WeVote
Log In

Bill

Bill

SB 5438

Facilitating supportive relationships with family and significant individuals within the behavioral health system.

2023-2024 Regular Session Introduced by Matt Boehnke and 5 co-sponsors

Directs HCA and DSHS to prioritize meaningful family involvement in behavioral health care, review policies with stakeholders, and protect family rights to support recovery.

Senate Rules "X" file.
0
WeVote Research Nonpartisan
Bill Summary · SB 5438

SB 5438 — “Family Care Act” (facilitating supportive relationships within the behavioral health system)

Status snapshot
- Multiple related versions were considered during the 2023–2024 legislative sessions; House passed an amended version (3rd reading) in March 2023. The bill has proceeded through Human Services and Ways & Means committees and is listed in the Senate Rules “X” file. Different substitutes and amendments were filed; some provisions and deadlines vary by version.

Purpose and intent
- Directs the Health Care Authority (HCA) and the Department of Social and Health Services (DSHS) to operate and make policy in ways that recognize, protect, and promote meaningful relationships (family, friends, other significant persons) in the lives of behavioral health clients and state hospital patients. The goal is to nurture family involvement to support recovery, reduce trauma, and strengthen resilience.

Key provisions (substantive)
- Principles agencies must consider when overseeing the community behavioral health system and state hospitals:
- Encourage involvement of a caring, compassionate family member who can advocate in collaboration with medical professionals.
- Include families in children’s (and relatives’) behavioral health care when in the client’s/patient’s best interest; parents should be encouraged to engage and, when appropriate, have decision‑making roles.
- Avoid policies or practices that cause unnecessary trauma to families; enable family participation in care decisions without fear of negative consequences (loss of safety, residence, reprisal).
- Maintain family rights/responsibilities in decisions about residence, supervision, schooling, education, and health care where appropriate.
- Recognize and nurture non‑blood “family‑like” relationships and that development continues past age 18.
- Promote whole‑family approaches, assess service needs of family members, and assist in building or restoring healthy relationships.
- Closely monitor and frequently evaluate psychotropic medication use in children, and provide expert support to parents regarding risks and benefits.
- Use the legal system as a last resort; avoid handling medication management through at‑risk youth petitions; discourage severing parental rights solely to access services absent evidence of abuse/neglect (unless in child’s best interest).

  • Agency reviews and stakeholder consultation:

    • HCA must review its behavioral‑health policies and DSHS must review state hospital policies related to facilitating family engagement.
    • Reviews must be done in consultation with stakeholders, family members, and peers, and identify and eliminate policies that undermine family integrity or discourage engagement.
    • Deadlines differ by version: some drafts required completion by June 30, 2024; later substitutes moved the deadline to June 30, 2025.
    • Agencies may notify the Governor and relevant legislative committees of review completion and outcomes.

  • Limits, exclusions, and privacy:

    • Amended versions removed a provision that would have authorized disclosure of health information to family when (a) there is a record of significant involvement and the client does not object, or (b) the client lacks capacity and professional judgment favors family involvement.
    • Some substituted versions explicitly exclude from the review any reconsideration of existing statutes governing adolescent consent, certain health‑information release rules, and specific court/provider standards (lists of RCW sections cited).

Other important details
- The bill does not create a private right of action.
- No appropriation included in the reported versions; a fiscal note is available.
- Effective date language in some versions: 90 days after adjournment of the session in which the bill is passed.
- A variety of committee hearings and executive actions occurred in 2023–2024 (Human Services, Ways & Means, Health Care & Wellness, Appropriations). Some reintroduction/retention activity appears in later sessions.

Who would be affected
- State agencies (Health Care Authority; DSHS/state hospitals) — required to consider and implement the principles and complete reviews.
- Managed care organizations, Behavioral Health Administrative Service Organizations (BHASOs), and contracted providers — policies and contracts administered/overseen by HCA could be influenced.
- Behavioral‑health clients and state hospital patients, and their families/other significant persons — potential changes in family engagement practices, decision‑making inclusion, and supports.
- Parents/guardians of minors — emphasis on parental engagement and medication oversight for children.

Notes on versions and debate
- The bill evolved through multiple substitutes and amendments. Key changes included (1) moving review deadlines, (2) narrowing or removing language about disclosure of health information to family, and (3) expressly excluding certain statutory areas (adolescent consent and related protections) from the required policy reviews. Readers should consult the most recent enrolled or committee‑reported version for final text.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.