2536-S2.E AMS HSC S4981.2

E2SHB 2536  - S COMM AMD
     By Committee on Human Services & Corrections

OUT OF ORDER 03/01/2012

     Strike everything after the enacting clause and insert the following:

"NEW SECTION.  Sec. 1   (1) The legislature recognizes that the use of evidence-based practices plays a very important role in the delivery of services to children and juveniles. Especially in times of diminished resources, it is critical to fund practices which are known to provide desired outcomes rather than continue to expend moneys on programs that may be familiar but less effective.
     (2) Evidence-based practices or programs are those that are cost-effective and include at least two randomized or statistically controlled evaluations demonstrating that the program or practice is effective in obtaining improved outcomes for its intended population.
     (3) The legislature intends that prevention and intervention services delivered to children and juveniles in the areas of mental health, child welfare, and juvenile justice must be primarily evidence-based, and it is anticipated that such services will be provided in a manner that is culturally competent.
     (4) The legislature also acknowledges that the availability of evidence-based practices in each of the areas of mental health, child welfare, juvenile justice, and in different geographic areas of the state may vary. Thus, it would be unwise to require one hundred percent use of evidence-based practices. It is the intention of the legislature to require a graduated approach for each of these areas, the use of emerging best practices or promising practices, rather than evidence-based practices, is also necessary to the graduated goals of increasing the number of evidence-based practices.
     (5) It is the intent of the legislature that the department of social and health services will ensure that an expansion of the use of evidence-based practices be accomplished using existing resources by coordinating the purchase of evidence-based services, the development of a trained workforce and the implementation of a system of care that supports evidence-based practices by the juvenile rehabilitation administration, the division of behavioral health and recovery services, and the children's administration.
     (6) It is the intent of the legislature that agencies that provide children's mental health and child welfare services and services within the juvenile justice system must meet their goals regarding the use of evidence-based practices in contracted programs within six years.
     (7) The legislature recognizes that in order to effectively provide evidence-based practices, contractors must have a workforce trained in these programs, and there must be an evaluation of the outcomes from their use. For purposes of this act, "contractors" does not include county probation staff that provide evidence-based programs.

Sec. 2   RCW 13.40.020 and 2010 c 181 s 10 are each amended to read as follows:
     For the purposes of this chapter:
     (1) "Community-based rehabilitation" means one or more of the following: Employment; attendance of information classes; literacy classes; counseling, outpatient substance abuse treatment programs, outpatient mental health programs, anger management classes, education or outpatient treatment programs to prevent animal cruelty, or other services; or attendance at school or other educational programs appropriate for the juvenile as determined by the school district. Placement in community-based rehabilitation programs is subject to available funds;
     (2) "Community-based sanctions" may include one or more of the following:
     (a) A fine, not to exceed five hundred dollars;
     (b) Community restitution not to exceed one hundred fifty hours of community restitution;
     (3) "Community restitution" means compulsory service, without compensation, performed for the benefit of the community by the offender as punishment for committing an offense. Community restitution may be performed through public or private organizations or through work crews;
     (4) "Community supervision" means an order of disposition by the court of an adjudicated youth not committed to the department or an order granting a deferred disposition. A community supervision order for a single offense may be for a period of up to two years for a sex offense as defined by RCW 9.94A.030 and up to one year for other offenses. As a mandatory condition of any term of community supervision, the court shall order the juvenile to refrain from committing new offenses. As a mandatory condition of community supervision, the court shall order the juvenile to comply with the mandatory school attendance provisions of chapter 28A.225 RCW and to inform the school of the existence of this requirement. Community supervision is an individualized program comprised of one or more of the following:
     (a) Community-based sanctions;
     (b) Community-based rehabilitation;
     (c) Monitoring and reporting requirements;
     (d) Posting of a probation bond;
     (5) "Confinement" means physical custody by the department of social and health services in a facility operated by or pursuant to a contract with the state, or physical custody in a detention facility operated by or pursuant to a contract with any county. The county may operate or contract with vendors to operate county detention facilities. The department may operate or contract to operate detention facilities for juveniles committed to the department. Pretrial confinement or confinement of less than thirty-one days imposed as part of a disposition or modification order may be served consecutively or intermittently, in the discretion of the court;
     (6) "Court," when used without further qualification, means the juvenile court judge(s) or commissioner(s);
     (7) "Criminal history" includes all criminal complaints against the respondent for which, prior to the commission of a current offense:
     (a) The allegations were found correct by a court. If a respondent is convicted of two or more charges arising out of the same course of conduct, only the highest charge from among these shall count as an offense for the purposes of this chapter; or
     (b) The criminal complaint was diverted by a prosecutor pursuant to the provisions of this chapter on agreement of the respondent and after an advisement to the respondent that the criminal complaint would be considered as part of the respondent's criminal history. A successfully completed deferred adjudication that was entered before July 1, 1998, or a deferred disposition shall not be considered part of the respondent's criminal history;
     (8) "Department" means the department of social and health services;
     (9) "Detention facility" means a county facility, paid for by the county, for the physical confinement of a juvenile alleged to have committed an offense or an adjudicated offender subject to a disposition or modification order. "Detention facility" includes county group homes, inpatient substance abuse programs, juvenile basic training camps, and electronic monitoring;
     (10) "Diversion unit" means any probation counselor who enters into a diversion agreement with an alleged youthful offender, or any other person, community accountability board, youth court under the supervision of the juvenile court, or other entity except a law enforcement official or entity, with whom the juvenile court administrator has contracted to arrange and supervise such agreements pursuant to RCW 13.40.080, or any person, community accountability board, or other entity specially funded by the legislature to arrange and supervise diversion agreements in accordance with the requirements of this chapter. For purposes of this subsection, "community accountability board" means a board comprised of members of the local community in which the juvenile offender resides. The superior court shall appoint the members. The boards shall consist of at least three and not more than seven members. If possible, the board should include a variety of representatives from the community, such as a law enforcement officer, teacher or school administrator, high school student, parent, and business owner, and should represent the cultural diversity of the local community;
     (11) "Foster care" means temporary physical care in a foster family home or group care facility as defined in RCW 74.15.020 and licensed by the department, or other legally authorized care;
     (12) "Institution" means a juvenile facility established pursuant to chapters 72.05 and 72.16 through 72.20 RCW;
     (13) "Intensive supervision program" means a parole program that requires intensive supervision and monitoring, offers an array of individualized treatment and transitional services, and emphasizes community involvement and support in order to reduce the likelihood a juvenile offender will commit further offenses;
     (14) "Juvenile," "youth," and "child" mean any individual who is under the chronological age of eighteen years and who has not been previously transferred to adult court pursuant to RCW 13.40.110, unless the individual was convicted of a lesser charge or acquitted of the charge for which he or she was previously transferred pursuant to RCW 13.40.110 or who is not otherwise under adult court jurisdiction;
     (15) "Juvenile offender" means any juvenile who has been found by the juvenile court to have committed an offense, including a person eighteen years of age or older over whom jurisdiction has been extended under RCW 13.40.300;
     (16) "Labor" means the period of time before a birth during which contractions are of sufficient frequency, intensity, and duration to bring about effacement and progressive dilation of the cervix;
     (17) "Local sanctions" means one or more of the following: (a) 0-30 days of confinement; (b) 0-12 months of community supervision; (c) 0-150 hours of community restitution; or (d) $0-$500 fine;
     (18) "Manifest injustice" means a disposition that would either impose an excessive penalty on the juvenile or would impose a serious, and clear danger to society in light of the purposes of this chapter;
     (19) "Monitoring and reporting requirements" means one or more of the following: Curfews; requirements to remain at home, school, work, or court-ordered treatment programs during specified hours; restrictions from leaving or entering specified geographical areas; requirements to report to the probation officer as directed and to remain under the probation officer's supervision; and other conditions or limitations as the court may require which may not include confinement;
     (20) "Offense" means an act designated a violation or a crime if committed by an adult under the law of this state, under any ordinance of any city or county of this state, under any federal law, or under the law of another state if the act occurred in that state;
     (21) "Physical restraint" means the use of any bodily force or physical intervention to control a juvenile offender or limit a juvenile offender's freedom of movement in a way that does not involve a mechanical restraint. Physical restraint does not include momentary periods of minimal physical restriction by direct person-to-person contact, without the aid of mechanical restraint, accomplished with limited force and designed to:
     (a) Prevent a juvenile offender from completing an act that would result in potential bodily harm to self or others or damage property;
     (b) Remove a disruptive juvenile offender who is unwilling to leave the area voluntarily; or
     (c) Guide a juvenile offender from one location to another;
     (22) "Postpartum recovery" means (a) the entire period a woman or youth is in the hospital, birthing center, or clinic after giving birth and (b) an additional time period, if any, a treating physician determines is necessary for healing after the youth leaves the hospital, birthing center, or clinic;
     (23) "Probation bond" means a bond, posted with sufficient security by a surety justified and approved by the court, to secure the offender's appearance at required court proceedings and compliance with court-ordered community supervision or conditions of release ordered pursuant to RCW 13.40.040 or 13.40.050. It also means a deposit of cash or posting of other collateral in lieu of a bond if approved by the court;
     (24) "Respondent" means a juvenile who is alleged or proven to have committed an offense;
     (25) "Restitution" means financial reimbursement by the offender to the victim, and shall be limited to easily ascertainable damages for injury to or loss of property, actual expenses incurred for medical treatment for physical injury to persons, lost wages resulting from physical injury, and costs of the victim's counseling reasonably related to the offense. Restitution shall not include reimbursement for damages for mental anguish, pain and suffering, or other intangible losses. Nothing in this chapter shall limit or replace civil remedies or defenses available to the victim or offender;
     (26) "Restraints" means anything used to control the movement of a person's body or limbs and includes:
     (a) Physical restraint; or
     (b) Mechanical device including but not limited to: Metal handcuffs, plastic ties, ankle restraints, leather cuffs, other hospital-type restraints, tasers, or batons;
     (27) "Secretary" means the secretary of the department of social and health services. "Assistant secretary" means the assistant secretary for juvenile rehabilitation for the department;
     (28) "Services" means services which provide alternatives to incarceration for those juveniles who have pleaded or been adjudicated guilty of an offense or have signed a diversion agreement pursuant to this chapter;
     (29) "Sex offense" means an offense defined as a sex offense in RCW 9.94A.030;
     (30) "Sexual motivation" means that one of the purposes for which the respondent committed the offense was for the purpose of his or her sexual gratification;
     (31) "Surety" means an entity licensed under state insurance laws or by the state department of licensing, to write corporate, property, or probation bonds within the state, and justified and approved by the superior court of the county having jurisdiction of the case;
     (32) "Transportation" means the conveying, by any means, of an incarcerated pregnant youth from the institution or detention facility to another location from the moment she leaves the institution or detention facility to the time of arrival at the other location, and includes the escorting of the pregnant incarcerated youth from the institution or detention facility to a transport vehicle and from the vehicle to the other location;
     (33) "Violation" means an act or omission, which if committed by an adult, must be proven beyond a reasonable doubt, and is punishable by sanctions which do not include incarceration;
     (34) "Violent offense" means a violent offense as defined in RCW 9.94A.030;
     (35) "Youth court" means a diversion unit under the supervision of the juvenile court;
     (36) "Evidence-based" means a program or practice that is cost-effective and includes at least two randomized or statistically controlled evaluations that have demonstrated improved outcomes for its intended population.
     (37) "Prevention and treatment services" means services and programs for children and youth and their families that are specifically directed to address behaviors that have resulted or may result in truancy, abuse or neglect, out-of-home placements, chemical dependency, substance abuse, sexual aggressiveness, delinquency, aggression, family dysfunction, recidivism, or mental or emotional disorders.
     (38) "Outcome-based" means a program or practice that is cost-effective and has been assessed as demonstrating effectiveness in improving outcomes for its intended population
.

NEW SECTION.  Sec. 3   A new section is added to chapter 13.40 RCW to read as follows:
     (1) The department, and any other state agency that administers funds related to juvenile offenders under this chapter, shall, in accordance with the graduated requirements of subsection (3) of this section:
     (a) Expend state funds on prevention and treatment programs for juvenile offenders that are evidence-based or outcome-based, as identified by the Washington state institute of public policy; and
     (b) In consultation with the Washington state institute for public policy, initiate or continue the review of sound promising, outcome-based and research-based practices with the goal of identifying and expanding the number and type of available evidence-based programs that are cost-beneficial and effective at reducing criminal recidivism of the program participants. In its review of practices, the department shall work to identify programs that have been utilized with a diverse set of clients as well as consult with tribal governments, experts within ethnically diverse communities, and community organizations that service diverse communities.
     (2) When necessary to meet the requirements of subsection (3) of this section, the department shall include in its contracts with providers of prevention and treatment services for juvenile offenders a provision affirming that the provider shall provide evidence-based services, that the services must be provided by staff who are trained in providing evidence-based services, and that the services must be accompanied by monitoring and quality control procedures that ensure that they are delivered according to the applicable standards and in a manner that is culturally competent and effective within ethnically diverse populations. The department may use performance requirements or incentives in determining the amounts payable in contracts or grants.
     (3)(a) In order to prevent undue disturbance to existing department programs, the department shall ensure that: (i) No less than sixty percent of the funds expended for prevention and treatment services to juvenile offenders meet the requirements of this section during fiscal years 2014 and 2015; (ii) no less than sixty-five percent of the funds expended meet the requirements of this section during fiscal years 2016 and 2017; and (iii) no less than seventy-five percent of the funds expended meet the requirements of this section during fiscal years 2018 and 2019.
     (b) The requirements of (a) of this subsection apply only to treatment or service needs for which evidence-based practices have been identified.
     (c) The department shall prioritize spending on evidence-based prevention and treatment services to juvenile offenders in a manner that maximizes the cost benefit to the state, in collaboration with the Washington association of juvenile court administrators.
     (d) If the department is unable to meet the requirements of (a) of this subsection in any fiscal year, it must report to the legislature regarding its efforts and plans to bring the department into compliance with the requirements of this act.
     (e) The determination of the amount of funds expended for evidence-based prevention and treatment services must include program costs necessary to directly implement evidence-based programs, including discrete staffing and training costs which would not have been incurred but for implementation of an evidence-based program. Funds expended for indirect administrative costs may not be included in the determination of amounts expended for evidence-based services.
     (f) Nothing in this section requires the department to take actions that are in conflict with the Presidential Executive Order 13175 or that adversely impact tribal-state consultation protocols or contractual relations.

Sec. 4   RCW 71.24.025 and 2008 c 261 s 2 are each amended to read as follows:
     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Acutely mentally ill" means a condition which is limited to a short-term severe crisis episode of:
     (a) A mental disorder as defined in RCW 71.05.020 or, in the case of a child, as defined in RCW 71.34.020;
     (b) Being gravely disabled as defined in RCW 71.05.020 or, in the case of a child, a gravely disabled minor as defined in RCW 71.34.020; or
     (c) Presenting a likelihood of serious harm as defined in RCW 71.05.020 or, in the case of a child, as defined in RCW 71.34.020.
     (2) "Available resources" means funds appropriated for the purpose of providing community mental health programs, federal funds, except those provided according to Title XIX of the Social Security Act, and state funds appropriated under this chapter or chapter 71.05 RCW by the legislature during any biennium for the purpose of providing residential services, resource management services, community support services, and other mental health services. This does not include funds appropriated for the purpose of operating and administering the state psychiatric hospitals.
     (3) "Child" means a person under the age of eighteen years.
     (4) "Chronically mentally ill adult" or "adult who is chronically mentally ill" means an adult who has a mental disorder and meets at least one of the following criteria:
     (a) Has undergone two or more episodes of hospital care for a mental disorder within the preceding two years; or
     (b) Has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding year; or
     (c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than twelve months. "Substantial gainful activity" shall be defined by the department by rule consistent with Public Law 92-603, as amended.
     (5) "Clubhouse" means a community-based program that provides rehabilitation services and is certified by the department of social and health services.
     (6) "Community mental health program" means all mental health services, activities, or programs using available resources.
     (7) "Community mental health service delivery system" means public or private agencies that provide services specifically to persons with mental disorders as defined under RCW 71.05.020 and receive funding from public sources.
     (8) "Community support services" means services authorized, planned, and coordinated through resource management services including, at a minimum, assessment, diagnosis, emergency crisis intervention available twenty-four hours, seven days a week, prescreening determinations for persons who are mentally ill being considered for placement in nursing homes as required by federal law, screening for patients being considered for admission to residential services, diagnosis and treatment for children who are acutely mentally ill or severely emotionally disturbed discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program, investigation, legal, and other nonresidential services under chapter 71.05 RCW, case management services, psychiatric treatment including medication supervision, counseling, psychotherapy, assuring transfer of relevant patient information between service providers, recovery services, and other services determined by regional support networks.
     (9) "Consensus-based" means a program or practice that has general support among treatment providers and experts, based on experience or professional literature, and may have anecdotal or case study support, or that is agreed but not possible to perform studies with random assignment and controlled groups.
     (10) "County authority" means the board of county commissioners, county council, or county executive having authority to establish a community mental health program, or two or more of the county authorities specified in this subsection which have entered into an agreement to provide a community mental health program.
     (11) "Department" means the department of social and health services.
     (12) "Designated mental health professional" means a mental health professional designated by the county or other authority authorized in rule to perform the duties specified in this chapter.
     (13) "Emerging best practice" or "promising practice" means a practice that presents, based on preliminary information, potential for becoming a research-based or consensus-based practice.
     (14) "Evidence-based" means a program or practice that ((has had multiple site random controlled trials across heterogeneous populations demonstrating that the program or practice is effective for the)) is cost-effective and includes at least two randomized or statistically controlled evaluations that have demonstrated improved outcomes for its intended population.
     (15) "Licensed service provider" means an entity licensed according to this chapter or chapter 71.05 RCW or an entity deemed to meet state minimum standards as a result of accreditation by a recognized behavioral health accrediting body recognized and having a current agreement with the department, that meets state minimum standards or persons licensed under chapter 18.57, 18.71, 18.83, or 18.79 RCW, as it applies to registered nurses and advanced registered nurse practitioners.
     (16) "Long-term inpatient care" means inpatient services for persons committed for, or voluntarily receiving intensive treatment for, periods of ninety days or greater under chapter 71.05 RCW. "Long-term inpatient care" as used in this chapter does not include: (a) Services for individuals committed under chapter 71.05 RCW who are receiving services pursuant to a conditional release or a court-ordered less restrictive alternative to detention; or (b) services for individuals voluntarily receiving less restrictive alternative treatment on the grounds of the state hospital.
     (17) "Mental health services" means all services provided by regional support networks and other services provided by the state for persons who are mentally ill.
     (18) "Mentally ill persons," "persons who are mentally ill," and "the mentally ill" mean persons and conditions defined in subsections (1), (4), (27), and (28) of this section.
     (19) "Outcome-based" means a program or practice that is cost-effective and has been assessed as demonstrating effectiveness in improving outcomes for its intended population.
     (20)
"Recovery" means the process in which people are able to live, work, learn, and participate fully in their communities.
     (((20))) (21) "Regional support network" means a county authority or group of county authorities or other entity recognized by the secretary in contract in a defined region.
     (((21))) (22) "Registration records" include all the records of the department, regional support networks, treatment facilities, and other persons providing services to the department, county departments, or facilities which identify persons who are receiving or who at any time have received services for mental illness.
     (((22))) (23) "Research-based" means a program or practice that has some research demonstrating effectiveness, but that does not yet meet the standard of evidence-based practices.
     (((23))) (24) "Residential services" means a complete range of residences and supports authorized by resource management services and which may involve a facility, a distinct part thereof, or services which support community living, for persons who are acutely mentally ill, adults who are chronically mentally ill, children who are severely emotionally disturbed, or adults who are seriously disturbed and determined by the regional support network to be at risk of becoming acutely or chronically mentally ill. The services shall include at least evaluation and treatment services as defined in chapter 71.05 RCW, acute crisis respite care, long-term adaptive and rehabilitative care, and supervised and supported living services, and shall also include any residential services developed to service persons who are mentally ill in nursing homes, boarding homes, and adult family homes, and may include outpatient services provided as an element in a package of services in a supported housing model. Residential services for children in out-of-home placements related to their mental disorder shall not include the costs of food and shelter, except for children's long-term residential facilities existing prior to January 1, 1991.
     (((24))) (25) "Resilience" means the personal and community qualities that enable individuals to rebound from adversity, trauma, tragedy, threats, or other stresses, and to live productive lives.
     (((25))) (26) "Resource management services" mean the planning, coordination, and authorization of residential services and community support services administered pursuant to an individual service plan for: (a) Adults and children who are acutely mentally ill; (b) adults who are chronically mentally ill; (c) children who are severely emotionally disturbed; or (d) adults who are seriously disturbed and determined solely by a regional support network to be at risk of becoming acutely or chronically mentally ill. Such planning, coordination, and authorization shall include mental health screening for children eligible under the federal Title XIX early and periodic screening, diagnosis, and treatment program. Resource management services include seven day a week, twenty-four hour a day availability of information regarding enrollment of adults and children who are mentally ill in services and their individual service plan to designated mental health professionals, evaluation and treatment facilities, and others as determined by the regional support network.
     (((26))) (27) "Secretary" means the secretary of social and health services.
     (((27))) (28) "Seriously disturbed person" means a person who:
     (a) Is gravely disabled or presents a likelihood of serious harm to himself or herself or others, or to the property of others, as a result of a mental disorder as defined in chapter 71.05 RCW;
     (b) Has been on conditional release status, or under a less restrictive alternative order, at some time during the preceding two years from an evaluation and treatment facility or a state mental health hospital;
     (c) Has a mental disorder which causes major impairment in several areas of daily living;
     (d) Exhibits suicidal preoccupation or attempts; or
     (e) Is a child diagnosed by a mental health professional, as defined in chapter 71.34 RCW, as experiencing a mental disorder which is clearly interfering with the child's functioning in family or school or with peers or is clearly interfering with the child's personality development and learning.
     (((28))) (29) "Severely emotionally disturbed child" or "child who is severely emotionally disturbed" means a child who has been determined by the regional support network to be experiencing a mental disorder as defined in chapter 71.34 RCW, including those mental disorders that result in a behavioral or conduct disorder, that is clearly interfering with the child's functioning in family or school or with peers and who meets at least one of the following criteria:
     (a) Has undergone inpatient treatment or placement outside of the home related to a mental disorder within the last two years;
     (b) Has undergone involuntary treatment under chapter 71.34 RCW within the last two years;
     (c) Is currently served by at least one of the following child-serving systems: Juvenile justice, child-protection/welfare, special education, or developmental disabilities;
     (d) Is at risk of escalating maladjustment due to:
     (i) Chronic family dysfunction involving a caretaker who is mentally ill or inadequate;
     (ii) Changes in custodial adult;
     (iii) Going to, residing in, or returning from any placement outside of the home, for example, psychiatric hospital, short-term inpatient, residential treatment, group or foster home, or a correctional facility;
     (iv) Subject to repeated physical abuse or neglect;
     (v) Drug or alcohol abuse; or
     (vi) Homelessness.
     (((29))) (30) "State minimum standards" means minimum requirements established by rules adopted by the secretary and necessary to implement this chapter for: (a) Delivery of mental health services; (b) licensed service providers for the provision of mental health services; (c) residential services; and (d) community support services and resource management services.
     (((30))) (31) "Treatment records" include registration and all other records concerning persons who are receiving or who at any time have received services for mental illness, which are maintained by the department, by regional support networks and their staffs, and by treatment facilities. Treatment records do not include notes or records maintained for personal use by a person providing treatment services for the department, regional support networks, or a treatment facility if the notes or records are not available to others.
     (((31))) (32) "Tribal authority," for the purposes of this section and RCW 71.24.300 only, means: The federally recognized Indian tribes and the major Indian organizations recognized by the secretary insofar as these organizations do not have a financial relationship with any regional support network that would present a conflict of interest.
     (33) "Prevention and treatment services" means services and programs for children and youth and their families that are specifically directed to address behaviors that have resulted or may result in truancy, abuse or neglect, out-of-home placements, chemical dependency, substance abuse, sexual aggressiveness, delinquency, aggression, family dysfunction, recidivism, or mental or emotional disorders.

NEW SECTION.  Sec. 5   A new section is added to chapter 71.24 RCW to read as follows:
     (1) The department, and any other state agency that administers funds related to prevention, treatment, and care of recipients of children's mental health services under this chapter, shall, in accordance with the graduated requirements of subsection (3) of this section:
     (a) Expend state funds on children's mental health prevention and treatment programs that are evidence-based or outcome-based, as identified by the Washington state institute of public policy, in consultation with a university-based evidence-based practice institute entity in Washington state;
     (b) In consultation with the Washington state institute for public policy and the University of Washington evidence-based practice institute, initiate or continue the ongoing review of sound promising, outcome-based, and research-based practices with the goal of identifying and expanding the number and type of available evidence-based programs that are cost-beneficial and effective at improving mental health outcomes for participants. In its review of practices, the department shall work to identify programs that have been utilized with a diverse set of clients as well as consult with tribal governments, experts within ethnically diverse communities, and community organizations that service diverse communities.
     (2) When necessary to meet the requirements of subsection (3) of this section, the department shall to the extent that funding is available for this purpose without diminishing availability of other mandatory medicaid services include in its contracts with regional support networks a provision requiring that contracted providers of children's mental health prevention and treatment services provide evidence-based and outcome-based services, that the services be provided by staff who are trained in providing evidence-based and outcome-based services, and that the services must be accompanied by monitoring and quality control procedures that ensure that they are delivered according to the applicable standards and in a manner that is culturally competent and effective within ethnically diverse populations. The department may use performance requirements or incentives in determining the amounts payable in contracts or grants.
     (3)(a) In order to prevent undue disturbance to existing department programs, and to the extent that the requirements of this subsection do not conflict with any department obligations under a court order or court-approved agreement, the department shall:
     (i) Establish a baseline of evidence-based practice, research-based practice, and outcome-based practice utilization within the department's managed mental health program by June 30, 2013. The baseline will include the number of children receiving evidence-based, research-based, and outcome-based practices, the percentage of children served who are receiving evidence-based, research-based, and outcome-based practices, the number of encounters of evidence-based, research-based, and outcome-based practice and the types of evidence-based, research-based, and outcome-based practices, and the percentage of encounters delivered to children served that are evidence-based, research-based, and outcome-based practices;
     (ii) By July 1, 2012, document a descriptive baseline of evidence-based, research-based, and outcome-based practice implementation within the department's prepaid inpatient health plans contracted network of community mental health providers;
     (iii) By July 1, 2012, seek federal technical assistance regarding the medicaid financing of evidence-based practices;
     (iv) By October 1, 2012, implement changes in the prepaid inpatient health plans contract and information systems that support implementation of client level reporting of participation in evidence-based, research-based, and outcome-based and promising practices; include contract language in prepaid inpatient health plans contracts; and modify data reporting instructions to insure consistency in the reporting of client level participation in evidence-based, research-based, and outcome-based services;
     (v) By October 1, 2012, match identified evidence-based and outcome-based practices to the medicaid mental health state plan to provide guidance to prepaid inpatient health plans to begin implementation and encounter reporting of evidence-based practices within existing resources; and
     (vi) By October 1, 2012, review the medicaid mental health state plan for opportunities to increase federal financial participation in the delivery of evidence-based practices;
     (b) For the 2013-2015 biennium, at least twenty-five percent of the encounters delivered to children served by regional support networks must be evidence-based, research-based, and outcome-based practices. For each subsequent biennium, the percentage of encounters using evidence-based, research-based, and outcome-based practices shall increase by fifteen percent above the applicable target for the previous biennium up at a maximum of seventy-five percent. If the department is unable to meet the requirements of this subsection in any biennium, it must report to the legislature regarding its efforts and plans to bring the department into compliance with the requirements of this act.
     (c) Over a five-year period, ending June 30, 2019, and with incremental increases each fiscal year, the department shall:
     (i) Subject to the appropriation of funds to support it, implement a standardized assessment tool that will direct children toward available evidence-based and outcome-based practices as appropriate;
     (ii) To the extent that funds are available, reinforce standardized implementation of evidence-based practices for which training and workforce development has already occurred but which are not yet fully implemented statewide;
     (iii) To the extent funds are available, initiate statewide workforce development for at least one additional evidence-based practice within a period of two fiscal years and sustain training and dissemination activities for existing evidence-based programs implemented by the department. The department shall prioritize evidence-based practices for adoption that maximize the ability to secure federal financial participation through its medicaid mental health managed care program; and
     (iv) Place language in prepaid inpatient health plan contracts requiring implementation of evidence-based and outcome-based practices for which workforce development is provided; and
     (d) The department shall prioritize evidence-based and outcome-based practices for adoption that maximize its ability to secure federal financial participation through its medicaid mental health managed care program.
     (4) The requirements of (a) of this subsection apply only to treatment or service needs for which evidence-based practices have been identified.
     (5) Nothing in this section requires the department to:
     (a) Take actions that are in conflict with Presidential Executive Order 13175 or that adversely impact tribal-state consultation protocols or contractual relations; or
     (b) Redirect funds in a manner that conflicts with the requirements of the department's section 1915(b) medicaid mental health waiver or that would substantially reduce federal financial participation in services provided under the department's section 1915(b) medicaid mental health waiver and impair access to appropriate and effective services for a substantial number of medical clients.

Sec. 6   RCW 74.13.020 and 2011 c 330 s 4 are each reenacted and amended to read as follows:
     For purposes of this chapter:
     (1) "Case management" means the management of services delivered to children and families in the child welfare system, including permanency services, caseworker-child visits, family visits, the convening of family group conferences, the development and revision of the case plan, the coordination and monitoring of services needed by the child and family, and the assumption of court-related duties, excluding legal representation, including preparing court reports, attending judicial hearings and permanency hearings, and ensuring that the child is progressing toward permanency within state and federal mandates, including the Indian child welfare act.
     (2) "Child" means:
     (a) A person less than eighteen years of age; or
     (b) A person age eighteen to twenty-one years who is eligible to receive the extended foster care services authorized under RCW 74.13.031.
     (3) "Child protective services" has the same meaning as in RCW 26.44.020.
     (4) "Child welfare services" means social services including voluntary and in-home services, out-of-home care, case management, and adoption services which strengthen, supplement, or substitute for, parental care and supervision for the purpose of:
     (a) Preventing or remedying, or assisting in the solution of problems which may result in families in conflict, or the neglect, abuse, exploitation, or criminal behavior of children;
     (b) Protecting and caring for dependent, abused, or neglected children;
     (c) Assisting children who are in conflict with their parents, and assisting parents who are in conflict with their children, with services designed to resolve such conflicts;
     (d) Protecting and promoting the welfare of children, including the strengthening of their own homes where possible, or, where needed;
     (e) Providing adequate care of children away from their homes in foster family homes or day care or other child care agencies or facilities.
     "Child welfare services" does not include child protection services.
     (5) "Committee" means the child welfare transformation design committee.
     (6) "Department" means the department of social and health services.
     (7) "Extended foster care services" means residential and other support services the department is authorized to provide to foster children. These services include, but are not limited to, placement in licensed, relative, or otherwise approved care, or supervised independent living settings; assistance in meeting basic needs; independent living services; medical assistance; and counseling or treatment.
     (8) "Measurable effects" means a statistically significant change which occurs as a result of the service or services a supervising agency is assigned in a performance-based contract, in time periods established in the contract.
     (9) "Out-of-home care services" means services provided after the shelter care hearing to or for children in out-of-home care, as that term is defined in RCW 13.34.030, and their families, including the recruitment, training, and management of foster parents, the recruitment of adoptive families, and the facilitation of the adoption process, family reunification, independent living, emergency shelter, residential group care, and foster care, including relative placement.
     (10) "Performance-based contracting" means the structuring of all aspects of the procurement of services around the purpose of the work to be performed and the desired results with the contract requirements set forth in clear, specific, and objective terms with measurable outcomes. Contracts shall also include provisions that link the performance of the contractor to the level and timing of reimbursement.
     (11) "Permanency services" means long-term services provided to secure a child's safety, permanency, and well-being, including foster care services, family reunification services, adoption services, and preparation for independent living services.
     (12) "Primary prevention services" means services which are designed and delivered for the primary purpose of enhancing child and family well-being and are shown, by analysis of outcomes, to reduce the risk to the likelihood of the initial need for child welfare services.
     (13) "Supervising agency" means an agency licensed by the state under RCW 74.15.090, or licensed by a federally recognized Indian tribe located in this state under RCW 74.15.190, that has entered into a performance-based contract with the department to provide case management for the delivery and documentation of child welfare services, as defined in this section.
     (14) "Evidence-based" means a program or practice that is cost-effective and includes at least two randomized or statistically controlled evaluations that have demonstrated improved outcomes for its intended population.
     (15) "Prevention and treatment services" means services and programs for children and youth and their families that are specifically directed to address behaviors that have resulted or may result in truancy, abuse or neglect, out-of-home placements, chemical dependency, substance abuse, sexual aggressiveness, delinquency, aggression, family dysfunction, recidivism, or mental or emotional disorders.
     (16) "Research-based" means a program or practice that has some research demonstrating effectiveness, but that does not yet meet the standard of evidence-based practices.
     (17) "Outcome-based" means a program or practice that is cost-effective and has been assessed as demonstrating effectiveness in improving outcomes for its intended population.

NEW SECTION.  Sec. 7   A new section is added to chapter 74.13 RCW to read as follows:
     (1) The department, and any other state agency that administers funds related to prevention, treatment, and care of recipients of child welfare services under this chapter, shall, in accordance with the graduated requirements of subsection (3) of this section:
     (a) Expend state funds on prevention and treatment programs for recipients of child welfare services that are outcome-based, research-based, or evidence-based, as identified by the Washington state institute for public policy, in consultation with a university-based evidence-based practice entity in Washington state; and
     (b) In consultation with the Washington state institute for public policy and a university-based evidence-based practice entity in Washington state, initiate and continue the review of sound promising, outcome-based and research-based practices with the goal of identifying and expanding the number and type of available evidence-based programs that are cost-beneficial and effective at reducing abuse and neglect, safely reducing rates of out-of-home placement, decreasing the length of time required to obtain permanency for children in out-of-home care, or improving child well-being for participants. In its review of practices, the department shall work to identify programs that have been utilized with a diverse set of clients as well as consult with tribal governments, experts within ethnically diverse communities, and community organizations that service diverse communities.
     (2) When necessary to meet the requirements of subsection (3) of this section, the department shall include in any contracts with providers of prevention and treatment services for recipients of child welfare services a provision affirming that the provider shall provide research-based and evidence-based services, and that the services must be provided by staff who are trained in providing evidence-based services, and the services must be accompanied by monitoring and quality control procedures that ensure that they are delivered according to the applicable standards and in a manner that is culturally competent and effective within ethnically diverse populations. The department may use performance requirements or incentives in determining the amounts payable in contracts or grants.
     (3)(a) In order to prevent undue disturbance to existing department programs and to allow time for a workforce to be sufficiently trained in evidence-based practices, the requirements of this section are graduated. To the extent that these requirements do not conflict with the department's obligations under any court order or court-approved agreement, the department shall ensure that:
     (i)(A) During fiscal years 2014 and 2015, no less than thirty-five percent of the funds expended for prevention and treatment services for recipients of child welfare services meet the requirements of this section;
     (B) No less than thirty-five percent of families open for services have one or more members receiving evidence-based, outcome-based, or research-based programs; and
     (C) No less than thirty-five percent of child welfare service contractors provide evidence-based, outcome-based, or research-based programs;
     (ii)(A) During fiscal years 2016 and 2017, no less than fifty percent of the funds expended for recipients of child welfare services meet the requirements of this section;
     (B) No less than fifty percent of families open for services have one or more members receiving evidence-based, outcome-based, or research-based programs; and
     (C) No less than fifty percent of child welfare service contractors provide evidence-based, outcome-based, or research-based programs; and
     (iii)(A) During fiscal years 2018 and 2019, no less than seventy-five percent of the funds expended for recipients of child welfare services meet the requirements of this section;
     (B) No less than seventy-five percent of families open for services have one or more members receiving evidence-based, outcome-based, or research-based programs; and
     (C) No less than seventy-five percent of child welfare service contractors provide evidence-based, outcome-based, or research-based programs.
     (b) Nothing in this section shall require the department to take actions that are in conflict with the Presidential Executive Order 13175 or that adversely impact tribal-state consultation protocols or contractual relations.
     (c) The requirements of (a) of this subsection apply only to treatment or service needs for which research-based, outcome-based, or evidence-based practices have been identified.
     (d) If the department is unable to meet the requirements of (a) of this subsection in any fiscal year, it must report to the legislature regarding its efforts and plans to bring the department into compliance with the requirements of this act.

NEW SECTION.  Sec. 8   (1) In order to achieve the requirements of sections 5 and 7 of this act, the department shall, to the extent practicable:
     (a) Redirect existing funding resources as necessary to coordinate the purchase of evidence-based prevention and treatment services and the development of a workforce trained to implement evidence-based practices;
     (b) Utilize existing data reporting systems and quality management processes at the state and local level for monitoring the quality control and fidelity of the implementation of evidence-based practices;
     (c) Identify components of evidence-based practices for which federal matching funds might be claimed and seek such matching funds to support implementation of evidence-based practices.
     (2) The department to avoid duplication and maximize the efficient use of funds shall designate a lead agency to coordinate training for the delivery of evidence-based programs pursuant to sections 3 and 5 of this act.
     (3) All training of the child welfare workforce will be delivered through the alliance for workforce excellence at the University of Washington school of social work in accordance with their existing agreement with the children's administration. Any such training will be offered as funds are available and in a manner that optimizes federal reimbursement.
     (4) By June 30, 2013, the department must complete an initial report with baseline data regarding funds expended for evidence-based practices and report to the appropriate legislative committees. Thereafter, the department shall report to the legislature regarding its progress in the coordination of the purchase of evidence-based prevention and treatment services and of the development of a workforce trained to implement evidence-based practices. The first report must be completed no later than December 31, 2013, and the department shall report annually, thereafter.
     (5) Nothing in this act requires the department to:
     (a) Take actions that are in conflict with Presidential Executive Order 13175 or that adversely impact tribal-state consultation protocols or contractual relations; or
     (b) Redirect funds in a manner that:
     (i) Conflicts with the requirements of the department's section 1915(b) medicaid mental health waiver; or
     (ii) Would substantially reduce federal financial participation in mental health, child welfare, or other health care services provided through department programs, resulting in impaired access to appropriate and effective services for a substantial number of eligible clients.

NEW SECTION.  Sec. 9   A new section is added to chapter 43.20A RCW to read as follows:
     The department, in consultation with a university-based evidence-based practice institute entity in Washington, the Washington partnership council on juvenile justice, the child mental health systems of care planning committee, the children, youth, and family advisory committee, the Washington state racial disproportionality advisory committee, a university-based child welfare research entity in Washington state, the Washington association of juvenile court administrators, and the Washington state institute for public policy, shall:
     (1) Develop an integrated and accountable system of care for the coordination and the delivery of research-based, outcome-based, and evidence-based prevention and treatment services to children and youth and their families in the areas of mental health, child welfare, and juvenile justice;
     (2) Ensure that implementation of research-based, outcome-based, and evidence-based prevention and treatment programs are accompanied by monitoring and quality control procedures designed to ensure that they are delivered with fidelity to the program and that corrective action is taken when these standards are not met; and
     (3) Acknowledge any existing system of quality control for the juvenile justice system and shall work within that system in meeting the graduated requirements set forth in section 3 of this act.

NEW SECTION.  Sec. 10   A new section is added to chapter 43.20A RCW to read as follows:
     (1) The department of social and health services shall track and document compliance with sections 3, 5, and 7 of this act.
     (2) The Washington state institute for public policy, in consultation with a university-based evidence-based practice entity in Washington state, and with any necessary assistance from the department, shall work collaboratively to prepare a report to the appropriate legislative committees. The report must include:
     (a) An assessment of the amount of funds expended for the evidence-based, outcome-based, and research-based prevention and treatment services;
     (b) An assessment of program fidelity to the evidence-based, outcome-based, and research-based prevention and treatment models;
     (c) An assessment of outcomes for children and youth who receive evidence-based, outcome-based, and research-based prevention and treatment services, including an analysis that is disaggregated by race, ethnicity, and gender; and
     (d) A description of the method of the documentation of the department's compliance with the requirements of sections 3, 5, and 7 of this act.
     (3) The first report must be completed no later than July 1, 2013; the second report must be completed no later than July 1, 2015; and the final report must be completed no later than December 1, 2019.

NEW SECTION.  Sec. 11   The Washington state institute for public policy and the University of Washington evidence based practice institute are encouraged to seek matching philanthropic and federal funds to meet the requirements of this act."

E2SHB 2536  - S COMM AMD
     By Committee on Human Services & Corrections

OUT OF ORDER 03/01/2012

     On page 1, line 2 of the title, after "juveniles;" strike the remainder of the title and insert "amending RCW 13.40.020 and 71.24.025; reenacting and amending RCW 74.13.020; adding a new section to chapter 13.40 RCW; adding a new section to chapter 71.24 RCW; adding a new section to chapter 74.13 RCW; adding new sections to chapter 43.20A RCW; and creating new sections."

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