. Gov. Inslee directed the Workforce Training and Education Coordinating Board, in partnership with the Health Workforce Council, to evaluate current and projected workforce shortages in behavioral health.
• Address the opioid crisis. In 2016, Gov. Inslee signed Executive Order 16-09 directing state agencies to work with local public health, tribal governors and other partners across the state on an opioid response plan to reduce opioid abuse, increase addiction treatment and make overdose antidotes more accessible.

• A healthier Washington. In 2015, more than 700,000 Washingtonians were enrolled in new, more affordable health care plans thanks to our state exchange, bringing the state’s uninsured rate to an all-time low: 6 percent.
• Better health care information on price and quality. In an effort to make health care data more transparent and available, Gov. Inslee worked to pass SB 5084, which created an all-payer claims database. The database gives consumers, employers, medical providers and policy makers the information they need to make informed decisions about buying and using health care.
• Better mental health care. Mental health care is one of Gov. Inslee’s top priorities.
  • He worked to pass HB 1450, which made it easier for the families of people with mental health issues to get proper emergency mental care for their loved ones.
  • He also helped pass SB 5177 to address the unacceptably long wait times of people charged with crimes whose ability to stand trial is in question until they receive certain mental health services, a process known as “competency restoration.”
  • The final 2015-2017 budget invested $40 million in the forensic mental health system by increasing staff and available beds and created the Office of Forensic Mental Health Services.
• Ensuring the Healthiest Next Generation. The 2015-2017 budget continued the governor’s Healthiest Next Generation initiative and programs to promote healthy eating and physical activity.
• Fair pay for health care workers. Supported living providers help thousands of people with disabilities and health issues remain at home instead of living in costly assisted care facilities. These providers, many of whom earn minimum wage, received their first raise in eight years.
• Homeless youth. Gov. Inslee’s Homeless Youth Act established the Office of Youth Homelessness within the Department of Commerce, charged with coordinating services to make sure that youth can easily access the resources they need. The office makes recommendations to the governor and Legislature about the strategies and resources needed to improve youth homelessness services.
• Support for our veterans. Gov. Inslee’s veterans’ tuition bill makes veterans, their spouses and their children eligible to attend our public colleges and universities and pay resident tuition rates.

• A healthier Washington. Gov. Inslee launched the Healthiest Next Generation initiative to make Washington’s next generation the healthiest ever. The initiative’s workgroup recommends state policies that support community-led encouragement for children to be more active and eat better.
• Better mental health care. The governor’s HB 2572 passed to improve mental health care integration, cost transparency and the purchasing of health care. SB 6312 is the complimentary bill that improved the way we care for people with severe mental illness, integrated chemical dependency with that care and began the integration of care to treat the whole person.
• Support for our veterans.
  • The governor’s office worked to pass HB 2363, which allows developmentally disabled children of military service members to continue to qualify for home and community based services while the service member and family are out of state due to military assignment. Washington was the first state in the nation to pass such legislation.
  • The governor’s request legislation HB 2171 passed to help strengthen economic protections for military personnel.

• Affordable health care. With bipartisan support, Washington implemented the Affordable Care Act and expanded Medicaid to ensure access to affordable health care for low-income families. Read Gov. Inslee's Executive Order on the Affordable Care Act here.
• Support for our veterans. Gov. Inslee’s first executive order helped boost the hiring of Washington’s veterans. The order increased the state’s collective efforts to make sure veterans and their families share in Washington’s prosperity.