Past to Present


In 2014, the Washington State Legislature passed SB6312, which mandated the creation of Behavioral Health Organizations (BHOs) to oversee the delivery of Mental Health and Substance Use Disorder services in Washington State. The Commissioners of Chelan, Douglas and Grant counties voted to become North Central Washington Behavioral Health (NCWBH), which will be administered by Douglas County. Prior to this, Chelan and Douglas Counties implemented mental health services as a Regional Support Network (RSN) and Grant County implement mental health service under the Spokane County Regional Support Network. However, SB6312 reorganized the regions in the state where services are implemented and added chemical dependency; thus BHOs were developed.

Creation of NCWBH changed funding for substance use disorder services for the Medicaid population from a Fee for Service system, in which providers are paid a fixed amount for a given delivered service, to a Managed Care system, in which NCWBH receives a capitated payment for each Medicaid recipient within our regional service area. NCWBH is responsible for ensuring all medically necessary behavioral health services are available to those individuals in the NCWBH region.

Douglas County has been the administrative entity for Chelan and Douglas Counties (CDRSN) for almost 20 years, overseeing public mental health services in our region. The CDRSN operated as a Managed Care organization under the Federal Regulations (42 CFR 438) since 1997.

To transition from CDRSN to a BHO, NCWBH responded to the State requirement for a Detailed Plan, which was due to the State on October 31, 2015, and outlined our intentions for the delivery of both mental health and substance use disorder services. This transition occurred on April 1, 2016.


NCWBH currently contracts with four mental health providers and two substance use disorder providers within the regional service area for Medicaid-funded behavioral health services. Contracts are available for public view:

NCWBH remains a department of Douglas County with a 3-member Governing Board. As part of the RSN to BHO transition, NCWBH identified additional staffing needs and added positions in many areas of oversight and clinical care.


NCWBH maintains a variety of feedback and advisement meetings to ensure satisfactory delivery of services. These include open Governing Board meetings, Advisory Board meetings and membership, Quality Review Team membership, and FYSPRT membership.