This bill adds new sections and amends existing law to create statewide behavioral health training, voluntary certification endorsements, reimbursement rules, a pilot project, and a co-response training academy for first responders addressing behavioral health emergencies. It directs the University of Washington behavioral health crisis outreach response and education center to develop a nine-hour EMS training by July 1, 2026 and a supplemental advanced course by January 1, 2027; the Department of Health must adopt rules by January 1, 2027 recognizing the basic training as an optional continuing-education module for EMTs and for physician’s trained advanced EMTs and paramedics. Beginning July 1, 2027 the secretary must issue a voluntary behavioral health endorsement for EMTs, physician’s trained advanced EMTs, and paramedics who complete the required training; the amendment to RCW 18.71.205 also clarifies practice limits tied to medical program directors, disciplinary governance under chapter 18.130 RCW, and the definition of an “approved medical program director.” The bill creates reimbursement and pilot project responsibilities in chapter 71.24 RCW, requiring medical assistance programs to reimburse fire and EMS agencies when behavioral health services are provided by personnel with the behavioral health endorsement, and directing the authority to run a pilot in four BH-ASOs (effective January 1, 2026 through June 30, 2027) to develop best practices for coordinated behavioral health emergency responses and billing strategies; pilot sites must be selected on both sides of the Cascade crest and have or plan to integrate 911 and 988 capacity. The authority (or its designee) must report on the pilot by July 1, 2027. The UW center, in consultation with BH-ASOs and the authority, must run a co-response education training academy, initially certifying best crisis response practices in three BH-ASOs and expanding to all 10 BH-ASOs by 2027; that certification is optional and may not be required for licensure, the UW may grant funds to small and rural programs, and it must produce an assessment to the governor and legislature by June 30, 2026 and annually thereafter and host an annual statewide conference. The changes are a mix of new law (new sections in chapters 18.73 and 71.24 RCW and a new training academy), amendments to existing law (RCW 18.71.205 and RCW 71.24.905), procedural changes (training development, rulemaking, endorsements, reporting, and reimbursement requirements), and programmatic additions (pilot project and academy). Several details are incomplete in the provided text: subsection (3) of the pilot project section is missing, the amendment text for RCW 71.24.905 is not fully shown, the statutory identity of “the authority” used in new chapter 71.24 provisions is not defined here, and some referenced language in other sections is not visible.

If enacted, the bill creates a statewide, optional behavioral health training pathway for EMTs, physician's trained advanced EMTs, and paramedics: the University of Washington must develop a nine-hour course by July 1, 2026 and a supplemental advanced course by January 1, 2027, the Department of Health will recognize the training as an optional ongoing-training module, and the secretary will issue a voluntary behavioral health endorsement to certified personnel beginning July 1, 2027. The law also requires Medicaid/medical assistance reimbursement for behavioral health services provided by endorsed EMTs and endorsed advanced EMTs/paramedics, funds a pilot in four BH-ASO regions to develop response best practices and billing strategies (Jan 1, 2026–June 30, 2027) with a report due July 1, 2027, and establishes a UW-run co-response training academy to certify best crisis response practices statewide by 2027, with grants available to help small and rural programs attend. The people and organizations most affected are EMTs, advanced EMTs, paramedics, fire and EMS agencies, law enforcement co-response teams, BH-ASOs, the UW center, and state health agencies; they will face new responsibilities to deliver or take training, pursue voluntary endorsements, update operations to qualify for reimbursement, and participate in pilot and reporting work. Agencies will incur training and administrative costs and need to plan for billing and program changes, though some costs could be offset by Medicaid reimbursement and UW grants (grants are subject to appropriations). Important implementation details are missing from the provided text—most notably the identity and exact powers of "the authority," the full pilot description, and the text of the RCW 71.24.905 amendment—so exact billing rules, fiscal impacts, and operational timelines remain uncertain.