FINAL BILL REPORT

SSB 5362

                              C 120 L 89

BYSenate Committee on Health Care & Corrections (originally sponsored by Senators West, Talmadge, Niemi, Smith, Johnson, Kreidler, Wojahn and Anderson)

Regulating the administration of antipsychotic medications.

Senate Committee on Health Care & Corrections

House Committe on Human Services

SYNOPSIS AS ENACTED

BACKGROUND:

State law provides no procedures which define the rights of mentally ill persons regarding the involuntary administration of antipsychotic medications.  Antipsychotic medications include drugs used to treat serious mental illness associated with thought disorders.

In July 1988, the Washington State Supreme Court, in Harper v. State, decided that antipsychotic medication is an invasive medical procedure and may not be administered involuntarily without a court hearing and specific determination that there is a compelling state interest in overriding the patient's will.

The ruling has been generally interpreted to make questionable the involuntary administration of antipsychotic medications in emergency situations involving persons who are believed to be a danger to themselves or others.  In addition, it is interpreted to require a separate hearing on the involuntary administration of antipsychotic medications, even for persons already involuntarily committed for psychiatric treatment.

SUMMARY:

Protection of the public safety is declared as one of the purposes of the Mental Health Involuntary Treatment Act.

A person may refuse shock treatment and the administration of antipsychotic medication.  However, a court may order such treatments if:  it finds by clear, cogent and convincing evidence that there is a compelling state interest in so doing; the proposed treatment is necessary and effective; and medically acceptable alternatives are not available, have not been successful, or are not likely to be effective.

If the person is unable to make a rational and informed decision in these matters, the court shall make a substituted judgment for the patient.

The person is granted the right to a hearing, to be present, to present evidence and other due process rights.

Court orders for the involuntary administration of antipsychotic medication are effective for periods of commitment.

Antipsychotic medication may be administered involuntarily to persons detained or committed under the Involuntary Treatment Act, if the person presents an imminent likelihood of serious harm to himself or others, if persons responsible for the person's treatment determine that alternatives are not available, or will not be effective, and if they determine that an emergency exists which requires treatment before a court hearing can be held.

In the case of such emergencies, a petition authorizing the administration of antipsychotic medication must be filed on the next judicial day.  A hearing must be held on the petition within two judicial days.

The requirement that physicians complete medical examinations on persons detained in evaluation and treatment facilities is modified to allow physician assistants or nurse practitioners to assist in completing the examinations.

Gender specific terminology is deleted.

Provisions governing the administration of antipsychotic medication and shock treatment are extended to minors according to Chapter 71.34 RCW.

VOTES ON FINAL PASSAGE:

     Senate   40    5

     House 94  2 (House amended)

     Senate   39    5 (Senate concurred)

EFFECTIVE:April 20, 1989