5223-SAMSKEISS2218.1SSB 5223S AMD40By Senator KeiserADOPTED 03/10/2003 Strike everything after the enacting clause and insert thefollowing:"PART IGeneral ProvisionsNEW SECTION.Sec. (1) The legislature declares that anindividual with capacity has the ability to control decisions relatingto his or her own mental health care. The legislature finds that: (a) Some mental illnesses cause individuals to fluctuate betweencapacity and incapacity; (b) During periods when an individual's capacity is unclear, theindividual may be unable to access needed treatment because theindividual may be unable to give informed consent; (c) Early treatment may prevent an individual from becoming so illthat involuntary treatment is necessary; and (d) Mentally ill individuals need some method of expressing theirinstructions and preferences for treatment and providing advanceconsent to or refusal of treatment. The legislature recognizes that a mental health advance directivecan be an essential tool for an individual to express his or herchoices at a time when the effects of mental illness have not deprivedhim or her of the power to express his or her instructions orpreferences. (2) The legislature further finds that: (a) A mental health advance directive must provide the individualwith a full range of choices; (b) Mentally ill individuals have varying perspectives on whetherthey want to be able to revoke a directive during periods ofincapacity; 1 (c) For a mental health advance directive to be an effective tool,individuals must be able to choose how they want their directivestreated during periods of incapacity; and (d) There must be clear standards so that treatment providers canreadily discern an individual's treatment choices. Consequently, the legislature affirms that, pursuant to otherprovisions of law, a validly executed mental health advance directiveis to be respected by agents, guardians, and other surrogate decisionmakers, health care providers, professional persons, and health carefacilities.NEW SECTION.Sec. The definitions in this section applythroughout this chapter unless the context clearly requires otherwise. (1) "Adult" means any individual who has attained the age ofmajority or is an emancipated minor. (2) "Agent" has the same meaning as an attorneyinfact or agent asprovided in chapter 11.94 RCW. (3) "Capacity" means that an adult has not been found to beincapacitated pursuant to this chapter or RCW 11.88.010(1)(e). (4) "Court" means a superior court under chapter 2.08 RCW. (5) "Health care facility" means a hospital, as defined in RCW70.41.020; an institution, as defined in RCW 71.12.455; a statehospital, as defined in RCW 72.23.010; a nursing home, as defined inRCW 18.51.010; or a clinic that is part of a community mental healthservice delivery system, as defined in RCW 71.24.025. (6) "Health care provider" means an osteopathic physician orosteopathic physician's assistant licensed under chapter 18.57 or18.57A RCW, a physician or physician's assistant licensed under chapter18.71 or 18.71A RCW, or an advanced registered nurse practitionerlicensed under RCW 18.79.050. (7) "Incapacitated" means an adult who: (a) Is unable tounderstand the nature, character, and anticipated results of proposedtreatment or alternatives; understand the recognized serious possiblerisks, complications, and anticipated benefits in treatments andalternatives, including nontreatment; or communicate his or herunderstanding or treatment decisions; or (b) has been found to beincompetent pursuant to RCW 11.88.010(1)(e). 2 (8) "Informed consent" means consent that is given after theperson: (a) Is provided with a description of the nature, character,and anticipated results of proposed treatments and alternatives, andthe recognized serious possible risks, complications, and anticipatedbenefits in the treatments and alternatives, including nontreatment, inlanguage that the person can reasonably be expected to understand; or(b) elects not to be given the information included in (a) of thissubsection. (9) "Longterm care facility" has the same meaning as defined inRCW 43.190.020. (10) "Mental disorder" means any organic, mental, or emotionalimpairment which has substantial adverse effects on an individual'scognitive or volitional functions. (11) "Mental health advance directive" or "directive" means awritten document in which the principal makes a declaration ofinstructions or preferences or appoints an agent to make decisions onbehalf of the principal regarding the principal's mental healthtreatment, or both, and that is consistent with the provisions of thischapter. (12) "Mental health professional" means a psychiatrist,psychologist, psychiatric nurse, or social worker, and such othermental health professionals as may be defined by rules adopted by thesecretary pursuant to the provisions of chapter 71.05 RCW. (13) "Principal" means an adult who has executed a mental healthadvance directive. (14) "Professional person" means a mental health professional andshall also mean a physician, registered nurse, and such others as maybe defined by rules adopted by the secretary pursuant to the provisionsof chapter 71.05 RCW.NEW SECTION.Sec. (1) The definition of informed consent is tobe construed to be consistent with that term as it is used in chapter7.70 RCW. (2) The definitions of mental disorder, mental health professional,and professional person are to be construed to be consistent with thoseterms as they are defined in RCW 71.05.020. 3 NEW SECTION.Sec. For the purposes of this chapter, an adultis presumed to have capacity.PART IIThe Document:Creation, Contents, RevocationNEW SECTION.Sec. (1) An adult with capacity may execute amental health advance directive. (2) A directive executed in accordance with this chapter ispresumed to be valid. The inability to honor one or more provisions ofa directive does not affect the validity of the remaining provisions. (3) A directive may include any provision relating to mental healthtreatment or the care of the principal or the principal's personalaffairs. Without limitation, a directive may include: (a) The principal's preferences and instructions for mental healthtreatment; (b) Consent to specific types of mental health treatment; (c) Refusal to consent to specific types of mental healthtreatment; (d) Consent to admission to and retention in a facility for mentalhealth treatment for up to fourteen days; (e) Descriptions of situations that may cause the principal toexperience a mental health crisis; (f) Suggested alternative responses that may supplement or be inlieu of direct mental health treatment, such as treatment approachesfrom other providers; (g) Appointment of an agent pursuant to chapter 11.94 RCW to makemental health treatment decisions on the principal's behalf, includingauthorizing the agent to provide consent on the principal's behalf tovoluntary admission to inpatient mental health treatment; and (h) The principal's nomination of a guardian or limited guardian asprovided in RCW 11.94.010 for consideration by the court ifguardianship proceedings are commenced. (4) A directive may be combined with or be independent of anomination of a guardian or other durable power of attorney underchapter 11.94 RCW, so long as the processes for each are executed inaccordance with its own statutes. 4 NEW SECTION.Sec. (1) A directive shall: (a) Be in writing; (b) Contain language that clearly indicates that the principalintends to create a directive; (c) Be dated and signed by the principal or at the principal'sdirection in the principal's presence if the principal is unable tosign; (d) Designate whether the principal wishes to be able to revoke thedirective during any period of incapacity or wishes to be unable torevoke the directive during any period of incapacity; and (e) Be witnessed in writing by at least two adults, each of whomshall declare that he or she personally knows the principal, waspresent when the principal dated and signed the directive, and that theprincipal did not appear to be incapacitated or acting under fraud,undue influence, or duress. (2) A directive that includes the appointment of an agent underchapter 11.94 RCW shall contain the words "This power of attorney shallnot be affected by the incapacity of the principal," or "This power ofattorney shall become effective upon the incapacity of the principal,"or similar words showing the principal's intent that the authorityconferred shall be exercisable notwithstanding the principal'sincapacity. (3) A directive is valid upon execution, but all or part of thedirective may take effect at a later time as designated by theprincipal in the directive. (4) A directive may: (a) Be revoked, in whole or in part, pursuant to the provisions ofsection 8 of this act; or (b) Expire under its own terms.NEW SECTION.Sec. A directive may not: (1) Create an entitlement to mental health or medical treatment orsupersede a determination of medical necessity; (2) Obligate any health care provider, professional person, orhealth care facility to pay the costs associated with the treatmentrequested; (3) Obligate any health care provider, professional person, or 5 health care facility to be responsible for the nontreatment personalcare of the principal or the principal's personal affairs outside thescope of services the facility normally provides; (4) Replace or supersede the provisions of any will or testamentarydocument or supersede the provisions of intestate succession; (5) Be revoked by an incapacitated principal unless that principalselected the option to permit revocation while incapacitated at thetime his or her directive was executed; or (6) Be used as the authority for inpatient admission for more thanfourteen days in any twentyone day period.NEW SECTION.Sec. (1)(a) A principal with capacity may, bywritten statement by the principal or at the principal's direction inthe principal's presence, revoke a directive in whole or in part. (b) An incapacitated principal may revoke a directive only if he orshe elected at the time of executing the directive to be able to revokewhen incapacitated. (2) The revocation need not follow any specific form so long as itis written and the intent of the principal can be discerned. (3) The principal shall provide a copy of his or her writtenstatement of revocation to his or her agent, if any, and to each healthcare provider, professional person, or health care facility thatreceived a copy of the directive from the principal. (4) The written statement of revocation is effective: (a) As to a health care provider, professional person, or healthcare facility, upon receipt. The professional person, health careprovider, or health care facility, or persons acting under theirdirection shall make the statement of revocation part of theprincipal's medical record; and (b) As to the principal's agent, upon receipt. The principal'sagent shall notify the principal's health care provider, professionalperson, or health care facility of the revocation and provide them witha copy of the written statement of revocation. (5) A directive also may: (a) Be revoked, in whole or in part, expressly or to the extent ofany inconsistency, by a subsequent directive; or (b) Be superseded or revoked by a court order, including any orderentered in a criminal matter. A directive may be superseded by a court 6 order regardless of whether the order contains an explicit reference tothe directive. To the extent a directive is not in conflict with acourt order, the directive remains effective, subject to the provisionsof section 15 of this act. A directive shall not be interpreted in amanner that interferes with: (i) Incarceration or detention by thedepartment of corrections, in a city or county jail, or by thedepartment of social and health services; or (ii) treatment of aprincipal who is subject to involuntary treatment pursuant to chapter10.77, 70.96A, 71.05, 71.09, or 71.34 RCW. (6) A directive that would have otherwise expired but is effectivebecause the principal is incapacitated remains effective until theprincipal is no longer incapacitated unless the principal has electedto be able to revoke while incapacitated and has revoked the directive. (7) When a principal with capacity consents to treatment thatdiffers from, or refuses treatment consented to in, the provisions ofhis or her directive, the consent or refusal constitutes a waiver ofthat provision and does not constitute a revocation of the provision ordirective unless the principal also revokes the directive or provision.NEW SECTION.Sec. A witness may not be any of the following: (1) A person designated to make health care decisions on theprincipal's behalf; (2) A health care provider or professional person directly involvedwith the provision of care to the principal at the time the directiveis executed; (3) An owner, operator, employee, or relative of an owner oroperator of a health care facility or longterm care facility in whichthe principal is a patient or resident; (4) A person who is related by blood, marriage, or adoption to theperson or with whom the principal has a dating relationship, as definedin RCW 26.50.010; (5) A person who is declared to be an incapacitated person; or (6) A person who would benefit financially if the principal makingthe directive undergoes mental health treatment.NEW SECTION.Sec. (1) If a directive authorizes theappointment of an agent, the provisions of chapter 11.94 RCW and RCW7.70.065 shall apply unless otherwise stated in this chapter. 7 (2) The principal who appoints an agent must notify the agent inwriting of the appointment. (3) An agent must act in good faith. (4) An agent may make decisions on behalf of the principal. Unlessthe principal has revoked the directive, the decisions must beconsistent with the instructions and preferences the principal hasexpressed in the directive, or if not expressed, as otherwise known tothe agent. If the principal's instructions or preferences are notknown, the agent shall make a decision he or she determines is in thebest interest of the principal. (5) Except to the extent the right is limited by the appointment orany federal or state law, the agent has the same right as the principalto receive, review, and authorize the use and disclosure of theprincipal's health care information when the agent is acting on behalfof the principal and to the extent required for the agent to carry outhis or her duties. This subsection shall be construed to be consistentwith chapters 70.02, 70.24, 70.96A, 71.05, and 71.34 RCW, and withfederal law regarding health care information. (6) Unless otherwise provided in the appointment and agreed to inwriting by the agent, the agent is not, as a result of acting in thecapacity of agent, personally liable for the cost of treatment providedto the principal. (7) An agent may resign or withdraw at any time by giving writtennotice to the principal. The agent must also give written notice toany health care provider, professional person, or health care facilityproviding treatment to the principal. The resignation or withdrawal iseffective upon receipt unless otherwise specified in the resignation orwithdrawal. (8) If the directive gives the agent authority to act while theprincipal has capacity, the decisions of the principal supersede thoseof the agent at any time the principal has capacity. (9) Unless otherwise provided in the durable power of attorney, theprincipal may revoke the agent's appointment as provided under otherstate law.PART IIICapacity and Process for Incapacitated Persons 8 NEW SECTION.Sec. (1) For the purposes of this chapter, aprincipal, agent, professional person, or health care provider may seeka determination whether the principal is incapacitated or has regainedcapacity. (2)(a) For the purposes of this chapter, no adult may be declaredan incapacitated person except by: (i) A court, if the request is made by the principal or theprincipal's agent; (ii) One mental health professional and one health care provider;or (iii) Two health care providers. (b) One of the persons making the determination under (a)(ii) or(iii) of this subsection must be a psychiatrist, psychologist, or apsychiatric advanced registered nurse practitioner. (3) When a professional person or health care provider requests acapacity determination, he or she shall promptly inform the principalthat: (a) A request for capacity determination has been made; and (b) The principal may request that the determination be made by acourt. (4) At least one mental health professional or health care providermust personally examine the principal prior to making a capacitydetermination. (5)(a) When a court makes a determination whether a principal hascapacity, the court shall, at a minimum, be informed by the testimonyof one mental health professional familiar with the principal andshall, except for good cause, give the principal an opportunity toappear in court prior to the court making its determination. (b) To the extent that local court rules permit, any party orwitness may testify telephonically. (6) When a court has made a determination regarding a principal'scapacity and there is a subsequent change in the principal's condition,subsequent determinations whether the principal is incapacitated may bemade in accordance with any of the provisions of subsection (2) of thissection.NEW SECTION.Sec. A principal may bring an action to contestthe validity of his or her directive. If an action under this section 9 is commenced while an action to determine the principal's capacity ispending, the court shall consolidate the actions and decide the issuessimultaneously.NEW SECTION.Sec. (1) An initial determination of capacitymust be completed within fortyeight hours of a request made by aperson authorized in section 11 of this act. During the period betweenthe request for an initial determination of the principal's capacityand completion of that determination, the principal may not be treatedunless he or she consents at the time or treatment is otherwiseauthorized by state or federal law. (2)(a)(i) When an incapacitated principal is admitted to inpatienttreatment pursuant to the provisions of his or her directive, his orher capacity must be reevaluated within seventy-two hours or when therehas been a change in the principal's condition that indicates that heor she appears to have regained capacity, whichever occurs first. (ii) When an incapacitated principal has been admitted to andremains in inpatient treatment for more than seventy-two hours pursuantto the provisions of his or her directive, the principal's capacitymust be reevaluated when there has been a change in his or hercondition that indicates that he or she appears to have regainedcapacity. (iii) When a principal who is being treated on an inpatient basisand has been determined to be incapacitated requests, or his or heragent requests, a redetermination of the principal's capacity theredetermination must be made within seventy-two hours. (b) When a principal who has been determined to be incapacitated isbeing treated on an outpatient basis and there is a request for aredetermination of his or her capacity, the redetermination must bemade within five days of the first request following a determination. (3)(a) When a principal who has appointed an agent for mentalhealth treatment decisions requests a determination or redeterminationof capacity, the agent must make reasonable efforts to obtain thedetermination or redetermination. (b) When a principal who does not have an agent for mental healthtreatment decisions is being treated in an inpatient facility andrequests a determination or redetermination of capacity, the mentalhealth professional or health care provider must complete the 10 determination or, if the principal is seeking a determination from acourt, must make reasonable efforts to notify the person authorized tomake decisions for the principal under RCW 7.70.065 of the principal'srequest. (c) When a principal who does not have an agent for mental healthtreatment decisions is being treated on an outpatient basis, the personrequesting a capacity determination must arrange for the determination. (4) If no determination has been made within the time framesestablished in subsection (1) or (2) of this section, the principalshall be considered to have capacity. (5) When an incapacitated principal is being treated pursuant tohis or her directive, a request for a redetermination of capacity doesnot prevent treatment.NEW SECTION.Sec. (1) A principal who: (a) Chose not to be able to revoke his or her directive during anyperiod of incapacity; (b) Consented to voluntary admission to inpatient mental healthtreatment, or authorized an agent to consent on the principal's behalf;and (c) At the time of admission to inpatient treatment, refuses to beadmitted,may only be admitted into inpatient mental health treatment undersubsection (2) of this section. (2) A principal may only be admitted to inpatient mental healthtreatment under his or her directive if, prior to admission, aphysician member of the treating facility's professional staff: (a) Evaluates the principal's mental condition, including a reviewof reasonably available psychiatric and psychological history,diagnosis, and treatment needs, and determines, in conjunction withanother health care provider or mental health professional, that theprincipal is incapacitated; (b) Obtains the informed consent of the agent, if any, designatedin the directive; (c) Makes a written determination that the principal needs aninpatient evaluation or is in need of inpatient treatment and that theevaluation or treatment cannot be accomplished in a less restrictivesetting; and 11 (d) Documents in the principal's medical record a summary of thephysician's findings and recommendations for treatment or evaluation. (3) In the event the admitting physician is not a psychiatrist, theprincipal shall receive a complete psychological assessment by a mentalhealth professional within twenty-four hours of admission to determinethe continued need for inpatient evaluation or treatment. (4)(a) If it is determined that the principal has capacity, thenthe principal may only be admitted to, or remain in, inpatienttreatment if he or she consents at the time or is detained under theinvoluntary treatment provisions of chapter 70.96A, 71.05, or 71.34RCW. (b) If a principal who is determined by two health care providersor one mental health professional and one health care provider to beincapacitated continues to refuse inpatient treatment, the principalmay immediately seek injunctive relief for release from the facility. (5) If, at the end of the period of time that the principal or theprincipal's agent, if any, has consented to voluntary inpatienttreatment, but no more than fourteen days after admission, theprincipal has not regained capacity or has regained capacity butrefuses to consent to remain for additional treatment, the principalmust be released during reasonable daylight hours, unless detainedunder chapter 70.96A, 71.05, or 71.34 RCW. (6)(a) Except as provided in (b) of this subsection, any principalwho is voluntarily admitted to inpatient mental health treatment underthis chapter shall have all the rights provided to individuals who arevoluntarily admitted to inpatient treatment under chapter 71.05, 71.34,or 72.23 RCW. (b) Notwithstanding RCW 71.05.050 regarding consent to inpatienttreatment for a specified length of time, the choices an incapacitatedprincipal expressed in his or her directive shall control, provided,however, that a principal who takes action demonstrating a desire to bedischarged, in addition to making statements requesting to bedischarged, shall be discharged, and no principal shall be restrainedin any way in order to prevent his or her discharge. (7) Consent to inpatient admission in a directive is effective onlywhile the professional person, health care provider, and health carefacility are in substantial compliance with the material provisions ofthe directive related to inpatient treatment. 12 PART IVProvider Responsibilities and ImmunitiesNEW SECTION.Sec. (1) Upon receiving a directive, a healthcare provider, professional person, or health care facility providingtreatment to the principal, or persons acting under the direction ofthe health care provider, professional person, or health care facility,shall make the directive a part of the principal's medical record andshall be deemed to have actual knowledge of the directive's contents. (2) When acting under authority of a directive, a health careprovider, professional person, or health care facility shall act inaccordance with the provisions of the directive to the fullest extentpossible, unless in the determination of the health care provider,professional person, or health care facility: (a) Compliance with the provision would violate the acceptedstandard of care established in RCW 7.70.040; (b) The requested treatment is not available; (c) Compliance with the provision would violate applicable law; or (d) It is an emergency situation and compliance would endanger anyperson's life or health. (3)(a) In the case of a principal committed or detained under theinvoluntary treatment provisions of chapter 10.77, 70.96A, 71.05,71.09, or 71.34 RCW, those provisions of a principal's directive that,in the determination of the health care provider, professional person,or health care facility, are inconsistent with the purpose of thecommitment or with any order of the court relating to the commitmentare invalid during the commitment. (b) Remaining provisions of a principal's directive are advisorywhile the principal is committed or detained. The treatment provider is encouraged to follow the remainingprovisions of the directive, except as provided in (a) of thissubsection or subsection (2) of this section. (4) In the case of a principal who is incarcerated or committed ina state or local correctional facility, provisions of the principal'sdirective that are inconsistent with reasonable penological objectivesor administrative hearings regarding involuntary medication are invalidduring the period of incarceration or commitment. In addition,treatment may be given despite refusal of the principal or the 13 provisions of the directive: (a) For any reason under subsection (2)of this section; or (b) if, without the benefit of the specifictreatment measure, there is a significant possibility that the personwill harm self or others before an improvement of the person'scondition occurs. (5)(a) If the health care provider, professional person, or healthcare facility is, at the time of receiving the directive, unable orunwilling to comply with any part or parts of the directive for anyreason, the health care provider, professional person, or health carefacility shall promptly notify the principal and, if applicable, his orher agent and shall document the reason in the principal's medicalrecord. (b) If the health care provider, professional person, or healthcare facility is acting under authority of a directive and is unable tocomply with any part or parts of the directive for the reasons listedin subsection (2) or (3) of this section, the health care provider,professional person, or health care facility shall promptly notify theprincipal and if applicable, his or her agent, and shall document thereason in the principal's medical record. (6) In the event that one or more parts of the directive are notfollowed because of one or more of the reasons set forth in subsection(2) or (4) of this section, all other parts of the directive shall befollowed. (7) If no provider-patient relationship has previously beenestablished, nothing in this chapter requires the establishment of aprovider-patient relationship.NEW SECTION.Sec. Where a principal consents in a directiveto electroconvulsive therapy, the health care provider, professionalperson, or health care facility, or persons acting under the directionof the health care provider, professional person, or health carefacility, shall document the therapy and the reason it was used in theprincipal's medical record.NEW SECTION.Sec. (1) For the purposes of this section,"provider" means a private or public agency, government entity, healthcare provider, professional person, health care facility, or person 14 acting under the direction of a health care provider or professionalperson, health care facility, or longterm care facility. (2) A provider is not subject to civil liability or sanctions forunprofessional conduct under the uniform disciplinary act, chapter18.130 RCW, when in good faith and without negligence: (a) The provider provides treatment to a principal in the absenceof actual knowledge of the existence of a directive, or providestreatment pursuant to a directive in the absence of actual knowledge ofthe revocation of the directive; (b) A health care provider or mental health professional determinesthat the principal is or is not incapacitated for the purpose ofdeciding whether to proceed according to a directive, and acts uponthat determination; (c) The provider administers or does not administer mental healthtreatment according to the principal's directive in good faith relianceupon the validity of the directive and the directive is subsequentlyfound to be invalid; (d) The provider does not provide treatment according to thedirective for one of the reasons authorized under section 15 of thisact; or (e) The provider provides treatment according to the principal'sdirective.PART VInterpretive ProvisionsNEW SECTION.Sec. (1) Where an incapacitated principal hasexecuted more than one valid directive and has not revoked any of thedirectives: (a) The directive most recently created shall be treated as theprincipal's mental health treatment preferences and instructions as toany inconsistent or conflicting provisions, unless provided otherwisein either document. (b) Where a directive executed under this chapter is inconsistentwith a directive executed under any other chapter, the most recentlycreated directive controls as to the inconsistent provisions. (2) Where an incapacitated principal has appointed more than one 15 agent under chapter ll.94 RCW with authority to make mental healthtreatment decisions, RCW 11.94.010 controls. (3) The treatment provider shall inquire of a principal whether theprincipal is subject to any court orders that would affect theimplementation of his or her directive.NEW SECTION.Sec. (1) Directives validly executed before theeffective date of this section shall be given full force and effectuntil revoked, superseded, or expired. (2) A directive validly executed in another political jurisdictionis valid to the extent permitted by Washington state law.NEW SECTION.Sec. Any person with reasonable cause to believethat a directive has been created or revoked under circumstancesamounting to fraud, duress, or undue influence may petition the courtfor appointment of a guardian for the person or to review the actionsof the agent or person alleged to be involved in improper conduct underRCW 11.94.090 or 74.34.110.NEW SECTION.Sec. The fact that a person has executed adirective does not constitute an indication of mental disorder or thatthe person is not capable of providing informed consent.NEW SECTION.Sec. A person shall not be required to executeor to refrain from executing a directive, nor shall the existence of adirective be used as a criterion for insurance, as a condition forreceiving mental or physical health services, or as a condition ofadmission to or discharge from a health care facility or longterm carefacility.NEW SECTION.Sec. No person or health care facility may useor threaten abuse, neglect, financial exploitation, or abandonment ofthe principal, as those terms are defined in RCW 74.34.020, to carryout the directive.NEW SECTION.Sec. A directive does not limit any authorityotherwise provided in Title 10, 70, or 71 RCW, or any other applicable 16 state or federal laws to detain a person, take a person into custody,or to admit, retain, or treat a person in a health care facility.NEW SECTION.Sec. (1) If a principal who is a resident of alongterm care facility is admitted to inpatient mental healthtreatment pursuant to his or her directive, the principal shall beallowed to be readmitted to the same longterm care facility as if hisor her inpatient admission had been for a physical condition on thesame basis that the principal would be readmitted under state orfederal statute or rule when: (a) The treating facility's professional staff determine thatinpatient mental health treatment is no longer medically necessary forthe resident. The determination shall be made in writing by apsychiatrist or by a mental health professional and a physician; or (b) The person's consent to admission in his or her directive hasexpired. (2)(a) If the longterm care facility does not have a bed availableat the time of discharge, the treating facility may discharge theresident, in consultation with the resident and agent if any, and inaccordance with a medically appropriate discharge plan, to anotherlongterm care facility. (b) This section shall apply to inpatient mental health treatmentadmission of longterm care facility residents, regardless of whetherthe admission is directly from a facility, hospital emergency room, orother location. (c) This section does not restrict the right of the resident to anearlier release from the inpatient treatment facility. This sectiondoes not restrict the right of a longterm care facility to initiatetransfer or discharge of a resident who is readmitted pursuant to thissection, provided that the facility has complied with the lawsgoverning the transfer or discharge of a resident. (3) The joint legislative audit and review committee shall conductan evaluation of the operation and impact of this section. Thecommittee shall report its findings to the appropriate committees ofthe legislature by December 1, 2004.PART VIThe Form 17 NEW SECTION.Sec. The directive shall be in substantially thefollowing form:Mental Health Advance Directive
NOTICE TO PERSONSCREATING A MENTAL HEALTH ADVANCE DIRECTIVE
This is an important legal document. It creates an advance directive for mental health treatment. Before signing thisdocument you should know these important facts:
(1) This document is called an advance directive and allows you to make decisions in advance about your mental health treatment, including medications, shortterm admission to inpatient treatment and electroconvulsive therapy.
YOU DO NOT HAVE TO FILL OUT OR SIGN THIS FORM.IF YOU DO NOT SIGN THIS FORM, IT WILL NOT TAKE EFFECT.
If you choose to complete and sign this document, you may still decide to leave some items blank.
(2) You have the right to appoint a person as your agent to make treatment decisions for you. You must notify your agent that you have appointed him or her as an agent. The person you appoint has a duty to act consistently with your wishes made known by you. If your agent does not know what your wishes are, he or she has a duty to act in your best interest. Your agent has the right to withdraw from the appointment at any time.
(3) The instructions you include with this advance directive and the authority you give your agent to act will only become effective under the conditions you select in this document. You may choose to limit this directive and your agent's authority to times when you are incapacitated or to times when you are exhibiting symptoms or behavior that you specify. You may also make this directive effective immediately. No matter when you choose to make this directive effective, your treatment providers must still seek your informed consent at all times that you have capacity to give informed consent.
(4) You have the right to revoke this document in writing at any time you have capacity.
YOU MAY NOT REVOKE THIS DIRECTIVE WHEN YOU HAVE BEEN FOUND TO BE INCAPACITATED UNLESS YOU HAVE SPECIFICALLY STATED IN THIS DIRECTIVE THAT YOU WANT IT TO BE REVOCABLE WHEN YOU ARE INCAPACITATED.
(5) This directive will stay in effect until you revoke it unless you specify an expiration date. If you specify an expiration date and you are incapacitated at the time it expires, it will remain in effect until you have capacity to make treatment decisions again unless you chose to be able to revoke it while you are incapacitated and you revoke the directive.
(6) You cannot use your advance directive to consent to civil commitment. The procedures that apply to your advance directive are different than those provided for in the Involuntary Treatment Act. Involuntary treatment is a different process.
(7) If there is anything in this directive that you do not understand, you should ask a lawyer to explain it to you.
(8) You should be aware that there are some circumstances where your provider may not have to follow your directive.
(9) You should discuss any treatment decisions in your directive with your provider.
18 (10) You may ask the court to rule on the validity of your directive.
PART I.STATEMENT OF INTENT TO CREATE AMENTAL HEALTH ADVANCE DIRECTIVE
I, . . . . . . . . . . being a person with capacity, willfully and voluntarily execute this mental health advance directiveso that my choices regarding my mental health care will be carried out in circumstances when I am unable to expressmy instructions and preferences regarding my mental health care. If a guardian is appointed by a court to make mentalhealth decisions for me, I intend this document to take precedence over all other means of ascertaining my intent.
The fact that I may have left blanks in this directive does not affect its validity in any way. I intend that allcompleted sections be followed. If I have not expressed a choice, my agent should make the decision that he or shedetermines is in my best interest. I intend this directive to take precedence over any other directives I have previouslyexecuted, to the extent that they are inconsistent with this document, or unless I expressly state otherwise in eitherdocument.
I understand that I may revoke this directive in whole or in part if I am a person with capacity. I understand that Icannot revoke this directive if a court, two health care providers, or one mental health professional and one health careprovider find that I am an incapacitated person, unless, when I executed this directive, I chose to be able to revoke thisdirective while incapacitated.
I understand that, except as otherwise provided in law, revocation must be in writing. I understand that nothing inthis directive, or in my refusal of treatment to which I consent in this directive, authorizes any health care provider,professional person, health care facility, or agent appointed in this directive to use or threaten to use abuse, neglect,financial exploitation, or abandonment to carry out my directive.
I understand that there are some circumstances where my provider may not have to follow my directive.
PART II.WHEN THIS DIRECTIVE IS EFFECTIVE
YOU MUST COMPLETE THIS PART FOR YOUR DIRECTIVE TO BE VALID.
I intend that this directive become effective (YOU MUST CHOOSE ONLY ONE):
. . . . . . Immediately upon my signing of this directive.
. . . . . . If I become incapacitated.
. . . . . . When the following circumstances, symptoms, or behaviors occur:
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PART III.DURATION OF THIS DIRECTIVE
YOU MUST COMPLETE THIS PART FOR YOUR DIRECTIVE TO BE VALID.
I want this directive to (YOU MUST CHOOSE ONLY ONE):
. . . . . . Remain valid and in effect for an indefinite period of time.
. . . . . . Automatically expire . . . . . . years from the date it was created.
19 PART IV.WHEN I MAY REVOKE THIS DIRECTIVE
YOU MUST COMPLETE THIS PART FOR THIS DIRECTIVE TO BE VALID.
I intend that I be able to revoke this directive (YOU MUST CHOOSE ONLY ONE):
. . . . . . Only when I have capacity. I understand that choosing this option means I may only revoke this directive if I have capacity. I further understand that if I choose this option and become incapacitated while this directive is in effect, I may receive treatment that I specify in this directive, even if I object at the time.
. . . . . . Even if I am incapacitated. I understand that choosing this option means that I may revoke this directive even if I am incapacitated. I further understand that if I choose this option and revoke this directive while I am incapacitated I may not receive treatment that I specify in this directive, even if I want the treatment.
PART V.PREFERENCES AND INSTRUCTIONS ABOUT TREATMENT, FACILITIES, AND PHYSICIANS
A. Preferences and Instructions About Physician(s) to be Involved in My Treatment
I would like the physician(s) named below to be involved in my treatment decisions:Dr. . . . . . . . . . . . . . . . . Contact information:Dr. . . . . . . . . . . . . . . . . Contact information:
I do not wish to be treated by Dr.
B. Preferences and Instructions About Other Providers
I am receiving other treatment or care from providers who I feel have an impact on my mental health care. I wouldlike the following treatment provider(s) to be contacted when this directive is effective:
Name . . . . . . . . . . . . . . . . . . . . Profession . . . . . . . . . . . . . . . . . . . . Contact information
Name . . . . . . . . . . . . . . . . . . . . Profession . . . . . . . . . . . . . . . . . . . . Contact information
C. Preferences and Instructions About Medications for Psychiatric Treatment (initial and complete all thatapply)
. . . . . . I consent, and authorize my agent (if appointed) to consent, to the followingmedications:
. . . . . . I do not consent, and I do not authorize my agent (if appointed) to consent, to the administration of thefollowing medications:
. . . . . . I am willing to take the medications excluded above if my only reason for excluding them is the side effectswhich includeand these side effects can be eliminated by dosage adjustment or other means
. . . . . . I am willing to try any other medication the hospital doctor recommends
. . . . . . I am willing to try any other medications my outpatient doctor recommends
. . . . . . I do not want to try any other medications.
Medication Allergies
20 I have allergies to, or severe side effects from, the following:
Other Medication Preferences or Instructions
. . . . . . I have the following other preferences or instructions about medications
D. Preferences and Instructions About Hospitalization and Alternatives(initial all that apply and, if desired, rank "1" for first choice, "2" for second choice, and so on)
. . . . . . In the event my psychiatric condition is serious enough to require 24-hour care and I have no physicalconditions that require immediate access to emergency medical care, I prefer to receive this care in programs/facilitiesdesigned as alternatives to psychiatric hospitalizations.
. . . . . . I would also like the interventions below to be tried before hospitalization is considered:
. . . . . . Calling someone or having someone call me when needed.
Name: Telephone:
. . . . . . Staying overnight with someone
Name: Telephone:
. . . . . . Having a mental health service provider come to see me
. . . . . . Going to a crisis triage center or emergency room
. . . . . . Staying overnight at a crisis respite (temporary) bed
. . . . . . Seeing a service provider for help with psychiatric medications
. . . . . . Other, specify:
Authority to Consent to Inpatient Treatment
I consent, and authorize my agent (if appointed) to consent, to voluntary admission to inpatient mental healthtreatment for . . . . . . days (not to exceed 14 days)
(Sign one):
. . . . . . If deemed appropriate by my agent (if appointed) and treating physician
(Signature)
or
. . . . . . Under the following circumstances (specify symptoms, behaviors, or circumstances that indicate the need forhospitalization)
(Signature)
. . . . . . I do not consent, or authorize my agent (if appointed) to consent, to inpatient treatment
(Signature)
Hospital Preferences and Instructions
If hospitalization is required, I prefer the following hospitals:
21 I do not consent to be admitted to the following hospitals:
E. Preferences and Instructions About Preemergency
I would like the interventions below to be tried before use of seclusion or restraint is considered (initial all that apply):
. . . . . . "Talk me down" one-on-one
. . . . . . More medication
. . . . . . Time out/privacy
. . . . . . Show of authority/force
. . . . . . Shift my attention to something else
. . . . . . Set firm limits on my behavior
. . . . . . Help me to discuss/vent feelings
. . . . . . Decrease stimulation
. . . . . . Offer to have neutral person settle dispute
. . . . . . Other, specify
F. Preferences and Instructions About Seclusion, Restraint, and Emergency Medications
If it is determined that I am engaging in behavior that requires seclusion, physical restraint, and/or emergency use ofmedication, I prefer these interventions in the order I have chosen (choose "1" for first choice, "2" for second choice,and so on):
. . . . . . Seclusion
. . . . . . Seclusion and physical restraint (combined)
. . . . . . Medication by injection
. . . . . . Medication in pill or liquid form
In the event that my attending physician decides to use medication in response to an emergency situation after dueconsideration of my preferences and instructions for emergency treatments stated above, I expect the choice ofmedication to reflect any preferences and instructions I have expressed in Part III C of this form. The preferences andinstructions I express in this section regarding medication in emergency situations do not constitute consent to use ofthe medication for nonemergency treatment.
G. Preferences and Instructions About Electroconvulsive Therapy(ECT or Shock Therapy)
My wishes regarding electroconvulsive therapy are (sign one):
. . . . . . I do not consent, nor authorize my agent (if appointed) to consent, to the administration of electroconvulsivetherapy
(Signature)
. . . . . . I consent, and authorize my agent (if appointed) to consent, to the administration of electroconvulsive therapy
(Signature)
22 . . . . . . I consent, and authorize my agent (if appointed) to consent, to the administration of electroconvulsive therapy,but only under the following conditions:
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(Signature)
H. Preferences and Instructions About Who is Permitted to Visit
If I have been admitted to a mental health treatment facility, the following people are not permitted to visit me there:
Name:
Name:
Name:
I understand that persons not listed above may be permitted to visit me.
I. Additional Instructions About My Mental Health Care
Other instructions about my mental health care:
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In case of emergency, please contact:
Name: Address:
Work telephone: Home telephone:
Physician: Address:
Telephone:
The following may help me to avoid a hospitalization:
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I generally react to being hospitalized as follows:
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Staff of the hospital or crisis unit can help me by doing the following:
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J. Refusal of Treatment
I do not consent to any mental health treatment.
(Signature)
PART VI. DURABLE POWER OF ATTORNEY (APPOINTMENT OF MY AGENT)
(Fill out this part only if you wish to appoint an agent or nominate a guardian.)
23 I authorize an agent to make mental health treatment decisions on my behalf. The authority granted to my agentincludes the right to consent, refuse consent, or withdraw consent to any mental health care, treatment, service, orprocedure, consistent with any instructions and/or limitations I have set forth in this directive. I intend that thosedecisions should be made in accordance with my expressed wishes as set forth in this document. If I have notexpressed a choice in this document and my agent does not otherwise know my wishes, I authorize my agent to makethe decision that my agent determines is in my best interest. This agency shall not be affected by my incapacity.Unless I state otherwise in this durable power of attorney, I may revoke it unless prohibited by other state law.
A. Designation of an Agent
I appoint the following person as my agent to make mental health treatment decisions for me as authorized in thisdocument and request that this person be notified immediately when this directive becomes effective:
Name: Address:
Work telephone: Home telephone:
Relationship:
B. Designation of Alternate Agent
If the person named above is unavailable, unable, or refuses to serve as my agent, or I revoke that person's authority toserve as my agent, I hereby appoint the following person as my alternate agent and request that this person be notifiedimmediately when this directive becomes effective or when my original agent is no longer my agent:
Name: Address:
Work telephone: Home telephone:
Relationship:
C. When My Spouse is My Agent (initial if desired)
. . . . . . If my spouse is my agent, that person shall remain my agent even if we become legally separated or ourmarriage is dissolved, unless there is a court order to the contrary or I have remarried.
D. Limitations on My Agent's Authority
I do not grant my agent the authority to consent on my behalf to the following:
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E. Limitations on My Ability to Revoke this Durable Power of Attorney
I choose to limit my ability to revoke this durable power of attorney as follows:
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F. Preference as to Court-Appointed Guardian
In the event a court appoints a guardian who will make decisions regarding my mental health treatment, I nominatethe following person as my guardian:
Name: Address:
Work telephone: Home telephone:
Relationship:
24 The appointment of a guardian of my estate or my person or any other decision maker shall not give the guardian ordecision maker the power to revoke, suspend, or terminate this directive or the powers of my agent, except asauthorized by law.
(Signature required if nomination is made)
PART VII. OTHER DOCUMENTS
(Initial all that apply)
I have executed the following documents that include the power to make decisions regarding health care services formyself:
. . . . . . Health care power of attorney (chapter 11.94 RCW)
. . . . . . "Living will" (Health care directive; chapter 70.122 RCW)
. . . . . . I have appointed more than one agent. I understand that the most recently appointed agent controls except asstated below:
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PART VIII. NOTIFICATION OF OTHERS AND CARE OF PERSONAL AFFAIRS
(Fill out this part only if you wish to provide nontreatment instructions.)
I understand the preferences and instructions in this part are NOT the responsibility of my treatment provider and thatno treatment provider is required to act on them.
A. Who Should Be Notified
I desire my agent to notify the following individuals as soon as possible when this directive becomes effective:
Name: Address:
Day telephone: Evening telephone:
Name: Address:
Day telephone: Evening telephone:
B. Preferences or Instructions About Personal Affairs
I have the following preferences or instructions about my personal affairs (e.g., care of dependents, pets, household) if Iam admitted to a mental health treatment facility:
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C. Additional Preferences and Instructions:
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25 PART IX.SIGNATURE
By signing here, I indicate that I understand the purpose and effect of this document and that I am giving myinformed consent to the treatments and/or admission to which I have consented or authorized my agent to consent inthis directive. I intend that my consent in this directive be construed as being consistent with the elements of informedconsent under chapter 7.70 RCW.
Signature: Date:
Printed Name:
This directive was signed and declared by the "Principal," to be his or her directive, in our presence who, at his or herrequest, have signed our names below as witnesses. We declare that, at the time of the creation of this instrument, thePrincipal is personally known to us, and, according to our best knowledge and belief, has capacity at this time and doesnot appear to be acting under duress, undue influence, or fraud. We further declare that none of us is:
(A) A person designated to make medical decisions on the principal's behalf;
(B) A health care provider or professional person directly involved with the provision of care to the principal at thetime the directive is executed;
(C) An owner, operator, employee, or relative of an owner or operator of a health care facility or long-term carefacility in which the principal is a patient or resident;
(D) A person who is related by blood, marriage, or adoption to the person, or with whom the principal has a datingrelationship as defined in RCW 26.50.010;
(E) An incapacitated person;
(F) A person who would benefit financially if the principal undergoes mental health treatment; or
(G) A minor.
Witness 1: Signature: Date:
Printed Name:
Telephone: Address:
Witness 2: Signature: Date:
Printed Name:
Telephone: Address:
PART X.RECORD OF DIRECTIVE
I have given a copy of this directive to the following persons:
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DO NOT FILL OUT PART XI UNLESS YOU INTEND TO REVOKETHIS DIRECTIVE IN PART OR IN WHOLE
PART XI.REVOCATION OF THIS DIRECTIVE
(Initial any that apply):
26 . . . . . . I am revoking the following part(s) of this directive (specify):
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. . . . . . I am revoking all of this directive.
By signing here, I indicate that I understand the purpose and effect of my revocation and that no person is bound byany revoked provision(s). I intend this revocation to be interpreted as if I had never completed the revokedprovision(s).
Signature: Date:
Printed Name:
DO NOT SIGN THIS PART UNLESS YOU INTEND TO REVOKE THISDIRECTIVE IN PART OR IN WHOLE
PART VIIAmendatory SectionsSec. RCW 11.94.010 and 1995 c 297 s 9 are each amended to readas follows: (1) Whenever a principal designates another as his or her attorneyin fact or agent, by a power of attorney in writing, and the writingcontains the words "This power of attorney shall not be affected bydisability of the principal," or "This power of attorney shall becomeeffective upon the disability of the principal," or similar wordsshowing the intent of the principal that the authority conferred shallbe exercisable notwithstanding the principal's disability, theauthority of the attorney in fact or agent is exercisable on behalf ofthe principal as provided notwithstanding later disability orincapacity of the principal at law or later uncertainty as to whetherthe principal is dead or alive. All acts done by the attorney in factor agent pursuant to the power during any period of disability orincompetence or uncertainty as to whether the principal is dead oralive have the same effect and inure to the benefit of and bind theprincipal or the principal's guardian or heirs, devisees, and personalrepresentative as if the principal were alive, competent, and notdisabled. A principal may nominate, by a durable power of attorney,the guardian or limited guardian of his or her estate or person forconsideration by the court if protective proceedings for theprincipal's person or estate are thereafter commenced. The court shallmake its appointment in accordance with the principal's most recentnomination in a durable power of attorney except for good cause or 27 disqualification. If a guardian thereafter is appointed for theprincipal, the attorney in fact or agent, during the continuance of theappointment, shall account to the guardian rather than the principal.The guardian has the same power the principal would have had if theprincipal were not disabled or incompetent, to revoke, suspend orterminate all or any part of the power of attorney or agency. (2) Persons shall place reasonable reliance on any determination ofdisability or incompetence as provided in the instrument that specifiesthe time and the circumstances under which the power of attorneydocument becomes effective. (3)(a) A principal may authorize his or her attorneyinfact toprovide informed consent for health care decisions on the principal'sbehalf. If a principal has appointed more than one agent withauthority to make mental health treatment decisions in accordance witha directive under chapter 71. RCW (sections 1 through 26 of thisact), to the extent of any conflict, the most recently appointed agentshall be treated as the principal's agent for mental health treatmentdecisions unless provided otherwise in either appointment. (b) Unless he or she is the spouse, or adult child or brother orsister of the principal, none of the following persons may act as theattorneyinfact for the principal: Any of the principal's physicians,the physicians' employees, or the owners, administrators, or employeesof the health care facility or longterm care facility as defined inRCW 43.190.020 where the principal resides or receives care. Exceptwhen the principal has consented in a mental health advance directiveexecuted under chapter 71. RCW (sections 1 through 26 of this act) toinpatient admission or electroconvulsive therapy, this authorization issubject to the same limitations as those that apply to a guardian underRCW 11.92.043(5) (a) through (c).NEW SECTION.Sec. A new section is added to chapter 11.94 RCWto read as follows: No person appointed by a principal as an agent to make mentalhealth treatment decisions pursuant to a mental health advancedirective under chapter 71.-- RCW (sections 1 through 26 of this act)shall be compensated for the performance of his or her duties as anagent to make mental health treatment decisions. This section does not 28 prohibit an agent from receiving reimbursement for reasonable expensesincurred in the performance of his or her duties under chapter 71.--RCW (sections 1 through 26 of this act).Sec. RCW 7.70.065 and 1987 c 162 s 1 are each amended to readas follows: (1) Informed consent for health care for a patient who is notcompetent, as defined in RCW 11.88.010(1)(((b))) (e), to consent may beobtained from a person authorized to consent on behalf of such patient.Persons authorized to provide informed consent to health care on behalfof a patient who is not competent to consent shall be a member of oneof the following classes of persons in the following order of priority: (a) The appointed guardian of the patient, if any; (b) The individual, if any, to whom the patient has given a durablepower of attorney that encompasses the authority to make health caredecisions; (c) The patient's spouse; (d) Children of the patient who are at least eighteen years of age; (e) Parents of the patient; and (f) Adult brothers and sisters of the patient. (2) If the physician seeking informed consent for proposed healthcare of the patient who is not competent to consent makes reasonableefforts to locate and secure authorization from a competent person inthe first or succeeding class and finds no such person available,authorization may be given by any person in the next class in the orderof descending priority. However, no person under this section mayprovide informed consent to health care: (a) If a person of higher priority under this section has refusedto give such authorization; or (b) If there are two or more individuals in the same class and thedecision is not unanimous among all available members of that class. (3) Before any person authorized to provide informed consent onbehalf of a patient not competent to consent exercises that authority,the person must first determine in good faith that that patient, ifcompetent, would consent to the proposed health care. If such adetermination cannot be made, the decision to consent to the proposedhealth care may be made only after determining that the proposed healthcare is in the patient's best interests. 29 NEW SECTION.Sec. A new section is added to chapter 7.70 RCWto read as follows: Consent to treatment or admission contained in a validly executedmental health advance directive constitutes informed consent forpurposes of this chapter.NEW SECTION.Sec. A new section is added to chapter 9A.60 RCWto read as follows: (1) For purposes of this section "mental health advance directive"means a written document that is a "mental health advance directive" asdefined in section 2 of this act. (2) A person is guilty of fraudulent creation or revocation of amental health advance directive if he or she knowingly: (a) Makes, completes, alters, or revokes the mental health advancedirective of another without the principal's consent; (b) Utters, offers, or puts off as true a mental health advancedirective that he or she knows to be forged; or (c) Obtains or prevents the signature of a principal or witness toa mental health advance directive by deception or duress. (3) Fraudulent creation or revocation of a mental health advancedirective is a class C felony.Sec. RCW 9.94A.515 and 2002 c 340 s 2, 2002 c 324 s 2, 2002 c290 s 2, 2002 c 253 s 4, 2002 c 229 s 2, 2002 c 134 s 2, and 2002 c 133s 4 are each reenacted and amended to read as follows:TABLE 2
CRIMES INCLUDED WITHINEACH SERIOUSNESS LEVEL
XVIAggravated Murder 1 (RCW 10.95.020)
XVHomicide by abuse (RCW 9A.32.055)
Malicious explosion 1 (RCW 70.74.280(1))
Murder 1 (RCW 9A.32.030)
XIVMurder 2 (RCW 9A.32.050)
30 XIIIMalicious explosion 2 (RCW 70.74.280(2))
Malicious placement of an explosive 1 (RCW 70.74.270(1))
XIIAssault 1 (RCW 9A.36.011)
Assault of a Child 1 (RCW 9A.36.120)
Malicious placement of an imitation device 1 (RCW 70.74.272(1)(a))
Rape 1 (RCW 9A.44.040)
Rape of a Child 1 (RCW 9A.44.073)
XIManslaughter 1 (RCW 9A.32.060)
Rape 2 (RCW 9A.44.050)
Rape of a Child 2 (RCW 9A.44.076)
XChild Molestation 1 (RCW 9A.44.083)
Indecent Liberties (with forcible compulsion) (RCW 9A.44.100(1)(a))
Kidnapping 1 (RCW 9A.40.020)
Leading Organized Crime (RCW 9A.82.060(1)(a))
Malicious explosion 3 (RCW 70.74.280(3))
Manufacture of methamphetamine (RCW 69.50.401(a)(1)(ii))
Over 18 and deliver heroin, methamphetamine, a narcotic from Schedule I or II, or flunitrazepam from Schedule IV to someone under 18 (RCW 69.50.406)
Sexually Violent Predator Escape (RCW 9A.76.115)
IXAssault of a Child 2 (RCW 9A.36.130)
Controlled Substance Homicide (RCW 69.50.415)
Explosive devices prohibited (RCW 70.74.180)
31 Hit and RunDeath (RCW 46.52.020(4)(a))
Homicide by Watercraft, by being under the influence of intoxicating liquor or any drug (RCW 79A.60.050)
Inciting Criminal Profiteering (RCW 9A.82.060(1)(b))
Malicious placement of an explosive 2 (RCW 70.74.270(2))
Over 18 and deliver narcotic from Schedule III, IV, or V or a nonnarcotic, except flunitrazepam or methamphetamine, from Schedule IV to someone under 18 and 3 years junior (RCW 69.50.406)
Robbery 1 (RCW 9A.56.200)
Sexual Exploitation (RCW 9.68A.040)
Vehicular Homicide, by being under the influence of intoxicating liquor or any drug (RCW 46.61.520)
VIIIArson 1 (RCW 9A.48.020)
Deliver or possess with intent to deliver methamphetamine (RCW 69.50.401(a)(1)(ii))
Homicide by Watercraft, by the operation of any vessel in a reckless manner (RCW 79A.60.050)
Manslaughter 2 (RCW 9A.32.070)
Manufacture, deliver, or possess with intent to deliver amphetamine (RCW 69.50.401(a)(1)(ii))
32 Manufacture, deliver, or possess with intent to deliver heroin or cocaine (when the offender has a criminal history in this state or any other state that includes a sex offense or serious violent offense or the Washington equivalent) (RCW 69.50.401(a)(1)(i))
Possession of Ephedrine or any of its Salts or Isomers or Salts of Isomers, Pseudoephedrine or any of its Salts or Isomers or Salts of Isomers, Pressurized Ammonia Gas, or Pressurized Ammonia Gas Solution with intent to manufacture methamphetamine (RCW 69.50.440)
Promoting Prostitution 1 (RCW 9A.88.070)
Selling for profit (controlled or counterfeit) any controlled substance (RCW 69.50.410)
Theft of Ammonia (RCW 69.55.010)
Vehicular Homicide, by the operation of any vehicle in a reckless manner (RCW 46.61.520)
VIIBurglary 1 (RCW 9A.52.020)
Child Molestation 2 (RCW 9A.44.086)
Civil Disorder Training (RCW 9A.48.120)
Dealing in depictions of minor engaged in sexually explicit conduct (RCW 9.68A.050)
Driveby Shooting (RCW 9A.36.045)
Homicide by Watercraft, by disregard for the safety of others (RCW 79A.60.050)
33 Indecent Liberties (without forcible compulsion) (RCW 9A.44.100(1) (b) and (c))
Introducing Contraband 1 (RCW 9A.76.140)
Involving a minor in drug dealing (RCW 69.50.401(f))
Malicious placement of an explosive 3 (RCW 70.74.270(3))
Manufacture, deliver, or possess with intent to deliver heroin or cocaine (except when the offender has a criminal history in this state or any other state that includes a sex offense or serious violent offense or the Washington equivalent) (RCW 69.50.401(a)(1)(i))
Sending, bringing into state depictions of minor engaged in sexually explicit conduct (RCW 9.68A.060)
Unlawful Possession of a Firearm in the first degree (RCW 9.41.040(1)(a))
Use of a Machine Gun in Commission of a Felony (RCW 9.41.225)
Vehicular Homicide, by disregard for the safety of others (RCW 46.61.520)
VIBail Jumping with Murder 1 (RCW 9A.76.170(3)(a))
Bribery (RCW 9A.68.010)
Incest 1 (RCW 9A.64.020(1))
Intimidating a Judge (RCW 9A.72.160)
Intimidating a Juror/Witness (RCW 9A.72.110, 9A.72.130)
34 Malicious placement of an imitation device 2 (RCW 70.74.272(1)(b))
Manufacture, deliver, or possess with intent to deliver narcotics from Schedule I or II (except heroin or cocaine) or flunitrazepam from Schedule IV (RCW 69.50.401(a)(1)(i))
Rape of a Child 3 (RCW 9A.44.079)
Theft of a Firearm (RCW 9A.56.300)
Unlawful Storage of Ammonia (RCW 69.55.020)
VAbandonment of dependent person 1 (RCW 9A.42.060)
Advancing money or property for extortionate extension of credit (RCW 9A.82.030)
Bail Jumping with class A Felony (RCW 9A.76.170(3)(b))
Child Molestation 3 (RCW 9A.44.089)
Criminal Mistreatment 1 (RCW 9A.42.020)
Custodial Sexual Misconduct 1 (RCW 9A.44.160)
Delivery of imitation controlled substance by person eighteen or over to person under eighteen (RCW 69.52.030(2))
Domestic Violence Court Order Violation (RCW 10.99.040, 10.99.050, 26.09.300, 26.10.220, 26.26.138, 26.50.110, 26.52.070, or 74.34.145)
Extortion 1 (RCW 9A.56.120)
Extortionate Extension of Credit (RCW 9A.82.020)
35 Extortionate Means to Collect Extensions of Credit (RCW 9A.82.040)
Incest 2 (RCW 9A.64.020(2))
Kidnapping 2 (RCW 9A.40.030)
Perjury 1 (RCW 9A.72.020)
Persistent prison misbehavior (RCW 9.94.070)
Possession of a Stolen Firearm (RCW 9A.56.310)
Rape 3 (RCW 9A.44.060)
Rendering Criminal Assistance 1 (RCW 9A.76.070)
Sexual Misconduct with a Minor 1 (RCW 9A.44.093)
Sexually Violating Human Remains (RCW 9A.44.105)
Stalking (RCW 9A.46.110)
Taking Motor Vehicle Without Permission 1 (RCW 9A.56.070(1))
IVArson 2 (RCW 9A.48.030)
Assault 2 (RCW 9A.36.021)
Assault by Watercraft (RCW 79A.60.060)
Bribing a Witness/Bribe Received by Witness (RCW 9A.72.090, 9A.72.100)
Cheating 1 (RCW 9.46.1961)
Commercial Bribery (RCW 9A.68.060)
Counterfeiting (RCW 9.16.035(4))
Endangerment with a Controlled Substance (RCW 9A.42.100)
Escape 1 (RCW 9A.76.110)
Hit and RunInjury (RCW 46.52.020(4)(b))
36 Hit and Run with VesselInjury Accident (RCW 79A.60.200(3))
Identity Theft 1 (RCW 9.35.020(2)(a))
Indecent Exposure to Person Under Age Fourteen (subsequent sex offense) (RCW 9A.88.010)
Influencing Outcome of Sporting Event (RCW 9A.82.070)
Knowingly Trafficking in Stolen Property (RCW 9A.82.050(2))
Malicious Harassment (RCW 9A.36.080)
Manufacture, deliver, or possess with intent to deliver narcotics from Schedule III, IV, or V or nonnarcotics from Schedule IV (except marijuana, amphetamine, methamphetamines, or flunitrazepam) (RCW 69.50.401(a)(1) (iii) through (v))
Residential Burglary (RCW 9A.52.025)
Robbery 2 (RCW 9A.56.210)
Theft of Livestock 1 (RCW 9A.56.080)
Threats to Bomb (RCW 9.61.160)
Use of Proceeds of Criminal Profiteering (RCW 9A.82.080 (1) and (2))
Vehicular Assault, by being under the influence of intoxicating liquor or any drug, or by the operation or driving of a vehicle in a reckless manner (RCW 46.61.522)
Willful Failure to Return from Furlough (RCW 72.66.060)
IIIAbandonment of dependent person 2 (RCW 9A.42.070)
37 Assault 3 (RCW 9A.36.031)
Assault of a Child 3 (RCW 9A.36.140)
Bail Jumping with class B or C Felony (RCW 9A.76.170(3)(c))
Burglary 2 (RCW 9A.52.030)
Communication with a Minor for Immoral Purposes (RCW 9.68A.090)
Criminal Gang Intimidation (RCW 9A.46.120)
Criminal Mistreatment 2 (RCW 9A.42.030)
Custodial Assault (RCW 9A.36.100)
Delivery of a material in lieu of a controlled substance (RCW 69.50.401(c))
Escape 2 (RCW 9A.76.120)
Extortion 2 (RCW 9A.56.130)
Harassment (RCW 9A.46.020)
Intimidating a Public Servant (RCW 9A.76.180)
Introducing Contraband 2 (RCW 9A.76.150)
Maintaining a Dwelling or Place for Controlled Substances (RCW 69.50.402(a)(6))
Malicious Injury to Railroad Property (RCW 81.60.070)
Manufacture, deliver, or possess with intent to deliver marijuana (RCW 69.50.401(a)(1)(iii))
Manufacture, distribute, or possess with intent to distribute an imitation controlled substance (RCW 69.52.030(1))
Patronizing a Juvenile Prostitute (RCW 9.68A.100)
38 Perjury 2 (RCW 9A.72.030)
Possession of Incendiary Device (RCW 9.40.120)
Possession of Machine Gun or ShortBarreled Shotgun or Rifle (RCW 9.41.190)
Promoting Prostitution 2 (RCW 9A.88.080)
Recklessly Trafficking in Stolen Property (RCW 9A.82.050(1))
Securities Act violation (RCW 21.20.400)
Tampering with a Witness (RCW 9A.72.120)
Telephone Harassment (subsequent conviction or threat of death) (RCW 9.61.230)
Theft of Livestock 2 (RCW 9A.56.080)
Unlawful Imprisonment (RCW 9A.40.040)
Unlawful possession of firearm in the second degree (RCW 9.41.040(1)(b))
Unlawful Use of Building for Drug Purposes (RCW 69.53.010)
Vehicular Assault, by the operation or driving of a vehicle with disregard for the safety of others (RCW 46.61.522)
Willful Failure to Return from Work Release (RCW 72.65.070)
IIComputer Trespass 1 (RCW 9A.52.110)
Counterfeiting (RCW 9.16.035(3))
Create, deliver, or possess a counterfeit controlled substance (RCW 69.50.401(b))
39 Escape from Community Custody (RCW 72.09.310)
Health Care False Claims (RCW 48.80.030)
Identity Theft 2 (RCW 9.35.020(2)(b))
Improperly Obtaining Financial Information (RCW 9.35.010)
Malicious Mischief 1 (RCW 9A.48.070)
Possession of controlled substance that is either heroin or narcotics from Schedule I or II or flunitrazepam from Schedule IV (RCW 69.50.401(d))
Possession of phencyclidine (PCP) (RCW 69.50.401(d))
Possession of Stolen Property 1 (RCW 9A.56.150)
Theft 1 (RCW 9A.56.030)
Theft of Rental, Leased, or Leasepurchased Property (valued at one thousand five hundred dollars or more) (RCW 9A.56.096(4))
Trafficking in Insurance Claims (RCW 48.30A.015)
Unlawful Practice of Law (RCW 2.48.180)
Unlicensed Practice of a Profession or Business (RCW 18.130.190(7))
IAttempting to Elude a Pursuing Police Vehicle (RCW 46.61.024)
False Verification for Welfare (RCW 74.08.055)
Forged Prescription (RCW 69.41.020)
Forged Prescription for a Controlled Substance (RCW 69.50.403)
Forgery (RCW 9A.60.020)
40 Fraudulent Creation or Revocation of a Mental Health Advance Directive (section 31 of this act)
Malicious Mischief 2 (RCW 9A.48.080)
Possess Controlled Substance that is a Narcotic from Schedule III, IV, or V or Nonnarcotic from Schedule IV (except phencyclidine or flunitrazepam) (RCW 69.50.401(d))
Possession of Stolen Property 2 (RCW 9A.56.160)
Reckless Burning 1 (RCW 9A.48.040)
Taking Motor Vehicle Without Permission 2 (RCW 9A.56.070(2))
Theft 2 (RCW 9A.56.040)
Theft of Rental, Leased, or Leasepurchased Property (valued at two hundred fifty dollars or more but less than one thousand five hundred dollars) (RCW 9A.56.096(4))
Unlawful Issuance of Checks or Drafts (RCW 9A.56.060)
Unlawful Use of Food Stamps (RCW 9.91.140 (2) and (3))
Vehicle Prowl 1 (RCW 9A.52.095)
Sec. RCW 9.94A.515 and 2002 c 340 s 2, 2002 c 324 s 2, 2002 c290 s 7, 2002 c 253 s 4, 2002 c 229 s 2, 2002 c 134 s 2, and 2002 c 133s 4 are each reenacted and amended to read as follows:TABLE 2
CRIMES INCLUDED WITHINEACH SERIOUSNESS LEVEL
41 XVIAggravated Murder 1 (RCW 10.95.020)
XVHomicide by abuse (RCW 9A.32.055)
Malicious explosion 1 (RCW 70.74.280(1))
Murder 1 (RCW 9A.32.030)
XIVMurder 2 (RCW 9A.32.050)
XIIIMalicious explosion 2 (RCW 70.74.280(2))
Malicious placement of an explosive 1 (RCW 70.74.270(1))
XIIAssault 1 (RCW 9A.36.011)
Assault of a Child 1 (RCW 9A.36.120)
Malicious placement of an imitation device 1 (RCW 70.74.272(1)(a))
Rape 1 (RCW 9A.44.040)
Rape of a Child 1 (RCW 9A.44.073)
XIManslaughter 1 (RCW 9A.32.060)
Rape 2 (RCW 9A.44.050)
Rape of a Child 2 (RCW 9A.44.076)
XChild Molestation 1 (RCW 9A.44.083)
Indecent Liberties (with forcible compulsion) (RCW 9A.44.100(1)(a))
Kidnapping 1 (RCW 9A.40.020)
Leading Organized Crime (RCW 9A.82.060(1)(a))
Malicious explosion 3 (RCW 70.74.280(3))
Sexually Violent Predator Escape (RCW 9A.76.115)
IXAssault of a Child 2 (RCW 9A.36.130)
Explosive devices prohibited (RCW 70.74.180)
Hit and RunDeath (RCW 46.52.020(4)(a))
42 Homicide by Watercraft, by being under the influence of intoxicating liquor or any drug (RCW 79A.60.050)
Inciting Criminal Profiteering (RCW 9A.82.060(1)(b))
Malicious placement of an explosive 2 (RCW 70.74.270(2))
Robbery 1 (RCW 9A.56.200)
Sexual Exploitation (RCW 9.68A.040)
Vehicular Homicide, by being under the influence of intoxicating liquor or any drug (RCW 46.61.520)
VIIIArson 1 (RCW 9A.48.020)
Homicide by Watercraft, by the operation of any vessel in a reckless manner (RCW 79A.60.050)
Manslaughter 2 (RCW 9A.32.070)
Promoting Prostitution 1 (RCW 9A.88.070)
Theft of Ammonia (RCW 69.55.010)
Vehicular Homicide, by the operation of any vehicle in a reckless manner (RCW 46.61.520)
VIIBurglary 1 (RCW 9A.52.020)
Child Molestation 2 (RCW 9A.44.086)
Civil Disorder Training (RCW 9A.48.120)
Dealing in depictions of minor engaged in sexually explicit conduct (RCW 9.68A.050)
Driveby Shooting (RCW 9A.36.045)
Homicide by Watercraft, by disregard for the safety of others (RCW 79A.60.050)
43 Indecent Liberties (without forcible compulsion) (RCW 9A.44.100(1) (b) and (c))
Introducing Contraband 1 (RCW 9A.76.140)
Malicious placement of an explosive 3 (RCW 70.74.270(3))
Sending, bringing into state depictions of minor engaged in sexually explicit conduct (RCW 9.68A.060)
Unlawful Possession of a Firearm in the first degree (RCW 9.41.040(1)(a))
Use of a Machine Gun in Commission of a Felony (RCW 9.41.225)
Vehicular Homicide, by disregard for the safety of others (RCW 46.61.520)
VIBail Jumping with Murder 1 (RCW 9A.76.170(3)(a))
Bribery (RCW 9A.68.010)
Incest 1 (RCW 9A.64.020(1))
Intimidating a Judge (RCW 9A.72.160)
Intimidating a Juror/Witness (RCW 9A.72.110, 9A.72.130)
Malicious placement of an imitation device 2 (RCW 70.74.272(1)(b))
Rape of a Child 3 (RCW 9A.44.079)
Theft of a Firearm (RCW 9A.56.300)
Unlawful Storage of Ammonia (RCW 69.55.020)
VAbandonment of dependent person 1 (RCW 9A.42.060)
44 Advancing money or property for extortionate extension of credit (RCW 9A.82.030)
Bail Jumping with class A Felony (RCW 9A.76.170(3)(b))
Child Molestation 3 (RCW 9A.44.089)
Criminal Mistreatment 1 (RCW 9A.42.020)
Custodial Sexual Misconduct 1 (RCW 9A.44.160)
Domestic Violence Court Order Violation (RCW 10.99.040, 10.99.050, 26.09.300, 26.10.220, 26.26.138, 26.50.110, 26.52.070, or 74.34.145)
Extortion 1 (RCW 9A.56.120)
Extortionate Extension of Credit (RCW 9A.82.020)
Extortionate Means to Collect Extensions of Credit (RCW 9A.82.040)
Incest 2 (RCW 9A.64.020(2))
Kidnapping 2 (RCW 9A.40.030)
Perjury 1 (RCW 9A.72.020)
Persistent prison misbehavior (RCW 9.94.070)
Possession of a Stolen Firearm (RCW 9A.56.310)
Rape 3 (RCW 9A.44.060)
Rendering Criminal Assistance 1 (RCW 9A.76.070)
Sexual Misconduct with a Minor 1 (RCW 9A.44.093)
Sexually Violating Human Remains (RCW 9A.44.105)
Stalking (RCW 9A.46.110)
45 Taking Motor Vehicle Without Permission 1 (RCW 9A.56.070(1))
IVArson 2 (RCW 9A.48.030)
Assault 2 (RCW 9A.36.021)
Assault by Watercraft (RCW 79A.60.060)
Bribing a Witness/Bribe Received by Witness (RCW 9A.72.090, 9A.72.100)
Cheating 1 (RCW 9.46.1961)
Commercial Bribery (RCW 9A.68.060)
Counterfeiting (RCW 9.16.035(4))
Endangerment with a Controlled Substance (RCW 9A.42.100)
Escape 1 (RCW 9A.76.110)
Hit and RunInjury (RCW 46.52.020(4)(b))
Hit and Run with VesselInjury Accident (RCW 79A.60.200(3))
Identity Theft 1 (RCW 9.35.020(2)(a))
Indecent Exposure to Person Under Age Fourteen (subsequent sex offense) (RCW 9A.88.010)
Influencing Outcome of Sporting Event (RCW 9A.82.070)
Knowingly Trafficking in Stolen Property (RCW 9A.82.050(2))
Malicious Harassment (RCW 9A.36.080)
Residential Burglary (RCW 9A.52.025)
Robbery 2 (RCW 9A.56.210)
Theft of Livestock 1 (RCW 9A.56.080)
Threats to Bomb (RCW 9.61.160)
46 Use of Proceeds of Criminal Profiteering (RCW 9A.82.080 (1) and (2))
Vehicular Assault, by being under the influence of intoxicating liquor or any drug, or by the operation or driving of a vehicle in a reckless manner (RCW 46.61.522)
Willful Failure to Return from Furlough (RCW 72.66.060)
IIIAbandonment of dependent person 2 (RCW 9A.42.070)
Assault 3 (RCW 9A.36.031)
Assault of a Child 3 (RCW 9A.36.140)
Bail Jumping with class B or C Felony (RCW 9A.76.170(3)(c))
Burglary 2 (RCW 9A.52.030)
Communication with a Minor for Immoral Purposes (RCW 9.68A.090)
Criminal Gang Intimidation (RCW 9A.46.120)
Criminal Mistreatment 2 (RCW 9A.42.030)
Custodial Assault (RCW 9A.36.100)
Escape 2 (RCW 9A.76.120)
Extortion 2 (RCW 9A.56.130)
Harassment (RCW 9A.46.020)
Intimidating a Public Servant (RCW 9A.76.180)
Introducing Contraband 2 (RCW 9A.76.150)
Malicious Injury to Railroad Property (RCW 81.60.070)
Patronizing a Juvenile Prostitute (RCW 9.68A.100)
Perjury 2 (RCW 9A.72.030)
47 Possession of Incendiary Device (RCW 9.40.120)
Possession of Machine Gun or ShortBarreled Shotgun or Rifle (RCW 9.41.190)
Promoting Prostitution 2 (RCW 9A.88.080)
Recklessly Trafficking in Stolen Property (RCW 9A.82.050(1))
Securities Act violation (RCW 21.20.400)
Tampering with a Witness (RCW 9A.72.120)
Telephone Harassment (subsequent conviction or threat of death) (RCW 9.61.230)
Theft of Livestock 2 (RCW 9A.56.080)
Unlawful Imprisonment (RCW 9A.40.040)
Unlawful possession of firearm in the second degree (RCW 9.41.040(1)(b))
Vehicular Assault, by the operation or driving of a vehicle with disregard for the safety of others (RCW 46.61.522)
Willful Failure to Return from Work Release (RCW 72.65.070)
IIComputer Trespass 1 (RCW 9A.52.110)
Counterfeiting (RCW 9.16.035(3))
Escape from Community Custody (RCW 72.09.310)
Health Care False Claims (RCW 48.80.030)
Identity Theft 2 (RCW 9.35.020(2)(b))
48 Improperly Obtaining Financial Information (RCW 9.35.010)
Malicious Mischief 1 (RCW 9A.48.070)
Possession of Stolen Property 1 (RCW 9A.56.150)
Theft 1 (RCW 9A.56.030)
Theft of Rental, Leased, or Leasepurchased Property (valued at one thousand five hundred dollars or more) (RCW 9A.56.096(4))
Trafficking in Insurance Claims (RCW 48.30A.015)
Unlawful Practice of Law (RCW 2.48.180)
Unlicensed Practice of a Profession or Business (RCW 18.130.190(7))
IAttempting to Elude a Pursuing Police Vehicle (RCW 46.61.024)
False Verification for Welfare (RCW 74.08.055)
Forgery (RCW 9A.60.020)
Fraudulent Creation or Revocation of a Mental Health Advance Directive (section 31 of this act)
Malicious Mischief 2 (RCW 9A.48.080)
Possession of Stolen Property 2 (RCW 9A.56.160)
Reckless Burning 1 (RCW 9A.48.040)
Taking Motor Vehicle Without Permission 2 (RCW 9A.56.070(2))
Theft 2 (RCW 9A.56.040)
49 Theft of Rental, Leased, or Leasepurchased Property (valued at two hundred fifty dollars or more but less than one thousand five hundred dollars) (RCW 9A.56.096(4))
Unlawful Issuance of Checks or Drafts (RCW 9A.56.060)
Unlawful Use of Food Stamps (RCW 9.91.140 (2) and (3))
Vehicle Prowl 1 (RCW 9A.52.095)
PART VIIIMiscellaneous ProvisionsNEW SECTION.Sec. Sections 1 through 26 of this actconstitute a new chapter in Title 71 RCW.NEW SECTION.Sec. If any provision of this act or itsapplication to any person or circumstance is held invalid, theremainder of the act or the application of the provision to otherpersons or circumstances is not affected.NEW SECTION.Sec. Section 32 of this act expires July 1,2004.NEW SECTION.Sec. Section 33 of this act takes effect July 1,2004.NEW SECTION.Sec. Part headings used in this act are not anypart of the law.SSB 5223S AMD40By Senator KeiserADOPTED 03/10/2003 50 On page 1, line 1 of the title, after directives; strike theremainder of the title and insert amending RCW 11.94.010 and 7.70.065;reenacting and amending RCW 9.94A.515 and 9.94A.515; adding a newsection to chapter 11.94 RCW; adding a new section to chapter 7.70 RCW;adding a new section to chapter 9A.60 RCW; adding a new chapter toTitle 71 RCW; creating a new section; prescribing penalties; providingan effective date; and providing an expiration date.Clarifies the interaction between directives and courtorders and the interaction between sections of the bill. Eliminatessection 26, which was inaccurate. Makes technical corrections.--- END --- 51