History of the King County Mental Health Plan
The King County Mental Health, Chemical Abuse and Dependency Services Division (MHCADSD) is responsible for planning, implementing and evaluating the publicly funded, countywide system of care for adults and children with mental illness residing in King County.
In addition to these services, Crisis and Commitment Services, a section of MHCADSD, is responsible for providing 24-hour crisis outreach services to persons experiencing psychiatric emergencies. Crisis and Commitment Services is also responsible for processing referrals and conducting investigations under the Washington State Involuntary Treatment Act.
Washington State's mental health reform began with Substitute Senate Bill 5400 enacted in 1989, which shifted responsibility and accountability for services from the state to county-based entities called Regional Support Networks (RSNs). King County RSN was established in 1990 and is managed by the King County MHCADS Division. Under SSB 5400 and our contract with the State of Washington, KCRSN is responsible for providing services and supports for adults with serious and persistent mental Illness and children with severe emotional disturbances.
The second phase of mental health reform was the implementation of the King County Mental Health Plan (MHP) for outpatient mental health services in April 1995. The “Prepaid Inpatient Health Plan” (PIHP) was created in response to a federal waiver granted to the state to establish regionalized administration of the Medicaid program. The King County Mental Health Plan replaced the former fee-for-service structure with a managed care system. It was designed to increase access to care, client satisfaction, administrative efficiency, and create greater accountability for outcomes and quality.
The third phase of reform began in 2005 when the Recovery Plan for Mental Health Services was published, and the King County Council approved King County Ordinance 15327. This ordinance:
- adopted the recovery model as the foundation for developing and operating the mental health services for which King County is responsible
- adopted a five-year plan work program for converting the service system to a recovery-based model
- required a detailed implementation plan and created a progress reporting process.
2008 is year three of this multi-year system change process.