The House Health Care & Wellness Committee voted to report substitute House Bill 18 13 out of committee with a do-pass recommendation after adopting an amendment that replaces an immediate procurement requirement with a strategic planning requirement for Medicaid behavioral health crisis services.

Sponsor Representative Macri described the amendment Blake 208 as the most significant change: it "removes the requirement for the Healthcare Authority to reprocure for Medicaid managed care services and instead requires that they do a plan related to reprocurement that allows various stakeholders to provide input." The amendment also adds tribes and Indian health providers into planning, transition plans and annual reporting on crisis services, and narrows the carve-out to crisis response services rather than the entire behavioral-health continuum.

Supporters said the change was designed to improve coordination of crisis and stabilization services while ensuring tribal participation. Representative Macri said the bill "aims to look at how we both oversee and fund our behavioral health crisis response services" and acknowledged further negotiations with stakeholders would continue.

Opponents on the committee expressed procedural and fiscal reservations. Representative Schmick said members were "mixed" because of uncertainty about how payment and care coordination would work if some crisis services are shifted out of managed care organizations.

The roll call showed the substitute passed 18–1 (18 ayes, 1 nay). The committee recorded that the substitute was reported out of committee with a do-pass recommendation.

Ending: The substitute directs the Health Care Authority to develop a strategic plan for reprocurement and to include tribes and urban Indian health providers in planning and reporting; stakeholders indicated further work is expected as the bill advances.