Advocates began spring worried budgets for state mental-health programs would be slashed by $82 million due to federal Medicaid cuts, but this week they are celebrating big gains.

Not only were the cuts replaced during the state legislative session that ended Sunday, but $18 million in new money was granted to bolster addiction treatment. Mental-health advocates also won long-sought "parity" for insurance coverage.

It adds up to what some describe as the most significant legislative session for mental health in more than a decade.

"We got so much more bipartisan support than in the past, and a number of legislators showed a great deal of not only intelligence, but also courage," said Jim Adams, South King County president of the National Alliance for the Mentally Ill, a nonprofit advocacy group. "This was one of our better years."

The funding for addiction, spread over two years, was agreed to near the end of the session only after the bill's champion, Sen. Jim Hargrove, D-Hoquiam, threatened to pull his vote for the state budget unless some form of the bill passed.

The Hargrove legislation almost doubles the number of adults who will be treated for chemical dependency to 27,000 and adds another 1,000 slots for teens. Many addicts are also mentally ill, and the bill directs social-service agencies to assess people for both mental-health issues and addiction at the same time.

The bill includes a pilot program to treat so-called "frequent fliers" — people who cycle through the health and legal systems so regularly they cost taxpayers millions of dollars.

The measure also launches a pilot project to open two new secure detoxification centers, one in Eastern Washington, the other in King or Pierce county. The detox centers each will serve up to 16 people who are involuntarily committed.

Significant in Hargrove's bill is a provision that allows counties to add their own money by raising the sales tax by one-tenth of a cent for every dollar spent. That could add up to another $88 million per year if every county pursues the tax increase.

Mentally ill people are increasingly clogging prisons and emergency rooms, Hargrove said.

His bill will better identify those people and treat them separately before they get lost in the system, Hargrove said.

Many groups see the benefit of such an approach.

"In law enforcement, we are frequently called upon to deal with individuals who have co-occurring disorders — especially mental illness and substance abuse," King County Sheriff Sue Rahr said in an e-mail. "This is an important step in providing the tools and direction to more effectively and safely deal with individuals suffering both issues."

Among the people who spoke out against Hargrove's bill was a group with Scientology ties that argues too much emphasis is placed on medicating mentally ill people. Others raised concerns about involuntary commitments.

Legislators also included $80 million over two years to patch almost all the cuts to Medicaid, the federal-state health program for the poor. The money will go to community providers to help keep an estimated 1,600 severely mentally ill people in residential services and pay for mental-health care for 43,000 others.

The state had used savings from other Medicaid programs to help people with mental illness who don't qualify for Medicaid, but federal authorities put a stop to the practice.

Earlier in the session, legislators passed a bill that requires equal health coverage for mental and physical illnesses, ending seven years of frustration for mental-health advocates who saw the idea rejected session after session. Small businesses, self-insured companies and plans purchased by individuals remain exempt from the new rules.

Business groups strenuously opposed so-called mental-health parity, arguing it would drive up health-insurance premiums and could force some people off insurance altogether.

Adams, the mental-health advocate, sees other positive news coming from the session, including a bill sponsored by Rep. Eileen Cody, D-Seattle, that holds mental-health providers to tougher standards, and other measures that support low-income housing. But he warned there is a long way to go to break down the stigma and inequities faced by those living with mental illness.

"These bills start a journey; they are not the end," Adams said.

Nick Perry: 206-515-5639 or nperry@seattletimes.com