Q&A: Senator Manka Dhingra on Behavioral Health – State of Reform


Senator Manka Dhingra (D-45e) Chairs the Senate Behavioral Health Subcommittee, is Deputy Chairman of the Senate Law and Justice Committee, and sits on the Ways and Means Committee. During her time in the legislature, Senator Dhingra advocated for behavioral health bills, support for domestic violence survivors and gun safety.

More information from this interview on non-health care bills can be found on the website Washington State Wire, our sister site.

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Aaron Kunkler: As the 2022 legislature approaches, what are your political priorities?

Senator Manka Dhingra: This is a short session. I also think that myself and a lot of lawmakers, much of the public, are just enough exhausted. So I don’t expect big bills or new ideas or concepts. I think a lot of the job is to fine-tune the work we’ve been doing, make adjustments as needed, and perfect or improve the governance system. Because, frankly, in the last four years since I won and we took the majority, there have been huge changes in terms of putting people first, making sure people have access to services and support.

We had the big one domestic violence bill last session, where really, once again, Washington is leading the country in how we provide service and support to survivors of domestic violence, sexual assault and stalking. And we have the problem of coercive checks that appear at the last minute in the Senate. So there will be a bill to ensure that we put it back in place. I know that our office has been contacted a lot since Housemaid released on Netflix because it is coercive control in Washington state. And now there is no protection for that in our state.

We will definitely see it. In fact, I actually have a town hall tomorrow on Domestic Violence, talking about the barriers and how we can streamline the system for survivors, as we have seen a 30% increase in deaths among survivors. domestic violence. I mean, a lot of the murders that we’ve seen this year, last year, were, unfortunately, domestic violence.

The behavior assistance is going to be huge, as well as the manpower. We made a record investment in behavioral health in the last session, for both substance use disorders and mental health. A lot of these grants for these programs have not been used, because the agencies say they don’t have the manpower for it. Which is really unfortunate, because people have wanted those dollars for so long. And now that they’re finally here, they don’t have the manpower. So really take a look at this. And take a look at not just the behavioral health workforce, I think you can include all the health care providers in there, because they’ve been really stressed out for a year and a half.

AK: On the issue of manpower, what specific pieces of legislation are you considering or ways in which the state could help you?

MARYLAND: So, you know, we make sure that we make more use of peers within the system. So certified peers right now in our state you can only use them if they work with an agency. So anyone who has private insurance does not have access to their peers. And there’s a lot they can do in terms of coordinating care, making that connection with individuals and making sure they stay in treatment, or do that first introduction to treatment. I think there are many possibilities to create these pathways for certified peers to provide more of these services. In recent years, in my opinion, health bills, I have implemented a coordination of care requiring it. It’s really a subset of people who can really help with this component.

There is a program in the UK that has been really effective. It’s called a Behavioral Health Support Specialist, and it’s a bachelor’s degree. And this is something that is of great interest to the University of Washington as well. So I’m going to prepare a bill to ensure that we have that in our range of professionals. Because there is so much work that master-level clinicians do, it’s administrative. If they have these behavioral health support specialists, there is a good way for them to distribute that workload.

I know there is a lot of interest in repaying the loans, in setting up a lot of other structures to make sure we get people on the ground. And then I know there are ideas on how to keep people in the field once you’re in the field. Retention is also a huge element, people are really exhausted. So during assembly days and having a health subcommittee, a working session will actually be devoted to the workforce and recommendations from different groups.

… Again, making sure we have apprenticeship programs, really looking at the CDP, the professional license in chemical dependence, and the MHB, the professional license in mental health, to see how we can just make sure that we don’t create unnecessary obstacles to get those.

AK: Absoutely. It seems the state is genuinely interested in expanding learning opportunities in areas where they have not been a traditional path.

MARYLAND: Absolutely yes. I think we just don’t use them as much as other countries and states. I’m really glad we’re looking at this. Traditionally people say no, learning means working with your hands. It could be a plumber or an electrician, but that is not true at all. You have things you can do for all professionals all the time. In my district we have the Tesla STEM school. We call it internships when we do it in an office, but it’s the same thing. But you can formalize a lot of this work. And this really is the best way to recruit people into a profession is to give them this opportunity earlier.

The other big behavioral health bill I’m going to have concerns outpatient assisted treatment. Right now in our state the way it works is that it is an option available to you after hospitalization. I want to take it and make it an option before hospitalization. This is done in many other states, and this is in fact what the recommendation model of the Treatment advocacy center. And so, that will essentially say that you can seek outpatient assisted treatment before you need to be hospitalized so that you can provide those services and support. So that’s the same thing we’ve done for the last three years, where we sort of pull back when you provide services so that it’s as early as possible in the process, instead of waiting for this crisis to happen. occur.

In our state, it is the excellent DCR, the designated crisis responders, who filed the petition, which is a very specific situation, other states do not have this concept. If the assisted outpatient treatment would actually extend that to mean that a DCR can petition as they normally do, or someone who already has a treatment relationship with the individual. So a person who is already on treatment and their provider can see them decompensate and they know they’re headed for hospitalization, they can step in and say, “Hey, can we do that because we know this person is going. end up hospitalized if she doesn’t get that help.

So we are expanding this because we know that DCRs are completely overloaded. When this system was first created in Washington, I think there were concerns about misuse or someone manipulating the system, but our standards are so high and they still require legal action. So I’m very excited about this component because I really want to see how it will work.

AK: You mentioned that this session will mainly focus on refining recently passed bills. What invoices are you thinking of?

MARYLAND: The long-term care law is definitely on the list. And, you know, there’s an advisory committee that was set up under this one to make recommendations. I think those recommendations are due next month. So I think it’s definitely on the list of things we need to work on. I am sure there will be more to do in the area of ​​housing.

I’ll tell you another thing about health care that interests me. I will have a breast milk equity bill. This is for premature babies and infants in our neonatal intensive care unit. They’re given a lot of medicine, but really, one of the things that would be great would be if our doctors could just prescribe breast milk and bill for it. And we have a few states across the country that do. And we’re looking at the New York model, and a bill on it. It really is the best for infants and premature babies and I think we have donor breast milk. So we really make sure that our health care providers can actually prescribe breast milk, instead of a lot of other drugs that are needed to stabilize our very, very little Washingtonians.


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