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the bill is not enacted by June 30, 2023, the amounts provided in 1 this subsection shall lapse. 2 (46)(a) $4,792,000 of the general fund—state appropriation for 3 fiscal year 2024, $4,894,000 of the general fund—state appropriation 4 for fiscal year 2025, and $9,881,000 of the general fund—federal 5 appropriation are provided solely to support providers that are ready 6 to accept patients who are in acute care beds and no longer require 7 inpatient care, but are unable to be transitioned to appropriate 8 postacute care settings. These patients are generally referred to as 9 difficult to discharge hospital patients because of their behaviors. 10 (i) The department shall broaden the current discharge and 11 referral case management practices for difficult to discharge 12 hospital patients waiting in acute care hospitals to include 13 referrals to all long-term care behavioral health settings, including 14 enhanced services facilities, enhanced adult residential care, and 15 enhanced adult residential care with community stability supports 16 contracts or community behavioral health support services, including 17 supportive supervision and oversight and skills development and 18 restoration. These home and community-based providers are contracted 19 to provide various levels of personal care, nursing, and behavior 20 supports for difficult to discharge hospital patients with 21 significant behavior support needs. 22 (ii) Patients ready to discharge from acute care hospitals with 23 diagnosed behaviors or behavior history, and a likelihood of 24 unsuccessful placement in other licensed long-term care facilities, a 25 history of rejected applications for admissions, or a history of 26 unsuccessful placements shall be fully eligible for referral to 27 available beds in enhanced services facilities or enhanced adult 28 residential care with contracts that adequately meet the patient's 29 long-term care needs. 30 (iii) Previous or current detainment under the involuntary 31 treatment act shall not be a requirement for individuals in acute 32 care hospitals to be eligible for these specialized settings. The 33 department shall develop a standard process for acute care hospitals 34 to refer patients to the department for placement in enhanced 35 services facilities and enhanced adult residential care with 36 contracts to provide behavior support. 37 (b) The department must adopt a payment model that incorporates 38 the following adjustments: 39 p. 195 ESSB 5187.SL