Behavioral Health Organizations

Better Care Through Integrated Behavioral Health Organizations.

In 2014 the State Legislature passed Senate Bill 6312, directing the Washington State Department of Social and Health Services (DSHS) to integrate funding and oversight for behavioral health (mental health and substance use) treatment services.  An important reason for this change is to better coordinate care for people with co-occurring disorders.  

As of April 1, 2016, these services are now purchased by regionally-operated Behavioral Health Organizations (BHOs) through a managed-care structure.  The BHO that serves the counties of Spokane, Pend Oreille, Okanogan, Ferry, Adams, Lincoln, and Stevens, is called the Spokane County Regional Behavioral Health Organization (SCRBHO). 
BHOs are located within newly-formed Regional Service Areas (RSAs). There is one BHO per RSA.

Regional Service Areas (RSAs) define new geographical boundaries for the state to purchase behavioral and physical health care through managed care contracts. RSAs are geographic regions, not administrative authorities. RSAs were authorized in 2014 legislation and include :

  • contiguous counties,
  • contain at least 60,000 people on Medicaid,
  • possess an adequate number of health care providers, and
  • reflect natural physical and behavioral health service referral patterns

DSHS and the state Health Care Authority (HCA) jointly designated RSAs in November 2014 and made a revision in June 2015. HCA will contract with managed care health plans to provide physical healthcare within these regions.


Questions or comments about the BHO transition may be emailed to [email protected]

Click here to see an overview of Mental Health and Substance Use Disorder funding, contracted services, and populations served by the SCRBHO.