HB 1809
In CommitteeHouse
Behavioral health response
Professionalizing first responders and co-responders through training and reimbursement for behavioral health emergency response.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
HB 1809 expands training and certification options for emergency medical personnel to better respond to behavioral health emergencies, and creates pathways for reimbursement and coordination with crisis response systems. It establishes a voluntary behavioral health endorsement for EMTs and paramedics, funds training through the University of Washington, and launches pilot programs to improve crisis response coordination and billing.
- Requires the Department of Health to adopt rules by January 1, 2027, recognizing a state-developed behavioral health training as an optional module in ongoing training for EMTs and paramedics.
- Tasks the University of Washington’s Behavioral Health Crisis Outreach Response and Education Center with developing a 9-hour behavioral health training course for EMS personnel by July 1, 2026, offered in in-person, online, or hybrid formats.
- Creates a voluntary behavioral health endorsement for EMTs and paramedics, issued starting July 1, 2027, upon successful completion of advanced training covering topics like overdose response, de-escalation, and suicide prevention.
- Requires the Health Care Authority to reimburse fire departments and EMS agencies for behavioral health services provided by certified personnel with the behavioral health endorsement under medical assistance (Medicaid) programs.
- Launches a pilot project (Jan 2026–Jun 2027) in four regions to test best practices and billing strategies for co-response teams, and to assess training needs for first responders.
- Establishes a co-response education training academy leading to optional certification in crisis response, starting in three regions and expanding statewide by 2027, with grants available for rural programs.
Who is affected
- Emergency medical technicians (EMTs) and paramedics — EMS personnel (EMTs, paramedics) can voluntarily earn a state-recognized behavioral health endorsement after completing specialized training, improving their ability to respond to crises and potentially increasing reimbursement for related services.
- Fire departments and emergency medical service agencies — Fire departments and EMS agencies that respond to behavioral health emergencies may receive new state reimbursement for providing these services, and may benefit from pilot programs testing billing strategies.
- Co-response and mobile crisis teams — Staff at local co-response and mobile crisis teams can access optional, state-supported training and certification in crisis response best practices, with grants available to help rural programs cover training costs.
- Residents experiencing behavioral health emergencies — People experiencing behavioral health crises may benefit from more appropriate, less emergency-room-dependent responses, as first responders are trained and incentivized to connect them with community-based services.
- State and local governments — State and local governments may see reduced costs over time due to fewer unnecessary emergency department visits and improved coordination between 911 and 988 crisis response systems.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Creates a state-developed, 9-hour behavioral health training course for EMS personnel, improving first responders’ ability to de-escalate crises and connect individuals to community-based care — reducing unnecessary ER visits and hospitalizations.
HealthcarePeopleRef: Sec. 2 & Sec. 3Mandates Medicaid reimbursement for behavioral health services delivered by certified EMS personnel, enabling sustainable expansion of crisis response and reducing reliance on costly emergency department use — especially for Medicaid-enrolled individuals in crisis.
HealthcarePeopleRef: Sec. 5Launches pilot programs and a statewide co-response training academy to improve coordination between 911 and 988 systems, supporting more appropriate responses to behavioral health emergencies and reducing criminalization of mental health crises.
Public SafetyPeopleRef: Sec. 6 & Sec. 7Provides grants to offset training costs for rural co-response teams, helping expand access to crisis response training in underserved areas and supporting workforce development where resources are scarce.
EducationPeopleRef: Sec. 7(2)Aims to reduce taxpayer costs over time by diverting behavioral health crises away from emergency departments and toward community-based services — though savings depend on successful implementation and scale of participation.
FinancialLean peopleRef: Sec. 1(2)(c)
Potential Concerns (5)
Mandates Medicaid reimbursement for behavioral health services provided by certified EMS personnel, but does not guarantee funding or set reimbursement rates — creating administrative complexity and potential delays in service expansion if reimbursement rates are set too low to cover costs.
Public SafetyRef: Sec. 5Pilot project sites are selected by the Health Care Authority, with geographic and system-integration criteria, but the bill does not require equitable distribution across urban/rural or high/low-need communities — risking concentration of benefits in better-resourced regions.
Local GovernmentRef: Sec. 6(2)The behavioral health endorsement is voluntary, and training is offered through third-party providers (e.g., community colleges), meaning uptake may be low without strong incentives — limiting impact on workforce capacity and leaving many first responders without the new skills.
Business & EmploymentLean peopleRef: Sec. 3(4)Reimbursement for behavioral health services is contingent on legislative appropriation and participation levels; without guaranteed funding, fire/EMS agencies — especially small or rural ones — may absorb training and service costs without recoupment, straining budgets.
FinancialLean peopleRef: Fiscal Impact sectionGrants for rural co-response programs are available but capped in scope (e.g., “small and rural”); without clear eligibility thresholds or funding levels, many rural teams may not qualify or receive meaningful support, worsening regional disparities.
Local GovernmentRef: Sec. 7(2)
Who Is Most Affected
EMS personnel (EMTs/paramedics) gain optional, state-recognized credentials that improve crisis response capabilities and may increase job satisfaction and career pathways; however, uptake depends on training access and employer support, and the voluntary nature limits broad impact.
Fire departments and EMS agencies gain new Medicaid reimbursement authority and access to state-supported training, potentially improving sustainability of crisis response — but small/rural agencies may struggle with upfront costs if reimbursement rates lag or are delayed.
Co-response and mobile crisis teams gain access to standardized training and state grants for rural programs, strengthening capacity and integration with 911/988 systems — though benefits may be uneven without guaranteed funding for all regions.
Residents in behavioral health crises benefit from more appropriate, less traumatic responses and better linkage to care — reducing ER overcrowding and criminalization — but outcomes depend on timely rollout and equitable access across regions.
State and local governments may see long-term savings from reduced ED use and better crisis outcomes, but short-term costs include training, pilot implementation, and administrative overhead — with net fiscal impact contingent on participation and reimbursement rates.