BILL REQ. #: S-1209.1
| State of Washington | 59th Legislature | 2005 Regular Session |
Read first time 02/04/2005. Referred to Committee on Human Services & Corrections.
AN ACT Relating to the omnibus treatment of mental and substance abuse disorders act of 2005; amending RCW 71.05.020, 71.24.025, 10.77.010, 71.05.360, 71.05.215, 71.05.370, 71.05.420, 71.05.620, 71.05.630, 71.05.640, 71.05.660, 71.05.550, 74.09.010, and 71.05.157; reenacting and amending RCW 71.05.390 and 9.94A.505; adding new sections to chapter 71.05 RCW; adding new sections to chapter 70.96A RCW; adding new sections to chapter 2.28 RCW; adding a new section to chapter 26.12 RCW; adding a new section to chapter 9.94A RCW; adding new sections to chapter 74.09 RCW; adding a new section to chapter 72.23 RCW; adding new sections to chapter 71.02 RCW; adding a new section to chapter 13.34 RCW; adding a new section to chapter 71A.12 RCW; adding a new section to chapter 82.14 RCW; adding new chapters to Title 70 RCW; creating new sections; recodifying RCW 71.05.370 and 71.05.035; repealing RCW 71.05.060, 71.05.070, 71.05.090, 71.05.200, 71.05.250, 71.05.450, 71.05.460, 71.05.470, 71.05.480, 71.05.490, 71.05.050, 71.05.395, 71.05.400, 71.05.410, 71.05.430, 71.05.610, 71.05.650, and 71.05.670; prescribing penalties; making an appropriation; providing effective dates; providing an expiration date; and declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 101 The legislature finds that persons with
mental disorders, chemical dependency disorders, or co-occurring mental
and substance abuse disorders are disproportionately more likely to be
confined in a correctional institution, become homeless, become
involved with child protective services or involved in a dependency
proceeding, or lose those state and federal benefits to which they may
be entitled as a result of their disorders. The legislature finds that
prior state policy of addressing mental health and chemical dependency
in isolation from each other has not been cost-effective and has often
resulted in longer-term, more costly treatment that may be less
effective over time. The legislature finds that a substantial number
of persons have co-occurring mental and substance abuse disorders and
that identification and integrated treatment of co-occurring disorders
is critical to successful outcomes and recovery. Consequently, the
legislature intends to:
(1) Establish a process for determining which persons with mental
disorders and substance abuse disorders have co-occurring disorders;
(2) Reduce the gap between available chemical dependency treatment
and the documented need for treatment;
(3) Improve treatment outcomes by shifting treatment, where
possible to evidence-based, research-based, and consensus-based
treatment practices and by removing barriers to the use of those
practices;
(4) Expand the authority for and use of therapeutic courts
including drug courts, mental health courts, and family therapeutic
courts;
(5) Improve access to treatment for persons who are not enrolled in
medicaid by improving and creating consistency in the application
processes, and by ending the practice of early termination of
eligibility of confined persons;
(6) Improve access to inpatient treatment by creating expanded
services facilities for persons needing intensive treatment in a secure
setting who do not need inpatient care, but are unable to access
treatment under current licensing restrictions in other settings;
(7) Establish secure detoxification centers for persons
involuntarily detained as gravely disabled or presenting a likelihood
of serious harm due to chemical dependency and authorize combined
crisis responders for both mental disorders and chemical dependency
disorders on a pilot basis and study the outcomes;
(8) Following the receipt of outcomes from the pilot programs in
subsection (7) of this section, implement a single, comprehensive,
involuntary treatment act with a unified set of standards, rights,
obligations, and procedures for adults and children with mental
disorders, chemical dependency disorders, and co-occurring disorders;
(9) Slow or stop the loss of inpatient and intensive residential
beds and children's long-term inpatient placements and refine the
balance of state hospital and community inpatient and residential beds;
(10) Improve cross-system collaboration including collaboration
with first responders and hospital emergency rooms, schools, primary
care, developmental disabilities, law enforcement and corrections, and
federally funded and licensed programs including, but not limited to,
federally qualified health centers; and
(11) Amend existing state law to address organizational and
structural barriers to effective use of state funds for treating
persons with mental and substance abuse disorders, minimize internal
inconsistencies, clarify policy and requirements, and maximize the
opportunity for effective and cost-effective outcomes.
NEW SECTION. Sec. 102 (1) The department of social and health
services shall explore and report to the appropriate committees of the
legislature by December 1, 2005, on the feasibility, costs, benefits,
and time frame to access federal medicaid funds for mental health and
substance abuse treatment under the following provisions:
(a) The optional clinic provisions;
(b) Children's mental health treatment or co-occurring disorders
treatment under the EPSDT provisions;
(c) Targeted case management, including a plan for coordination of
various case management opportunities under medicaid.
(2) The department shall provide the appropriate committees of the
legislature with a clear and concise explanation of the reasons for
reducing state hospital capacity and the differences in costs and
benefits of treatment in state and community hospital treatment.
(3) The department may not reduce the capacity of either state
hospital until at least an equal number of skilled nursing,
residential, expanded services facility, or supported housing
placements are available in the community to the persons displaced by
the capacity reduction. The department shall retain sufficient
capacity at the state hospital to address the cyclical need for
hospitalization for persons moved to the community under a bed
reduction program. For purposes of this section, "sufficient" means
not less than one hospital bed for every ten beds created in the
community unless the department can demonstrate conclusively to the
legislature that a lesser ratio is sufficient.
NEW SECTION. Sec. 103 A new section is added to chapter 71.05
RCW to read as follows:
(1) Not later than July 1, 2006, all persons providing treatment
under this chapter shall use the integrated comprehensive screening
process for chemical dependency and mental disorders adopted pursuant
to section 701 of this act and shall document the numbers of clients
with co-occurring mental and substance abuse disorders based on a
quadrant system of low and high needs.
(2) Not later than January 1, 2007, all persons providing treatment
under this chapter shall also implement the integrated comprehensive
assessment process for chemical dependency and mental disorders adopted
pursuant to section 701 of this act and shall document the numbers of
clients with co-occurring mental and substance abuse disorders based on
a quadrant system of low and high needs.
(3) Treatment providers and regional support networks who fail to
implement the integrated comprehensive screening and assessment process
for chemical dependency and mental disorders by July 1, 2007, shall be
subject to contractual penalties established under section 701 of this
act.
Sec. 104 RCW 71.05.020 and 2000 c 94 s 1 are each amended to read
as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Admission" or "admit" means a decision by a physician that a
person should be examined or treated as a patient in a hospital;
(2) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes, but is not limited to atypical
antipsychotic medications;
(3) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient;
(4) "Commitment" means the determination by a court that a person
should be detained for a period of either evaluation or treatment, or
both, in an inpatient or a less restrictive setting;
(5) "Conditional release" means a revocable modification of a
commitment, which may be revoked upon violation of any of its terms;
(6) "County designated mental health professional" means a mental
health professional appointed by the county or the regional support
network to perform the duties specified in this chapter;
(7) "Custody" means involuntary detention under the provisions of
this chapter or chapter 10.77 RCW, uninterrupted by any period of
unconditional release from commitment from a facility providing
involuntary care and treatment;
(8) "Department" means the department of social and health
services;
(9) "Designated chemical dependency specialist" means a person
designated by the county alcoholism and other drug addiction program
coordinator designated under RCW 70.96A.310 to perform the commitment
duties described in chapter 70.96A RCW and sections 202 through 216 of
this act;
(10) "Designated crisis responder" means a mental health
professional appointed by the county or the regional support network to
perform the duties specified in this chapter;
(11) "Detention" or "detain" means the lawful confinement of a
person, under the provisions of this chapter;
(((10))) (12) "Developmental disabilities professional" means a
person who has specialized training and three years of experience in
directly treating or working with persons with developmental
disabilities and is a psychiatrist, psychologist, or social worker, and
such other developmental disabilities professionals as may be defined
by rules adopted by the secretary;
(((11))) (13) "Developmental disability" means that condition
defined in RCW 71A.10.020(3);
(((12))) (14) "Discharge" means the termination of hospital medical
authority. The commitment may remain in place, be terminated, or be
amended by court order;
(((13))) (15) "Evaluation and treatment facility" means any
facility which can provide directly, or by direct arrangement with
other public or private agencies, emergency evaluation and treatment,
outpatient care, and timely and appropriate inpatient care to persons
suffering from a mental disorder, and which is certified as such by the
department. A physically separate and separately operated portion of
a state hospital may be designated as an evaluation and treatment
facility. A facility which is part of, or operated by, the department
or any federal agency will not require certification. No correctional
institution or facility, or jail, shall be an evaluation and treatment
facility within the meaning of this chapter;
(((14))) (16) "Gravely disabled" means a condition in which a
person, as a result of a mental disorder: (a) Is in danger of serious
physical harm resulting from a failure to provide for his or her
essential human needs of health or safety; or (b) manifests severe
deterioration in routine functioning evidenced by repeated and
escalating loss of cognitive or volitional control over his or her
actions and is not receiving such care as is essential for his or her
health or safety;
(((15))) (17) "Habilitative services" means those services provided
by program personnel to assist persons in acquiring and maintaining
life skills and in raising their levels of physical, mental, social,
and vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the individual being assisted as manifested by prior
charged criminal conduct;
(((16))) (18) "History of one or more violent acts" refers to the
period of time ten years prior to the filing of a petition under this
chapter, excluding any time spent, but not any violent acts committed,
in a mental health facility or in confinement as a result of a criminal
conviction;
(((17))) (19) "Individualized service plan" means a plan prepared
by a developmental disabilities professional with other professionals
as a team, for an individual with developmental disabilities, which
shall state:
(a) The nature of the person's specific problems, prior charged
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
(e) The staff responsible for carrying out the plan;
(f) Where relevant in light of past criminal behavior and due
consideration for public safety, the criteria for proposed movement to
less-restrictive settings, criteria for proposed eventual discharge or
release, and a projected possible date for discharge or release; and
(g) The type of residence immediately anticipated for the person
and possible future types of residences;
(((18))) (20) "Judicial commitment" means a commitment by a court
pursuant to the provisions of this chapter;
(((19))) (21) "Likelihood of serious harm" means:
(a) A substantial risk that: (i) Physical harm will be inflicted
by an individual upon his or her own person, as evidenced by threats or
attempts to commit suicide or inflict physical harm on oneself; (ii)
physical harm will be inflicted by an individual upon another, as
evidenced by behavior which has caused such harm or which places
another person or persons in reasonable fear of sustaining such harm;
or (iii) physical harm will be inflicted by an individual upon the
property of others, as evidenced by behavior which has caused
substantial loss or damage to the property of others; or
(b) The individual has threatened the physical safety of another
and has a history of one or more violent acts;
(((20))) (22) "Mental disorder" means any organic, mental, or
emotional impairment which has substantial adverse effects on an
individual's cognitive or volitional functions;
(((21))) (23) "Mental health professional" means a psychiatrist,
psychologist, psychiatric nurse, or social worker, and such other
mental health professionals as may be defined by rules adopted by the
secretary pursuant to the provisions of this chapter;
(((22))) (24) "Peace officer" means a law enforcement official of
a public agency or governmental unit, and includes persons specifically
given peace officer powers by any state law, local ordinance, or
judicial order of appointment;
(((23))) (25) "Private agency" means any person, partnership,
corporation, or association that is not a public agency, whether or not
financed in whole or in part by public funds, which constitutes an
evaluation and treatment facility or private institution, hospital, or
sanitarium, which is conducted for, or includes a department or ward
conducted for, the care and treatment of persons who are mentally ill;
(((24))) (26) "Professional person" means a mental health
professional and shall also mean a physician, registered nurse, and
such others as may be defined by rules adopted by the secretary
pursuant to the provisions of this chapter;
(((25))) (27) "Psychiatrist" means a person having a license as a
physician and surgeon in this state who has in addition completed three
years of graduate training in psychiatry in a program approved by the
American medical association or the American osteopathic association
and is certified or eligible to be certified by the American board of
psychiatry and neurology;
(((26))) (28) "Psychologist" means a person who has been licensed
as a psychologist pursuant to chapter 18.83 RCW;
(((27))) (29) "Public agency" means any evaluation and treatment
facility or institution, hospital, or sanitarium which is conducted
for, or includes a department or ward conducted for, the care and
treatment of persons who are mentally ill((;[,])), if the agency is
operated directly by, federal, state, county, or municipal government,
or a combination of such governments;
(((28))) (30) "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 individuals who are receiving or who at any
time have received services for mental illness.
(31) "Release" means legal termination of the commitment under the
provisions of this chapter;
(((29))) (32) "Resource management services" has the meaning given
in chapter 71.24 RCW;
(((30))) (33) "Secretary" means the secretary of the department of
social and health services, or his or her designee;
(((31))) (34) "Social worker" means a person with a master's or
further advanced degree from an accredited school of social work or a
degree deemed equivalent under rules adopted by the secretary;
(((32))) (35) "Treatment records" include registration and all
other records concerning individuals 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 an individual providing
treatment services for the department, regional support networks, or a
treatment facility if the notes or records are not available to others.
(36) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
Sec. 105 RCW 71.24.025 and 2001 c 323 s 8 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 under RCW 71.24.045,
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, except as negotiated
according to RCW 71.24.300(1)(e).
(3) "Child" means a person under the age of eighteen years.
(4) "Chronically mentally ill adult" 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) "Community mental health program" means all mental health
services, activities, or programs using available resources.
(6) "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.
(7) "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 mentally ill persons 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 acutely mentally ill and severely
emotionally disturbed children 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, and other services determined by regional support networks.
(8) "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.
(9) "Department" means the department of social and health
services.
(10) "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
individuals licensed under chapter 18.57, 18.71, 18.83, or 18.79 RCW,
as it applies to registered nurses and advanced registered nurse
practitioners.
(11) "Mental health services" means all services provided by
regional support networks and other services provided by the state for
the mentally ill.
(12) "Mentally ill persons" and "the mentally ill" mean persons and
conditions defined in subsections (1), (4), (((17), and)) (18), and
(19) of this section.
(13) "Regional support network" means a county authority or group
of county authorities recognized by the secretary that enter into joint
operating agreements to contract with the secretary pursuant to this
chapter.
(14) "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 individuals who are receiving or who at any
time have received services for mental illness.
(15) "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 acutely mentally ill persons, chronically
mentally ill adults, severely emotionally disturbed children, or
seriously disturbed adults 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 mentally ill persons in nursing homes. 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.
(((15))) (16) "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) Acutely mentally ill adults and children; (b) chronically
mentally ill adults; (c) severely emotionally disturbed children; or
(d) seriously disturbed adults 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 mentally ill adults' and
children's enrollment in services and their individual service plan to
county-designated mental health professionals, evaluation and treatment
facilities, and others as determined by the regional support network.
(((16))) (17) "Secretary" means the secretary of social and health
services.
(((17))) (18) "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.
(((18))) (19) "Severely emotionally disturbed child" 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 mentally ill or
inadequate caretaker;
(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.
(((19))) (20) "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.
(((20))) (21) "Treatment records" include registration and all
other records concerning individuals 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 an individual providing
treatment services for the department, regional support networks, or a
treatment facility if the notes or records are not available to others.
(22) "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.
Sec. 106 RCW 10.77.010 and 2004 c 157 s 2 are each amended to
read as follows:
As used in this chapter:
(1) "Admission" means acceptance based on medical necessity, of a
person as a patient.
(2) "Commitment" means the determination by a court that a person
should be detained for a period of either evaluation or treatment, or
both, in an inpatient or a less-restrictive setting.
(3) "Conditional release" means modification of a court-ordered
commitment, which may be revoked upon violation of any of its terms.
(4) "County designated mental health professional" has the same
meaning as provided in RCW 71.05.020.
(5) A "criminally insane" person means any person who has been
acquitted of a crime charged by reason of insanity, and thereupon found
to be a substantial danger to other persons or to present a substantial
likelihood of committing criminal acts jeopardizing public safety or
security unless kept under further control by the court or other
persons or institutions.
(6) "Department" means the state department of social and health
services.
(7) "Detention" or "detain" means the lawful confinement of a
person, under the provisions of this chapter, pending evaluation.
(8) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with persons with developmental disabilities and is
a psychiatrist or psychologist, or a social worker, and such other
developmental disabilities professionals as may be defined by rules
adopted by the secretary.
(9) "Developmental disability" means the condition as defined in
RCW 71A.10.020(3).
(10) "Discharge" means the termination of hospital medical
authority. The commitment may remain in place, be terminated, or be
amended by court order.
(11) "Furlough" means an authorized leave of absence for a resident
of a state institution operated by the department designated for the
custody, care, and treatment of the criminally insane, consistent with
an order of conditional release from the court under this chapter,
without any requirement that the resident be accompanied by, or be in
the custody of, any law enforcement or institutional staff, while on
such unescorted leave.
(12) "Habilitative services" means those services provided by
program personnel to assist persons in acquiring and maintaining life
skills and in raising their levels of physical, mental, social, and
vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the individual being assisted as manifested by prior
charged criminal conduct.
(13) "History of one or more violent acts" means violent acts
committed during: (a) The ten-year period of time prior to the filing
of criminal charges; plus (b) the amount of time equal to time spent
during the ten-year period in a mental health facility or in
confinement as a result of a criminal conviction.
(14) "Incompetency" means a person lacks the capacity to understand
the nature of the proceedings against him or her or to assist in his or
her own defense as a result of mental disease or defect.
(15) "Indigent" means any person who is financially unable to
obtain counsel or other necessary expert or professional services
without causing substantial hardship to the person or his or her
family.
(16) "Individualized service plan" means a plan prepared by a
developmental disabilities professional with other professionals as a
team, for an individual with developmental disabilities, which shall
state:
(a) The nature of the person's specific problems, prior charged
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
(e) The staff responsible for carrying out the plan;
(f) Where relevant in light of past criminal behavior and due
consideration for public safety, the criteria for proposed movement to
less-restrictive settings, criteria for proposed eventual release, and
a projected possible date for release; and
(g) The type of residence immediately anticipated for the person
and possible future types of residences.
(17) "Professional person" means:
(a) A psychiatrist licensed as a physician and surgeon in this
state who has, in addition, completed three years of graduate training
in psychiatry in a program approved by the American medical association
or the American osteopathic association and is certified or eligible to
be certified by the American board of psychiatry and neurology or the
American osteopathic board of neurology and psychiatry;
(b) A psychologist licensed as a psychologist pursuant to chapter
18.83 RCW; or
(c) A social worker with a master's or further advanced degree from
an accredited school of social work or a degree deemed equivalent under
rules adopted by the secretary.
(18) "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 individuals who are receiving or who at any
time have received services for mental illness.
(19) "Release" means legal termination of the court-ordered
commitment under the provisions of this chapter.
(((19))) (20) "Secretary" means the secretary of the department of
social and health services or his or her designee.
(((20))) (21) "Treatment" means any currently standardized medical
or mental health procedure including medication.
(((21))) (22) "Treatment records" include registration and all
other records concerning individuals 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 an individual providing
treatment services for the department, regional support networks, or a
treatment facility if the notes or records are not available to others.
(23) "Violent act" means behavior that: (a)(i) Resulted in; (ii)
if completed as intended would have resulted in; or (iii) was
threatened to be carried out by a person who had the intent and
opportunity to carry out the threat and would have resulted in,
homicide, nonfatal injuries, or substantial damage to property; or (b)
recklessly creates an immediate risk of serious physical injury to
another person. As used in this subsection, "nonfatal injuries" means
physical pain or injury, illness, or an impairment of physical
condition. "Nonfatal injuries" shall be construed to be consistent
with the definition of "bodily injury," as defined in RCW 9A.04.110.
Sec. 107 RCW 71.05.360 and 1997 c 112 s 30 are each amended to
read as follows:
(1)(a) Every person involuntarily detained or committed under the
provisions of this chapter shall be entitled to all the rights set
forth in this chapter and shall retain all rights not denied him or her
under this chapter except as chapter 9.41 RCW may limit the right of a
person to purchase or possess a firearm or to qualify for a concealed
pistol license.
(b) No person shall be presumed incompetent as a consequence of
receiving an evaluation or voluntary or involuntary treatment for a
mental disorder, under this chapter or any prior laws of this state
dealing with mental illness. Competency shall not be determined or
withdrawn except under the provisions of chapter 10.97 or 11.88 RCW.
(c) Any person who leaves a public or private agency following
evaluation or treatment for mental disorder shall be given a written
statement setting forth the substance of this section.
(2) Each person involuntarily detained or committed pursuant to
this chapter shall have the right to adequate care and individualized
treatment.
(3) The provisions of this chapter shall not be construed to deny
to any person treatment by spiritual means through prayer in accordance
with the tenets and practices of a church or religious denomination.
(4) Persons receiving evaluation or treatment under this chapter
shall be given a reasonable choice of an available physician or other
professional person qualified to provide such services.
(5) Whenever any person is detained for evaluation and treatment
pursuant to this chapter, both the person and, if possible, a
responsible member of his or her immediate family, guardian, or
conservator, if any, shall be advised as soon as possible in writing or
orally, by the officer or person taking him or her into custody or by
personnel of the evaluation and treatment facility where the person is
detained that unless the person is released or voluntarily admits
himself or herself for treatment within seventy-two hours of the
initial detention:
(a) A judicial hearing in a superior court, either by a judge or
court commissioner thereof, shall be held not more than seventy-two
hours after the initial detention to determine whether there is
probable cause to detain the person after the seventy-two hours have
expired for up to an additional fourteen days without further automatic
hearing for the reason that the person is a mentally ill person whose
mental disorder presents a likelihood of serious harm or that the
person is gravely disabled;
(b) The person has a right to communicate immediately with an
attorney; has a right to have an attorney appointed to represent him or
her before and at the probable cause hearing if he or she is indigent;
and has the right to be told the name and address of the attorney the
mental health professional has designated pursuant to this chapter;
(c) The person has the right to remain silent and that any
statement he or she makes may be used against him or her;
(d) The person has the right to present evidence and to cross-examine witnesses who testify against him or her at the probable cause
hearing; and
(e) The person has the right to refuse psychiatric medications,
including antipsychotic medication beginning twenty-four hours prior to
the probable cause hearing.
(6) When proceedings are initiated under section 323 (2), (3), or
(4)(b) of this act, no later than twelve hours after such person is
admitted to the evaluation and treatment facility the personnel of the
evaluation and treatment facility or the county designated mental
health professional shall serve on such person a copy of the petition
for initial detention and the name, business address, and phone number
of the designated attorney and shall forthwith commence service of a
copy of the petition for initial detention on the designated attorney.
(7) The judicial hearing described in subsection (5) of this
section is hereby authorized, and shall be held according to the
provisions of subsection (5) of this section and rules promulgated by
the supreme court.
(8) At the probable cause hearing the detained person shall have
the following rights in addition to the rights previously specified:
(a) To present evidence on his or her behalf;
(b) To cross-examine witnesses who testify against him or her;
(c) To be proceeded against by the rules of evidence;
(d) To remain silent;
(e) To view and copy all petitions and reports in the court file.
(9) The physician-patient privilege or the psychologist-client
privilege shall be deemed waived in proceedings under this chapter
relating to the administration of antipsychotic medications. As to
other proceedings under this chapter, the privileges shall be waived
when a court of competent jurisdiction in its discretion determines
that such waiver is necessary to protect either the detained person or
the public.
The waiver of a privilege under this section is limited to records
or testimony relevant to evaluation of the detained person for purposes
of a proceeding under this chapter. Upon motion by the detained person
or on its own motion, the court shall examine a record or testimony
sought by a petitioner to determine whether it is within the scope of
the waiver.
The record maker shall not be required to testify in order to
introduce medical or psychological records of the detained person so
long as the requirements of RCW 5.45.020 are met except that portions
of the record which contain opinions as to the detained person's mental
state must be deleted from such records unless the person making such
conclusions is available for cross-examination.
(10) Insofar as danger to the individual or others is not created,
each person involuntarily detained, treated in a less restrictive
alternative course of treatment, or committed for treatment and
evaluation pursuant to this chapter shall have, in addition to other
rights not specifically withheld by law, the following rights, a list
of which shall be prominently posted in all facilities, institutions,
and hospitals providing such services:
(a) To wear his or her own clothes and to keep and use his or her
own personal possessions, except when deprivation of same is essential
to protect the safety of the resident or other persons;
(b) To keep and be allowed to spend a reasonable sum of his or her
own money for canteen expenses and small purchases;
(c) To have access to individual storage space for his or her
private use;
(d) To have visitors at reasonable times;
(e) To have reasonable access to a telephone, both to make and
receive confidential calls, consistent with an effective treatment
program;
(f) To have ready access to letter writing materials, including
stamps, and to send and receive uncensored correspondence through the
mails;
(g) Not to consent to the administration of antipsychotic
medications and not to thereafter be administered antipsychotic
medications unless ordered by a court under RCW 71.05.370 or pursuant
to an administrative hearing under RCW 71.05.215;
(h) Not to consent to the performance of electroconvulsant therapy
or surgery, except emergency life-saving surgery, unless ordered under
RCW 71.05.370;
(i) To dispose of property and sign contracts unless such person
has been adjudicated an incompetent in a court proceeding directed to
that particular issue;
(j) Not to have psychosurgery performed on him or her under any
circumstances.
(11) Every person involuntarily detained shall immediately be
informed of his or her right to a hearing to review the legality of his
or her detention and of his or her right to counsel, by the
professional person in charge of the facility providing evaluation and
treatment, or his or her designee, and, when appropriate, by the court.
If the person so elects, the court shall immediately appoint an
attorney to assist him or her.
(12) A person challenging his or her detention or his or her
attorney, shall have the right to designate and have the court appoint
a reasonably available independent physician or licensed mental health
professional to examine the person detained, the results of which
examination may be used in the proceeding. The person shall, if he or
she is financially able, bear the cost of such expert information,
otherwise such expert examination shall be at public expense.
(13) Nothing contained in this chapter shall prohibit the patient
from petitioning by writ of habeas corpus for release.
(14) Nothing in this chapter shall prohibit a person committed on
or prior to January 1, 1974, from exercising a right available to him
or her at or prior to January 1, 1974, for obtaining release from
confinement.
Sec. 108 RCW 71.05.215 and 1997 c 112 s 16 are each amended to
read as follows:
(1) A person ((found to be)) who is gravely disabled or presents a
likelihood of serious harm as a result of a mental or chemical
dependency disorder or co-occurring mental and chemical dependency
disorders has a right to refuse antipsychotic medication unless it is
determined that the failure to medicate may result in a likelihood of
serious harm or substantial deterioration or substantially prolong the
length of involuntary commitment and there is no less intrusive course
of treatment than medication in the best interest of that person.
(2) ((The department shall adopt rules to carry out the purposes of
this chapter. These rules shall include:))
The physician must attempt to obtain the informed consent of an
involuntary committed person prior to administration of antipsychotic
medication and document the attempt to obtain consent in the person's
medical record with the reasons that antipsychotic medication is
necessary.
(a) An attempt to obtain the informed consent of the person prior
to administration of antipsychotic medication.
(b) For short-term treatment up to thirty days, the right to refuse
antipsychotic medications unless there is an additional concurring
medical opinion approving medication.
(c) For continued treatment beyond thirty days through the hearing
on any petition filed under RCW 71.05.370(7), the right to periodic
review of the decision to medicate by the medical director or designee.
(d) Administration of antipsychotic medication in an emergency and
review of this decision within twenty-four hours. An emergency exists
if the person presents an imminent likelihood of serious harm, and
medically acceptable alternatives to administration of antipsychotic
medications are not available or are unlikely to be successful; and in
the opinion of the physician, the person's condition constitutes an
emergency requiring the treatment be instituted prior to obtaining a
second medical opinion.
(e) Documentation in the medical record of the physician's attempt
to obtain informed consent and the reasons why antipsychotic medication
is being administered over the person's objection or lack of consent.
(3) If an involuntary committed person refuses antipsychotic
medications, the medications may not be administered unless the person
has first had a hearing by a panel composed of a psychologist,
psychiatrist, and the medical director of the facility, none of whom
may be involved in the person's treatment at the time of the hearing.
(4) If a majority of the panel determines that there is clear,
cogent, and convincing evidence demonstrating that treatment with
antipsychotic medications is medically appropriate, that failure to
medicate may result in a likelihood of serious harm or substantial
deterioration or substantially prolong the length of involuntary
commitment, and that there is no less intrusive course of treatment
than medication in the best interest of that person, the person may be
medicated, subject to the provisions of subsections (5) through (7) of
this section.
(5) Medication ordered pursuant to a decision of the panel may only
be continued on an involuntary basis if the panel conducts a second
hearing on the written record and a majority of the panel determines
that there continues to be clear, cogent, and convincing evidence
demonstrating that treatment with antipsychotic medications continues
to be medically appropriate, that failure to medicate may result in a
likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment, and that
there is no less intrusive course of treatment than medication in the
best interest of that person.
(a) Following the second hearing, involuntary medication with
antipsychotic medication may be continued if the treating psychiatrist
certifies, not less than every fourteen days, that the medication
continues to be medically appropriate and failure to medicate may
result in a likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment, and that
there is no less intrusive course of treatment than medication in the
best interest of that person.
(b) No administrative order for involuntary medication may be
continued beyond one hundred eighty days, or the next commitment
proceeding in the superior court, whichever comes first.
(6) The committed person may appeal the panel's decision to the
medical director within twenty-four hours and the medical director must
decide the appeal within twenty-four hours of receipt.
(7) The committed person may seek judicial review of the medical
director's decision at the next commitment proceeding or by means of an
extraordinary writ.
(8) Minutes of the hearing shall be kept and a copy shall be
provided to the committed person.
(9) With regard to the involuntary medication hearing, the
committed person has the right:
(a) To notice at least twenty-four hours in advance of the hearing
that includes the intent to convene the hearing, the tentative
diagnosis and the factual basis for the diagnosis, and why the staff
believes that medication is necessary;
(b) Not to be medicated between the delivery of the notice and the
hearing;
(c) To attend the hearing;
(d) To present evidence, including witnesses, and to cross-examine
witnesses, including staff;
(e) To the assistance of a lay assistant, who is not involved in
the case and who understands psychiatric issues;
(f) To receive a copy of the minutes of the hearing; and
(g) To appeal the panel's decision to the medical director.
Sec. 109 RCW 71.05.370 and 1997 c 112 s 31 are each amended to
read as follows:
((Insofar as danger to the individual or others is not created,
each person involuntarily detained, treated in a less restrictive
alternative course of treatment, or committed for treatment and
evaluation pursuant to this chapter shall have, in addition to other
rights not specifically withheld by law, the following rights, a list
of which shall be prominently posted in all facilities, institutions,
and hospitals providing such services:)) (1) A court of competent jurisdiction may order that a
person involuntarily detained, or committed for inpatient treatment and
evaluation or to treatment in a less restrictive alternative pursuant
to this chapter be administered antipsychotic medications or the
performance of electroconvulsant therapy or surgery pursuant to the
following standards and procedures:
(1) To wear his or her own clothes and to keep and use his or her
own personal possessions, except when deprivation of same is essential
to protect the safety of the resident or other persons;
(2) To keep and be allowed to spend a reasonable sum of his or her
own money for canteen expenses and small purchases;
(3) To have access to individual storage space for his or her
private use;
(4) To have visitors at reasonable times;
(5) To have reasonable access to a telephone, both to make and
receive confidential calls;
(6) To have ready access to letter writing materials, including
stamps, and to send and receive uncensored correspondence through the
mails;
(7) Not to consent to the administration of antipsychotic
medications beyond the hearing conducted pursuant to RCW 71.05.320(2)
or the performance of electroconvulsant therapy or surgery, except
emergency life-saving surgery, unless ordered by a court of competent
jurisdiction
(a) The administration of antipsychotic medication or
electroconvulsant therapy shall not be ordered by the court unless the
petitioning party proves by clear, cogent, and convincing evidence that
((there exists a compelling state interest that justifies overriding
the patient's lack of consent to the administration of antipsychotic
medications or electroconvulsant therapy, that the proposed treatment
is necessary and effective, and that medically acceptable alternative
forms of treatment are not available, have not been successful, or are
not likely to be effective)) treatment with antipsychotic medications
is medically appropriate, that failure to medicate may result in a
likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment, and that
there is no less intrusive course of treatment than medication or
electroconvulsive therapy in the best interest of the person.
(b) The court shall make specific findings of fact concerning: (i)
The existence of ((one or more compelling state interests)) the
likelihood of serious harm or substantial deterioration or
substantially prolonging the length of involuntary commitment; (ii) the
necessity and effectiveness of the treatment; ((and)) (iii) the
person's desires regarding the proposed treatment; and (iv) the best
interests of the person. If the ((patient)) person is unable to make
a rational and informed decision about consenting to or refusing the
proposed ((treatment)) electroconvulsive therapy, the court shall make
a substituted judgment for the patient as if he or she were competent
to make such a determination.
(c) The person shall be present at any hearing on a request to
administer antipsychotic medication or electroconvulsant therapy filed
pursuant to this ((subsection)) section. The person has the right:
(i) To be represented by an attorney;
(ii) To present evidence;
(iii) To cross-examine witnesses;
(iv) To have the rules of evidence enforced;
(v) To remain silent;
(vi) To view and copy all petitions and reports in the court file;
and
(vii) To be given reasonable notice and an opportunity to prepare
for the hearing.
(d) The court may appoint a psychiatrist, psychologist within their
scope of practice, or physician to examine and testify on behalf of
such person. The court shall appoint a psychiatrist, psychologist
within their scope of practice, or physician designated by such person
or the person's counsel to testify on behalf of the person in cases
where an order for electroconvulsant therapy is sought.
(((d))) (e) An order for the administration of antipsychotic
medications entered following a hearing conducted pursuant to this
section shall be effective for the period of the current involuntary
treatment order, and any interim period during which the person is
awaiting trial or hearing on a new petition for involuntary treatment
or involuntary medication.
(((e))) (2) Any person detained pursuant to RCW 71.05.320(2), who
subsequently refuses antipsychotic medication, shall be entitled to the
procedures set forth in ((RCW 71.05.370(7))) subsection (1) of this
section.
(((f))) (3) Antipsychotic medication may be administered to a
nonconsenting person detained or committed pursuant to this chapter
without a court order:
(a) Pursuant to RCW 71.05.215(2); or
(b) Under the following circumstances:
(i) A person presents an imminent likelihood of serious harm;
(ii) Medically acceptable alternatives to administration of
antipsychotic medications are not available, have not been successful,
or are not likely to be effective; and
(iii) In the opinion of the physician with responsibility for
treatment of the person, or his or her designee, the person's condition
constitutes an emergency requiring the treatment be instituted before
a judicial hearing as authorized pursuant to this section can be held.
If antipsychotic medications are administered over a person's lack
of consent pursuant to (b) of this subsection, a petition for an order
authorizing the administration of antipsychotic medications shall be
filed on the next judicial day. The hearing shall be held within two
judicial days. If deemed necessary by the physician with
responsibility for the treatment of the person, administration of
antipsychotic medications may continue until the hearing is held;
(((8) To dispose of property and sign contracts unless such person
has been adjudicated an incompetent in a court proceeding directed to
that particular issue;)) (4) No court has the authority to order
psychosurgery performed on ((
(9) Not to havehim or her)) any person involuntarily
detained, treated in a less restrictive alternative course of
treatment, or committed for treatment and evaluation pursuant to this
chapter under any circumstances.
NEW SECTION. Sec. 110 RCW 71.05.370 is recodified as a new
section in chapter 71.05 RCW to be codified in proximity to RCW
71.05.215.
Sec. 111 RCW 71.05.390 and 2004 c 166 s 6, 2004 c 157 s 5, and
2004 c 33 s 2 are each reenacted and amended to read as follows:
Except as provided in this section, RCW 71.05.445, 71.05.630,
70.96A.150, or pursuant to a valid release under RCW 70.02.030, the
fact of admission and all information and records compiled, obtained,
or maintained in the course of providing services to either voluntary
or involuntary recipients of services at public or private agencies
shall be confidential.
Information and records may be disclosed only:
(1) In communications between qualified professional persons to
meet the requirements of this chapter, in the provision of services or
appropriate referrals, or in the course of guardianship proceedings.
The consent of the patient, or his or her guardian, shall be obtained
before information or records may be disclosed by a professional person
employed by a facility unless provided to a professional person:
(a) Employed by the facility;
(b) Who has medical responsibility for the patient's care;
(c) Who is a county designated mental health professional;
(d) Who is providing services under chapter 71.24 RCW;
(e) Who is employed by a state or local correctional facility where
the person is confined or supervised; or
(f) Who is providing evaluation, treatment, or follow-up services
under chapter 10.77 RCW.
(2) When the communications regard the special needs of a patient
and the necessary circumstances giving rise to such needs and the
disclosure is made by a facility providing outpatient services to the
operator of a care facility in which the patient resides.
(3)(a) When the person receiving services, or his or her guardian,
designates persons to whom information or records may be released, or
if the person is a minor, when his or her parents make such
designation.
(b) A public or private agency shall release to a patient's next of
kin, attorney, guardian, or conservator, if any:
(i) The information that the person is presently a patient in the
facility or that the person is seriously physically ill;
(ii) A statement evaluating the mental and physical condition of
the patient, and a statement of the probable duration of the patient's
confinement, if such information is requested by the next of kin,
attorney, guardian, or conservator; and
(iii) Such other information requested by the next of kin or
attorney as may be necessary to decide whether or not proceedings
should be instituted to appoint a guardian or conservator.
(4) To the extent necessary for a recipient to make a claim, or for
a claim to be made on behalf of a recipient for aid, insurance, or
medical assistance to which he or she may be entitled.
(5)(a) For either program evaluation or research, or both:
PROVIDED, That the secretary adopts rules for the conduct of the
evaluation or research, or both. Such rules shall include, but need
not be limited to, the requirement that all evaluators and researchers
must sign an oath of confidentiality substantially as follows:
"As a condition of conducting evaluation or research concerning
persons who have received services from (fill in the facility, agency,
or person) I, . . . . . . . . ., agree not to divulge, publish, or
otherwise make known to unauthorized persons or the public any
information obtained in the course of such evaluation or research
regarding persons who have received services such that the person who
received such services is identifiable.
I recognize that unauthorized release of confidential information
may subject me to civil liability under the provisions of state law.
| /s/ . . . . . . . . . . . . " |
Sec. 112 RCW 71.05.420 and 1990 c 3 s 113 are each amended to
read as follows:
Except as provided in RCW 71.05.425, when any disclosure of
information or records is made as authorized by RCW 71.05.390 ((through
71.05.410)), the physician in charge of the patient or the professional
person in charge of the facility shall promptly cause to be entered
into the patient's medical record the date and circumstances under
which said disclosure was made, the names and relationships to the
patient, if any, of the persons or agencies to whom such disclosure was
made, and the information disclosed.
Sec. 113 RCW 71.05.620 and 1989 c 205 s 12 are each amended to
read as follows:
(((1) Informed consent for disclosure of information from court or
treatment records to an individual, agency, or organization must be in
writing and must contain the following information:)) The files and records of court proceedings under this chapter
and chapters 71.05, 70.96A, and 70.-- (sections 202 through 216 of this
act) RCW shall be closed but shall be accessible to any individual who
is the subject of a petition and to the individual's attorney, guardian
ad litem, resource management services, or service providers authorized
to receive such information by resource management services.
(a) The name of the individual, agency, or organization to which
the disclosure is to be made;
(b) The name of the individual whose treatment record is being
disclosed;
(c) The purpose or need for the disclosure;
(d) The specific type of information to be disclosed;
(e) The time period during which the consent is effective;
(f) The date on which the consent is signed; and
(g) The signature of the individual or person legally authorized to
give consent for the individual.
(2)
Sec. 114 RCW 71.05.630 and 2000 c 75 s 5 are each amended to read
as follows:
(1) Except as otherwise provided by law, all treatment records
shall remain confidential((. Treatment records)) and may be released
only to the persons designated in this section, or to other persons
designated in an informed written consent of the patient.
(2) Treatment records of an individual may be released without
informed written consent in the following circumstances:
(a) To an individual, organization, or agency as necessary for
management or financial audits, or program monitoring and evaluation.
Information obtained under this subsection shall remain confidential
and may not be used in a manner that discloses the name or other
identifying information about the individual whose records are being
released.
(b) To the department, the director of regional support networks,
or a qualified staff member designated by the director only when
necessary to be used for billing or collection purposes. The
information shall remain confidential.
(c) For purposes of research as permitted in chapter 42.48 RCW.
(d) Pursuant to lawful order of a court.
(e) To qualified staff members of the department, to the director
of regional support networks, to resource management services
responsible for serving a patient, or to service providers designated
by resource management services as necessary to determine the progress
and adequacy of treatment and to determine whether the person should be
transferred to a less restrictive or more appropriate treatment
modality or facility. The information shall remain confidential.
(f) Within the treatment facility where the patient is receiving
treatment, confidential information may be disclosed to individuals
employed, serving in bona fide training programs, or participating in
supervised volunteer programs, at the facility when it is necessary to
perform their duties.
(g) Within the department as necessary to coordinate treatment for
mental illness, developmental disabilities, alcoholism, or drug abuse
of individuals who are under the supervision of the department.
(h) To a licensed physician who has determined that the life or
health of the individual is in danger and that treatment without the
information contained in the treatment records could be injurious to
the patient's health. Disclosure shall be limited to the portions of
the records necessary to meet the medical emergency.
(i) To a facility that is to receive an individual who is
involuntarily committed under chapter 71.05 RCW, or upon transfer of
the individual from one treatment facility to another. The release of
records under this subsection shall be limited to the treatment records
required by law, a record or summary of all somatic treatments, and a
discharge summary. The discharge summary may include a statement of
the patient's problem, the treatment goals, the type of treatment which
has been provided, and recommendation for future treatment, but may not
include the patient's complete treatment record.
(j) Notwithstanding the provisions of RCW 71.05.390(7), to a
correctional facility or a corrections officer who is responsible for
the supervision of an individual who is receiving inpatient or
outpatient evaluation or treatment. Except as provided in RCW
71.05.445 and 71.34.225, release of records under this section is
limited to:
(i) An evaluation report provided pursuant to a written supervision
plan.
(ii) The discharge summary, including a record or summary of all
somatic treatments, at the termination of any treatment provided as
part of the supervision plan.
(iii) When an individual is returned from a treatment facility to
a correctional facility, the information provided under (j)(iv) of this
subsection.
(iv) Any information necessary to establish or implement changes in
the individual's treatment plan or the level or kind of supervision as
determined by resource management services. In cases involving a
person transferred back to a correctional facility, disclosure shall be
made to clinical staff only.
(k) To the individual's counsel or guardian ad litem, without
modification, at any time in order to prepare for involuntary
commitment or recommitment proceedings, reexaminations, appeals, or
other actions relating to detention, admission, commitment, or
patient's rights under chapter 71.05 RCW.
(l) To staff members of the protection and advocacy agency or to
staff members of a private, nonprofit corporation for the purpose of
protecting and advocating the rights of persons with mental illness or
developmental disabilities. Resource management services may limit the
release of information to the name, birthdate, and county of residence
of the patient, information regarding whether the patient was
voluntarily admitted, or involuntarily committed, the date and place of
admission, placement, or commitment, the name and address of a guardian
of the patient, and the date and place of the guardian's appointment.
Any staff member who wishes to obtain additional information shall
notify the patient's resource management services in writing of the
request and of the resource management services' right to object. The
staff member shall send the notice by mail to the guardian's address.
If the guardian does not object in writing within fifteen days after
the notice is mailed, the staff member may obtain the additional
information. If the guardian objects in writing within fifteen days
after the notice is mailed, the staff member may not obtain the
additional information.
(3) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for ((alcoholism or drug)) chemical
dependency, the department may restrict the release of the information
as necessary to comply with federal law and regulations.
Sec. 115 RCW 71.05.640 and 2000 c 94 s 11 are each amended to
read as follows:
(1) Procedures shall be established by resource management services
to provide reasonable and timely access to individual treatment
records. However, access may not be denied at any time to records of
all medications and somatic treatments received by the individual.
(2) Following discharge, the individual shall have a right to a
complete record of all medications and somatic treatments prescribed
during evaluation, admission, or commitment and to a copy of the
discharge summary prepared at the time of his or her discharge. A
reasonable and uniform charge for reproduction may be assessed.
(3) Treatment records may be modified prior to inspection to
protect the confidentiality of other patients or the names of any other
persons referred to in the record who gave information on the condition
that his or her identity remain confidential. Entire documents may not
be withheld to protect such confidentiality.
(4) At the time of discharge all individuals shall be informed by
resource management services of their rights as provided in RCW
((71.05.610)) 71.05.390 and 71.05.620 through 71.05.690.
Sec. 116 RCW 71.05.660 and 1989 c 205 s 16 are each amended to
read as follows:
Nothing in this chapter ((205, Laws of 1989)) or chapter 70.96A,
71.05, or 70.-- (sections 202 through 216 of this act) RCW shall be
construed to interfere with communications between physicians or
psychologists and patients and attorneys and clients.
NEW SECTION. Sec. 117 A new section is added to chapter 71.05
RCW to read as follows:
A petition for commitment under this chapter may be joined with a
petition for commitment under chapter 70.96A RCW.
NEW SECTION. Sec. 201 Sections 202 through 216 of this act
constitute a new chapter in Title
NEW SECTION. Sec. 202 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "Admission" or "admit" means a decision by a physician that an
individual should be examined or treated as a patient in a hospital, an
evaluation and treatment facility, or other inpatient facility, or a
decision by a professional person in charge or his or her designee that
an individual should be detained as a patient for evaluation and
treatment in a secure detoxification facility or other certified
chemical dependency provider.
(2) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes but is not limited to atypical
antipsychotic medications.
(3) "Approved treatment program" means a discrete program of
chemical dependency treatment provided by a treatment program certified
by the department as meeting standards adopted under chapter 70.96A
RCW.
(4) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient.
(5) "Chemical dependency" means:
(a) Alcoholism;
(b) Drug addiction; or
(c) Dependence on alcohol and one or more other psychoactive
chemicals, as the context requires.
(6) "Chemical dependency professional" means a person certified as
a chemical dependency professional by the department of health under
chapter 18.205 RCW.
(7) "Commitment" means the determination by a court that an
individual should be detained for a period of either evaluation or
treatment, or both, in an inpatient or a less restrictive setting.
(8) "Conditional release" means a revocable modification of a
commitment that may be revoked upon violation of any of its terms.
(9) "County-designated crisis responder" means a person designated
by the county or regional support network to perform the duties
specified in this chapter.
(10) "County-designated mental health professional" means a mental
health professional appointed by the county or the regional support
network to perform the duties in chapter 71.05 RCW.
(11) "Custody" means involuntary detention under either chapter
71.05 or 70.96A RCW or this chapter, uninterrupted by any period of
unconditional release from commitment from a facility providing
involuntary care and treatment.
(12) "Department" means the department of social and health
services.
(13) "Designated chemical dependency specialist" or "specialist"
means a person designated by the county alcoholism and other drug
addiction program coordinator designated under RCW 70.96A.310 to
perform the commitment duties described in RCW 70.96A.140 and this
chapter, and qualified to do so by meeting standards adopted by the
department.
(14) "Detention" or "detain" means the lawful confinement of an
individual under this chapter, or chapter 70.96A or 71.05 RCW.
(15) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with individuals with developmental disabilities
and is a psychiatrist, psychologist, or social worker, and such other
developmental disabilities professionals as may be defined by rules
adopted by the secretary.
(16) "Developmental disability" means that condition defined in RCW
71A.10.020.
(17) "Discharge" means the termination of facility authority. The
commitment may remain in place, be terminated, or be amended by court
order.
(18) "Evaluation and treatment facility" means any facility that
can provide directly, or by direct arrangement with other public or
private agencies, emergency evaluation and treatment, outpatient care,
and timely and appropriate inpatient care to individuals suffering from
a mental disorder, and that is certified as such by the department. A
physically separate and separately operated portion of a state hospital
may be designated as an evaluation and treatment facility. A facility
that is part of, or operated by, the department or any federal agency
does not require certification. No correctional institution or
facility, or jail, may be an evaluation and treatment facility within
the meaning of this chapter.
(19) "Facility" means either an evaluation and treatment facility
or a secure detoxification facility.
(20) "Gravely disabled" means a condition in which an individual,
as a result of a mental disorder, or as a result of the use of alcohol
or other psychoactive chemicals:
(a) Is in danger of serious physical harm resulting from a failure
to provide for his or her essential human needs of health or safety; or
(b) Manifests severe deterioration in routine functioning evidenced
by repeated and escalating loss of cognitive or volitional control over
his or her actions and is not receiving such care as is essential for
his or her health or safety.
(21) "History of one or more violent acts" refers to the period of
time ten years before the filing of a petition under this chapter, or
chapter 70.96A or 71.05 RCW, excluding any time spent, but not any
violent acts committed, in a mental health facility or a long-term
alcoholism or drug treatment facility, or in confinement as a result of
a criminal conviction.
(22) "Intoxicated individual" means an individual whose mental or
physical functioning is substantially impaired as a result of the use
of alcohol or other psychoactive chemicals.
(23) "Judicial commitment" means a commitment by a court under this
chapter.
(24) "Licensed physician" means a person licensed to practice
medicine or osteopathic medicine and surgery in the state of
Washington.
(25) "Likelihood of serious harm" means:
(a) A substantial risk that:
(i) Physical harm will be inflicted by an individual upon his or
her own person, as evidenced by threats or attempts to commit suicide
or inflict physical harm on oneself;
(ii) Physical harm will be inflicted by an individual upon another,
as evidenced by behavior that has caused such harm or that places
another person or persons in reasonable fear of sustaining such harm;
or
(iii) Physical harm will be inflicted by an individual upon the
property of others, as evidenced by behavior that has caused
substantial loss or damage to the property of others; or
(b) The individual has threatened the physical safety of another
and has a history of one or more violent acts.
(26) "Mental disorder" means any organic, mental, or emotional
impairment that has substantial adverse effects on an individual's
cognitive or volitional functions.
(27) "Mental health professional" means a psychiatrist,
psychologist, psychiatric nurse, or social worker, and such other
mental health professionals as may be defined by rules adopted by the
secretary under the authority of chapter 71.05 RCW.
(28) "Peace officer" means a law enforcement official of a public
agency or governmental unit, and includes persons specifically given
peace officer powers by any state law, local ordinance, or judicial
order of appointment.
(29) "Private agency" means any person, partnership, corporation,
or association that is not a public agency, whether or not financed in
whole or in part by public funds, that constitutes an evaluation and
treatment facility or private institution, hospital, or sanitarium, or
approved treatment program, that is conducted for, or includes a
department or ward conducted for, the care and treatment of individuals
who are mentally ill and/or chemically dependent.
(30) "Professional person in charge" or "professional person" means
a physician or chemical dependency counselor as defined in rule by the
department, who is empowered by a certified treatment program with
authority to make assessment, admission, continuing care, and discharge
decisions on behalf of the certified program.
(31) "Psychiatrist" means a person having a license as a physician
and surgeon in this state who has in addition completed three years of
graduate training in psychiatry in a program approved by the American
medical association or the American osteopathic association and is
certified or eligible to be certified by the American board of
psychiatry and neurology.
(32) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(33) "Public agency" means any evaluation and treatment facility or
institution, hospital, or sanitarium, or approved treatment program
that is conducted for, or includes a department or ward conducted for,
the care and treatment of individuals who are mentally ill and/or
chemically dependent, if the agency is operated directly by federal,
state, county, or municipal government, or a combination of such
governments.
(34) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW or this chapter.
(35) "Secretary" means the secretary of the department or the
secretary's designee.
(36) "Secure detoxification facility" means a facility operated by
either a public or private agency or by the program of an agency that
serves the purpose of providing evaluation and assessment, and acute
and/or subacute detoxification services for intoxicated individuals and
includes security measures sufficient to protect the patients, staff,
and community.
(37) "Social worker" means a person with a master's or further
advanced degree from an accredited school of social work or a degree
deemed equivalent under rules adopted by the secretary.
(38) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
NEW SECTION. Sec. 203 (1) The secretary, in consultation with
the Washington state association of counties, shall select and contract
with regional support networks or counties to provide two integrated
crisis response and involuntary treatment pilot programs for adults and
shall allocate resources for both integrated services and secure
detoxification services in the pilot areas. In selecting the two
regional support networks or counties, the secretary shall endeavor to
site one in an urban and one in a rural regional support network or
county.
(2) The regional support networks or counties shall implement the
pilot programs by providing integrated crisis response and involuntary
treatment to individuals with a chemical dependency, a mental disorder,
or both, consistent with this chapter. The pilot programs shall:
(a) Combine the crisis responder functions of a county-designated
mental health professional under chapter 71.05 RCW and a county-designated chemical dependency specialist under chapter 70.96A RCW by
establishing a new county-designated crisis responder who is authorized
to conduct investigations and detain individuals up to seventy-two
hours to the proper facility;
(b) Provide training to the crisis responders as required by the
department;
(c) Provide sufficient staff and resources to ensure availability
of an adequate number of crisis responders twenty-four hours a day,
seven days a week;
(d) Provide the administrative and court-related staff, resources,
and processes necessary to facilitate the legal requirements of the
initial detention and the commitment hearings for individuals with a
chemical dependency;
(e) Participate in the evaluation and report to assess the outcomes
of the pilot programs including providing data and information as
requested;
(f) Provide the other services necessary to the implementation of
the pilot programs, consistent with this chapter as determined by the
secretary in contract.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
NEW SECTION. Sec. 204 To qualify as a county-designated crisis
responder, a person must have received chemical dependency training as
determined by the department and be a:
(1) Psychiatrist, psychologist, psychiatric nurse, or social worker
as defined in chapters 71.05 and 71.34 RCW;
(2) Person with a master's degree or further advanced degree in
counseling or one of the social sciences from an accredited college or
university and, in addition, have at least two years of experience in
direct treatment of individuals with mental illness or emotional
disturbance, such experience gained under the direction of a mental
health professional;
(3) Person who meets the waiver criteria of RCW 71.24.260, which
waiver was granted before 1986;
(4) Person who had an approved waiver to perform the duties of a
mental health professional that was requested by the regional support
network and granted by the department before July 1, 2001; or
(5) Person who has been granted a time-limited exception of the
minimum requirements of a mental health professional by the department
consistent with rules adopted by the secretary.
NEW SECTION. Sec. 205 In addition to the provisions of this
chapter, a designated crisis responder has all the powers and duties of
a county-designated mental health professional as well as the powers
and duties of a designated chemical dependency specialist under RCW
70.96A.120.
NEW SECTION. Sec. 206 (1)(a) When a county-designated crisis
responder receives information alleging that a person, as a result of
a mental disorder and/or chemical dependency presents a likelihood of
serious harm or is gravely disabled, the county-designated crisis
responder may, after investigation and evaluation of the specific facts
alleged and of the reliability and credibility of any person providing
information to initiate detention, if satisfied that the allegations
are true and that the person will not voluntarily seek appropriate
treatment, file a petition for initial detention. Before filing the
petition, the county-designated crisis responder must personally
interview the person, unless the person refuses an interview, and
determine whether the person will voluntarily receive appropriate
evaluation and treatment at either an evaluation and treatment
facility, a detoxification facility, or other certified chemical
dependency provider.
(b)(i)(A) Whenever it appears, by petition for initial detention,
to the satisfaction of a judge of the superior court that a person
presents as a result of a mental disorder, a likelihood of serious
harm, or is gravely disabled, and that the person has refused or failed
to accept appropriate evaluation and treatment voluntarily, the judge
may issue an order requiring the person to appear within twenty-four
hours after service of the order at a designated evaluation and
treatment facility for not more than a seventy-two hour evaluation and
treatment period; or
(B) Whenever it appears, by petition for initial detention, to the
satisfaction of a judge of the superior court, district court, or other
court permitted by court rule, that a person presents as a result of a
chemical dependency, a likelihood of serious harm, or is gravely
disabled, and that the person has refused or failed to accept
appropriate evaluation and treatment voluntarily, the judge may issue
an order requiring the person to appear within twenty-four hours after
service of the order at a secure detoxification facility or other
certified chemical dependency provider for not more than a seventy-two
hour evaluation and treatment period.
(ii) The order issued under this subsection (1)(b) shall state the
address of the evaluation and treatment facility, secure detoxification
facility, or other certified chemical dependency provider to which the
person is to report; whether the required seventy-two hour evaluation
and treatment services may be delivered on an outpatient or inpatient
basis; and that if the person named in the order fails to appear at the
evaluation and treatment facility, secure detoxification facility, or
other certified chemical dependency provider at or before the date and
time stated in the order, the person may be involuntarily taken into
custody for evaluation and treatment. The order shall also designate
retained counsel or, if counsel is appointed from a list provided by
the court, the name, business address, and telephone number of the
attorney appointed to represent the person.
(c) The county-designated crisis responder shall then serve or
cause to be served on such person, his or her guardian, and
conservator, if any, a copy of the order to appear, together with a
notice of rights and a petition for initial detention. After service
on the person, the county-designated crisis responder shall file the
return of service in court and provide copies of all papers in the
court file to the evaluation and treatment facility or secure
detoxification facility and the designated attorney. The
county-designated crisis responder shall notify the court and the
prosecuting attorney that a probable cause hearing will be held within
seventy-two hours of the date and time of outpatient evaluation or
admission to the evaluation and treatment facility, secure
detoxification facility, or other certified chemical dependency
provider. The person shall be permitted to remain in his or her home
or other place of his or her choosing before the time of evaluation and
shall be permitted to be accompanied by one or more of his or her
relatives, friends, an attorney, a personal physician, or other
professional or religious advisor to the place of evaluation. An
attorney accompanying the person to the place of evaluation shall be
permitted to be present during the admission evaluation. Any other
individual accompanying the person may be present during the admission
evaluation. The facility may exclude the individual if his or her
presence would present a safety risk, delay the proceedings, or
otherwise interfere with the evaluation.
(d) If the person ordered to appear does appear on or before the
date and time specified, the evaluation and treatment facility, secure
detoxification facility, or other certified chemical dependency
provider may admit the person as required by subsection (3) of this
section or may provide treatment on an outpatient basis. If the person
ordered to appear fails to appear on or before the date and time
specified, the evaluation and treatment facility, secure detoxification
facility, or other certified chemical dependency provider shall
immediately notify the county-designated crisis responder who may
notify a peace officer to take the person or cause the person to be
taken into custody and placed in an evaluation and treatment facility,
a secure detoxification facility, or other certified chemical
dependency provider. Should the county-designated crisis responder
notify a peace officer authorizing the officer to take a person into
custody under this subsection, the county-designated crisis responder
shall file with the court a copy of the authorization and a notice of
detention. At the time the person is taken into custody there shall
commence to be served on the person, his or her guardian, and
conservator, if any, a copy of the original order together with a
notice of detention, a notice of rights, and a petition for initial
detention.
(2) If a county-designated crisis responder receives information
alleging that a person, as the result of:
(a) A mental disorder, presents an imminent likelihood of serious
harm, or is in imminent danger because of being gravely disabled, after
investigation and evaluation of the specific facts alleged and of the
reliability and credibility of the person or persons providing the
information if any, the county-designated crisis responder may take the
person, or cause by oral or written order the person to be taken into
emergency custody in an evaluation and treatment facility for not more
than seventy-two hours as described in this chapter; or
(b) Chemical dependency, presents an imminent likelihood of serious
harm, or is in imminent danger because of being gravely disabled, after
investigation and evaluation of the specific facts alleged and of the
reliability and credibility of the person or persons providing the
information if any, the county-designated crisis responder may take the
person, or cause by oral or written order the person to be taken into
emergency custody in a secure detoxification facility for not more than
seventy-two hours as described in this chapter.
(3) If the county-designated crisis responder petitions for
detention of a person whose actions constitute a likelihood of serious
harm, or who is gravely disabled, the evaluation and treatment
facility, the secure detoxification facility, or other certified
chemical dependency provider providing seventy-two hour evaluation and
treatment must immediately accept on a provisional basis the petition
and the person. The evaluation and treatment facility, the secure
detoxification facility, or other certified chemical dependency
provider shall then evaluate the person's condition and admit, detain,
transfer, or discharge such person in accordance with this chapter.
The facility shall notify in writing the court and the
county-designated crisis responder of the date and time of the initial
detention of each person involuntarily detained so that a probable
cause hearing will be held no later than seventy-two hours after
detention.
(4) A peace officer may, without prior notice of the proceedings
provided for in subsection (1) of this section, take or cause the
person to be taken into custody and immediately delivered to an
evaluation and treatment facility, secure detoxification facility,
other certified chemical dependency treatment provider only pursuant to
subsections (1)(d) and (2) of this section.
(5) Nothing in this chapter limits the power of a peace officer to
take a person into custody and immediately deliver the person to the
emergency department of a local hospital or to a detoxification
facility.
NEW SECTION. Sec. 207 (1) A person or public or private entity
employing a person is not civilly or criminally liable for performing
duties under this chapter if the duties were performed in good faith
and without gross negligence.
(2) This section does not relieve a person from giving the required
notices under RCW 71.05.330(2) or 71.05.340(1)(b), or the duty to warn
or to take reasonable precautions to provide protection from violent
behavior where the patient has communicated an actual threat of
physical violence against a reasonably identifiable victim or victims.
The duty to warn or to take reasonable precautions to provide
protection from violent behavior is discharged if reasonable efforts
are made to communicate the threat to the victim or victims and to law
enforcement personnel.
NEW SECTION. Sec. 208 If the evaluation and treatment facility,
secure detoxification facility, or other certified chemical dependency
provider admits the person, it may detain the person for evaluation and
treatment for a period not to exceed seventy-two hours from the time of
acceptance. The computation of the seventy-two hour period excludes
Saturdays, Sundays, and holidays.
NEW SECTION. Sec. 209 Whenever any individual is detained for
evaluation and treatment for a mental disorder under section 206 of
this act, chapter 71.05 RCW applies.
NEW SECTION. Sec. 210 (1) An individual detained for seventy-two
hour evaluation and treatment under section 207 of this act or RCW
70.96A.120 may be detained for not more than fourteen additional days
of involuntary chemical dependency treatment if there are beds
available at the secure detoxification facility and the following
conditions are met:
(a) The professional person in charge of the agency or facility or
the person's designee providing evaluation and treatment services in a
secure detoxification facility has assessed the person's condition and
finds that the condition is caused by chemical dependency and either
results in a likelihood of serious harm or in the detained person being
gravely disabled, and the professional person or his or her designee is
prepared to testify those conditions are met;
(b) The person has been advised of the need for voluntary treatment
and the professional person in charge of the agency or facility or his
or her designee has evidence that he or she has not in good faith
volunteered for treatment; and
(c) The professional person in charge of the agency or facility or
the person's designee has filed a petition for fourteen-day involuntary
detention with the superior court, district court, or other court
permitted by court rule. The petition must be signed by the chemical
dependency professional who has examined the individual.
(2) The petition under subsection (1)(c) of this section shall be
accompanied by a certificate of a licensed physician who has examined
the individual, unless the individual whose commitment is sought has
refused to submit to a medical examination, in which case the fact of
refusal shall be alleged in the petition. The certificate shall set
forth the licensed physician's findings in support of the allegations
of the petition. A physician employed by the petitioning program or
the department is eligible to be the certifying physician.
(3) The petition shall state facts that support the finding that
the person, as a result of chemical dependency, presents a likelihood
of serious harm or is gravely disabled, and that there are no less
restrictive alternatives to detention in the best interest of the
person or others. The petition shall state specifically that less
restrictive alternative treatment was considered and specify why
treatment less restrictive than detention is not appropriate.
(4) A copy of the petition shall be served on the detained person,
his or her attorney, and his or her guardian or conservator, if any,
before the probable cause hearing.
(5)(a) The court shall inform the person whose commitment is sought
of his or her right to contest the petition, be represented by counsel
at every stage of any proceedings relating to his or her commitment,
and have counsel appointed by the court or provided by the court, if he
or she wants the assistance of counsel and is unable to obtain counsel.
If the court believes that the person needs the assistance of counsel,
the court shall require, by appointment if necessary, counsel for him
or her regardless of his or her wishes. The person shall, if he or she
is financially able, bear the costs of such legal service; otherwise
such legal service shall be at public expense. The person whose
commitment is sought shall be informed of his or her right to be
examined by a licensed physician of his or her choice. If the person
is unable to obtain a licensed physician and requests examination by a
physician, the court shall appoint a reasonably available licensed
physician designated by the person.
(b) At the conclusion of the probable cause hearing, if the court
finds by a preponderance of the evidence that the person, as the result
of chemical dependency, presents a likelihood of serious harm or is
gravely disabled and, after considering less restrictive alternatives
to involuntary detention and treatment, finds that no such alternatives
are in the best interest of such person or others, the court shall
order that the person be detained for involuntary chemical dependency
treatment not to exceed fourteen days in a secure detoxification
facility.
NEW SECTION. Sec. 211 If an individual is detained for
additional treatment beyond fourteen days under section 210 of this
act, the professional staff of the agency or facility may petition for
additional treatment under RCW 70.96A.140.
NEW SECTION. Sec. 212 The prosecuting attorney of the county in
which an action under this chapter is taken must represent the
petitioner in judicial proceedings under this chapter for the
involuntary chemical dependency treatment of an individual, including
any judicial proceeding where the individual sought to be treated for
chemical dependency challenges the action.
NEW SECTION. Sec. 213 (1) Every person involuntarily detained or
committed under this chapter as a result of a mental disorder is
entitled to all the rights set forth in this chapter and in chapter
71.05 RCW, and retains all rights not denied him or her under this
chapter or chapter 71.05 RCW.
(2) Every person involuntarily detained or committed under this
chapter as a result of a chemical dependency is entitled to all the
rights set forth in this chapter and chapter 70.96A RCW, and retains
all rights not denied him or her under this chapter or chapter 70.96A
RCW.
NEW SECTION. Sec. 214 (1) When a county designated crisis
responder is notified by a jail that a defendant or offender who was
subject to a discharge review under RCW 71.05.232 is to be released to
the community, the county designated crisis responder shall evaluate
the person within seventy-two hours of release.
(2) When an offender is under court-ordered treatment in the
community and the supervision of the department of corrections, and the
treatment provider becomes aware that the person is in violation of the
terms of the court order, the treatment provider shall notify the
county designated crisis responder of the violation and request an
evaluation for purposes of revocation of the less restrictive
alternative.
(3) When a county designated crisis responder becomes aware that an
offender who is under court-ordered treatment in the community and the
supervision of the department of corrections is in violation of a
treatment order or a condition of supervision that relates to public
safety, or the county designated crisis responder detains a person
under this chapter, the county designated crisis responder shall notify
the person's treatment provider and the department of corrections.
(4) When an offender who is confined in a state correctional
facility or is under supervision of the department of corrections in
the community is subject to a petition for involuntary treatment under
this chapter, the petitioner shall notify the department of corrections
and the department of corrections shall provide documentation of its
risk assessment or other concerns to the petitioner and the court if
the department of corrections classified the offender as a high risk or
high needs offender.
(5) Nothing in this section creates a duty on any treatment
provider or county designated crisis responder to provide offender
supervision.
NEW SECTION. Sec. 215 The secretary may adopt rules to implement
this chapter.
NEW SECTION. Sec. 216 The provisions of RCW 71.05.550 apply to
this chapter.
NEW SECTION. Sec. 217 (1) The Washington state institute for
public policy shall evaluate the pilot programs and make a preliminary
report to appropriate committees of the legislature by December 1,
2007, and a final report by September 30, 2008.
(2) The evaluation of the pilot programs shall include:
(a) Whether the county designated crisis responder pilot program:
(i) Has increased efficiency of evaluation and treatment of persons
involuntarily detained for seventy-two hours;
(ii) Is cost-effective;
(iii) Results in better outcomes for persons involuntarily
detained;
(iv) Increased the effectiveness of the crisis response system in
the pilot catchment areas;
(b) The effectiveness of providing a single chapter in the Revised
Code of Washington to address initial detention of individuals with
mental disorders or chemical dependency, in crisis response situations
and the likelihood of effectiveness of providing a single,
comprehensive involuntary treatment act.
(3) The reports shall consider the impact of the pilot programs on
the existing mental health system and on the individuals served by the
system.
Sec. 218 RCW 71.05.550 and 1973 1st ex.s. c 142 s 60 are each
amended to read as follows:
The department of social and health services, in planning and
providing funding to counties pursuant to chapter 71.24 RCW, shall
recognize the financial necessities imposed upon counties by
implementation of this chapter and chapter 70.-- RCW (sections 202
through 216 of this act), and shall consider needs, if any, for
additional community mental health services and facilities and
reduction in commitments to state hospitals for the mentally ill
accomplished by individual counties, in planning and providing such
funding. The state shall provide financial assistance to the counties
to enable the counties to meet all increased costs, if any, to the
counties resulting from their administration of the provisions of
chapter 142, Laws of 1973 1st ex. sess.
NEW SECTION. Sec. 219 Sections 202 through 216 of this act
expire March 1, 2008.
NEW SECTION. Sec. 220 A new section is added to chapter 70.96A
RCW to read as follows:
(1) The secretary shall select and contract with regional support
networks or counties to provide intensive case management for
chemically dependent persons with histories of high utilization of
crisis services at two sites, which shall be in the regional support
networks or counties contracted for the pilot program established in
chapter 70.-- RCW (sections 202 through 216 of this act).
(2) The contracted sites shall implement the pilot programs by
providing intensive case management to persons with a primary chemical
dependency diagnosis or dual primary chemical dependency and mental
health diagnoses, through the employment of chemical dependency case
managers. The chemical dependency case managers shall:
(a) Be trained in and use the integrated, comprehensive screening
and assessment process adopted under section 701 of this act;
(b) Reduce the use of crisis medical, chemical dependency and
mental health services, including but not limited to, emergency room
admissions, hospitalizations, detoxification programs, inpatient
psychiatric admissions, involuntary treatment petitions, emergency
medical services, and ambulance services;
(c) Reduce the use of emergency first responder services including
police, fire, emergency medical, and ambulance services;
(d) Reduce the number of criminal justice interventions including
arrests, bookings, jail days, court appearances, and prosecutor and
defense costs;
(e) Where appropriate and available, work with therapeutic courts
including drug courts and mental health courts to maximize the outcomes
for the individual and reduce the likelihood of reoffense;
(f) Coordinate with local offices of the economic services
administration to assist the person in accessing and remaining enrolled
in those programs to which the person may be entitled;
(g) Where appropriate and available, coordinate with primary care
and other programs operated through the federal government including
federally qualified health centers, Indian health programs, and
veterans' health programs for which the person is eligible to reduce
duplication of services and conflicts in case approach;
(h) Where appropriate, advocate for the client's needs to assist
the person in achieving and maintaining stability and progress toward
recovery; and
(i) Document the numbers of persons with co-occurring mental and
substance abuse disorders and the point of determination of the co-occurring disorder by quadrant of intensity of need.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
NEW SECTION. Sec. 301 (1) Sections 302 through 387 of this act
constitute a new chapter in Title
(2) Sections 302 through 387 of this act take effect July 1, 2009.
NEW SECTION. Sec. 302 The legislature finds that mental
disorders and the abuse of alcohol and other drugs have become a
serious threat to the health of the citizens of the state of Washington
and that the use of psychoactive chemicals is a prime factor in the
current AIDS epidemic. The legislature also finds that some persons
with mental disorders and substance abuse disorders have little or no
insight into their condition and are unable or unwilling to seek
treatment voluntarily. The legislature further finds that it is not
always evident at the time of commitment that a person has co-occurring
mental and substance abuse disorders but that treatment of the
disabilities in isolation can lead to inappropriate or conflicting
treatment plans that can substantially reduce the opportunity for the
person to recover from his or her disorders. Therefore, a unified
involuntary treatment act is necessary.
The provisions of this chapter are intended by the legislature:
(1) To establish a single involuntary treatment act with a uniform
set of standards and procedures for persons with mental and substance
abuse disorders;
(2) To adequately assess whether a person presents a likelihood of
serious harm or a grave disability due to his or her disorder,
including an assessment of any prior history or pattern of repeated
hospitalizations or law enforcement interventions due to decompensation
in his or her mental or substance abuse disorder. The consideration of
prior mental history is particularly relevant in determining whether
the person would receive, if released, such care as is essential for
his or her health or safety;
(3) To prevent inappropriate, indefinite commitment of mentally
disordered and chemically dependent persons and to eliminate legal
disabilities that arise from such commitment where possible;
(4) To provide prompt evaluation and timely and appropriate
treatment of persons with serious mental and substance abuse disorders;
(5) To safeguard individual rights;
(6) To provide continuity of care for persons with serious mental
and substance abuse disorders, so that the procedures and services
authorized in this chapter are integrated with those in chapter 71.24
RCW to the maximum extent possible to provide a continuum of care
founded on evidence-based practices that support recovery, promote
independent living, encourage persons to participate in education and
employment to the maximum extent that they are able, reduce criminal
involvement, and reduce family violence and cycles of child abuse and
neglect leading to long-term use of the child welfare system;
(7) To encourage the integrated use of all existing agencies,
professional personnel, and public funds to prevent duplication of
services and unnecessary expenditures;
(8) To encourage, whenever appropriate, that services be provided
within the community;
(9) To promote the use of less restrictive alternatives to
inpatient commitments for persons with disorders that can be controlled
or stabilized in a less restrictive alternative. Within the guidelines
stated in In Re LaBelle 107 Wn.2d 196 (1986), the legislature intends
to encourage appropriate interventions at a point when there is the
best opportunity to restore the person to or maintain satisfactory
functioning; and
(10) To protect the public safety.
NEW SECTION. Sec. 303 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "Admission" or "admit" means a decision by a physician that an
individual should be examined or treated as a patient in a hospital, an
evaluation and treatment facility, or other inpatient facility, or a
decision by a professional person in charge or his or her designee that
an individual should be detained as a patient for evaluation and
treatment in a secure detoxification facility or other certified
chemical dependency provider.
(2) "Alcoholic" means a person who suffers from the disease of
alcoholism.
(3) "Alcoholism" means a disease, characterized by a dependency on
alcoholic beverages, loss of control over the amount and circumstances
of use, symptoms of tolerance, physiological or psychological
withdrawal, or both, if use is reduced or discontinued, and impairment
of health or disruption of social or economic functioning.
(4) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes but is not limited to atypical
antipsychotic medications.
(5) "Approved treatment program" means a discrete program of
chemical dependency treatment provided by a treatment program certified
by the department as meeting standards adopted under chapter 70.96A
RCW.
(6) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient.
(7) "Chemical dependency" means:
(a) Alcoholism;
(b) Drug addiction; or
(c) Dependence on alcohol and one or more other psychoactive
chemicals, as the context requires.
(8) "Chemical dependency professional" means a person certified as
a chemical dependency professional by the department of health under
chapter 18.205 RCW.
(9) "Chemical dependency program" means expenditures and activities
of the department designed and conducted to prevent or treat alcoholism
and other drug addiction, including reasonable administration and
overhead.
(10) "Commitment" means the determination by a court that an
individual should be detained for a period of either evaluation or
treatment, or both, in an inpatient or a less restrictive setting.
(11) "Conditional release" means a modification of a commitment
that may be revoked upon violation of any of its terms.
(12) "Custody" means involuntary detention under either chapter
71.05 or 70.96A RCW or this chapter, uninterrupted by any period of
unconditional release from commitment from a facility providing
involuntary care and treatment.
(13) "Department" means the department of social and health
services.
(14) "Designated chemical dependency specialist" or "specialist"
means a person designated by the county alcoholism and other drug
addiction program coordinator designated under RCW 70.96A.310 to
perform the commitment duties described in this chapter and chapter
70.96A RCW.
(15) "Designated crisis responder" means a person designated by the
county or regional support network to perform the duties specified in
this chapter.
(16) "Designated mental health professional" means a mental health
professional appointed by the county or the regional support network to
perform the duties in chapter 71.05 RCW.
(17) "Detention" or "detain" means the lawful confinement of an
individual under this chapter, or chapter 70.96A or 71.05 RCW.
(18) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with individuals with developmental disabilities
and is a psychiatrist, psychologist, or social worker, and such other
developmental disabilities professionals as may be defined by rules
adopted by the secretary.
(19) "Developmental disability" means that condition defined in RCW
71A.10.020.
(20) "Director" means the person administering the division of
alcohol and substance abuse or the mental health division within the
department.
(21) "Discharge" means the termination of facility authority. The
commitment may remain in place, be terminated, or be amended by court
order.
(22) "Drug addict" means a person who suffers from the disease of
drug addiction.
(23) "Drug addiction" means a disease characterized by a dependency
on psychoactive chemicals, loss of control over the amount and
circumstances of use, symptoms of tolerance, physiological or
psychological withdrawal, or both, if use is reduced or discontinued,
and impairment of health or disruption of social or economic
functioning.
(24) "Emergency service patrol" means a patrol established under
RCW 70.96A.170.
(25) "Evaluation and treatment facility" means any facility that
can provide directly, or by direct arrangement with other public or
private agencies, emergency evaluation and treatment, outpatient care,
and timely and appropriate inpatient care to individuals suffering from
a mental disorder, and that is certified as such by the department. A
physically separate and separately operated portion of a state hospital
may be designated as an evaluation and treatment facility. A facility
that is part of, or operated by, the department or any federal agency
does not require certification. No correctional institution or
facility, or jail, may be an evaluation and treatment facility within
the meaning of this chapter.
(26) "Facility" means either an evaluation and treatment facility
or a secure detoxification facility.
(27) "Gravely disabled" means a condition in which an individual,
as a result of a mental disorder, as a result of the use of alcohol or
other psychoactive chemicals, or both:
(a) Is in danger of serious physical harm resulting from a failure
to provide for his or her essential human needs of health or safety; or
(b) Manifests severe deterioration in routine functioning evidenced
by repeated and escalating loss of cognitive or volitional control over
his or her actions and is not receiving such care as is essential for
his or her health or safety.
(28) "Habilitative services" means those services provided by
program personnel to assist persons in acquiring and maintaining life
skills and in raising their levels of physical, mental, social, and
vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the individual being assisted as manifested by prior
charged criminal conduct.
(29) "History of one or more violent acts" refers to the period of
time ten years before the filing of a petition under this chapter, or
chapter 70.96A or 71.05 RCW, excluding any time spent, but not any
violent acts committed, in a mental health facility or a long-term
alcoholism or drug treatment facility, or in confinement as a result of
a criminal conviction.
(30) "Incapacitated by alcohol or other psychoactive chemicals"
means that a person, as a result of the use of alcohol or other
psychoactive chemicals, is gravely disabled or presents a likelihood of
serious harm to himself or herself, to any other person, or to
property.
(31) "Incompetent person" means a person who has been adjudged
incompetent by the superior court.
(32) "Individualized service plan" means a plan prepared by a
developmental disabilities professional with other professionals as a
team, for an individual with developmental disabilities, which shall
state:
(a) The nature of the person's specific problems, prior charged
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
(e) The staff responsible for carrying out the plan;
(f) Where relevant in light of past criminal behavior and due
consideration for public safety, the criteria for proposed movement to
less restrictive settings, criteria for proposed eventual discharge or
release, and a projected possible date for discharge or release; and
(g) The type of residence immediately anticipated for the person
and possible future types of residences.
(33) "Intoxicated person" means a person whose mental or physical
functioning is substantially impaired as a result of the use of alcohol
or other psychoactive chemicals.
(34) "Judicial commitment" means a commitment by a court under this
chapter.
(35) "Licensed physician" means a person licensed to practice
medicine or osteopathic medicine and surgery in the state of
Washington.
(36) "Likelihood of serious harm" means:
(a) A substantial risk that:
(i) Physical harm will be inflicted by an individual upon his or
her own person, as evidenced by threats or attempts to commit suicide
or inflict physical harm on oneself;
(ii) Physical harm will be inflicted by an individual upon another,
as evidenced by behavior that has caused such harm or that places
another person or persons in reasonable fear of sustaining such harm;
or
(iii) Physical harm will be inflicted by an individual upon the
property of others, as evidenced by behavior that has caused
substantial loss or damage to the property of others; or
(b) The individual has threatened the physical safety of another
and has a history of one or more violent acts.
(37) "Medical necessity" for inpatient care of a minor means a
requested certified inpatient service that is reasonably calculated to:
(a) Diagnose, arrest, or alleviate a chemical dependency; or (b)
prevent the worsening of chemical dependency conditions that endanger
life or cause suffering and pain, or result in illness or infirmity or
threaten to cause or aggravate a handicap, or cause physical deformity
or malfunction, and there is no adequate less restrictive alternative
available.
(38) "Mental disorder" means any organic, mental, or emotional
impairment that has substantial adverse effects on an individual's
cognitive or volitional functions.
(39) "Mental health professional" means a psychiatrist,
psychologist, psychiatric nurse, or social worker, and such other
mental health professionals as may be defined by rules adopted by the
secretary under the authority of chapter 71.05 RCW.
(40) "Minor" means a person less than eighteen years of age.
(41) "Parent" means the parent or parents who have the legal right
to custody of the child. Parent includes custodian or guardian.
(42) "Peace officer" means a law enforcement official of a public
agency or governmental unit, and includes persons specifically given
peace officer powers by any state law, local ordinance, or judicial
order of appointment.
(43) "Person" means an individual, including a minor.
(44) "Person in charge" means a physician or chemical dependency
counselor as defined in rule by the department, who is empowered by a
certified treatment program with authority to make assessment,
admission, continuing care, and discharge decisions on behalf of the
certified program.
(45) "Private agency" means any person, partnership, corporation,
or association that is not a public agency, whether or not financed in
whole or in part by public funds, that constitutes an evaluation and
treatment facility or private institution, hospital, or sanitarium, or
approved treatment program, that is conducted for, or includes a
department or ward conducted for, the care and treatment of individuals
who are mentally ill and/or chemically dependent.
(46) "Professional person" means a mental health professional and
shall also mean a physician, registered nurse, and such others as may
be defined in rules adopted by the secretary pursuant to the provisions
of this chapter.
(47) "Psychiatrist" means a person having a license as a physician
and surgeon in this state who has in addition completed three years of
graduate training in psychiatry in a program approved by the American
medical association or the American osteopathic association and is
certified or eligible to be certified by the American board of
psychiatry and neurology.
(48) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(49) "Public agency" means any evaluation and treatment facility or
institution, hospital, or sanitarium, or approved treatment program
that is conducted for, or includes a department or ward conducted for,
the care and treatment of individuals who are mentally ill and/or
chemically dependent, if the agency is operated directly by federal,
state, county, or municipal government, or a combination of such
governments.
(50) "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 individuals who are receiving or who at any
time have received services for mental illness.
(51) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW or this chapter.
(52) "Resource management services" has the meaning given in
chapter 71.24 RCW.
(53) "Secretary" means the secretary of the department or the
secretary's designee.
(54) "Secure detoxification facility" means a facility operated by
either a public or private agency or by the program of an agency that
serves the purpose of providing evaluation and assessment, and acute
and/or subacute detoxification services for intoxicated individuals and
includes security measures sufficient to protect the patients, staff,
and community.
(55) "Social worker" means a person with a master's or further
advanced degree from an accredited school of social work or a degree
deemed equivalent under rules adopted by the secretary.
(56) "Treatment" means the broad range of emergency,
detoxification, residential, inpatient and outpatient services and
care, including diagnostic evaluation, mental health or chemical
dependency education and counseling, medical, psychiatric,
psychological, and social service care, vocational rehabilitation and
career counseling, which may be extended to persons with mental and
substance abuse disorders, and their families.
(57) "Treatment program" means an organization, institution, or
corporation, public or private, engaged in the care, treatment, or
rehabilitation of alcoholics or other drug addicts.
(58) "Treatment records" include registration and all other records
concerning individuals 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 an individual providing
treatment services for the department, regional support networks, or a
treatment facility if the notes or records are not available to others.
(59) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
NEW SECTION. Sec. 304 The legislature intends that the
procedures and services authorized in this chapter be integrated with
those in chapters 70.96A, 71.05, 71.24, and 71.34 RCW to the maximum
extent necessary to assure a continuum of treatment to persons who are
under detention or involuntary treatment orders under this chapter. To
this end, regional support networks established in accordance with
chapter 71.24 RCW shall institute procedures which require timely
consultation with resource management services and county drug and
alcohol program coordinators, as appropriate, by a designated mental
health professional, designated chemical dependency specialist, or
designated crisis responder, and evaluation and treatment facilities to
assure that determinations to admit, detain, commit, treat, discharge,
or release persons with mental disorders, chemical dependency
disorders, or co-occurring mental and chemical dependency disorders
under this chapter are made only after appropriate information
regarding such person's treatment history and current treatment plan
has been sought from resource management services and the county drug
and alcohol program, as appropriate.
NEW SECTION. Sec. 305 Persons suffering from a mental disorder,
chemical dependency disorder, or both may not be involuntarily
committed for treatment of such disorder except pursuant to provisions
of this chapter, chapter 10.77 RCW, chapter 71.06 RCW, chapter 71.34
RCW, transfer pursuant to RCW 72.68.031 through 72.68.037, or pursuant
to court ordered evaluation and treatment not to exceed ninety days
pending a criminal trial or sentencing.
NEW SECTION. Sec. 306 Persons who are developmentally disabled,
impaired by chronic alcoholism or drug abuse, or suffering from
dementia and who otherwise meet the criteria for detention or judicial
commitment are not ineligible for detention or commitment based on this
condition alone.
NEW SECTION. Sec. 307 Pursuant to the interlocal cooperation
act, chapter 39.34 RCW, the department may enter into agreements to
accomplish the purposes of this chapter.
NEW SECTION. Sec. 308 All facilities, plans, or programs
receiving financial assistance under RCW 70.96A.040 are subject to the
provisions of RCW 70.96A.045 and 70.96A.047.
NEW SECTION. Sec. 309 To qualify as a designated crisis
responder, a person must have received chemical dependency training as
determined by the department and be a:
(1) Psychiatrist, psychologist, psychiatric nurse, or social worker
as defined in chapters 71.05 and 71.34 RCW;
(2) Person with a master's degree or further advanced degree in
counseling or one of the social sciences from an accredited college or
university and, in addition, have at least two years of experience in
direct treatment of individuals with mental illness or emotional
disturbance, such experience gained under the direction of a mental
health professional;
(3) Person who meets the waiver criteria of RCW 71.24.260, which
waiver was granted before 1986;
(4) Person who had an approved waiver to perform the duties of a
mental health professional that was requested by the regional support
network and granted by the department before July 1, 2001; or
(5) Person who has been granted a time-limited exception of the
minimum requirements of a mental health professional by the department
consistent with rules adopted by the secretary.
NEW SECTION. Sec. 310 (1)(a) When a designated mental health
professional, designated crisis responder, or designated chemical
dependency specialist receives information alleging that a person, as
a result of a mental disorder, chemical dependency disorder, or both,
presents a likelihood of serious harm or is gravely disabled, the
designated mental health professional, designated crisis responder, or
designated chemical dependency specialist may, after investigation and
evaluation of the specific facts alleged and of the reliability and
credibility of any person providing information to initiate detention,
if satisfied that the allegations are true and that the person will not
voluntarily seek appropriate treatment, file a petition for initial
detention. Before filing the petition, the designated mental health
professional, designated crisis responder, or designated chemical
dependency specialist must personally interview the person, unless the
person refuses an interview, and determine whether the person will
voluntarily receive appropriate evaluation and treatment at either an
evaluation and treatment facility, a detoxification facility, or other
certified chemical dependency provider.
(b)(i)(A) Whenever it appears, by petition for initial detention,
to the satisfaction of a judge of the superior court that a person
presents as a result of a mental disorder, chemical dependency
disorder, or both, a likelihood of serious harm, or is gravely
disabled, and that the person has refused or failed to accept
appropriate evaluation and treatment voluntarily, the judge may issue
an order requiring the person to appear within twenty-four hours after
service of the order at a designated evaluation and treatment facility
for not more than a seventy-two hour evaluation and treatment period;
or
(B) Whenever it appears, by petition for initial detention, to the
satisfaction of a judge of the superior court, district court, or other
court permitted by court rule, that a person presents as a result of a
chemical dependency, a likelihood of serious harm, or is gravely
disabled, and that the person has refused or failed to accept
appropriate evaluation and treatment voluntarily, the judge may issue
an order requiring the person to appear within twenty-four hours after
service of the order at a secure detoxification facility or other
certified chemical dependency provider for not more than a seventy-two
hour evaluation and treatment period.
(ii) The order issued under this subsection (1)(b) shall state the
address of the evaluation and treatment facility, secure detoxification
facility, or other certified chemical dependency provider to which the
person is to report; whether the required seventy-two hour evaluation
and treatment services may be delivered on an outpatient or inpatient
basis; and that if the person named in the order fails to appear at the
evaluation and treatment facility, secure detoxification facility, or
other certified chemical dependency provider at or before the date and
time stated in the order, the person may be involuntarily taken into
custody for evaluation and treatment. The order shall also designate
retained counsel or, if counsel is appointed from a list provided by
the court, the name, business address, and telephone number of the
attorney appointed to represent the person.
(c) The designated crisis responder shall then serve or cause to be
served on such person, his or her guardian, and conservator, if any, a
copy of the order to appear, together with a notice of rights and a
petition for initial detention. After service on the person, the
designated crisis responder shall file the return of service in court
and provide copies of all papers in the court file to the evaluation
and treatment facility or secure detoxification facility and the
designated attorney. The designated crisis responder shall notify the
court and the prosecuting attorney that a probable cause hearing will
be held within seventy-two hours of the date and time of outpatient
evaluation or admission to the evaluation and treatment facility,
secure detoxification facility, or other certified chemical dependency
provider. The person shall be permitted to remain in his or her home
or other place of his or her choosing before the time of evaluation and
shall be permitted to be accompanied by one or more of his or her
relatives, friends, an attorney, a personal physician, or other
professional or religious advisor to the place of evaluation. An
attorney accompanying the person to the place of evaluation shall be
permitted to be present during the admission evaluation. Any other
individual accompanying the person may be present during the admission
evaluation. The facility may exclude the individual if his or her
presence would present a safety risk, delay the proceedings, or
otherwise interfere with the evaluation.
(d) If the person ordered to appear does appear on or before the
date and time specified, the evaluation and treatment facility, secure
detoxification facility, or other certified chemical dependency
provider may admit the person as required by subsection (3) of this
section or may provide treatment on an outpatient basis. If the person
ordered to appear fails to appear on or before the date and time
specified, the evaluation and treatment facility, secure detoxification
facility, or other certified chemical dependency provider shall
immediately notify the designated crisis responder who may notify a
peace officer to take the person or cause the person to be taken into
custody and placed in an evaluation and treatment facility, a secure
detoxification facility, or other certified chemical dependency
provider. Should the designated crisis responder notify a peace
officer authorizing the officer to take a person into custody under
this subsection, the designated crisis responder shall file with the
court a copy of the authorization and a notice of detention. At the
time the person is taken into custody there shall commence to be served
on the person, his or her guardian, and conservator, if any, a copy of
the original order together with a notice of detention, a notice of
rights, and a petition for initial detention.
(2) If a designated crisis responder receives information alleging
that a person, as the result of a mental disorder, chemical dependency
disorder, or both, presents an imminent likelihood of serious harm, or
is in imminent danger because of being gravely disabled, after
investigation and evaluation of the specific facts alleged and of the
reliability and credibility of the person or persons providing the
information if any, the designated crisis responder may take the
person, or cause by oral or written order the person to be taken into
emergency custody in an evaluation and treatment facility, secure
detoxification facility, or other certified facility, for not more than
seventy-two hours as described in this chapter.
(3) If the designated crisis responder petitions for detention of
a person whose actions constitute a likelihood of serious harm, or who
is gravely disabled, the evaluation and treatment facility, the secure
detoxification facility, or other certified chemical dependency
provider providing seventy-two hour evaluation and treatment must
immediately accept on a provisional basis the petition and the person.
The evaluation and treatment facility, the secure detoxification
facility, or other certified chemical dependency provider shall then
evaluate the person's condition and admit, detain, transfer, or
discharge such person in accordance with this chapter. The facility
shall notify in writing the court and the designated crisis responder
of the date and time of the initial detention of each person
involuntarily detained so that a probable cause hearing will be held no
later than seventy-two hours after detention.
(4) A peace officer may, without prior notice of the proceedings
provided for in subsection (1) of this section, take or cause the
person to be taken into custody and immediately delivered to an
evaluation and treatment facility, secure detoxification facility, or
other certified chemical dependency provider only pursuant to
subsections (1)(d) and (2) of this section.
(5) Nothing in this chapter shall limit the power of a peace
officer to take a person into custody and immediately deliver the
person to the emergency department of a local hospital or to a
detoxification facility.
NEW SECTION. Sec. 311 If the evaluation and treatment facility,
secure detoxification facility, or other certified chemical dependency
provider admits the person, it may detain the person for evaluation and
treatment for a period not to exceed seventy-two hours from the time of
acceptance. The computation of the seventy-two hour period excludes
Saturdays, Sundays, and holidays.
NEW SECTION. Sec. 312 (1) An individual detained for a
seventy-two hour evaluation and treatment under section 207 of this act
or RCW 70.96A.120 may be detained for not more than fourteen additional
days of involuntary chemical dependency treatment if there are beds
available at the secure detoxification facility and the following
conditions are met:
(a) The professional person in charge of the agency or facility or
the person's designee providing evaluation and treatment services in a
secure detoxification facility has assessed the person's condition and
finds that the condition is caused by chemical dependency and either
results in a likelihood of serious harm or in the detained person being
gravely disabled, and the professional person or his or her designee is
prepared to testify those conditions are met;
(b) The person has been advised of the need for voluntary treatment
and the professional person in charge of the agency or facility or his
or her designee has evidence that he or she has not in good faith
volunteered for treatment; and
(c) The professional person in charge of the agency or facility or
the person's designee has filed a petition for fourteen-day involuntary
detention with the superior court, district court, or other court
permitted by court rule. The petition must be signed by the chemical
dependency professional who has examined the individual.
(2) The petition under subsection (1)(c) of this section shall be
accompanied by a certificate of a licensed physician who has examined
the individual, unless the individual whose commitment is sought has
refused to submit to a medical examination, in which case the fact of
refusal shall be alleged in the petition. The certificate shall set
forth the licensed physician's findings in support of the allegations
of the petition. A physician employed by the petitioning program or
the department is eligible to be the certifying physician.
(3) The petition shall state facts that support the finding that
the person, as a result of chemical dependency, presents a likelihood
of serious harm or is gravely disabled, and that there are no less
restrictive alternatives to detention in the best interest of the
person or others. The petition shall state specifically that less
restrictive alternative treatment was considered and specify why
treatment less restrictive than detention is not appropriate.
(4) A copy of the petition shall be served on the detained person,
his or her attorney, and his or her guardian or conservator, if any,
before the probable cause hearing.
(5)(a) The court shall inform the person whose commitment is sought
of his or her right to contest the petition, be represented by counsel
at every stage of any proceedings relating to his or her commitment,
and have counsel appointed by the court or provided by the court, if he
or she wants the assistance of counsel and is unable to obtain counsel.
If the court believes that the person needs the assistance of counsel,
the court shall require, by appointment if necessary, counsel for him
or her regardless of his or her wishes. The person shall, if he or she
is financially able, bear the costs of such legal service; otherwise
such legal service shall be at public expense. The person whose
commitment is sought shall be informed of his or her right to be
examined by a licensed physician of his or her choice. If the person
is unable to obtain a licensed physician and requests examination by a
physician, the court shall appoint a reasonably available licensed
physician designated by the person.
(b) At the conclusion of the probable cause hearing, if the court
finds by a preponderance of the evidence that the person, as the result
of chemical dependency, presents a likelihood of serious harm or is
gravely disabled and, after considering less restrictive alternatives
to involuntary detention and treatment, finds that no such alternatives
are in the best interest of such person or others, the court shall
order that the person be detained for involuntary chemical dependency
treatment not to exceed fourteen days in a secure detoxification
facility.
NEW SECTION. Sec. 313 If an individual is detained for
additional treatment beyond fourteen days under section 329 of this
act, the professional staff of the agency or facility may petition for
additional treatment under RCW 70.96A.140.
NEW SECTION. Sec. 314 The prosecuting attorney of the county in
which an action under this chapter is taken must represent the
petitioner in judicial proceedings under this chapter for the
involuntary chemical dependency treatment of an individual, including
any judicial proceeding where the individual sought to be treated for
chemical dependency challenges the action.
NEW SECTION. Sec. 315 Every person involuntarily detained or
committed under this chapter as a result of a mental disorder, chemical
dependency disorder, or both, is entitled to all the rights set forth
in this chapter and in chapter 71.05 or 70.96A RCW, and retains all
rights not denied him or her under this chapter or chapter 71.05 or
70.96A RCW.
NEW SECTION. Sec. 316 The department of social and health
services shall have the responsibility to determine whether all rights
of individuals recognized and guaranteed by the provisions of this
chapter and the Constitutions of the state of Washington and the United
States are in fact protected and effectively secured. To this end, the
department shall assign appropriate staff who shall from time to time
as may be necessary have authority to examine records, inspect
facilities, attend proceedings, and do whatever is necessary to
monitor, evaluate, and assure adherence to such rights. Such persons
shall also recommend such additional safeguards or procedures as may be
appropriate to secure individual rights set forth in this chapter and
as guaranteed by the state and federal Constitutions.
NEW SECTION. Sec. 317 Evaluation and treatment facilities
authorized pursuant to this chapter may be part of the comprehensive
community mental health services program conducted in counties pursuant
to chapter 71.24 RCW, and may receive funding pursuant to the
provisions thereof.
NEW SECTION. Sec. 318 The department, in planning and providing
funding to counties pursuant to chapter 71.24 RCW, shall recognize the
financial necessities imposed upon counties by implementation of this
chapter and shall consider needs, if any, for additional community
mental health services and facilities and reduction in commitments to
state hospitals for the mentally ill accomplished by individual
counties, in planning and providing such funding. The state shall
provide financial assistance to the counties to enable the counties to
meet all increased costs, if any, to the counties resulting from their
administration of the provisions of chapter 142, Laws of 1973 1st ex.
sess.
NEW SECTION. Sec. 319 The department shall adopt such rules as
may be necessary to effectuate the intent and purposes of this chapter,
which shall include but not be limited to evaluation of the quality of
the program and facilities operating pursuant to this chapter,
evaluation of the effectiveness and cost effectiveness of such programs
and facilities, and procedures and standards for certification and
other action relevant to evaluation and treatment facilities.
NEW SECTION. Sec. 320 The provisions of chapter 420, Laws of
1989 shall apply equally to persons in the custody of the department on
May 13, 1989, who were found by a court to be not guilty by reason of
insanity or incompetent to stand trial, or who have been found to have
committed acts constituting a felony pursuant to RCW 71.05.280(3) and
present a substantial likelihood of repeating similar acts, and the
secretary shall cause such persons to be evaluated to ascertain if such
persons are developmentally disabled for placement in a program
specifically reserved for the treatment and training of persons with
developmental disabilities.
NEW SECTION. Sec. 321 (1) The state and counties, cities, and
other municipalities may establish or contract for emergency service
patrols which are to be under the administration of the appropriate
jurisdiction. A patrol consists of persons trained to give assistance
in the streets and in other public places to persons who are
intoxicated. Members of an emergency service patrol shall be capable
of providing first aid in emergency situations and may transport
intoxicated persons to their homes and to and from treatment programs.
(2) The secretary shall adopt rules pursuant to chapter 34.05 RCW
for the establishment, training, and conduct of emergency service
patrols.
NEW SECTION. Sec. 322 The department shall ensure that the
provisions of this chapter are applied by the counties in a consistent
and uniform manner. The department shall also ensure that, to the
extent possible within available funds, the designated chemical
dependency specialists are specifically trained in adolescent chemical
dependency issues, the chemical dependency commitment laws, and the
criteria for commitment.
NEW SECTION. Sec. 323 (1)(a) When a designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder receives information alleging that a person, as a
result of a mental disorder, chemical dependency disorder, or both:
(i) Presents a likelihood of serious harm; or (ii) is gravely disabled;
the designated mental health professional, designated chemical
dependency specialist, or designated crisis responder may, after
investigation and evaluation of the specific facts alleged and of the
reliability and credibility of any person providing information to
initiate detention, if satisfied that the allegations are true and that
the person will not voluntarily seek appropriate treatment, file a
petition for initial detention. Before filing the petition, the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder must personally interview
the person, unless the person refuses an interview, and determine
whether the person will voluntarily receive appropriate evaluation and
treatment at an evaluation and treatment facility.
(b) Whenever it appears, by petition for initial detention, to the
satisfaction of a judge of the superior court that a person presents,
as a result of a mental disorder, chemical dependency disorder, or
both, a likelihood of serious harm, or is gravely disabled, and that
the person has refused or failed to accept appropriate evaluation and
treatment voluntarily, the judge may issue an order requiring the
person to appear within twenty-four hours after service of the order at
a designated evaluation and treatment facility for not more than a
seventy-two hour evaluation and treatment period. The order shall
state the address of the evaluation and treatment facility to which the
person is to report and whether the required seventy-two hour
evaluation and treatment services may be delivered on an outpatient or
inpatient basis and that if the person named in the order fails to
appear at the evaluation and treatment facility at or before the date
and time stated in the order, such person may be involuntarily taken
into custody for evaluation and treatment. The order shall also
designate retained counsel or, if counsel is appointed from a list
provided by the court, the name, business address, and telephone number
of the attorney appointed to represent the person.
(c) The designated mental health professional, designated chemical
dependency specialist, or designated crisis responder shall then serve
or cause to be served on such person, his or her guardian, and
conservator, if any, a copy of the order to appear together with a
notice of rights and a petition for initial detention. After service
on such person the designated mental health professional, designated
chemical dependency specialist, or designated crisis responder shall
file the return of service in court and provide copies of all papers in
the court file to the evaluation and treatment facility and the
designated attorney. The designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder shall notify the court and the prosecuting attorney that a
probable cause hearing will be held within seventy-two hours of the
date and time of outpatient evaluation or admission to the evaluation
and treatment facility. The person shall be permitted to remain in his
or her home or other place of his or her choosing prior to the time of
evaluation and shall be permitted to be accompanied by one or more of
his or her relatives, friends, an attorney, a personal physician, or
other professional or religious advisor to the place of evaluation. An
attorney accompanying the person to the place of evaluation shall be
permitted to be present during the admission evaluation. Any other
individual accompanying the person may be present during the admission
evaluation. The facility may exclude the individual if his or her
presence would present a safety risk, delay the proceedings, or
otherwise interfere with the evaluation.
(d) If the person ordered to appear does appear on or before the
date and time specified, the evaluation and treatment facility may
admit such person as required by RCW 71.05.170 or may provide treatment
on an outpatient basis. If the person ordered to appear fails to
appear on or before the date and time specified, the evaluation and
treatment facility shall immediately notify the designated mental
health professional, designated chemical dependency specialist, or
designated crisis responder who may notify a peace officer to take such
person or cause such person to be taken into custody and placed in an
evaluation and treatment facility. Should the designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder notify a peace officer authorizing him or her to take
a person into custody under the provisions of this subsection, he or
she shall file with the court a copy of such authorization and a notice
of detention. At the time such person is taken into custody there
shall commence to be served on such person, his or her guardian, and
conservator, if any, a copy of the original order together with a
notice of detention, a notice of rights, and a petition for initial
detention.
(2) When a designated mental health professional, designated
chemical dependency specialist, or designated crisis responder receives
information alleging that a person, as the result of a mental disorder,
chemical dependency disorder, or both, presents an imminent likelihood
of serious harm, or is in imminent danger because of being gravely
disabled, after investigation and evaluation of the specific facts
alleged and of the reliability and credibility of the person or persons
providing the information if any, the designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder may take such person, or cause by oral or written
order such person to be taken into emergency custody in an evaluation
and treatment facility for not more than seventy-two hours as described
in RCW 71.05.180.
(3) A peace officer may take such person or cause such person to be
taken into custody and placed in an evaluation and treatment facility
pursuant to subsection (1)(d) of this section.
(4) A peace officer may, without prior notice of the proceedings
provided for in subsection (1) of this section, take or cause such
person to be taken into custody and immediately delivered to an
evaluation and treatment facility or the emergency department of a
local hospital:
(a) Only pursuant to subsections (1)(d) and (2) of this section; or
(b) When he or she has reasonable cause to believe that such person
is suffering from a mental disorder, chemical dependency disorder, or
both and presents an imminent likelihood of serious harm or is in
imminent danger because of being gravely disabled.
(5) Persons delivered to evaluation and treatment facilities by
peace officers pursuant to subsection (4)(b) of this section may be
held by the facility for a period of up to twelve hours: PROVIDED,
That they are examined by a mental health professional within three
hours of their arrival. Within twelve hours of their arrival, the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder must file a supplemental
petition for detention, and commence service on the designated attorney
for the detained person.
NEW SECTION. Sec. 324 Any facility receiving a person pursuant
to RCW 71.05.150 shall require a petition for initial detention stating
the circumstances under which the person's condition was made known and
stating that such officer or person has evidence, as a result of his or
her personal observation or investigation, that the actions of the
person for which application is made constitute a likelihood of serious
harm, or that he or she is gravely disabled, and stating the specific
facts known to him or her as a result of his or her personal
observation or investigation, upon which he or she bases the belief
that such person should be detained for the purposes and under the
authority of this chapter.
If a person is involuntarily placed in an evaluation and treatment
facility pursuant to RCW 71.05.150, on the next judicial day following
the initial detention, the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder shall file with the court and serve the designated attorney
of the detained person the petition or supplemental petition for
initial detention, proof of service of notice, and a copy of a notice
of emergency detention.
NEW SECTION. Sec. 325 Whenever the designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder petitions for detention of a person whose actions
constitute a likelihood of serious harm, or who is gravely disabled,
the facility providing seventy-two hour evaluation and treatment must
immediately accept on a provisional basis the petition and the person.
The facility shall then evaluate the person's condition and admit,
detain, transfer, or discharge such person in accordance with RCW
71.05.210. The facility shall notify in writing the court and the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder of the date and time of the
initial detention of each person involuntarily detained in order that
a probable cause hearing shall be held no later than seventy-two hours
after detention.
The duty of a state hospital to accept persons for evaluation and
treatment under this section shall be limited by chapter 71.24 RCW.
NEW SECTION. Sec. 326 If the evaluation and treatment facility
admits the person, it may detain him or her for evaluation and
treatment for a period not to exceed seventy-two hours from the time of
acceptance as set forth in section 325 of this act. The computation of
such seventy-two hour period shall exclude Saturdays, Sundays and
holidays.
NEW SECTION. Sec. 327 If the person is not approved for
admission by a facility providing seventy-two hour evaluation and
treatment, and the individual has not been arrested, the facility shall
furnish transportation, if not otherwise available, for the person to
his or her place of residence or other appropriate place. If the
individual has been arrested, the evaluation and treatment facility
shall detain the individual for not more than eight hours at the
request of the peace officer in order to enable a peace officer to
return to the facility and take the individual back into custody.
NEW SECTION. Sec. 328 At the expiration of the fourteen-day
period of intensive treatment, a person may be confined for further
treatment pursuant to RCW 71.05.320 if:
(1) Such person after having been taken into custody for evaluation
and treatment has threatened, attempted, or inflicted: (a) Physical
harm upon the person of another or himself or herself, or substantial
damage upon the property of another, and (b) as a result of mental
disorder, chemical dependency disorder, or both presents a likelihood
of serious harm; or
(2) Such person was taken into custody as a result of conduct in
which he or she attempted or inflicted physical harm upon the person of
another or himself or herself, or substantial damage upon the property
of others, and continues to present, as a result of mental disorder,
chemical dependency disorder, or both, a likelihood of serious harm; or
(3) Such person has been determined to be incompetent and criminal
charges have been dismissed pursuant to RCW 10.77.090 (4), and has
committed acts constituting a felony, and as a result of a mental
disorder or co-occurring mental and chemical dependency disorders,
presents a substantial likelihood of repeating similar acts. In any
proceeding pursuant to this subsection it shall not be necessary to
show intent, willfulness, or state of mind as an element of the crime;
or
(4) Such person is gravely disabled.
NEW SECTION. Sec. 329 (1) At any time during a person's fourteen
day intensive treatment period, the professional person in charge of a
treatment facility or his or her professional designee or the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder may petition the superior
court for an order requiring such person to undergo an additional
period of treatment. Such petition must be based on one or more of the
grounds set forth in RCW 71.05.280.
(2) The petition shall summarize the facts which support the need
for further confinement and shall be supported by affidavits signed by
two examining physicians, or by one examining physician and examining
mental health professional. The affidavits shall describe in detail
the behavior of the detained person which supports the petition and
shall explain what, if any, less restrictive treatments which are
alternatives to detention are available to such person, and shall state
the willingness of the affiant to testify to such facts in subsequent
judicial proceedings under this chapter.
(3) If a person has been determined to be incompetent pursuant to
RCW 10.77.090(4), then the professional person in charge of the
treatment facility or his or her professional designee or the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder may directly file a petition
for one hundred eighty day treatment under RCW 71.05.280(3). No
petition for initial detention or fourteen day detention is required
before such a petition may be filed.
NEW SECTION. Sec. 330 The legislature intends that, when
evaluating a person who is identified under RCW 72.09.370(7), the
professional person at the evaluation and treatment facility shall,
when appropriate after consideration of the person's mental condition
and relevant public safety concerns, file a petition for a ninety-day
less restrictive alternative in lieu of a petition for a fourteen-day
commitment.
NEW SECTION. Sec. 331 (1) When a designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder is notified by a jail that a defendant or offender who
was subject to a discharge review under RCW 71.05.232 is to be released
to the community, the designated mental health professional, designated
chemical dependency specialist, or designated crisis responder shall
evaluate the person within seventy-two hours of release.
(2) When an offender is under court-ordered treatment in the
community and the supervision of the department of corrections, and the
treatment provider becomes aware that the person is in violation of the
terms of the court order, the treatment provider shall notify the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder of the violation and request
an evaluation for purposes of revocation of the less restrictive
alternative.
(3) When a designated mental health professional, designated
chemical dependency specialist, or designated crisis responder becomes
aware that an offender who is under court-ordered treatment in the
community and the supervision of the department of corrections is in
violation of a treatment order or a condition of supervision that
relates to public safety, or the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder detains a person under this chapter, the designated mental
health professional, designated chemical dependency specialist, or
designated crisis responder shall notify the person's treatment
provider and the department of corrections.
(4) When an offender who is confined in a state correctional
facility or is under supervision of the department of corrections in
the community is subject to a petition for involuntary treatment under
this chapter, the petitioner shall notify the department of corrections
and the department of corrections shall provide documentation of its
risk assessment or other concerns to the petitioner and the court if
the department of corrections classified the offender as a high risk or
high needs offender.
(5) Nothing in this section creates a duty on any treatment
provider or designated mental health professional, designated chemical
dependency specialist, or designated crisis responder to provide
offender supervision.
NEW SECTION. Sec. 332 (1) If an individual is referred to a
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder under RCW
10.77.090(1)(d)(iii)(A), the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder shall examine the individual within forty-eight hours. If
the designated mental health professional, designated chemical
dependency specialist, or designated crisis responder determines it is
not appropriate to detain the individual or petition for a ninety-day
less restrictive alternative under RCW 71.05.230(4), that decision
shall be immediately presented to the superior court for hearing. The
court shall hold a hearing to consider the decision of the designated
mental health professional, designated chemical dependency specialist,
or designated crisis responder not later than the next judicial day.
At the hearing the superior court shall review the determination of the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder and determine whether an
order should be entered requiring the person to be evaluated at an
evaluation and treatment facility. No person referred to an evaluation
and treatment facility may be held at the facility longer than seventy-two hours.
(2) If an individual is placed in an evaluation and treatment
facility under RCW 10.77.090(1)(d)(iii)(B), a professional person shall
evaluate the individual for purposes of determining whether to file a
ninety-day inpatient or outpatient petition under chapter 71.05 RCW.
Before expiration of the seventy-two hour evaluation period authorized
under RCW 10.77.090(1)(d)(iii)(B), the professional person shall file
a petition or, if the recommendation of the professional person is to
release the individual, present his or her recommendation to the
superior court of the county in which the criminal charge was
dismissed. The superior court shall review the recommendation not
later than forty-eight hours, excluding Saturdays, Sundays, and
holidays, after the recommendation is presented. If the court rejects
the recommendation to unconditionally release the individual, the court
may order the individual detained at a designated evaluation and
treatment facility for not more than a seventy-two hour evaluation and
treatment period and direct the individual to appear at a surety
hearing before that court within seventy-two hours, or the court may
release the individual but direct the individual to appear at a surety
hearing set before that court within eleven days, at which time the
prosecutor may file a petition under this chapter for ninety-day
inpatient or outpatient treatment. If a petition is filed by the
prosecutor, the court may order that the person named in the petition
be detained at the evaluation and treatment facility that performed the
evaluation under this subsection or order the respondent to be in
outpatient treatment. If a petition is filed but the individual fails
to appear in court for the surety hearing, the court shall order that
a mental health professional or peace officer shall take such person or
cause such person to be taken into custody and placed in an evaluation
and treatment facility to be brought before the court the next judicial
day after detention. Upon the individual's first appearance in court
after a petition has been filed, proceedings under RCW 71.05.310 and
71.05.320 shall commence. For an individual subject to this
subsection, the prosecutor or professional person may directly file a
petition for ninety-day inpatient or outpatient treatment and no
petition for initial detention or fourteen-day detention is required
before such a petition may be filed.
The court shall conduct the hearing on the petition filed under
this subsection within five judicial days of the date the petition is
filed. The court may continue the hearing upon the written request of
the person named in the petition or the person's attorney, for good
cause shown, which continuance shall not exceed five additional
judicial days. If the person named in the petition requests a jury
trial, the trial shall commence within ten judicial days of the date of
the filing of the petition. The burden of proof shall be by clear,
cogent, and convincing evidence and shall be upon the petitioner. The
person shall be present at such proceeding, which shall in all respects
accord with the constitutional guarantees of due process of law and the
rules of evidence pursuant to RCW 71.05.250.
During the proceeding the person named in the petition shall
continue to be detained and treated until released by order of the
court. If no order has been made within thirty days after the filing
of the petition, not including any extensions of time requested by the
detained person or his or her attorney, the detained person shall be
released.
(3) If a designated mental health professional, designated chemical
dependency specialist, or designated crisis responder or the
professional person and prosecuting attorney for the county in which
the criminal charge was dismissed or attorney general, as appropriate,
stipulate that the individual does not present a likelihood of serious
harm or is not gravely disabled, the hearing under this section is not
required and the individual, if in custody, shall be released.
(4) The individual shall have the rights specified in RCW
71.05.250.
NEW SECTION. Sec. 333 (1) An intoxicated person may come
voluntarily to an approved treatment program for treatment. A person
who appears to be intoxicated in a public place and to be in need of
help, if he or she consents to the proffered help, may be assisted to
his or her home, an approved treatment program or other health
facility.
(2) Except for a person who may be apprehended for possible
violation of laws not relating to alcoholism, drug addiction, or
intoxication and except for a person who may be apprehended for
possible violation of laws relating to driving or being in physical
control of a vehicle while under the influence of intoxicating liquor
or any drug and except for a person who may wish to avail himself or
herself of the provisions of RCW 46.20.308, a person who appears to be
incapacitated or gravely disabled by alcohol or other drugs and who is
in a public place or who has threatened, attempted, or inflicted
physical harm on himself, herself, or another, shall be taken into
protective custody by a peace officer or staff designated by the county
and as soon as practicable, but in no event beyond eight hours brought
to an approved treatment program for treatment. If no approved
treatment program is readily available he or she shall be taken to an
emergency medical service customarily used for incapacitated persons.
The peace officer or staff designated by the county, in detaining the
person and in taking him or her to an approved treatment program, is
taking him or her into protective custody and shall make every
reasonable effort to protect his or her health and safety. In taking
the person into protective custody, the detaining peace officer or
staff designated by the county may take reasonable steps including
reasonable force if necessary to protect himself or herself or effect
the custody. A taking into protective custody under this section is
not an arrest. No entry or other record shall be made to indicate that
the person has been arrested or charged with a crime.
(3) A person who comes voluntarily or is brought to an approved
treatment program shall be examined by a qualified person. He or she
may then be admitted as a patient or referred to another health
facility, which provides emergency medical treatment, where it appears
that such treatment may be necessary. The referring approved treatment
program shall arrange for his or her transportation.
(4) A person who is found to be incapacitated or gravely disabled
by alcohol or other drugs at the time of his or her admission or to
have become incapacitated or gravely disabled at any time after his or
her admission, may not be detained at the program for more than
seventy-two hours after admission as a patient, unless a petition is
filed under RCW 70.96A.140, as now or hereafter amended: PROVIDED,
That the treatment personnel at an approved treatment program are
authorized to use such reasonable physical restraint as may be
necessary to retain an incapacitated or gravely disabled person for up
to seventy-two hours from the time of admission. The seventy-two hour
periods specified in this section shall be computed by excluding
Saturdays, Sundays, and holidays. A person may consent to remain in
the program as long as the physician in charge believes appropriate.
(5) A person who is not admitted to an approved treatment program,
is not referred to another health facility, and has no funds, may be
taken to his or her home, if any. If he or she has no home, the
approved treatment program shall provide him or her with information
and assistance to access available community shelter resources.
(6) If a patient is admitted to an approved treatment program, his
or her family or next of kin shall be notified as promptly as possible
by the treatment program. If an adult patient who is not incapacitated
requests that there be no notification, his or her request shall be
respected.
(7) The peace officer, staff designated by the county, or treatment
facility personnel, who act in compliance with this chapter and are
performing in the course of their official duty are not criminally or
civilly liable therefor.
(8) If the person in charge of the approved treatment program
determines that appropriate treatment is available, the patient shall
be encouraged to agree to further diagnosis and appropriate voluntary
treatment.
NEW SECTION. Sec. 334 A person detained for seventy-two hour
evaluation and treatment may be detained for not more than fourteen
additional days of involuntary intensive treatment or ninety additional
days of a less restrictive alternative to involuntary intensive
treatment if the following conditions are met:
(1) The professional staff of the agency or facility providing
evaluation services has analyzed the person's condition and finds that
the condition is caused by mental disorder, chemical dependency
disorder, or both, and either results in a likelihood of serious harm,
or results in the detained person being gravely disabled and are
prepared to testify those conditions are met; and
(2) The person has been advised of the need for voluntary treatment
and the professional staff of the facility has evidence that he or she
has not in good faith volunteered; and
(3) The facility providing intensive treatment is certified to
provide such treatment by the department; and
(4) The professional staff of the agency or facility or the
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder has filed a petition for
fourteen day involuntary detention or a ninety day less restrictive
alternative with the court. The petition must be signed either by two
physicians or by one physician and a mental health professional who
have examined the person. If involuntary detention is sought the
petition shall state facts that support the finding that such person,
as a result of mental disorder, chemical dependency disorder, or both,
presents a likelihood of serious harm, or is gravely disabled and that
there are no less restrictive alternatives to detention in the best
interest of such person or others. The petition shall state
specifically that less restrictive alternative treatment was considered
and specify why treatment less restrictive than detention is not
appropriate. If an involuntary less restrictive alternative is sought,
the petition shall state facts that support the finding that such
person, as a result of mental disorder, chemical dependency disorder,
or both, presents a likelihood of serious harm, or is gravely disabled
and shall set forth the less restrictive alternative proposed by the
facility; and
(5) A copy of the petition has been served on the detained person,
his or her attorney and his or her guardian or conservator, if any,
prior to the probable cause hearing; and
(6) The court at the time the petition was filed and before the
probable cause hearing has appointed counsel to represent such person
if no other counsel has appeared; and
(7) The court has ordered a fourteen day involuntary intensive
treatment or a ninety day less restrictive alternative treatment after
a probable cause hearing has been held pursuant to RCW 71.05.240; and
(8) At the conclusion of the initial commitment period, the
professional staff of the agency or facility or the designated mental
health professional, designated chemical dependency specialist, or
designated crisis responder may petition for an additional period of
either ninety days of less restrictive alternative treatment or ninety
days of involuntary intensive treatment as provided in RCW 71.05.290;
and
(9) If the hospital or facility designated to provide outpatient
treatment is other than the facility providing involuntary treatment,
the outpatient facility so designated has agreed to assume such
responsibility.
NEW SECTION. Sec. 335 If a petition is filed for fourteen day
involuntary treatment or ninety days of less restrictive alternative
treatment, the court shall hold a probable cause hearing within
seventy-two hours of the initial detention of such person as determined
in RCW 71.05.180. If requested by the detained person or his or her
attorney, the hearing may be postponed for a period not to exceed
forty-eight hours. The hearing may also be continued subject to the
conditions set forth in RCW 71.05.210 or subject to the petitioner's
showing of good cause for a period not to exceed twenty-four hours.
At the conclusion of the probable cause hearing, if the court finds
by a preponderance of the evidence that such person, as the result of
a mental disorder, chemical dependency disorder, or both, presents a
likelihood of serious harm, or is gravely disabled, and, after
considering less restrictive alternatives to involuntary detention and
treatment, finds that no such alternatives are in the best interests of
such person or others, the court shall order that such person be
detained for involuntary treatment not to exceed fourteen days in a
facility certified to provide treatment by the department. If the
court finds that such person, as the result of a mental disorder,
chemical dependency disorder, or both, presents a likelihood of serious
harm, or is gravely disabled, but that treatment in a less restrictive
setting than detention is in the best interest of such person or
others, the court shall order an appropriate less restrictive course of
treatment for not to exceed ninety days.
The court shall specifically state to such person and give such
person notice in writing that if involuntary treatment beyond the
fourteen day period or beyond the ninety days of less restrictive
treatment is to be sought, such person will have the right to a full
hearing or jury trial as required by RCW 71.05.310. The court shall
also provide written notice that the person is barred from the
possession of firearms.
NEW SECTION. Sec. 336 (1) Involuntary intensive treatment
ordered at the time of the probable cause hearing shall be for no more
than fourteen days, and shall terminate sooner when, in the opinion of
the professional person in charge of the facility or his or her
professional designee, (a) the person no longer constitutes a
likelihood of serious harm, or (b) no longer is gravely disabled, or
(c) is prepared to accept voluntary treatment upon referral, or (d) is
to remain in the facility providing intensive treatment on a voluntary
basis.
(2) A person who has been detained for fourteen days of intensive
treatment shall be released at the end of the fourteen days unless one
of the following applies: (a) Such person agrees to receive further
treatment on a voluntary basis; or (b) such person is a patient to whom
RCW 71.05.280 is applicable.
NEW SECTION. Sec. 337 The petition for ninety day treatment
shall be filed with the clerk of the superior court at least three days
before expiration of the fourteen-day period of intensive treatment.
At the time of filing such petition, the clerk shall set a time for the
person to come before the court on the next judicial day after the day
of filing unless such appearance is waived by the person's attorney,
and the clerk shall notify the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder. The designated mental health professional, designated
chemical dependency specialist, or designated crisis responder shall
immediately notify the person detained, his or her attorney, if any,
and his or her guardian or conservator, if any, and the prosecuting
attorney, and provide a copy of the petition to such persons as soon as
possible.
At the time set for appearance the detained person shall be brought
before the court, unless such appearance has been waived and the court
shall advise him or her of his or her right to be represented by an
attorney and of his or her right to a jury trial. If the detained
person is not represented by an attorney, or is indigent or is
unwilling to retain an attorney, the court shall immediately appoint an
attorney to represent him or her. The court shall, if requested,
appoint a reasonably available licensed physician, psychologist, or
psychiatrist, designated by the detained person to examine and testify
on behalf of the detained person.
The court may, if requested, also appoint a professional person as
defined in RCW 71.05.020 to seek less restrictive alternative courses
of treatment and to testify on behalf of the detained person. In the
case of a developmentally disabled person who has been determined to be
incompetent pursuant to RCW 10.77.090(4), then the appointed
professional person under this section shall be a developmental
disabilities professional.
The court shall also set a date for a full hearing on the petition
as provided in RCW 71.05.310.
NEW SECTION. Sec. 338 The court shall conduct a hearing on the
petition for ninety day treatment within five judicial days of the
first court appearance after the probable cause hearing. The court may
continue the hearing upon the written request of the person named in
the petition or the person's attorney, for good cause shown, which
continuance shall not exceed five additional judicial days. If the
person named in the petition requests a jury trial, the trial shall
commence within ten judicial days of the first court appearance after
the probable cause hearing. The burden of proof shall be by clear,
cogent, and convincing evidence and shall be upon the petitioner. The
person shall be present at such proceeding, which shall in all respects
accord with the constitutional guarantees of due process of law and the
rules of evidence pursuant to RCW 71.05.250.
During the proceeding, the person named in the petition shall
continue to be treated until released by order of the superior court.
If no order has been made within thirty days after the filing of the
petition, not including extensions of time requested by the detained
person or his or her attorney, the detained person shall be released.
NEW SECTION. Sec. 339 (1) If the court or jury finds that
grounds set forth in RCW 71.05.280 have been proven and that the best
interests of the person or others will not be served by a less
restrictive treatment which is an alternative to detention, the court
shall remand him or her to the custody of the department or to a
facility certified for ninety day treatment by the department for a
further period of intensive treatment not to exceed ninety days from
the date of judgment: PROVIDED, That if the grounds set forth in RCW
71.05.280(3) are the basis of commitment, then the period of treatment
may be up to but not exceed one hundred eighty days from the date of
judgment in a facility certified for one hundred eighty day treatment
by the department. If the committed person is developmentally disabled
and has been determined incompetent pursuant to RCW 10.77.090(4), and
the best interests of the person or others will not be served by a
less-restrictive treatment which is an alternative to detention, the
court shall remand him or her to the custody of the department or to a
facility certified for one hundred eighty-day treatment by the
department. When appropriate and subject to available funds, treatment
and training of such persons must be provided in a program specifically
reserved for the treatment and training of developmentally disabled
persons. A person so committed shall receive habilitation services
pursuant to an individualized service plan specifically developed to
treat the behavior which was the subject of the criminal proceedings.
The treatment program shall be administered by developmental
disabilities professionals and others trained specifically in the needs
of developmentally disabled persons. The department may limit
admissions to this specialized program in order to ensure that
expenditures for services do not exceed amounts appropriated by the
legislature and allocated by the department for such services. The
department may establish admission priorities in the event that the
number of eligible persons exceeds the limits set by the department.
An order for treatment less restrictive than involuntary detention may
include conditions, and if such conditions are not adhered to, the
designated mental health professional or developmental disabilities
professional may order the person apprehended under the terms and
conditions of RCW 71.05.340.
If the court or jury finds that grounds set forth in RCW 71.05.280
have been proven, but finds that treatment less restrictive than
detention will be in the best interest of the person or others, then
the court shall remand him or her to the custody of the department or
to a facility certified for ninety day treatment by the department or
to a less restrictive alternative for a further period of less
restrictive treatment not to exceed ninety days from the date of
judgment: PROVIDED, That if the grounds set forth in RCW 71.05.280(3)
are the basis of commitment, then the period of treatment may be up to
but not exceed one hundred eighty days from the date of judgment.
(2) The person shall be released from involuntary treatment at the
expiration of the period of commitment imposed under subsection (1) of
this section unless the superintendent or professional person in charge
of the facility in which he or she is confined, or in the event of a
less restrictive alternative, the designated mental health professional
or developmental disabilities professional, files a new petition for
involuntary treatment on the grounds that the committed person;
(a) During the current period of court ordered treatment: (i) Has
threatened, attempted, or inflicted physical harm upon the person of
another, or substantial damage upon the property of another, and (ii)
as a result of a mental disorder, chemical dependency disorder, or
both, or as the result of a developmental disability, presents a
likelihood of serious harm; or
(b) Was taken into custody as a result of conduct in which he or
she attempted or inflicted serious physical harm upon the person of
another, and continues to present, as a result of mental disorder,
chemical dependency disorder, or both, or as the result of a
developmental disability, a likelihood of serious harm; or
(c) Is in custody pursuant to RCW 71.05.280(3) and as a result of
mental disorder, chemical dependency disorder, or both, or as the
result of a developmental disability, presents a substantial likelihood
of repeating similar acts considering the charged criminal behavior,
life history, progress in treatment, and the public safety; or
(d) Continues to be gravely disabled.
If the conduct required to be proven in (b) and (c) of this
subsection was found by a judge or jury in a prior trial under this
chapter, it shall not be necessary to reprove that element. Such new
petition for involuntary treatment shall be filed and heard in the
superior court of the county of the facility which is filing the new
petition for involuntary treatment unless good cause is shown for a
change of venue. The cost of the proceedings shall be borne by the
state.
The hearing shall be held as provided in RCW 71.05.310, and if the
court or jury finds that the grounds for additional confinement as set
forth in this subsection are present, the court may order the committed
person returned for an additional period of treatment not to exceed one
hundred eighty days from the date of judgment. At the end of the one
hundred eighty day period of commitment, the committed person shall be
released unless a petition for another one hundred eighty day period of
continued treatment is filed and heard in the same manner as provided
in this subsection. Successive one hundred eighty day commitments are
permissible on the same grounds and pursuant to the same procedures as
the original one hundred eighty day commitment.
(3) No person committed as provided in this section may be detained
unless a valid order of commitment is in effect. No order of
commitment can exceed one hundred eighty days in length.
NEW SECTION. Sec. 340 Whenever a designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder or professional person is conducting an evaluation
under this chapter, consideration shall include all reasonably
available information and records regarding: (1) Prior recommendations
for evaluation of the need for civil commitments when the
recommendation is made pursuant to an evaluation conducted under
chapter 10.77 RCW; (2) history of one or more violent acts; (3) prior
determinations of incompetency or insanity under chapter 10.77 RCW; and
(4) prior commitments under this chapter.
In addition, when conducting an evaluation for offenders identified
under RCW 72.09.370, the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder or professional person shall consider an offender's history
of judicially required or administratively ordered antipsychotic
medication while in confinement.
NEW SECTION. Sec. 341 The department shall develop statewide
protocols to be utilized by professional persons, designated mental
health professionals, designated chemical dependency specialists, or
designated crisis responders in administration of this chapter and
chapter 10.77 RCW. The protocols shall be updated at least every three
years. The protocols shall provide uniform development and application
of criteria in evaluation and commitment recommendations, of persons
who have, or are alleged to have, a mental disorder, chemical
dependency disorder, or both, and are subject to this chapter.
The initial protocols shall be developed not later than September
1, 1999. The department shall develop and update the protocols in
consultation with representatives of designated mental health
professionals, designated chemical dependency specialists, or
designated crisis responders, local government, law enforcement, county
and city prosecutors, public defenders, and groups concerned with
mental illness. The protocols shall be submitted to the governor and
legislature upon adoption by the department.
NEW SECTION. Sec. 342 (1) When a designated chemical dependency
specialist is notified by a jail that a defendant or offender who was
subject to a discharge review under RCW 71.05.232 is to be released to
the community, the designated chemical dependency specialist shall
evaluate the person within seventy-two hours of release, if the
person's treatment information indicates that he or she may need
chemical dependency treatment.
(2) When an offender is under court-ordered treatment in the
community and the supervision of the department of corrections, and the
treatment provider becomes aware that the person is in violation of the
terms of the court order, the treatment provider shall notify the
designated chemical dependency specialist of the violation and request
an evaluation for purposes of revocation of the conditional release.
(3) When a designated chemical dependency specialist becomes aware
that an offender who is under court-ordered treatment in the community
and the supervision of the department of corrections is in violation of
a treatment order or a condition of supervision that relates to public
safety, or the designated chemical dependency specialist detains a
person under this chapter, the designated chemical dependency
specialist shall notify the person's treatment provider and the
department of corrections.
(4) When an offender who is confined in a state correctional
facility or is under supervision of the department of corrections in
the community is subject to a petition for involuntary treatment under
this chapter, the petitioner shall notify the department of corrections
and the department of corrections shall provide documentation of its
risk assessment or other concerns to the petitioner and the court if
the department of corrections classified the offender as a high risk or
high needs offender.
(5) Nothing in this section creates a duty on any treatment
provider or designated chemical dependency specialist to provide
offender supervision.
NEW SECTION. Sec. 343 In any proceeding under this chapter to
modify a commitment order of a person committed to inpatient treatment
under grounds set forth in RCW 71.05.280(3) or 71.05.320(2)(c) in which
the requested relief includes treatment less restrictive than
detention, the prosecuting attorney shall be entitled to intervene.
The party initiating the motion to modify the commitment order shall
serve the prosecuting attorney of the county in which the criminal
charges against the committed person were dismissed with written notice
and copies of the initiating papers.
NEW SECTION. Sec. 344 (1)(a) When, in the opinion of the
superintendent or the professional person in charge of the hospital or
facility providing involuntary treatment, the committed person can be
appropriately served by outpatient treatment prior to or at the
expiration of the period of commitment, then such outpatient care may
be required as a term of conditional release for a period which, when
added to the inpatient treatment period, shall not exceed the period of
commitment. If the hospital or facility designated to provide
outpatient treatment is other than the facility providing involuntary
treatment, the outpatient facility so designated must agree in writing
to assume such responsibility. A copy of the terms of conditional
release shall be given to the patient, the designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder in the county in which the patient is to receive
outpatient treatment, and to the court of original commitment.
(b) Before a person committed under grounds set forth in RCW
71.05.280(3) or 71.05.320(2)(c) is conditionally released under (a) of
this subsection, the superintendent or professional person in charge of
the hospital or facility providing involuntary treatment shall in
writing notify the prosecuting attorney of the county in which the
criminal charges against the committed person were dismissed, of the
decision to conditionally release the person. Notice and a copy of the
terms of conditional release shall be provided at least thirty days
before the person is released from inpatient care. Within twenty days
after receiving notice, the prosecuting attorney may petition the court
in the county that issued the commitment order to hold a hearing to
determine whether the person may be conditionally released and the
terms of the conditional release. The prosecuting attorney shall
provide a copy of the petition to the superintendent or professional
person in charge of the hospital or facility providing involuntary
treatment, the attorney, if any, and guardian or conservator of the
committed person, and the court of original commitment. If the county
in which the committed person is to receive outpatient treatment is the
same county in which the criminal charges against the committed person
were dismissed, then the court shall, upon the motion of the
prosecuting attorney, transfer the proceeding to the court in that
county. The court shall conduct a hearing on the petition within ten
days of the filing of the petition. The committed person shall have
the same rights with respect to notice, hearing, and counsel as for an
involuntary treatment proceeding, except as set forth in this
subsection and except that there shall be no right to jury trial. The
issue to be determined at the hearing is whether or not the person may
be conditionally released without substantial danger to other persons,
or substantial likelihood of committing criminal acts jeopardizing
public safety or security. If the court disapproves of the conditional
release, it may do so only on the basis of substantial evidence.
Pursuant to the determination of the court upon the hearing, the
conditional release of the person shall be approved by the court on the
same or modified conditions or the person shall be returned for
involuntary treatment on an inpatient basis subject to release at the
end of the period for which he or she was committed, or otherwise in
accordance with the provisions of this chapter.
(2) The hospital or facility designated to provide outpatient care
or the secretary may modify the conditions for continued release when
such modification is in the best interest of the person. Notification
of such changes shall be sent to all persons receiving a copy of the
original conditions.
(3)(a) If the hospital or facility designated to provide outpatient
care, the designated mental health professional, designated chemical
dependency specialist, or designated crisis responder, or the secretary
determines that:
(i) A conditionally released person is failing to adhere to the
terms and conditions of his or her release;
(ii) Substantial deterioration in a conditionally released person's
functioning has occurred;
(iii) There is evidence of substantial decompensation with a
reasonable probability that the decompensation can be reversed by
further inpatient treatment; or
(iv) The person poses a likelihood of serious harm.
Upon notification by the hospital or facility designated to provide
outpatient care, or on his or her own motion, the designated mental
health professional, designated chemical dependency specialist, or
designated crisis responder or the secretary may order that the
conditionally released person be apprehended and taken into custody and
temporarily detained in an evaluation and treatment facility in or near
the county in which he or she is receiving outpatient treatment.
(b) The hospital or facility designated to provide outpatient
treatment shall notify the secretary or designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder when a conditionally released person fails to adhere
to terms and conditions of his or her conditional release or
experiences substantial deterioration in his or her condition and, as
a result, presents an increased likelihood of serious harm. The
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder or secretary shall order the
person apprehended and temporarily detained in an evaluation and
treatment facility in or near the county in which he or she is
receiving outpatient treatment.
(c) A person detained under this subsection (3) shall be held until
such time, not exceeding five days, as a hearing can be scheduled to
determine whether or not the person should be returned to the hospital
or facility from which he or she had been conditionally released. The
designated mental health professional, designated chemical dependency
specialist, or designated crisis responder or the secretary may modify
or rescind such order at any time prior to commencement of the court
hearing.
(d) The court that originally ordered commitment shall be notified
within two judicial days of a person's detention under the provisions
of this section, and the designated mental health professional,
designated chemical dependency specialist, or designated crisis
responder or the secretary shall file his or her petition and order of
apprehension and detention with the court and serve them upon the
person detained. His or her attorney, if any, and his or her guardian
or conservator, if any, shall receive a copy of such papers as soon as
possible. Such person shall have the same rights with respect to
notice, hearing, and counsel as for an involuntary treatment
proceeding, except as specifically set forth in this section and except
that there shall be no right to jury trial. The issues to be
determined shall be: (i) Whether the conditionally released person did
or did not adhere to the terms and conditions of his or her conditional
release; (ii) that substantial deterioration in the person's
functioning has occurred; (iii) there is evidence of substantial
decompensation with a reasonable probability that the decompensation
can be reversed by further inpatient treatment; or (iv) there is a
likelihood of serious harm; and, if any of the conditions listed in
this subsection (3)(d) have occurred, whether the terms of conditional
release should be modified or the person should be returned to the
facility.
(e) Pursuant to the determination of the court upon such hearing,
the conditionally released person shall either continue to be
conditionally released on the same or modified conditions or shall be
returned for involuntary treatment on an inpatient basis subject to
release at the end of the period for which he or she was committed for
involuntary treatment, or otherwise in accordance with the provisions
of this chapter. Such hearing may be waived by the person and his or
her counsel and his or her guardian or conservator, if any, but shall
not be waivable unless all such persons agree to waive, and upon such
waiver the person may be returned for involuntary treatment or
continued on conditional release on the same or modified conditions.
(4) The proceedings set forth in subsection (3) of this section may
be initiated by the designated mental health professional, designated
chemical dependency specialist, or designated crisis responder or the
secretary on the same basis set forth therein without requiring or
ordering the apprehension and detention of the conditionally released
person, in which case the court hearing shall take place in not less
than five days from the date of service of the petition upon the
conditionally released person.
Upon expiration of the period of commitment, or when the person is
released from outpatient care, notice in writing to the court which
committed the person for treatment shall be provided.
(5) The grounds and procedures for revocation of less restrictive
alternative treatment shall be the same as those set forth in this
section for conditional releases.
(6) In the event of a revocation of a conditional release, the
subsequent treatment period may be for no longer than the actual period
authorized in the original court order.
NEW SECTION. Sec. 345 (1) A person committed to the custody of
a program for treatment shall be discharged at any time before the end
of the period for which he or she has been committed and he or she
shall be discharged by order of the court if either of the following
conditions are met:
(a) In case of a chemically dependent person committed on the
grounds of likelihood of infliction of physical harm upon himself,
herself, or another, the likelihood no longer exists; or further
treatment will not be likely to bring about significant improvement in
the person's condition, or treatment is no longer adequate or
appropriate.
(b) In case of a chemically dependent person committed on the
grounds of the need of treatment and incapacity, that the incapacity no
longer exists.
(2) When in the opinion of the professional person in charge of the
program providing involuntary treatment under this chapter, the
committed patient can be appropriately served by less restrictive
treatment before expiration of the period of commitment, then the less
restrictive care may be required as a condition for early release for
a period which, when added to the initial treatment period, does not
exceed the period of commitment. If the program designated to provide
the less restrictive treatment is other than the program providing the
initial involuntary treatment, the program so designated must agree in
writing to assume such responsibility. A copy of the conditions for
early release shall be given to the patient, the designated chemical
dependency specialist of original commitment, and the court of original
commitment. The program designated to provide less restrictive care
may modify the conditions for continued release when the modifications
are in the best interests of the patient. If the program providing
less restrictive care and the designated chemical dependency specialist
determine that a conditionally released patient is failing to adhere to
the terms and conditions of his or her release, or that substantial
deterioration in the patient's functioning has occurred, then the
designated chemical dependency specialist shall notify the court of
original commitment and request a hearing to be held no less than two
and no more than seven days after the date of the request to determine
whether or not the person should be returned to more restrictive care.
The designated chemical dependency specialist shall file a petition
with the court stating the facts substantiating the need for the
hearing along with the treatment recommendations. The patient shall
have the same rights with respect to notice, hearing, and counsel as
for the original involuntary treatment proceedings. The issues to be
determined at the hearing are whether the conditionally released
patient did or did not adhere to the terms and conditions of his or her
release to less restrictive care or that substantial deterioration of
the patient's functioning has occurred and whether the conditions of
release should be modified or the person should be returned to a more
restrictive program. The hearing may be waived by the patient and his
or her counsel and his or her guardian or conservator, if any, but may
not be waived unless all such persons agree to the waiver. Upon
waiver, the person may be returned for involuntary treatment or
continued on conditional release on the same or modified conditions.
NEW SECTION. Sec. 346 Each person involuntarily detained and
accepted or admitted at an evaluation and treatment facility shall,
within twenty-four hours of his or her admission or acceptance at the
facility, be examined and evaluated by a licensed physician who may be
assisted by a physician assistant according to chapter 18.71A RCW or an
advanced registered nurse practitioner according to chapter 18.79 RCW
and a mental health professional, and shall receive such treatment and
care as his or her condition requires including treatment on an
outpatient basis for the period that he or she is detained, except
that, beginning twenty-four hours prior to a trial or hearing pursuant
to RCW 71.05.215, 71.05.240, 71.05.310, 71.05.320, 71.05.340, or
71.05.370, the individual may refuse psychiatric medications, but may
not refuse: (1) Any other medication previously prescribed by a person
licensed under Title 18 RCW; or (2) emergency lifesaving treatment, and
the individual shall be informed at an appropriate time of his or her
right of such refusal. The person shall be detained up to seventy-two
hours, if, in the opinion of the professional person in charge of the
facility, or his or her professional designee, the person presents a
likelihood of serious harm, or is gravely disabled. A person who has
been detained for seventy-two hours shall no later than the end of such
period be released, unless referred for further care on a voluntary
basis, or detained pursuant to court order for further treatment as
provided in this chapter.
If, after examination and evaluation, the licensed physician and
mental health professional determine that the initial needs of the
person would be better served by placement in a chemical dependency
treatment facility, then the person shall be referred to an approved
treatment program defined under RCW 70.96A.020.
An evaluation and treatment center admitting or accepting any
person pursuant to this chapter whose physical condition reveals the
need for hospitalization shall assure that such person is transferred
to an appropriate hospital for evaluation or admission for treatment.
Notice of such fact shall be given to the court, the designated
attorney, and the designated mental health professional, designated
chemical dependency specialist, or designated crisis responder and the
court shall order such continuance in proceedings under this chapter as
may be necessary, but in no event may this continuance be more than
fourteen days.
NEW SECTION. Sec. 347 At the time a person is involuntarily
admitted to an evaluation and treatment facility, the professional
person in charge or his or her designee shall take reasonable
precautions to inventory and safeguard the personal property of the
person detained. A copy of the inventory, signed by the staff member
making it, shall be given to the person detained and shall, in
addition, be open to inspection to any responsible relative, subject to
limitations, if any, specifically imposed by the detained person. For
purposes of this section, "responsible relative" includes the guardian,
conservator, attorney, spouse, parent, adult child, or adult brother or
sister of the person. The facility shall not disclose the contents of
the inventory to any other person without the consent of the patient or
order of the court.
NEW SECTION. Sec. 348 (1) When a state hospital admits a person
for evaluation or treatment under this chapter who has a history of one
or more violent acts and:
(a) Has been transferred from a correctional facility; or
(b) Is or has been under the authority of the department of
corrections or the indeterminate sentence review board,
the state hospital shall consult with the appropriate corrections and
chemical dependency personnel and the appropriate forensic staff at the
state hospital to conduct a discharge review to determine whether the
person presents a likelihood of serious harm and whether the person is
appropriate for release to a less restrictive alternative.
(2) When a state hospital returns a person who was reviewed under
subsection (1) of this section to a correctional facility, the hospital
shall notify the correctional facility that the person was subject to
a discharge review pursuant to this section.
NEW SECTION. Sec. 349 Nothing in this chapter shall prohibit the
professional person in charge of a treatment facility, or his or her
professional designee, from permitting a person detained for intensive
treatment to leave the facility for prescribed periods during the term
of the person's detention, under such conditions as may be appropriate.
NEW SECTION. Sec. 350 No indigent patient shall be conditionally
released or discharged from involuntary treatment without suitable
clothing, and the superintendent of a state hospital shall furnish the
same, together with such sum of money as he or she deems necessary for
the immediate welfare of the patient. Such sum of money shall be the
same as the amount required by RCW 72.02.100 to be provided to persons
in need being released from correctional institutions. As funds are
available, the secretary may provide payment to indigent persons
conditionally released pursuant to this chapter consistent with the
optional provisions of RCW 72.02.100 and 72.02.110, and may adopt rules
and regulations to do so.
NEW SECTION. Sec. 351 (1) A person who comes voluntarily or is
brought to an approved treatment program shall be examined by a
qualified person. He or she may then be admitted as a patient or
referred to another health facility, which provides emergency medical
treatment, where it appears that such treatment may be necessary. The
referring approved treatment program shall arrange for his or her
transportation.
(2) A person who is not admitted to an approved treatment program,
is not referred to another health facility, and has no funds, may be
taken to his or her home, if any. If he or she has no home, the
approved treatment program shall provide him or her with information
and assistance to access available community shelter resources.
(3) If the person in charge of the approved treatment program
determines that appropriate treatment is available, the patient shall
be encouraged to agree to further diagnosis and appropriate voluntary
treatment.
NEW SECTION. Sec. 352 The approved treatment program shall
provide for adequate and appropriate treatment of a person committed to
its custody. A person committed under this section may be transferred
from one approved public treatment program to another if transfer is
medically advisable.
NEW SECTION. Sec. 353 At the time a person is involuntarily
admitted to an evaluation and treatment facility, the professional
person in charge or his or her designee shall take reasonable
precautions to inventory and safeguard the personal property of the
person detained. A copy of the inventory, signed by the staff member
making it, shall be given to the person detained and shall, in
addition, be open to inspection to any responsible relative, subject to
limitations, if any, specifically imposed by the detained person. For
purposes of this section, "responsible relative" includes the guardian,
conservator, attorney, spouse, parent, adult child, or adult brother or
sister of the person. The facility shall not disclose the contents of
the inventory to any other person without the consent of the patient or
order of the court.
NEW SECTION. Sec. 354 (1) Before a person committed under
grounds set forth in RCW 71.05.280(3) is released because a new
petition for involuntary treatment has not been filed under RCW
71.05.320(2), the superintendent, professional person, or designated
mental health professional responsible for the decision whether to file
a new petition shall in writing notify the prosecuting attorney of the
county in which the criminal charges against the committed person were
dismissed, of the decision not to file a new petition for involuntary
treatment. Notice shall be provided at least forty-five days before
the period of commitment expires.
(2)(a) Before a person committed under grounds set forth in RCW
71.05.280(3) is permitted temporarily to leave a treatment facility
pursuant to RCW 71.05.270 for any period of time without constant
accompaniment by facility staff, the superintendent, professional
person in charge of a treatment facility, or his or her professional
designee shall in writing notify the prosecuting attorney of any county
of the person's destination and the prosecuting attorney of the county
in which the criminal charges against the committed person were
dismissed. The notice shall be provided at least forty-five days
before the anticipated leave and shall describe the conditions under
which the leave is to occur.
(b) The provisions of RCW 71.05.330(2) apply to proposed leaves,
and either or both prosecuting attorneys receiving notice under this
subsection may petition the court under RCW 71.05.330(2).
(3) Nothing in this section shall be construed to authorize
detention of a person unless a valid order of commitment is in effect.
(4) The existence of the notice requirements in this section will
not require any extension of the leave date in the event the leave plan
changes after notification.
(5) The notice requirements contained in this section shall not
apply to emergency medical transfers.
(6) The notice provisions of this section are in addition to those
provided in RCW 71.05.425.
NEW SECTION. Sec. 355 (1) Nothing in this chapter shall prohibit
the superintendent or professional person in charge of the hospital or
facility in which the person is being involuntarily treated from
releasing him or her prior to the expiration of the commitment period
when, in the opinion of the superintendent or professional person in
charge, the person being involuntarily treated no longer presents a
likelihood of serious harm.
Whenever the superintendent or professional person in charge of a
hospital or facility providing involuntary treatment pursuant to this
chapter releases a person prior to the expiration of the period of
commitment, the superintendent or professional person in charge shall
in writing notify the court which committed the person for treatment.
(2) Before a person committed under grounds set forth in RCW
71.05.280(3) or 71.05.320(2)(c) is released under this section, the
superintendent or professional person in charge shall in writing notify
the prosecuting attorney of the county in which the criminal charges
against the committed person were dismissed, of the release date.
Notice shall be provided at least thirty days before the release date.
Within twenty days after receiving notice, the prosecuting attorney may
petition the court in the county in which the person is being
involuntarily treated for a hearing to determine whether the person is
to be released. The prosecuting attorney shall provide a copy of the
petition to the superintendent or professional person in charge of the
hospital or facility providing involuntary treatment, the attorney, if
any, and the guardian or conservator of the committed person. The
court shall conduct a hearing on the petition within ten days of filing
the petition. The committed person shall have the same rights with
respect to notice, hearing, and counsel as for an involuntary treatment
proceeding, except as set forth in this subsection and except that
there shall be no right to jury trial. The issue to be determined at
the hearing is whether or not the person may be released without
substantial danger to other persons, or substantial likelihood of
committing criminal acts jeopardizing public safety or security. If
the court disapproves of the release, it may do so only on the basis of
substantial evidence. Pursuant to the determination of the court upon
the hearing, the committed person shall be released or shall be
returned for involuntary treatment subject to release at the end of the
period for which he or she was committed, or otherwise in accordance
with the provisions of this chapter.
NEW SECTION. Sec. 356 (1)(a) Except as provided in subsection
(2) of this section, at the earliest possible date, and in no event
later than thirty days before conditional release, final release,
authorized leave under RCW 71.05.325(2), or transfer to a facility
other than a state mental hospital, the superintendent shall send
written notice of conditional release, release, authorized leave, or
transfer of a person committed under RCW 71.05.280(3) or
71.05.320(2)(c) following dismissal of a sex, violent, or felony
harassment offense pursuant to RCW 10.77.090(4) to the following:
(i) The chief of police of the city, if any, in which the person
will reside; and
(ii) The sheriff of the county in which the person will reside.
(b) The same notice as required by (a) of this subsection shall be
sent to the following, if such notice has been requested in writing
about a specific person committed under RCW 71.05.280(3) or
71.05.320(2)(c) following dismissal of a sex, violent, or felony
harassment offense pursuant to RCW 10.77.090(4):
(i) The victim of the sex, violent, or felony harassment offense
that was dismissed pursuant to RCW 10.77.090(4) preceding commitment
under RCW 71.05.280(3) or 71.05.320(2)(c) or the victim's next of kin
if the crime was a homicide;
(ii) Any witnesses who testified against the person in any court
proceedings; and
(iii) Any person specified in writing by the prosecuting attorney.
Information regarding victims, next of kin, or witnesses requesting the
notice, information regarding any other person specified in writing by
the prosecuting attorney to receive the notice, and the notice are
confidential and shall not be available to the person committed under
this chapter.
(c) The thirty-day notice requirements contained in this subsection
shall not apply to emergency medical transfers.
(d) The existence of the notice requirements in this subsection
will not require any extension of the release date in the event the
release plan changes after notification.
(2) If a person committed under RCW 71.05.280(3) or 71.05.320(2)(c)
following dismissal of a sex, violent, or felony harassment offense
pursuant to RCW 10.77.090(4) escapes, the superintendent shall
immediately notify, by the most reasonable and expedient means
available, the chief of police of the city and the sheriff of the
county in which the person resided immediately before the person's
arrest. If previously requested, the superintendent shall also notify
the witnesses and the victim of the sex, violent, or felony harassment
offense that was dismissed pursuant to RCW 10.77.090(4) preceding
commitment under RCW 71.05.280(3) or 71.05.320(2) or the victim's next
of kin if the crime was a homicide. In addition, the secretary shall
also notify appropriate parties pursuant to RCW 71.05.410. If the
person is recaptured, the superintendent shall send notice to the
persons designated in this subsection as soon as possible but in no
event later than two working days after the department learns of such
recapture.
(3) If the victim, the victim's next of kin, or any witness is
under the age of sixteen, the notice required by this section shall be
sent to the parent or legal guardian of the child.
(4) The superintendent shall send the notices required by this
chapter to the last address provided to the department by the
requesting party. The requesting party shall furnish the department
with a current address.
(5) For purposes of this section the following terms have the
following meanings:
(a) "Violent offense" means a violent offense under RCW 9.94A.030;
(b) "Sex offense" means a sex offense under RCW 9.94A.030;
(c) "Next of kin" means a person's spouse, parents, siblings, and
children;
(d) "Felony harassment offense" means a crime of harassment as
defined in RCW 9A.46.060 that is a felony.
NEW SECTION. Sec. 357 In addition to any other information
required to be released under this chapter, the department is
authorized, pursuant to RCW 4.24.550, to release relevant information
that is necessary to protect the public, concerning a specific person
committed under RCW 71.05.280(3) or 71.05.320(2)(c) following dismissal
of a sex offense as defined in RCW 9.94A.030.
NEW SECTION. Sec. 358 If a patient is admitted to an approved
treatment program, his or her family or next of kin shall be notified
as promptly as possible by the treatment program. If an adult patient
who is not incapacitated requests that there be no notification, his or
her request shall be respected.
NEW SECTION. Sec. 359 When any court orders a person to receive
treatment under this chapter, the order shall include a statement that
if the person is, or becomes, subject to supervision by the department
of corrections, the person must notify the treatment provider and the
person's chemical dependency treatment information must be shared with
the department of corrections for the duration of the offender's
incarceration and supervision. Upon a petition by a person who does
not have a history of one or more violent acts, as defined in RCW
71.05.020, the court may, for good cause, find that public safety would
not be enhanced by the sharing of this person's information.
NEW SECTION. Sec. 360 Attorneys appointed for persons pursuant
to this chapter shall be compensated for their services as follows:
(1) The person for whom an attorney is appointed shall, if he or she is
financially able pursuant to standards as to financial capability and
indigency set by the superior court of the county in which the
proceeding is held, bear the costs of such legal services; (2) if such
person is indigent pursuant to such standards, the costs of such
services shall be borne by the county in which the proceeding is held,
subject however to the responsibility for costs provided in RCW
71.05.320(2).
NEW SECTION. Sec. 361 In any judicial proceeding for involuntary
commitment or detention, or in any proceeding challenging such
commitment or detention, the prosecuting attorney for the county in
which the proceeding was initiated shall represent the individuals or
agencies petitioning for commitment or detention and shall defend all
challenges to such commitment or detention: PROVIDED, That the
attorney general shall represent and provide legal services and advice
to state hospitals or institutions with regard to all provisions of and
proceedings under this chapter except in proceedings initiated by such
hospitals and institutions seeking fourteen day detention.
NEW SECTION. Sec. 362 When any court orders a person to receive
treatment under this chapter, the order shall include a statement that
if the person is, or becomes, subject to supervision by the department
of corrections, the person must notify the treatment provider and the
person's mental health treatment information must be shared with the
department of corrections for the duration of the offender's
incarceration and supervision, under RCW 71.05.445. Upon a petition by
a person who does not have a history of one or more violent acts, the
court may, for good cause, find that public safety would not be
enhanced by the sharing of this person's information.
NEW SECTION. Sec. 363 In each county the superior court may
appoint the following persons to assist the superior court in disposing
of its business: PROVIDED, That such positions may not be created
without prior consent of the county legislative authority:
(1) One or more attorneys to act as mental health commissioners;
and
(2) Such investigators, stenographers, and clerks as the court
shall find necessary to carry on the work of the mental health
commissioners.
The appointments provided for in this section shall be made by a
majority vote of the judges of the superior court of the county and may
be in addition to all other appointments of commissioners and other
judicial attaches otherwise authorized by law. Mental health
commissioners and investigators shall serve at the pleasure of the
judges appointing them and shall receive such compensation as the
county legislative authority shall determine. The appointments may be
full or part-time positions. A person appointed as a mental health
commissioner may also be appointed to any other commissioner position
authorized by law.
NEW SECTION. Sec. 364 The judges of the superior court of the
county by majority vote may authorize mental health commissioners,
appointed pursuant to RCW 71.05.135, to perform any or all of the
following duties:
(1) Receive all applications, petitions, and proceedings filed in
the superior court for the purpose of disposing of them pursuant to
this chapter;
(2) Investigate the facts upon which to base warrants, subpoenas,
orders to directions in actions, or proceedings filed pursuant to this
chapter;
(3) For the purpose of this chapter, exercise all powers and
perform all the duties of a court commissioner appointed pursuant to
RCW 2.24.010;
(4) Hold hearings in proceedings under this chapter and make
written reports of all proceedings under this chapter which shall
become a part of the record of superior court;
(5) Provide such supervision in connection with the exercise of its
jurisdiction as may be ordered by the presiding judge; and
(6) Cause the orders and findings to be entered in the same manner
as orders and findings are entered in cases in the superior court.
NEW SECTION. Sec. 365 A record of all applications, petitions,
and proceedings under this chapter shall be maintained by the county
clerk in which the application, petition, or proceeding was initiated.
NEW SECTION. Sec. 366 In any judicial proceeding in which a
professional person has made a recommendation regarding whether an
individual should be committed for treatment under this chapter, and
the court does not follow the recommendation, the court shall enter
findings that state with particularity its reasoning, including a
finding whether the state met its burden of proof in showing whether
the person presents a likelihood of serious harm.
NEW SECTION. Sec. 367 In making a determination of whether there
is a likelihood of serious harm in a hearing conducted under RCW
71.05.240 or 71.05.320, the court shall give great weight to any
evidence before the court regarding whether the person has: (1) A
recent history of one or more violent acts; or (2) a recent history of
one or more commitments under this chapter or its equivalent provisions
under the laws of another state which were based on a likelihood of
serious harm. The existence of prior violent acts or commitments under
this chapter or its equivalent shall not be the sole basis for
determining whether a person presents a likelihood of serious harm.
For the purposes of this section "recent" refers to the period of
time not exceeding three years prior to the current hearing.
NEW SECTION. Sec. 368 In determining whether an inpatient or
less restrictive alternative commitment under the process provided in
RCW 71.05.280 and 71.05.320(2) is appropriate, great weight shall be
given to evidence of a prior history or pattern of decompensation and
discontinuation of treatment resulting in: (1) Repeated
hospitalizations; or (2) repeated peace officer interventions resulting
in juvenile offenses, criminal charges, diversion programs, or jail
admissions. Such evidence may be used to provide a factual basis for
concluding that the individual would not receive, if released, such
care as is essential for his or her health or safety.
NEW SECTION. Sec. 369 The supreme court of the state of
Washington shall adopt such rules as it shall deem necessary with
respect to the court procedures and proceedings provided for by this
chapter.
NEW SECTION. Sec. 370 (1) When making a decision under this
chapter whether to require a less restrictive alternative treatment,
the court shall consider whether it is appropriate to include or
exclude time spent in confinement when determining whether the person
has committed a recent overt act.
(2) When determining whether an offender is a danger to himself or
herself or others under this chapter, a court shall give great weight
to any evidence submitted to the court regarding an offender's recent
history of judicially required or administratively ordered involuntary
antipsychotic medication while in confinement.
NEW SECTION. Sec. 371 The venue for proceedings under this
section is the county in which person to be committed resides or is
present.
NEW SECTION. Sec. 372 (1)(a) Every person involuntarily detained
or committed under the provisions of this chapter shall be entitled to
all the rights set forth in this chapter and shall retain all rights
not denied him or her under this chapter except as chapter 9.41 RCW may
limit the right of a person to purchase or possess a firearm or to
qualify for a concealed pistol license.
(b) No person shall be presumed incompetent as a consequence of
receiving an evaluation or voluntary or involuntary treatment for a
mental disorder, chemical dependency disorder, or both, under this
chapter, chapter 71.05 RCW, or any prior laws of this state dealing
with mental illness. Competency shall not be determined or withdrawn
except under the provisions of chapter 10.97 or 11.88 RCW.
(c) Any person who leaves a public or private agency following
evaluation or treatment for a mental disorder, chemical dependency
disorder, or both, shall be given a written statement setting forth the
substance of this section.
(2) Each person involuntarily detained or committed pursuant to
this chapter shall have the right to adequate care and individualized
treatment.
(3) The provisions of this chapter shall not be construed to deny
to any person treatment by spiritual means through prayer in accordance
with the tenets and practices of a church or religious denomination.
(4) Persons receiving evaluation or treatment under this chapter
shall be given a reasonable choice of an available physician or other
professional person qualified to provide such services.
(5) Whenever any person is detained for evaluation and treatment
pursuant to this chapter, both the person and, if possible, a
responsible member of his or her immediate family, guardian, or
conservator, if any, shall be advised as soon as possible in writing or
orally, by the officer or person taking him or her into custody or by
personnel of the evaluation and treatment facility where the person is
detained that unless the person is released or voluntarily admits
himself or herself for treatment within seventy-two hours of the
initial detention:
(a) That a judicial hearing in a superior court, either by a judge
or court commissioner thereof, shall be held not more than seventy-two
hours after the initial detention to determine whether there is
probable cause to detain the person after the seventy-two hours have
expired for up to an additional fourteen days without further automatic
hearing for the reason that the person is a mentally ill person whose
mental disorder, chemical dependency disorder, or both, presents a
likelihood of serious harm or that the person is gravely disabled;
(b) That the person has a right to communicate immediately with an
attorney; has a right to have an attorney appointed to represent him or
her before and at the probable cause hearing if he or she is indigent;
and has the right to be told the name and address of the attorney the
mental health professional has designated pursuant to this chapter;
(c) That the person has the right to remain silent and that any
statement he or she makes may be used against him or her;
(d) That the person has the right to present evidence and to cross-examine witnesses who testify against him or her at the probable cause
hearing; and
(e) That the person has the right to refuse psychiatric
medications, including antipsychotic medication beginning twenty-four
hours prior to the probable cause hearing.
(6) When proceedings are initiated under section 323 (2), (3), or
(4)(b) of this act, no later than twelve hours after such person is
admitted to the evaluation and treatment facility the personnel of the
evaluation and treatment facility or the designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder shall serve on such person a copy of the petition for
initial detention and the name, business address, and phone number of
the designated attorney and shall forthwith commence service of a copy
of the petition for initial detention on the designated attorney.
(7) The judicial hearing described in subsection (5) of this
section is hereby authorized, and shall be held according to the
provisions of subsection (5) of this section and rules promulgated by
the supreme court.
(8) At the probable cause hearing the detained person shall have
the following rights in addition to the rights previously specified:
(a) To present evidence on his or her behalf;
(b) To cross-examine witnesses who testify against him or her;
(c) To be proceeded against by the rules of evidence;
(d) To remain silent;
(e) To view and copy all petitions and reports in the court file.
(9) The physician-patient privilege or the psychologist-client
privilege shall be deemed waived in proceedings under this chapter
relating to the administration of antipsychotic medications. As to
other proceedings under this chapter, the privileges shall be waived
when a court of competent jurisdiction in its discretion determines
that such waiver is necessary to protect either the detained person or
the public.
The waiver of a privilege under this section is limited to records
or testimony relevant to evaluation of the detained person for purposes
of a proceeding under this chapter. Upon motion by the detained person
or on its own motion, the court shall examine a record or testimony
sought by a petitioner to determine whether it is within the scope of
the waiver.
The record maker shall not be required to testify in order to
introduce medical or psychological records of the detained person so
long as the requirements of RCW 5.45.020 are met except that portions
of the record which contains opinions as to the detained person's
mental state must be deleted from such records unless the person making
such conclusions is available for cross-examination.
(10) Insofar as danger to the individual or others is not created,
each person involuntarily detained, treated in a less restrictive
alternative course of treatment, or committed for treatment and
evaluation pursuant to this chapter shall have, in addition to other
rights not specifically withheld by law, the following rights, a list
of which shall be prominently posted in all facilities, institutions,
and hospitals providing such services:
(a) To wear his or her own clothes and to keep and use his or her
own personal possessions, except when deprivation of same is essential
to protect the safety of the resident or other persons;
(b) To keep and be allowed to spend a reasonable sum of his or her
own money for canteen expenses and small purchases;
(c) To have access to individual storage space for his or her
private use;
(d) To have visitors at reasonable times;
(e) To have reasonable access to a telephone, both to make and
receive confidential calls, consistent with an effective treatment
program;
(f) To have ready access to letter writing materials, including
stamps, and to send and receive uncensored correspondence through the
mails;
(g) Not to consent to the administration of antipsychotic
medications beyond the hearing conducted pursuant to section 339 of
this act, or the performance of electroconvulsant therapy or surgery,
except emergency life-saving surgery, unless ordered under section
. . . of this act;
(h) To dispose of property and sign contracts unless such person
has been adjudicated an incompetent in a court proceeding directed to
that particular issue;
(i) Not to have psychosurgery performed on him or her under any
circumstances.
(11) Every person involuntarily detained shall immediately be
informed of his or her right to a hearing to review the legality of his
or her detention and of his or her right to counsel, by the
professional person in charge of the facility providing evaluation and
treatment, or his or her designee, and, when appropriate, by the court.
If the person so elects, the court shall immediately appoint an
attorney to assist him or her.
(12) A person challenging his or her detention or his or her
attorney shall have the right to designate and have the court appoint
a reasonably available independent physician or licensed mental health
professional to examine the person detained, the results of which
examination may be used in the proceeding. The person shall, if he or
she is financially able, bear the cost of such expert information,
otherwise such expert examination shall be at public expense.
(13) Nothing contained in this chapter shall prohibit the patient
from petitioning by writ of habeas corpus for release.
(14) Nothing in this chapter shall prohibit a person committed on
or prior to January 1, 1974, from exercising a right available to him
or her at or prior to January 1, 1974, for obtaining release from
confinement.
(15) The court shall inform the person whose commitment or
recommitment is sought of his or her right to contest the application,
be represented by counsel at every stage of any proceedings relating to
his or her commitment and recommitment, and have counsel appointed by
the court or provided by the court, if he or she wants the assistance
of counsel and is unable to obtain counsel. If the court believes that
the person needs the assistance of counsel, the court shall require, by
appointment if necessary, counsel for him or her regardless of his or
her wishes. The person shall, if he or she is financially able, bear
the costs of such legal service; otherwise such legal service shall be
at public expense. The person whose commitment or recommitment is
sought shall be informed of his or her right to be examined by a
licensed physician of his or her choice. If the person is unable to
obtain a licensed physician and requests examination by a physician,
the court shall employ a licensed physician.
NEW SECTION. Sec. 373 (1) A person who is gravely disabled or
presents a likelihood of serious harm as a result of a mental or
chemical dependency disorder or co-occurring mental and chemical
dependency disorders has a right to refuse antipsychotic medication
unless it is determined that the failure to medicate may result in a
likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment and there is
no less intrusive course of treatment than medication in the best
interest of that person.
(2) The physician must attempt to obtain the informed consent of an
involuntary committed person prior to administration of antipsychotic
medication and document the attempt to obtain consent in the person's
medical record with the reasons that antipsychotic medication is
necessary.
(3) If an involuntary committed person refuses antipsychotic
medications, the medications may not be administered unless the person
has first had a hearing by a panel composed of a psychologist,
psychiatrist, and the medical director of the facility, none of whom
may be involved in the person's treatment at the time of the hearing.
(4) If a majority of the panel determines that there is clear,
cogent, and convincing evidence demonstrating that treatment with
antipsychotic medications is medically appropriate, that failure to
medicate may result in a likelihood of serious harm or substantial
deterioration or substantially prolong the length of involuntary
commitment, and that there is no less intrusive course of treatment
than medication in the best interest of that person, the person may be
medicated, subject to the provisions of subsections (5) through (7) of
this section.
(5) Medication ordered pursuant to a decision of the panel may only
be continued on an involuntary basis if the panel conducts a second
hearing on the written record and a majority of the panel determines
that there continues to be clear, cogent, and convincing evidence
demonstrating that treatment with antipsychotic medications continues
to be medically appropriate, that failure to medicate may result in a
likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment, and that
there is no less intrusive course of treatment than medication in the
best interest of that person.
(a) Following the second hearing, involuntary medication with
antipsychotic medication may be continued if the treating psychiatrist
certifies, not less than every fourteen days, that the medication
continues to be medically appropriate and failure to medicate may
result in a likelihood of serious harm or substantial deterioration or
substantially prolong the length of involuntary commitment, and that
there is no less intrusive course of treatment than medication in the
best interest of that person.
(b) No administrative order for involuntary medication may be
continued beyond one hundred eighty days, or the next commitment
proceeding in the superior court, whichever comes first.
(6) The committed person may appeal the panel's decision to the
medical director within twenty-four hours and the medical director must
decide the appeal within twenty-four hours of receipt.
(7) The committed person may seek judicial review of the medical
director's decision at the next commitment proceeding or by means of an
extraordinary writ.
(8) Minutes of the hearing shall be kept and a copy shall be
provided to the committed person.
(9) With regard to the involuntary medication hearing, the
committed person has the right:
(a) To notice at least twenty-four hours in advance of the hearing
that includes the intent to convene the hearing, the tentative
diagnosis and the factual basis for the diagnosis, and why the staff
believes that medication is necessary;
(b) Not to be medicated between the delivery of the notice and the
hearing;
(c) To attend the hearing;
(d) To present evidence, including witnesses, and to cross-examine
witnesses, including staff;
(e) To the assistance of a lay assistant, who is not involved in
the case and who understands psychiatric issues;
(f) To receive a copy of the minutes of the hearing; and
(g) To appeal the panel's decision to the medical director.
(10) If the person presents an imminent likelihood of serious harm,
and medically acceptable alternatives to administration of
antipsychotic medications are not available or are unlikely to be
successful, and in the opinion of the physician, the person's condition
constitutes an emergency requiring the treatment be instituted prior to
obtaining a second medical opinion, antipsychotic medications may be
administered and the panel must review the decision within twenty-four
hours.
NEW SECTION. Sec. 374 (1) A court of competent jurisdiction may
order that a person involuntarily detained, treated in a less
restrictive alternative course of treatment, or committed for treatment
and evaluation pursuant to this chapter be administered antipsychotic
medications or the performance of electroconvulsant therapy or surgery
pursuant to the following standards and procedures:
(a) The administration of antipsychotic medication or
electroconvulsant therapy shall not be ordered by the court unless the
petitioning party proves by clear, cogent, and convincing evidence that
treatment with antipsychotic medications is medically appropriate, that
failure to medicate may result in a likelihood of serious harm or
substantial deterioration or substantially prolong the length of
involuntary commitment, and that there is no less intrusive course of
treatment than medication or electroconvulsive therapy in the best
interest of the person.
(b) The court shall make specific findings of fact concerning: (i)
The existence of the likelihood of serious harm or substantial
deterioration or substantially prolonging the length of involuntary
commitment; (ii) the necessity and effectiveness of the treatment;
(iii) the person's desires regarding the proposed treatment; and (iv)
the best interests of the person. If the person is unable to make a
rational and informed decision about consenting to or refusing the
proposed electroconvulsive therapy, the court shall make a substituted
judgment for the patient as if he or she were competent to make such a
determination.
(c) The person shall be present at any hearing on a request to
administer antipsychotic medication or electroconvulsant therapy filed
pursuant to this section. The person has the right:
(i) To be represented by an attorney;
(ii) To present evidence;
(iii) To cross-examine witnesses;
(iv) To have the rules of evidence enforced;
(v) To remain silent;
(vi) To view and copy all petitions and reports in the court file;
and
(vii) To be given reasonable notice and an opportunity to prepare
for the hearing.
(d) The court may appoint a psychiatrist, psychologist within their
scope of practice, or physician to examine and testify on behalf of
such person. The court shall appoint a psychiatrist, psychologist
within their scope of practice, or physician designated by such person
or the person's counsel to testify on behalf of the person in cases
where an order for electroconvulsant therapy is sought.
(e) An order for the administration of antipsychotic medications
entered following a hearing conducted pursuant to this section shall be
effective for the period of the current involuntary treatment order,
and any interim period during which the person is awaiting trial or
hearing on a new petition for involuntary treatment or involuntary
medication.
(2) Any person detained pursuant to RCW 71.05.320(2), who
subsequently refuses antipsychotic medication, shall be entitled to the
procedures set forth in subsection (1) of this section.
(3)(a) Antipsychotic medication may be administered to a
nonconsenting person detained or committed pursuant to this chapter
without a court order:
(i) Pursuant to RCW 71.05.215; or
(ii) Under the following circumstances:
(A) A person presents an imminent likelihood of serious harm;
(B) Medically acceptable alternatives to administration of
antipsychotic medications are not available, have not been successful,
or are not likely to be effective; and
(C) In the opinion of the physician with responsibility for
treatment of the person, or his or her designee, the person's condition
constitutes an emergency requiring the treatment be instituted before
a judicial hearing as authorized pursuant to this section can be held.
(b) If antipsychotic medications are administered over a person's
lack of consent pursuant to (a)(ii) of this subsection, a petition for
an order authorizing the administration of antipsychotic medications
shall be filed on the next judicial day. The hearing shall be held
within two judicial days. If deemed necessary by the physician with
responsibility for the treatment of the person, administration of
antipsychotic medications may continue until the hearing is held.
(4) No court has the authority to order psychosurgery performed on
any person involuntarily detained, treated in a less restrictive
alternative course of treatment, or committed for treatment and
evaluation pursuant to this chapter under any circumstances.
NEW SECTION. Sec. 375 (1)(a) In addition to the responsibility
provided for by RCW 43.20B.330, any person, or his or her estate, or
his or her spouse, or the parents of a minor person who is
involuntarily detained pursuant to this chapter for the purpose of
treatment and evaluation outside of a facility maintained and operated
by the department shall be responsible for the cost of such care and
treatment.
(b) In the event that an individual is unable to pay for such
treatment or in the event payment would result in a substantial
hardship upon the individual or his or her family, then the county of
residence of such person shall be responsible for such costs. If it is
not possible to determine the county of residence of the person, the
cost shall be borne by the county where the person was originally
detained.
(c) The department shall, pursuant to chapter 34.05 RCW, adopt
standards as to:
(i) Inability to pay in whole or in part;
(ii) A definition of substantial hardship; and
(iii) Appropriate payment schedules. Such standards shall be
applicable to all county mental health administrative boards.
(d) Financial responsibility with respect to department services
and facilities shall continue to be as provided in RCW 43.20B.320
through 43.20B.360 and 43.20B.370.
(2) If the person has not paid or is unable to pay for treatment or
payment would result in a substantial hardship on the person or his or
her family, the program is entitled to any payment:
(a) Received by the person or to which he or she may be entitled
because of the services rendered; and
(b) From any public or private source available to the program
because of the treatment provided to the person.
(3) The department shall not refuse admission for diagnosis,
evaluation, guidance, or treatment to any applicant because it is
determined that the applicant is financially unable to contribute fully
or in part to the cost of any services.
(4)(a) The department may limit admissions of such applicants or
modify its programs in order to ensure that expenditures for services
or programs do not exceed amounts appropriated by the legislature and
are allocated by the department for such services or programs. The
department may establish admission priorities in the event that the
number of eligible applicants exceeds the limits set by the department.
(b) The department is authorized to allocate appropriated funds in
the manner that it determines best meets the purposes of this chapter.
Nothing in this chapter shall be construed to entitle any individual to
services authorized in this chapter, or to require the department or
its contractors to reallocate funds in order to ensure that services
are available to any eligible person upon demand.
NEW SECTION. Sec. 376 Except as provided in this section, RCW
71.05.445, 71.05.630, 70.96A.150, or pursuant to a valid release under
RCW 70.02.030, the fact of admission and all information and records
compiled, obtained, or maintained in the course of providing services
to either voluntary or involuntary recipients of services at public or
private agencies shall be confidential.
Information and records may be disclosed only:
(1) In communications between qualified professional persons to
meet the requirements of this chapter, in the provision of services or
appropriate referrals, or in the course of guardianship proceedings.
The consent of the patient, or his or her guardian, shall be obtained
before information or records may be disclosed by a professional person
employed by a facility unless provided to a professional person:
(a) Employed by the facility;
(b) Who has medical responsibility for the patient's care;
(c) Who is a designated mental health professional, designated
chemical dependency specialist, or designated crisis responder;
(d) Who is providing services under chapter 71.24 RCW;
(e) Who is employed by a state or local correctional facility where
the person is confined or supervised; or
(f) Who is providing evaluation, treatment, or follow-up services
under chapter 10.77 RCW.
(2) When the communications regard the special needs of a patient
and the necessary circumstances giving rise to such needs and the
disclosure is made by a facility providing outpatient services to the
operator of a care facility in which the patient resides.
(3)(a) When the person receiving services, or his or her guardian,
designates persons to whom information or records may be released, or
if the person is a minor, when his or her parents make such
designation.
(b) A public or private agency shall release to a patient's next of
kin, attorney, guardian, or conservator, if any:
(i) The information that the person is presently a patient in the
facility or that the person is seriously physically ill;
(ii) A statement evaluating the mental and physical condition of
the patient, and a statement of the probable duration of the patient's
confinement, if such information is requested by the next of kin,
attorney, guardian, or conservator; and such other information
requested by the next of kin or attorney as may be necessary to decide
whether or not proceedings should be instituted to appoint a guardian
or conservator.
(4) To the extent necessary for a recipient to make a claim, or for
a claim to be made on behalf of a recipient for aid, insurance, or
medical assistance to which he or she may be entitled.
(5)(a) For either program evaluation or research, or both:
PROVIDED, That the secretary adopts rules for the conduct of the
evaluation or research, or both. Such rules shall include, but need
not be limited to, the requirement that all evaluators and researchers
must sign an oath of confidentiality substantially as follows:
"As a condition of conducting evaluation or research concerning
persons who have received services from (fill in the facility, agency,
or person) I, . . . . . . . . , agree not to divulge, publish, or
otherwise make known to unauthorized persons or the public any
information obtained in the course of such evaluation or research
regarding persons who have received services such that the person who
received such services is identifiable.
I recognize that unauthorized release of confidential information
may subject me to civil liability under the provisions of state law.
| /s/ . . . . . . . . . . . . . . . . . . . . " |
NEW SECTION. Sec. 377 Except as provided in RCW 71.05.425, when
any disclosure of information or records is made as authorized by
sections . . . through . . . of this act, or pursuant to RCW 71.05.390
or 70.96A.150, the physician in charge of the patient or the
professional person in charge of the facility shall promptly cause to
be entered into the patient's medical record the date and circumstances
under which said disclosure was made, the names and relationships to
the patient, if any, of the persons or agencies to whom such disclosure
was made, and the information disclosed.
NEW SECTION. Sec. 378 The files and records of court proceedings
under this chapter, chapters 71.05, 70.96A, and 70.-- (sections 202
through 216 of this act) RCW shall be closed but shall be accessible to
any individual who is the subject of a petition and to the individual's
attorney, guardian ad litem, resource management services, or service
providers authorized to receive such information by resource management
services.
NEW SECTION. Sec. 379 (1) Except as otherwise provided by law,
all treatment records shall remain confidential and may be released
only to the persons designated in this section, or to other persons
designated in an informed written consent of the patient.
(2) Treatment records of an individual may be released without
informed written consent in the following circumstances:
(a) To an individual, organization, or agency as necessary for
management or financial audits, or program monitoring and evaluation.
Information obtained under this subsection shall remain confidential
and may not be used in a manner that discloses the name or other
identifying information about the individual whose records are being
released.
(b) To the department, the director of regional support networks,
or a qualified staff member designated by the director only when
necessary to be used for billing or collection purposes. The
information shall remain confidential.
(c) For purposes of research as permitted in chapter 42.48 RCW.
(d) Pursuant to lawful order of a court.
(e) To qualified staff members of the department, to the director
of regional support networks, to resource management services
responsible for serving a patient, or to service providers designated
by resource management services as necessary to determine the progress
and adequacy of treatment and to determine whether the person should be
transferred to a less restrictive or more appropriate treatment
modality or facility. The information shall remain confidential.
(f) Within the treatment facility where the patient is receiving
treatment, confidential information may be disclosed to individuals
employed, serving in bona fide training programs, or participating in
supervised volunteer programs, at the facility when it is necessary to
perform their duties.
(g) Within the department as necessary to coordinate treatment for
mental illness, developmental disabilities, alcoholism, or drug abuse
of individuals who are under the supervision of the department.
(h) To a licensed physician who has determined that the life or
health of the individual is in danger and that treatment without the
information contained in the treatment records could be injurious to
the patient's health. Disclosure shall be limited to the portions of
the records necessary to meet the medical emergency.
(i) To a facility that is to receive an individual who is
involuntarily committed under chapter 71.05 RCW, or upon transfer of
the individual from one treatment facility to another. The release of
records under this subsection shall be limited to the treatment records
required by law, a record or summary of all somatic treatments, and a
discharge summary. The discharge summary may include a statement of
the patient's problem, the treatment goals, the type of treatment which
has been provided, and recommendation for future treatment, but may not
include the patient's complete treatment record.
(j) Notwithstanding the provisions of RCW 71.05.390(7), to a
correctional facility or a corrections officer who is responsible for
the supervision of an individual who is receiving inpatient or
outpatient evaluation or treatment. Except as provided in RCW
71.05.445 and 71.34.225, release of records under this section is
limited to:
(i) An evaluation report provided pursuant to a written supervision
plan.
(ii) The discharge summary, including a record or summary of all
somatic treatments, at the termination of any treatment provided as
part of the supervision plan.
(iii) When an individual is returned from a treatment facility to
a correctional facility, the information provided under (j)(iv) of this
subsection.
(iv) Any information necessary to establish or implement changes in
the individual's treatment plan or the level or kind of supervision as
determined by resource management services. In cases involving a
person transferred back to a correctional facility, disclosure shall be
made to clinical staff only.
(k) To the individual's counsel or guardian ad litem, without
modification, at any time in order to prepare for involuntary
commitment or recommitment proceedings, reexaminations, appeals, or
other actions relating to detention, admission, commitment, or
patient's rights under chapter 71.05 RCW.
(l) To staff members of the protection and advocacy agency or to
staff members of a private, nonprofit corporation for the purpose of
protecting and advocating the rights of persons with mental illness or
developmental disabilities. Resource management services may limit the
release of information to the name, birthdate, and county of residence
of the patient, information regarding whether the patient was
voluntarily admitted, or involuntarily committed, the date and place of
admission, placement, or commitment, the name and address of a guardian
of the patient, and the date and place of the guardian's appointment.
Any staff member who wishes to obtain additional information shall
notify the patient's resource management services in writing of the
request and of the resource management services' right to object. The
staff member shall send the notice by mail to the guardian's address.
If the guardian does not object in writing within fifteen days after
the notice is mailed, the staff member may obtain the additional
information. If the guardian objects in writing within fifteen days
after the notice is mailed, the staff member may not obtain the
additional information.
(3) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for chemical dependency, the department
may restrict the release of the information as necessary to comply with
federal law and regulations.
NEW SECTION. Sec. 380 (1) Procedures shall be established by
resource management services to provide reasonable and timely access to
individual treatment records. However, access may not be denied at any
time to records of all medications and somatic treatments received by
the individual.
(2) Following discharge, the individual shall have a right to a
complete record of all medications and somatic treatments prescribed
during evaluation, admission, or commitment and to a copy of the
discharge summary prepared at the time of his or her discharge. A
reasonable and uniform charge for reproduction may be assessed.
(3) Treatment records may be modified prior to inspection to
protect the confidentiality of other patients or the names of any other
persons referred to in the record who gave information on the condition
that his or her identity remain confidential. Entire documents may not
be withheld to protect such confidentiality.
(4) At the time of discharge all individuals shall be informed by
resource management services of their rights as provided in RCW
71.05.390, and 71.05.620 through 71.05.690.
NEW SECTION. Sec. 381 Nothing in this chapter, chapter 70.96A,
71.05, or 70.-- (sections 202 through 216 of this act) RCW shall be
construed to interfere with communications between physicians or
psychologists and patients and attorneys and clients.
NEW SECTION. Sec. 382 (1) Neither the state nor any officer of
a public or private agency; superintendent, professional person in
charge or his or her professional designee, or attending staff of any
such agency; public official performing functions necessary to the
administration of this chapter; peace officer; designated mental health
professional, designated chemical dependency specialist, or designated
crisis responder; a unit of local government; or evaluation and
treatment facility shall be civilly or criminally liable for performing
duties pursuant to this chapter with regard to the decision of whether
to admit, discharge, release, administer antipsychotic medications, or
detain a person for evaluation and treatment: PROVIDED, That such
duties were performed in good faith and without gross negligence.
(2) This section does not relieve a person from giving the required
notices under this chapter or chapter 70.96A, 71.05, or 70.-- (sections
202 through 216 of this act), or the duty to warn or to take reasonable
precautions to provide protection from violent behavior where the
patient has communicated an actual threat of physical violence against
a reasonably identifiable victim or victims. The duty to warn or to
take reasonable precautions to provide protection from violent behavior
is discharged if reasonable efforts are made to communicate the threat
to the victim or victims and to law enforcement personnel.
NEW SECTION. Sec. 383 Except as provided in RCW 4.24.550, any
person may bring an action against an individual who has willfully
released confidential information or records concerning him or her in
violation of the provisions of this chapter, for the greater of the
following amounts:
(1) One thousand dollars; or
(2) Three times the amount of actual damages sustained, if any. It
shall not be a prerequisite to recovery under this section that the
plaintiff shall have suffered or be threatened with special, as
contrasted with general, damages.
Any person may bring an action to enjoin the release of
confidential information or records concerning him or her or his or her
ward, in violation of the provisions of this chapter, and may in the
same action seek damages as provided in this section.
The court may award to the plaintiff, should he or she prevail in
an action authorized by this section, reasonable attorney fees in
addition to those otherwise provided by law.
NEW SECTION. Sec. 384 Any person making or filing an application
alleging that a person should be involuntarily detained, certified,
committed, treated, or evaluated pursuant to this chapter shall not be
rendered civilly or criminally liable where the making and filing of
such application was in good faith.
NEW SECTION. Sec. 385 Any individual who knowingly, wilfully or
through gross negligence violates the provisions of this chapter by
detaining a person for more than the allowable number of days shall be
liable to the person detained in civil damages. It shall not be a
prerequisite to an action under this section that the plaintiff shall
have suffered or be threatened with special, as contrasted with general
damages.
NEW SECTION. Sec. 386 Any person who requests or obtains
confidential information pursuant to RCW 71.05.610 through 71.05.690
under false pretenses shall be guilty of a gross misdemeanor.
NEW SECTION. Sec. 387 The provisions of RCW 71.05.550 apply to
this chapter.
NEW SECTION. Sec. 401 A new section is added to chapter 70.96A
RCW to read as follows:
(1) The division of alcohol and substance abuse shall increase its
capacity to serve adults who meet chemical dependency treatment
criteria and who are enrolled in medicaid as follows:
(a) In fiscal year 2006, the division of alcohol and substance
abuse shall serve forty percent of the calculated need; and
(b) In fiscal year 2007, the division of alcohol and substance
abuse shall serve sixty percent of the calculated need.
(2) The division of alcohol and substance abuse shall increase its
capacity to serve minors who have passed their twelfth birthday and who
are not yet eighteen, who are under two hundred percent of the federal
poverty level as follows:
(a) In fiscal year 2006, the division of alcohol and substance
abuse shall serve forty percent of the calculated need; and
(b) In fiscal year 2007, the division of alcohol and substance
abuse shall serve sixty percent of the calculated need.
(3) For purposes of this section, "calculated need" means the
percentage of the population under two hundred percent of the federal
poverty level in need of chemical dependency services as determined in
the 2003 Washington state needs assessment study.
NEW SECTION. Sec. 402 A new section is added to chapter 70.96A
RCW to read as follows:
(1) Not later than July 1, 2006, all persons providing treatment
under this chapter shall use the integrated comprehensive screening
process for chemical dependency and mental disorders adopted pursuant
to section 701 of this act and shall document the numbers of clients
with co-occurring mental and substance abuse disorders based on a
quadrant system of low and high needs.
(2) Not later than January 1, 2007, all persons providing treatment
under this chapter shall also implement the integrated comprehensive
assessment process for chemical dependency and mental disorders adopted
pursuant to section 701 of this act and shall document the numbers of
clients with co-occurring mental and substance abuse disorders based on
a quadrant system of low and high needs.
(3) Treatment providers contracted to provide treatment under this
chapter who fail to implement the integrated comprehensive screening
and assessment process for chemical dependency and mental disorders by
July 1, 2007, are subject to contractual penalties established under
section 701 of this act.
NEW SECTION. Sec. 403 A new section is added to chapter 70.96A
RCW to read as follows:
(1) The director of the division of alcohol and substance abuse
shall assess the availability and cost-effectiveness of converting
disused skilled nursing facilities to inpatient or residential chemical
dependency treatment facilities.
(2) The assessment shall include:
(a) An assessment of the impact of the federal institutions of
mental disease exclusion for purposes of medicaid eligibility;
(b) The viability and cost-effectiveness of contracting with
private, nonprofit entities to operate state-owned facilities and the
difference in rates that would engender;
(c) The viability and cost-effectiveness of leasing state-owned
facilities at market rate to private, nonprofit entities;
(d) The estimated time to operation for these facilities.
(3) The department shall provide the appropriate committees of the
legislature with this assessment, not later than September 1, 2005.
(4) To the extent that the assessment demonstrates that conversion
of disused skilled nursing facilities is consistent with the purposes
of section . . . of this act and capital funds are appropriated for
this purpose, the secretary may acquire and convert such facilities and
enter contracts with private, nonprofit entities to operate them,
provided that rates are set in such a manner that no private, nonprofit
entity receives an effectively higher rate than a comparable vendor
that leases or owns its own facility.
NEW SECTION. Sec. 404 A new section is added to chapter 70.96A
RCW to read as follows:
A petition for commitment under this chapter may be joined with a
petition for commitment under chapter 71.05 RCW.
NEW SECTION. Sec. 405 A new section is added to chapter 70.96A
RCW to read as follows:
(1) The department of social and health services shall contract for
a chemical dependency specialist on site at each division of children
and family services office throughout the state to enhance the
timeliness and quality of child protective services assessments and to
better connect families to needed treatment services.
(2) The chemical dependency specialist's duties may include, but
are not limited to: Conducting on-site chemical dependency screening
and assessment, facilitating progress reports to department social
workers, in-service training of department social workers and staff on
substance abuse issues, referring clients from the department to
treatment providers, and providing consultation on cases to department
social workers.
(3) The department of social and health services shall provide
training in and ensure that each social worker is trained in uniform
assessment for mental health and chemical dependency. This subsection
shall apply to social workers performing risk assessments for the
department's child protective services or child welfare services
clients.
NEW SECTION. Sec. 501 Sections 502 through 533 of this act
constitute a new chapter in Title
NEW SECTION. Sec. 502 (1) The legislature finds that:
(a) There are individuals having medical and mental health
disorders, organic brain disease, traumatic brain injury, or dementia
that result in behavioral and safety issues that make them unsuccessful
in other licensed long-term care settings, such as nursing homes,
boarding homes, adult family homes, or group homes;
(b) Many of these individuals have been served for an extended
period in inappropriate settings such as state mental hospitals,
correctional facilities, and institutions for mental disorders;
(c) Some of the safety and care issues raised by these individuals
are directly related to impulse control issues and may require
additional security; and
(d) A new long-term care licensed facility is needed to meet the
complex long-term and nonemergent short-term care needs of this
population.
(2) Therefore the legislature intends to:
(a) Create a new long-term care licensed entity known as an
enhanced services facility;
(b) Encourage the establishment and maintenance of enhanced
services facilities in communities around the state;
(c) Divert certain individuals from inappropriate placements;
(d) Establish standards for the enhanced services facilities that
provide a humane, safe, and secure environment that adequately serves
and protects residents; and
(e) Establish standards for licensing and enforcement authority.
NEW SECTION. Sec. 503 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "Department" means the department of social and health
services.
(2) "Enhanced services facility" means a facility that provides
treatment and services to individuals who have been determined by the
department to be inappropriate for placement in other long-term care
settings due to complex medical, cognitive, and functional needs that
result in behavioral and safety issues.
(3) "Facility" means an enhanced services facility.
(4) "Physical restraint" means a manual method, obstacle, or
physical or mechanical device, material, or equipment attached or
adjacent to the resident's body that restricts freedom of movement or
access to his or her body, is used for discipline or convenience, and
not required to treat the resident's medical symptoms.
(5) "Resident" means an individual residing in an enhanced services
facility.
(6) "Restraint" means but is not limited to:
(a) Seclusion through placement of a resident alone in an area from
which the resident cannot leave at will;
(b) Chemical restraint through the use of a psychopharmacologic
drug that is used for discipline or convenience and not required to
treat the resident's medical symptoms;
(c) Physical restraint.
(7) "Significant change" means a deterioration in health, mental,
or psychosocial status that has caused or may cause either clinical
complications or life-threatening conditions or a significant
improvement that may affect a resident's eligibility.
NEW SECTION. Sec. 504 This chapter does not apply to the
following residential facilities:
(1) Nursing homes licensed under chapter 18.51 RCW;
(2) Boarding homes licensed under chapter 18.20 RCW;
(3) Adult family homes licensed under chapter 70.128 RCW;
(4) Facilities approved and certified under chapter 71A.22 RCW;
(5) Residential treatment facilities licensed under chapter 71.12
RCW; and
(6) Hospitals licensed under chapter 70.41 RCW.
NEW SECTION. Sec. 505 (1) In the interest of public health,
safety, and welfare, the department shall adopt facility rules
necessary to accomplish the purposes of this chapter.
(2) Such rules shall:
(a) Promote safe treatment and adequate care of individuals
residing in the facility and provide for safe, comfortable, and clean
conditions;
(b) Establish payment rates for facility services; and
(c) Establish license fees.
NEW SECTION. Sec. 506 (1) The standards in this chapter are the
minimum standards for facilities licensed under this chapter.
(2) An application for a license must be made to the department
upon forms provided by the department and must contain such information
as the department reasonably requires.
(3) The license fee shall be submitted with the application.
(4) The department shall provide the applicant with a copy of the
decision granting or denying an application for a license.
(5) The department shall not issue a license to a facility if the
department finds that the facility or any partner, officer, director,
managerial employee, or owner of five percent or more of the assets of
the facility has a history of significant noncompliance with federal or
state laws or regulations related to the provision of care or services
to vulnerable adults or children.
(6) An applicant or facility operator shall demonstrate financial
solvency and have the ability and relevant experience necessary to meet
other relevant safety, health, and operating standards.
NEW SECTION. Sec. 507 (1) No person may operate or maintain a
facility in this state without a license under this chapter.
(2) The licensee shall renew the license annually and pay the
annual license fee prior to renewal.
(3) A licensee shall have readily accessible and available for
review by the department, residents, and the public its license to
operate and a copy of the most recent inspection report and recent
complaint investigation reports issued by the department.
NEW SECTION. Sec. 508 (1) In any case in which the department
finds that a licensee of a facility, or any partner, officer, director,
owner of five percent or more of the assets of the facility, or
managing employee failed or refused to comply with the requirements of
this chapter or the rules established under them, the department may
take any or all of the following actions:
(a) Suspend, revoke, or refuse to renew a license;
(b) Order stop placement; or
(c) Assess civil monetary penalties.
(2) The department may suspend, revoke, or refuse to renew a
license, assess civil monetary penalties, or both, in any case in which
it finds that the licensee of a facility, or any partner, officer,
director, owner of five percent or more of the assets of the facility,
or managing employee:
(a) Operated a facility without a license or under a revoked or
suspended license;
(b) Knowingly or with reason to know made a false statement of a
material fact in the license application or any data attached thereto,
or in any matter under investigation by the department;
(c) Refused to allow representatives or agents of the department to
inspect all books, records, and files required to be maintained or any
portion of the premises of the facility;
(d) Willfully prevented, interfered with, or attempted to impede in
any way the work of any duly authorized representative of the
department and the lawful enforcement of any provision of this chapter;
(e) Willfully prevented or interfered with any representative of
the department in the preservation of evidence of any violation of any
of the provisions of this chapter or of the rules adopted under it; or
(f) Failed to pay any civil monetary penalty assessed by the
department under this chapter within ten days after the assessment
becomes final.
(3)(a) Civil penalties collected under this chapter shall be
deposited into a special fund administered by the department.
(b) Civil monetary penalties, if imposed, may be assessed and
collected, with interest, for each day the facility is or was out of
compliance. Civil monetary penalties shall not exceed three thousand
dollars per day. Each day upon which the same or a substantially
similar action occurs is a separate violation subject to the assessment
of a separate penalty.
(4) The department, through the director of residential care
services, may use the civil penalty monetary fund for the protection of
the health or property of residents of facilities found to be deficient
including:
(a) Payment for the cost of relocation of residents to other
facilities;
(b) Payment to maintain operation of a facility pending correction
of deficiencies or closure; and
(c) Reimbursement of a resident for personal funds or property
loss.
(5)(a) The department may issue a stop placement order on a
facility, effective upon oral or written notice, when the department
determines:
(i) The facility no longer substantially meets the requirements of
this chapter; and
(ii) The deficiency or deficiencies in the facility:
(A) Jeopardizes the health and safety of the residents; or
(B) Seriously limits the facility's capacity to provide adequate
care.
(b) When the department has ordered a stop placement, the
department may approve a readmission to the facility from a hospital,
residential treatment facility, or crisis intervention facility when
the department determines the readmission would be in the best interest
of the individual seeking readmission.
(6) If the department determines that an emergency exists and
resident health and safety is immediately jeopardized as a result of a
facility's failure or refusal to comply with this chapter, the
department may summarily suspend the facility's license and order the
immediate closure of the facility, or the immediate transfer of
residents, or both.
(7) If the department determines that the health or safety of the
residents is immediately jeopardized as a result of a facility's
failure or refusal to comply with requirements of this chapter, the
department may appoint temporary management to:
(a) Oversee the operation of the facility; and
(b) Ensure the health and safety of the facility's residents while:
(i) Orderly closure of the facility occurs; or
(ii) The deficiencies necessitating temporary management are
corrected.
NEW SECTION. Sec. 509 (1) All orders of the department denying,
suspending, or revoking the license or assessing a monetary penalty
shall become final twenty days after the same has been served upon the
applicant or licensee unless a hearing is requested.
(2) All orders of the department imposing stop placement, temporary
management, emergency closure, emergency transfer, or summary license
suspension shall be effective immediately upon notice, pending any
hearing.
(3) Subject to the requirements of subsection (2) of this section,
all hearings under this chapter and judicial review of such
determinations shall be in accordance with the administrative procedure
act, chapter 34.05 RCW.
NEW SECTION. Sec. 510 Operation of a facility without a license
in violation of this chapter and discrimination against medicaid
recipients are unfair or deceptive acts in trade or commerce and an
unfair method of competition for the purpose of applying the consumer
protection act, chapter 19.86 RCW.
NEW SECTION. Sec. 511 A person operating or maintaining a
facility without a license under this chapter is guilty of a
misdemeanor and each day of a continuing violation after conviction
shall be considered a separate offense.
NEW SECTION. Sec. 512 Notwithstanding the existence or use of
any other remedy, the department may, in the manner provided by law,
maintain an action in the name of the state for an injunction, civil
penalty, or other process against a person to restrain or prevent the
operation or maintenance of a facility without a license issued under
this chapter.
NEW SECTION. Sec. 513 (1) The department shall make or cause to
be made at least one inspection of each facility prior to licensure and
an unannounced full inspection of facilities at least once every
eighteen months. The statewide average interval between full facility
inspections must be fifteen months.
(2) Any duly authorized officer, employee, or agent of the
department may enter and inspect any facility at any time to determine
that the facility is in compliance with this chapter and applicable
rules, and to enforce any provision of this chapter. Complaint
inspections shall be unannounced and conducted in such a manner as to
ensure maximum effectiveness. No advance notice shall be given of any
inspection unless authorized or required by federal law.
(3) During inspections, the facility must give the department
access to areas, materials, and equipment used to provide care or
support to residents, including resident and staff records, accounts,
and the physical premises, including the buildings, grounds, and
equipment. The department has the authority to privately interview the
provider, staff, residents, and other individuals familiar with
resident care and treatment.
(4) Any public employee giving advance notice of an inspection in
violation of this section shall be suspended from all duties without
pay for a period of not less than five nor more than fifteen days.
(5) The department shall prepare a written report describing the
violations found during an inspection, and shall provide a copy of the
inspection report to the facility.
(6) The facility shall develop a written plan of correction for any
violations identified by the department and provide a plan of
correction to the department within ten working days from the receipt
of the inspection report.
NEW SECTION. Sec. 514 The facility shall only admit individuals:
(1) Who are over the age of eighteen;
(2) Who meet the resident eligibility requirements described in
section 516 of this act; and
(3) Whose needs the facility can safely and appropriately meet
through qualified and trained staff, services, equipment, and building
design.
NEW SECTION. Sec. 515 A facility shall respect a validly
executed advance directive including a mental health advance directive
under chapter 71.32 RCW pursuant to other provisions of law.
NEW SECTION. Sec. 516 (1) Prior to finding an individual
eligible for placement in a facility, the department shall make a
placement determination evaluation of the individual, unless the
individual is placed in the facility on an emergency basis. If the
resident is placed in the facility on an emergency basis, the placement
determination evaluation shall be completed within twenty-four hours of
placement.
(2) Individuals will be determined to be eligible for placement in
a facility only if all other long-term care options were attempted and
unsuccessful.
(3) The individual will only meet the eligibility requirements if
the following three categories are met:
(a) The individual must have at least one care need that requires:
(i) Daily care by or under the supervision of a registered nurse,
licensed practical nurse, certified or licensed treatment provider, or
mental health or behavioral health specialist; or
(ii) Minimal, substantial, or total assistance with three or more
activities of daily living; and
(b) The individual has traumatic or organic brain injury or other
cognitive impairment, mental illness, or mental disorder that results
in intractable psychiatric symptoms or behaviors requiring ongoing
supervision and facility services and two or more of the following
characteristics:
(i) Frequent or difficult-to-manage self-endangering behaviors;
(ii) Frequent or difficult-to-manage aggressive behaviors that
create a risk of safety, health, or significant property damage to
others;
(iii) Intrusive behaviors that put individuals or others at risk;
(iv) Complex medication needs which include psychotropic
medications; or
(v) Other symptoms identified by the department in rule; and
(c) The individual has two or more of the following placement
histories:
(i) The individual has been unsuccessful, or is likely to be
unsuccessful, in other licensed long-term care facilities, or certified
care settings;
(ii) The individual has a history of other problematic placements
as defined by the department;
(iii) Frequent or protracted mental health hospitalizations; or
(iv) Frequent incarcerations due to offenses against another
person.
NEW SECTION. Sec. 517 (1) The facility shall ensure that each
resident is afforded the basic civil and legal rights under federal and
state laws including the right to be treated with dignity and respect.
(2) Any person committed or admitted to a facility has the right to
adequate care and individualized treatment, including a department
placement evaluation before placement and ongoing resident care
planning.
(3) Residents have the right to the least restrictive treatment
appropriate to their individual condition.
(4) Nothing in this section prohibits a person committed to a
facility from exercising the rights available to them to obtain release
from confinement.
(5) Residents have the right to execute advance directives
regarding their care.
(6) Residents admitted to the facility under a court order shall
have the rights established in subsections (1) through (4) of this
section unless those rights are explicitly limited by applicable court
orders.
NEW SECTION. Sec. 518 (1) The total licensed capacity for a
facility shall not exceed sixteen residents.
(2) The facility shall provide an appropriate level of security
based upon the residents' behaviors and the need to protect residents
and the public.
(3) A facility may only hold one license; however, a facility may
be located in the same building as a licensed nursing home or boarding
home provided that:
(a) The facility is in an area totally separate and discrete from
the other licensed facility; and
(b) The two facilities maintain separate staffing unless limited
shared staffing is specifically authorized by rule.
(4) Nursing homes under chapter 18.51 RCW, boarding homes under
chapter 18.20 RCW, or adult family homes under chapter 70.128 RCW, that
become licensed as facilities under this chapter shall be deemed to
meet the applicable state and local rules, regulations, permits, and
code requirements. All other facilities are required to meet all
applicable state and local rules, regulations, permits, and code
requirements.
NEW SECTION. Sec. 519 The facility shall complete a
comprehensive assessment for each resident within fourteen days of
admission, at a minimum of every six months, and as needed based upon
the changing condition of each resident, including a significant change
of condition or a significant improvement in condition.
NEW SECTION. Sec. 520 The facility shall develop and implement
for each resident a plan of care based upon the resident assessment,
including plans for transfer or discharge and shall revise and update
the plan of care as needed.
NEW SECTION. Sec. 521 (1) The facility shall provide all
resident care and services in the least restrictive manner appropriate
for each resident's needs and abilities.
(2) The facility shall provide each resident with the medical,
personal, health or behavioral support, and mental health services
needed including:
(a) Assistance with activities of daily living;
(b) Medical or habilitative treatment;
(c) Medication services; and
(d) Dietary services.
(3) In the event that an individual is court ordered to reside in
the facility, the facility shall comply with the provisions of the
court order.
NEW SECTION. Sec. 522 (1) The facility shall transfer or
discharge a resident only for medical reasons, the resident's welfare,
the welfare of other residents, or nonpayment.
(2) The facility shall notify the appropriate placement entity to
obtain an evaluation of the resident immediately when there is a
significant change in the resident's behavior or mental condition that
might impact the resident's continued need for placement in the
facility.
NEW SECTION. Sec. 523 (1) The facility shall have staff on duty
on-site, sufficient in number, qualifications, and training to meet the
needs of the residents, and to carry out the provisions of this
chapter.
(2) At a minimum, the staffing must include a licensed nurse on-site twenty-four hours per day. A registered nurse shall be on duty
on-site at least sixteen hours per day, and readily available to the
facility for the remaining eight hours.
NEW SECTION. Sec. 524 (1) Each facility administrator must have
the following minimum qualifications:
(a) Be twenty-one years of age or older;
(b) Be of good moral and responsible character and reputation;
(c) Have a baccalaureate degree from a recognized institution of
higher learning;
(d) Have direct caregiving experience, obtained after age eighteen,
to vulnerable adults in a licensed or contracted setting before
appointment;
(e) Have management and administrative ability to carry out the
requirements of this chapter;
(f) Have sufficient training and experience as described in rule by
the department; and
(g) Have successfully completed a criminal background check through
the Washington state patrol criminal identification system and not been
convicted of any crime listed in RCW 43.43.830 or 43.43.842, or subject
to protective proceedings under chapter 74.34 RCW.
(2) The following individuals are deemed to meet facility
administrator requirements. An individual who:
(a) Successfully completes a background check, under subsection
(1)(g) of this section, before appointment as an administrator of a
facility; and
(b) Is currently licensed as a nursing home administrator; or
(c) Meets current boarding home administrator requirements.
NEW SECTION. Sec. 525 The health care of each resident must be
under the continuing supervision of a physician.
NEW SECTION. Sec. 526 (1) The facility shall develop and
implement written policies and procedures for all care and services
provided directly or indirectly by the facility.
(2) The written policies and procedures shall be made available to
staff, residents, members of residents' families, and the public.
NEW SECTION. Sec. 527 (1) A facility shall post in a place and
manner clearly visible to residents and visitors the toll-free
complaint telephone number maintained by the department.
(2) No facility shall discriminate or retaliate in any manner
against a resident or employee because the resident, employee, or any
other person made a complaint or provided information to the department
or the long-term care ombudsman.
NEW SECTION. Sec. 528 If the facility does not employ a
qualified professional able to furnish needed services, the facility
must have a written contract with a qualified professional or agency
outside the facility to furnish the needed services.
NEW SECTION. Sec. 529 At least sixty days before the effective
date of any change of ownership, or change of management of a facility,
the current operating entity must provide written notification about
the proposed change separately and in writing, to the department, each
resident of the facility, or the resident's guardian or representative.
NEW SECTION. Sec. 530 The facility shall:
(1) Maintain adequate resident records to enable the provision of
the care and services each resident requires and to respond
appropriately in emergency situations;
(2) Comply with the requirements of chapter 70.02 RCW regarding
medical records - health care information, access, and disclosure;
(3) Comply with all applicable state and federal requirements
related to documentation and confidentiality, including chapters 10.77,
10.97, 70.24, 70.96A, and 71.05 RCW; and
(4) If possible, obtain a signed release of information,
designating the department and the licensed facility as recipients of
health and treatment information.
NEW SECTION. Sec. 531 Standards for fire protection and the
enforcement thereof, with respect to all facilities licensed under this
chapter, are the responsibility of the chief of the Washington state
patrol, through the director of fire protection, who must adopt
recognized standards as applicable to facilities for the protection of
life against the cause and spread of fire and fire hazards. If the
facility to be licensed meets with the approval of the chief of the
Washington state patrol, through the director of fire protection, the
director of fire protection must submit to the department a written
report approving the facility with respect to fire protection before a
full license can be issued. The chief of the Washington state patrol,
through the director of fire protection, shall conduct an unannounced
full inspection of facilities at least once every eighteen months. The
statewide average interval between full facility inspections must be
fifteen months.
NEW SECTION. Sec. 532 Inspections of facilities by local
authorities must be consistent with the requirements adopted by the
chief of the Washington state patrol, through the director of fire
protection. Findings of a serious nature must be coordinated with the
department and the chief of the Washington state patrol, through the
director of fire protection, for determination of appropriate actions
to ensure a safe environment for residents. The chief of the
Washington state patrol, through the director of fire protection, has
exclusive authority to determine appropriate corrective action under
this section.
NEW SECTION. Sec. 533 No facility providing care and treatment
for individuals placed in a facility, acting in the course of its
duties, shall be civilly or criminally liable for performing its duties
under this chapter, provided that such duties were performed in good
faith and without gross negligence.
NEW SECTION. Sec. 601 A new section is added to chapter 2.28 RCW
to read as follows:
(1) Counties may establish and operate mental health courts.
(2) For the purposes of this section, "mental health court" means
a court that has special calendars or dockets designed to achieve a
reduction in recidivism and symptoms of mental illness among
nonviolent, mentally ill offenders by increasing their likelihood for
successful rehabilitation through early, continuous, and intense
judicially supervised treatment including drug treatment for persons
with co-occurring disorders; mandatory periodic reviews, including drug
testing if indicated; and the use of appropriate sanctions and other
rehabilitation services.
(3)(a) Any jurisdiction that seeks a state appropriation to fund a
mental health court program must first:
(i) Exhaust all federal funding that is available to support the
operations of its mental health court and associated services; and
(ii) Match, on a dollar-for-dollar basis, state moneys allocated
for mental health court programs with local cash or in-kind resources.
Moneys allocated by the state must be used to supplement, not supplant,
other federal, state, and local funds for mental health court
operations and associated services.
(b) Any county that establishes a mental health court pursuant to
this section shall establish minimum requirements for the participation
of offenders in the program. The mental health court may adopt local
requirements that are more stringent than the minimum. The minimum
requirements are:
(i) The offender would benefit from psychiatric treatment;
(ii) The offender has not previously been convicted of a serious
violent offense or sex offense as defined in RCW 9.94A.030; and
(iii) Without regard to whether proof of any of these elements is
required to convict, the offender is not currently charged with or
convicted of an offense:
(A) That is a sex offense;
(B) That is a serious violent offense;
(C) During which the defendant used a firearm; or
(D) During which the defendant caused substantial or great bodily
harm or death to another person.
NEW SECTION. Sec. 602 A new section is added to chapter 2.28 RCW
to read as follows:
Any county that has established a drug court and a mental health
court under this chapter may combine the functions of both courts into
a single therapeutic court.
NEW SECTION. Sec. 603 A new section is added to chapter 26.12
RCW to read as follows:
(1) Every county with a juvenile or family court shall establish
and operate a family therapeutic court component designed to be
effective for the court's size, location, and resources. A county with
a drug court for criminal cases or with a mental health court may
include a family therapeutic court as a component of its existing
program.
(2) For the purposes of this section, "family therapeutic court"
means a court that has special calendars or dockets designed for the
intense judicial supervision, coordination, and oversight of treatment
provided to parents and families who have substance abuse or mental
health problems and who are involved in the dependency or family law
system and is designed to achieve a reduction in:
(a) Child abuse and neglect;
(b) Out-of-home placement of children;
(c) Termination of parental rights; and
(d) Substance abuse or mental health symptoms among parents or
guardians and their children.
(3) To the extent possible, the family therapeutic court shall
provide services for parents and families co-located with the court or
as near to the court as practicable.
(4) The department of social and health services shall furnish
services to the family therapeutic court unless a court contracts with
providers outside of the department.
(5) Any jurisdiction that receives a state appropriation to fund a
family therapeutic court must first exhaust all federal funding
available for the development and operation of the family therapeutic
court including but not limited to funding from the office of national
drug control policy that is available to support the operations of drug
court and associated services.
(6) Moneys allocated by the state for a family therapeutic court
must be used to supplement, not supplant, other federal, state, local,
and private funding for court operations and associated services under
this section.
(7) Any county that establishes a family therapeutic court or
receives funds for an existing court under this section shall:
(a) Establish minimum requirements for the participation in the
program; and
(b) Develop an evaluation component of the court, including
tracking the success rates in graduating from treatment, reunifying
parents with their children, and the costs and benefits of the court.
NEW SECTION. Sec. 604 A new section is added to chapter 9.94A
RCW to read as follows:
The court may refer any defendant who will benefit from substance
abuse or mental health treatment, or both, to a drug court or mental
health court established under chapter 2.28 RCW if the defendant has
not previously been convicted of a serious violent offense or sex
offense, and is not currently charged with an offense:
(1) That is a sex offense;
(2) That is a serious violent offense;
(3) During which the defendant used a firearm; or
(4) During which the defendant caused substantial or great bodily
harm or death to another person.
Sec. 605 RCW 9.94A.505 and 2002 c 290 s 17, 2002 c 289 s 6, and
2002 c 175 s 6 are each reenacted and amended to read as follows:
(1) When a person is convicted of a felony, the court shall impose
punishment as provided in this chapter.
(2)(a) The court shall impose a sentence as provided in the
following sections and as applicable in the case:
(i) Unless another term of confinement applies, the court shall
impose a sentence within the standard sentence range established in RCW
9.94A.510 or 9.94A.517;
(ii) RCW 9.94A.700 and 9.94A.705, relating to community placement;
(iii) RCW 9.94A.710 and 9.94A.715, relating to community custody;
(iv) RCW 9.94A.545, relating to community custody for offenders
whose term of confinement is one year or less;
(v) RCW 9.94A.570, relating to persistent offenders;
(vi) RCW 9.94A.540, relating to mandatory minimum terms;
(vii) RCW 9.94A.650, relating to the first-time offender waiver;
(viii) RCW 9.94A.660, relating to the drug offender sentencing
alternative;
(ix) RCW 9.94A.670, relating to the special sex offender sentencing
alternative;
(x) RCW 9.94A.712, relating to certain sex offenses;
(xi) RCW 9.94A.535, relating to exceptional sentences;
(xii) RCW 9.94A.589, relating to consecutive and concurrent
sentences.
(b) If a standard sentence range has not been established for the
offender's crime, the court shall impose a determinate sentence which
may include not more than one year of confinement; community
restitution work; until July 1, 2000, a term of community supervision
not to exceed one year and on and after July 1, 2000, a term of
community custody not to exceed one year, subject to conditions and
sanctions as authorized in RCW 9.94A.710 (2) and (3); and/or other
legal financial obligations. The court may impose a sentence which
provides more than one year of confinement if the court finds reasons
justifying an exceptional sentence as provided in RCW 9.94A.535.
(3) Before a defendant is convicted, a court may refer the
defendant to a drug court or mental health court as provided in section
604 of this act.
(4) If the court imposes a sentence requiring confinement of thirty
days or less, the court may, in its discretion, specify that the
sentence be served on consecutive or intermittent days. A sentence
requiring more than thirty days of confinement shall be served on
consecutive days. Local jail administrators may schedule court-ordered
intermittent sentences as space permits.
(((4))) (5) If a sentence imposed includes payment of a legal
financial obligation, it shall be imposed as provided in RCW 9.94A.750,
9.94A.753, 9.94A.760, and 43.43.7541.
(((5))) (6) Except as provided under RCW 9.94A.750(4) and
9.94A.753(4), a court may not impose a sentence providing for a term of
confinement or community supervision, community placement, or community
custody which exceeds the statutory maximum for the crime as provided
in chapter 9A.20 RCW.
(((6))) (7) The sentencing court shall give the offender credit for
all confinement time served before the sentencing if that confinement
was solely in regard to the offense for which the offender is being
sentenced.
(((7))) (8) The court shall order restitution as provided in RCW
9.94A.750 and 9.94A.753.
(((8))) (9) As a part of any sentence, the court may impose and
enforce crime-related prohibitions and affirmative conditions as
provided in this chapter.
(((9))) (10) The court may order an offender whose sentence
includes community placement or community supervision to undergo a
mental status evaluation and to participate in available outpatient
mental health treatment, if the court finds that reasonable grounds
exist to believe that the offender is a mentally ill person as defined
in RCW 71.24.025, and that this condition is likely to have influenced
the offense. An order requiring mental status evaluation or treatment
must be based on a presentence report and, if applicable, mental status
evaluations that have been filed with the court to determine the
offender's competency or eligibility for a defense of insanity. The
court may order additional evaluations at a later date if deemed
appropriate.
(((10))) (11) In any sentence of partial confinement, the court may
require the offender to serve the partial confinement in work release,
in a program of home detention, on work crew, or in a combined program
of work crew and home detention.
(((11))) (12) In sentencing an offender convicted of a crime of
domestic violence, as defined in RCW 10.99.020, if the offender has a
minor child, or if the victim of the offense for which the offender was
convicted has a minor child, the court may, as part of any term of
community supervision, community placement, or community custody, order
the offender to participate in a domestic violence perpetrator program
approved under RCW 26.50.150.
Sec. 606 RCW 74.09.010 and 1990 c 296 s 6 are each amended to
read as follows:
As used in this chapter:
(1) "Children's health program" means the health care services
program provided to children under eighteen years of age and in
households with incomes at or below the federal poverty level as
annually defined by the federal department of health and human services
as adjusted for family size, and who are not otherwise eligible for
medical assistance or the limited casualty program for the medically
needy.
(2) (("Committee" means the children's health services committee
created in section 3 of this act.)) "Community services office" means the county or local office
defined in RCW 74.04.005.
(3)
(3) "Confined" means incarcerated in a correctional institution or
admitted to an institute of mental disease.
(4) "Correctional institution" means a correctional institution
defined in RCW 9.94.049.
(5) "County" means the board of county commissioners, county
council, county executive, or tribal jurisdiction, or its designee. A
combination of two or more county authorities or tribal jurisdictions
may enter into joint agreements to fulfill the requirements of RCW
74.09.415 through 74.09.435.
(((4))) (6) "Department" means the department of social and health
services.
(((5))) (7) "Department of health" means the Washington state
department of health created pursuant to RCW 43.70.020.
(((6))) (8) "Institute of mental disease" has the meaning defined
in 42 C.F.R., part 435, Sec. 1009.
(9) "Internal management" means the administration of medical
assistance, medical care services, the children's health program, and
the limited casualty program.
(((7))) (10) "Likely to be eligible" means that a person:
(a) Was enrolled in the medicaid, supplemental security income, or
social security disability income programs before he or she was
confined and his or her enrollment was terminated during his or her
confinement;
(b) Was enrolled in the medicaid, supplemental security income, or
social security disability income programs at any time during the five
years before his or her confinement; or
(c) Was not previously enrolled in a medicaid, supplemental
security income, or social security disability income program but is
likely to meet eligibility criteria upon his or her release from
confinement.
(11) "Limited casualty program" means the medical care program
provided to medically needy persons as defined under Title XIX of the
federal social security act, and to medically indigent persons who are
without income or resources sufficient to secure necessary medical
services.
(((8))) (12) "Medicaid eligibility category" refers to all existing
eligibility categories established in the state medicaid plan,
including enrollment in medicaid by virtue of eligibility to receive
cash payments under the supplemental security income or social security
disability income programs of the social security administration.
(13) "Medical assistance" means the federal aid medical care
program provided to categorically needy persons as defined under Title
XIX of the federal social security act.
(((9))) (14) "Medical care services" means the limited scope of
care financed by state funds and provided to general assistance
recipients, and recipients of alcohol and drug addiction services
provided under chapter 74.50 RCW.
(((10))) (15) "Nursing home" means nursing home as defined in RCW
18.51.010.
(((11))) (16) "Parent" means a parent, guardian, or legal
custodian.
(17) "Poverty" means the federal poverty level determined annually
by the United States department of health and human services, or
successor agency.
(((12))) (18) "Prerelease agreement" means a formal agreement with
the social security administration under which a correctional agency,
institution for mental diseases, or community services office will work
collaboratively to ensure that applications for supplemental security
income or social security disability income are speedily handled by the
social security administration.
(19) "Secretary" means the secretary of social and health services.
(20) "Suspend" means to place a person's medicaid eligibility on an
inactive status in a manner that the person remains eligible for
medicaid and continues on the state medicaid rolls but medicaid
benefits are not payable for services furnished.
NEW SECTION. Sec. 607 A new section is added to chapter 74.09
RCW to read as follows:
(1) The economic services administration shall adopt standardized
statewide screening and application practices and forms. These
practices and forms shall be implemented in every local office not
later than January 1, 2006.
(2) The forms shall be structured to facilitate completion by
persons with disabilities, including those with mental disorders.
(3) Neither the department nor any local office may exclude a
person from application or screen that person as ineligible for
medicaid based solely on a determination that the person is using or
addicted to alcohol or other psychoactive substances, as defined in
chapter 70.96A RCW.
(4) Neither the department nor any local office may remove a
confined person from an active medicaid caseload sooner than required
by federal law.
(5) Subject to available funds, the department shall provide
persons with technical assistance in preparing applications and
maintaining eligibility for medicaid. The department shall seek public
or private funding to establish technical assistance programs including
bilingual supports and peer support networks.
NEW SECTION. Sec. 608 A new section is added to chapter 74.09
RCW to read as follows:
The department shall adopt rules and policies providing that when
a person with a mental disorder is confined:
(1) The person's eligibility for medicaid will be suspended rather
than terminated for as long as is permitted by federal law;
(2) The person shall not be terminated from medicaid unless the
department determines that, excluding ineligibility based solely on the
person's confinement, the person:
(a) No longer meets the medicaid eligibility criteria under which
he or she had qualified; and
(b) Is not eligible for medicaid under any other medicaid
eligibility criteria; and
(3) The confined person's medicaid eligibility will be fully
restored on the day of release unless and until the department
determines that the individual is no longer eligible for medicaid.
NEW SECTION. Sec. 609 A new section is added to chapter 74.09
RCW to read as follows:
(1) The secretary shall require community services offices to enter
agreements with correctional institutions and institutes for mental
disease to establish practices for the speedy restoration and the
speedy enrollment of persons who are likely to be eligible for medicaid
while confined or upon release for confinement.
(2) At a minimum, the practices shall:
(a) Identify confined persons with mental disorders:
(i) Whose supplemental security income or social security
disability insurance was suspended during confinement;
(ii) Who are likely to be eligible for medicaid while confined or
upon release from confinement; or
(iii) Who are likely to be eligible for supplemental security
income or social security disability insurance upon release from
confinement;
(b) Ensure that, at the earliest possible time, prior to release
when a release date is known, applications for:
(i) Reinstatement of supplemental security income or social
security disability insurance upon release are filed on the person's
behalf;
(ii) Medicaid, supplemental security income, and social security
disability insurance, as appropriate, are filed, to the extent
practicable, well in advance of release and, where possible, at least
ninety days before release;
(c) Assist confined persons with mental disorders who do not have
valid photo identification to acquire the necessary identification to
receive benefits; and
(d) Ensure that when the confined person is able to give informed
consent under chapter 7.70 RCW and refuses to file an application under
this chapter, applications under (b) of this subsection are not
required.
(3)(a) The community services office shall provide all applicants
with a copy of the application.
(b) For those persons who are able to give informed consent under
chapter 7.70 RCW and refuse to file an application under subsection (2)
of this section:
(i) The refusal must be in writing, signed by the person;
(ii) The refusal shall be documented in the person's file by the
community services office and the correctional institution or institute
for mental disease; and
(iii) The community services office shall provide the person with
a copy of the signed refusal.
NEW SECTION. Sec. 610 A new section is added to chapter 74.09
RCW to read as follows:
(1) The department shall:
(a) Establish procedures for receiving medicaid applications on
behalf of confined persons in anticipation of their release from
confinement;
(b) Expeditiously review applications filed on behalf of confined
persons and, to the extent practicable, complete the review before the
person is released. All reviews shall be completed within fourteen
days of receiving the application.
(2) The process shall assess whether the person is presently
eligible to be enrolled in medicaid or likely to be eligible upon
release from confinement.
(a) If the person is eligible to be enrolled while incarcerated,
the person shall be enrolled but placed on suspended status. The
person shall be provided a medicaid card entitling him or her to
receive benefits effective upon his or her release. If the person is
confined in a correctional institution the medicaid card shall be kept
with his or her personal effects and provided to the person upon
release.
(b) If the person is not eligible to be enrolled in medicaid while
confined, but is likely to be eligible for medicaid upon release, the
person shall be enrolled in the temporary medicaid eligibility program
described in section . . . of this act, and placed on suspended status
pending release from confinement. The person shall be provided a
medicaid card entitling him or her to receive benefits under the
temporary medicaid eligibility program effective upon his or her
release. If the person is confined in a correctional institution the
medicaid card shall be kept with his or her personal effects and
provided to the person upon release.
NEW SECTION. Sec. 611 A new section is added to chapter 74.09
RCW to read as follows:
The department shall accept a disability determination made by a
physician or any other health care professional permitted under federal
law after an examination of the confined person.
NEW SECTION. Sec. 612 (1) The joint legislative audit and review
committee shall investigate and assess whether there are existing
facilities in the state that could be converted to use as a regional
jail for offenders who have mental or chemical dependency disorders, or
both, that need specialized housing and treatment arrangements.
(2) The joint legislative audit and review committee shall consider
the feasibility of using at least the following facilities or types of
facilities:
(a) Green Hill School;
(b) Existing or renovated facilities at the former Northern State
Hospital;
(c) Closed wards at Western State Hospital;
(d) Fircrest School; and
(e) Closed or abandoned nursing homes.
(3) The analysis shall include an assessment of when such
facilities could be available for use as a regional jail and the
potential costs, costs avoided, and benefits of at least the following
considerations:
(a) Any impact on existing offenders or residents;
(b) The conversion of the facilities;
(c) Infrastructure tied to the facilities;
(d) Whether the facility is, or can be, sized proportionately to
the available pool of offenders;
(e) Changes in criminal justice costs, including transport, access
to legal assistance, and access to courts;
(f) Reductions in jail populations; and
(g) Changes in treatment costs for these offenders.
(4) The joint legislative audit and review committee shall report
its findings and recommendations to the appropriate committees of the
legislature not later than December 15, 2005.
NEW SECTION. Sec. 613 (1) By January 1, 2006, the department of
social and health services shall reduce the waiting times for
competency evaluation and restoration as follows:
(a) Not longer than seven days for outpatient competency
evaluation;
(b) Not longer than ten days for inpatient competency evaluation;
and
(c) Not longer than seven days for inpatient competency
restoration.
(2) The department of social and health services shall report to
the legislature with an analysis of several alternative strategies for
addressing increases in forensic population and minimizing waiting
periods for competency evaluation and restoration. The report shall
discuss, at a minimum, the costs and advantages of, and barriers to co-locating professional persons in jails, performing restoration
treatment in less restrictive alternatives than the state hospitals,
and the use of regional jail facilities to accomplish competency
evaluation and restoration.
Sec. 614 RCW 71.05.157 and 2004 c 166 s 16 are each amended to
read as follows:
(1) When a county designated mental health professional is notified
by a jail that a defendant or offender who was subject to a discharge
review under RCW 71.05.232 is to be released to the community, the
county designated mental health professional shall evaluate the person
within seventy-two hours of release.
(2) When an offender is under court-ordered treatment in the
community and the supervision of the department of corrections, and the
treatment provider becomes aware that the person is in violation of the
terms of the court order, the treatment provider shall notify the
county designated mental health professional of the violation and
request an evaluation for purposes of revocation of the less
restrictive alternative.
(3) When a county designated mental health professional becomes
aware that an offender who is under court-ordered treatment in the
community and the supervision of the department of corrections is in
violation of a treatment order or a condition of supervision that
relates to public safety, or the county designated mental health
professional detains a person under this chapter, the county designated
mental health professional shall notify the person's treatment provider
and the department of corrections.
(4) When an offender who is confined in a state correctional
facility or is under supervision of the department of corrections in
the community is subject to a petition for involuntary treatment under
this chapter, the petitioner shall notify the department of corrections
and the department of corrections shall provide documentation of its
risk assessment or other concerns to the petitioner and the court if
the department of corrections classified the offender as a high risk or
high needs offender.
(5) Nothing in this section creates a duty on any treatment
provider or county designated mental health professional to provide
offender supervision.
NEW SECTION. Sec. 615 A new section is added to chapter 70.96A
RCW to read as follows:
(1) Treatment providers shall inquire of each person seeking
treatment, at intake, whether the person is subject to court ordered
mental health or chemical dependency treatment, whether civil or
criminal, and document the person's response in his or her record. If
the person is in treatment on the effective date of this section, and
the treatment provider has not inquired whether the person is subject
to court ordered mental health or chemical dependency treatment, the
treatment provider shall inquire on the person's next treatment session
and document the person's response in his or her record.
(2) Treatment providers shall inquire of each person seeking
treatment, at intake, whether the person is subject to supervision of
any kind by the department of corrections and document the person's
response in his or her record. If the person is in treatment on the
effective date of this section, and the treatment provider has not
inquired whether the person is subject to supervision of any kind by
the department of corrections, the treatment provider shall inquire on
the person's next treatment session and document the person's response
in his or her record.
(3) For all persons who are subject to both court ordered mental
health or chemical dependency treatment and supervision by the
department of corrections, the treatment provider shall request an
authorization to release records and notify the person that, unless
expressly excluded by the court order the law requires treatment
providers to share information with the department of corrections and
the person's mental health treatment provider.
(4) If the treatment provider has reason to believe that a person
is subject to supervision by the department of corrections but the
person's record does not indicate that he or she is, the treatment
provider may call any department of corrections office and provide the
person's name and birth date. If the person is subject to supervision,
the treatment provider shall request, and the department of corrections
shall provide, the name and contact information for the person's
community corrections officer.
NEW SECTION. Sec. 701 (1) The department of social and health
services shall adopt, not later than January 1, 2006, an integrated and
comprehensive screening and assessment process for chemical dependency
and mental disorders. The integrated screening process shall be
implemented statewide by all chemical dependency and mental health
treatment providers as well as all county designated mental health
professionals, county designated chemical dependency specialists, and
county designated crisis responders not later than July 1, 2006. The
integrated, comprehensive assessment process shall be implemented
statewide by all chemical dependency and mental health treatment
providers as well as all county designated mental health professionals,
county designated chemical dependency specialists, and county
designated crisis responders not later than January 1, 2007.
(2) The department shall provide adequate training to effect
statewide implementation by the dates designated in this section and
shall report the rates of co-occurring disorders and the stage of
screening or assessment at which the co-occurring disorder was
identified to the caseload forecast council.
(3) The department shall establish contractual penalties to
contracted treatment providers, the regional support networks, and
their contracted providers for failure to implement the integrated
screening and assessment process by July 1, 2007.
NEW SECTION. Sec. 702 A new section is added to chapter 72.23
RCW to read as follows:
(1) The department shall provide the appropriate committees of the
legislature with a clear and concise explanation of the reasons for
reducing state hospital capacity and the differences in costs and
benefits of treatment in state and community hospital treatment.
(2) The department may not reduce the capacity of either state
hospital until at least an equal number of skilled nursing,
residential, expanded services facility, or supported housing
placements are available in the community to the persons displaced by
the capacity reduction. The department shall retain sufficient
capacity at the state hospital to address the cyclical need for
hospitalization for persons moved to the community under a bed
reduction program. For purposes of this section, "sufficient" means
not less than one hospital bed for every ten beds created in the
community unless the department can demonstrate conclusively to the
legislature that a lesser ratio is sufficient.
NEW SECTION. Sec. 801 A new section is added to chapter 71.02
RCW to read as follows:
(1) By June 30, 2006, the department shall develop and implement a
matrix or set of matrices for providing services based on the following
principles:
(a) Maximizing evidence-based practices where these practices
exist; where no evidence-based practice exists, the use of research-based practices, including but not limited to, the adaptation of
evidence-based practices to new situations; where no evidence-based or
research-based practices exist the use of consensus-based practices;
and to the extent that funds are available and, where funds are
available, the use of promising practices;
(b) Maximizing the person's independence, recovery, and employment
by consideration of the person's strengths and supports in the
community;
(c) Maximizing the person's participation in treatment decisions
including, where possible, the person's awareness of, and technical
assistance in preparing, mental health advance directives; and
(d) Collaboration with consumer-based support programs.
(2) The matrix or set of matrices shall include both adults and
children and persons with co-occurring mental and substance abuse
disorders and shall build on the service intensity quadrant models that
have been developed in this state.
(3)(a) The department shall require, by contract with the regional
support networks, that providers maximize the use of evidence-based,
research-based, and consensus-based practices and document the
percentage of clients enrolled in evidence-based, research-based, and
consensus-based programs by program type.
(b) The department shall establish a schedule of penalties for
regional support networks and providers who, by July 1, 2007, are not
using evidence-based, research-based, and consensus-based programs to
provide at least forty percent, and by July 1, 2008, at least sixty
percent, of all services rendered. The regional support network shall
pay the penalties to the department and may require the penalties to be
repaid by the providers.
(4) The following definitions apply to this section:
(a) "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
population.
(b) "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.
(c) "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.
(d) "Promising practice" means a practice that presents, based on
preliminary information, potential for becoming a research-based or
consensus-based practice.
NEW SECTION. Sec. 802 A new section is added to chapter 13.34
RCW to read as follows:
The department of social and health services and the department of
health shall develop and expand comprehensive services for the drug-affected and alcohol-affected infants model project, developed pursuant
to RCW 13.34.800. The expansion shall be in evidence-based, research-based, or consensus-based practices, as those terms are defined in
section 801 of this act, and shall expand capacity in underserved
regions of the state.
NEW SECTION. Sec. 803 A new section is added to chapter 71.02
RCW to read as follows:
(1) The department of social and health services shall collaborate
with community providers of mental health services to identify and
utilize federally qualified health centers for children in out-of-home
care and other populations of vulnerable children who are in need of an
evaluation and treatment for mental health services and do not qualify
for medicaid or treatment services through the regional support
networks.
(2) If no appropriate mental health services are available at a
federally qualified health center for a child described in subsection
(1) of this section, the regional support network must provide a child,
at a minimum, with a mental health evaluation and out-patient mental
health treatment where appropriate.
(3) Where appropriate and available, the department shall refer a
child described in subsection (1) of this section to a primary
intervention program.
NEW SECTION. Sec. 804 The Washington state institute for public
policy shall assess the long-term and intergenerational cost-effectiveness of investing in the treatment of chemical dependency
disorders, mental disorders, and co-occurring mental and substance
abuse disorders. The assessment shall use, to the extent possible,
existing governmental data bases and research and determine the net
present value of costs avoided or minimized. These costs include, but
are not limited to, primary care, jail or prison, competency
evaluations and restorations, child protective services interventions,
dependencies, foster care, emergency service interventions, and
prosecutorial, defense, and court costs. If possible, the institute
shall indicate whether prevention and early intervention programs
differ from acute and chronic treatment programs in long-term cost-effectiveness.
NEW SECTION. Sec. 901 RCW 71.05.035 is recodified as a new
section in chapter 71A.12 RCW.
NEW SECTION. Sec. 902 The sum of . . . . . . dollars, or as much
thereof as may be necessary, is appropriated for the biennium ending
June 30, 2007, from the general fund to the department of social and
health services to provide vendor rate increases for inpatient mental
health treatment providers, children's long-term inpatient treatment
providers, and chemical dependency treatment providers.
The rate increases shall be prioritized for those programs that
maximize the use of evidence-based practices, research-based practices,
and consensus-based practices as defined in section 801 of this act.
NEW SECTION. Sec. 903 If any provision of this act or its
application to any person or circumstance is held invalid, the
remainder of the act or the application of the provision to other
persons or circumstances is not affected.
NEW SECTION. Sec. 904 The following acts or parts of acts are
each repealed:
(1) RCW 71.05.060 (Rights of persons complained against) and 1973
1st ex.s. c 142 s 11;
(2) RCW 71.05.070 (Prayer treatment) and 1973 1st ex.s. c 142 s 12;
(3) RCW 71.05.090 (Choice of physicians) and 1973 2nd ex.s. c 24 s
3 & 1973 1st ex.s. c 142 s 14;
(4) RCW 71.05.200 (Notice and statement of rights -- Probable cause
hearing) and 1998 c 297 s 11, 1997 c 112 s 14, 1989 c 120 s 5, 1974
ex.s. c 145 s 13, & 1973 1st ex.s. c 142 s 25;
(5) RCW 71.05.250 (Probable cause hearing -- Detained person's
rights -- Waiver of privilege -- Limitation -- Records as evidence) and 1989
c 120 s 7, 1987 c 439 s 6, 1974 ex.s. c 145 s 17, & 1973 1st ex.s. c
142 s 30;
(6) RCW 71.05.450 (Competency -- Effect -- Statement of Washington law)
and 1994 sp.s. c 7 s 440 & 1973 1st ex.s. c 142 s 50;
(7) RCW 71.05.460 (Right to counsel) and 1997 c 112 s 33 & 1973 1st
ex.s. c 142 s 51;
(8) RCW 71.05.470 (Right to examination) and 1997 c 112 s 34 & 1973
1st ex.s. c 142 s 52;
(9) RCW 71.05.480 (Petitioning for release -- Writ of habeas corpus)
and 1974 ex.s. c 145 s 29 & 1973 1st ex.s. c 142 s 53; and
(10) RCW 71.05.490 (Rights of persons committed before January 1,
1974) and 1997 c 112 s 35 & 1973 1st ex.s. c 142 s 54.
NEW SECTION. Sec. 905 The following acts or parts of acts are
each repealed:
(1) RCW 71.05.050 (Voluntary application for mental health
services -- Rights -- Review of condition and status -- Detention -- Person
refusing voluntary admission, temporary detention) and 2000 c 94 s 3,
1998 c 297 s 6, 1997 c 112 s 5, 1979 ex.s. c 215 s 6, 1975 1st ex.s. c
199 s 2, 1974 ex.s. c 145 s 6, & 1973 1st ex.s. c 142 s 10;
(2) RCW 71.05.395 (Application of uniform health care information
act, chapter 70.02 RCW) and 1993 c 448 s 8;
(3) RCW 71.05.400 (Release of information to patient's next of kin,
attorney, guardian, conservator -- Notification of patient's death) and
1993 c 448 s 7, 1974 ex.s. c 115 s 1, 1973 2nd ex.s. c 24 s 6, & 1973
1st ex.s. c 142 s 45;
(4) RCW 71.05.410 (Notice of disappearance of patient) and 1997 c
112 s 32, 1973 2nd ex.s. c 24 s 7, & 1973 1st ex.s. c 142 s 46; and
(5) RCW 71.05.430 (Statistical data) and 1973 1st ex.s. c 142 s 48.
NEW SECTION. Sec. 906 RCW 71.05.610 (Treatment records--Definitions) and 1989 c 205 s 11 are each repealed.
NEW SECTION. Sec. 907 The following acts or parts of acts are
each repealed:
(1) RCW 71.05.650 (Treatment records -- Notation of and access to
released data) and 1989 c 205 s 15; and
(2) RCW 71.05.670 (Treatment records -- Violations -- Civil action) and
1999 c 13 s 10.
NEW SECTION. Sec. 908 A new section is added to chapter 82.14
RCW to read as follows:
(1) A county legislative authority may authorize, fix, and impose
a sales and use tax in accordance with the terms of this chapter.
(2) The tax authorized in this section shall be in addition to any
other taxes authorized by law and shall be collected from those persons
who are taxable by the state under chapters 82.08 and 82.12 RCW upon
the occurrence of any taxable event within the county. The rate of tax
shall equal one-tenth of one percent of the selling price in the case
of a sales tax, or value of the article used, in the case of a use tax.
(3) Moneys collected under this section shall be used solely for
the purpose of providing new or expanded chemical dependency or mental
health treatment services. Moneys collected under this section shall
not be used to supplant existing funding for these purposes.
NEW SECTION. Sec. 909 This act shall be so applied and construed
as to effectuate its general purpose to make uniform the law with
respect to the subject of this act among those states which enact it.
NEW SECTION. Sec. 910 Captions and part headings used in this
chapter are not part of the law.
NEW SECTION. Sec. 911 (1) If specific funding for the purposes
of this act, with the exception of sections 301 through 387 of this
act, referencing this act by bill or chapter number, is not provided by
June 30, 2005, this act is null and void.
(2) If specific funding for the purposes of sections 301 through
387 of this act, referencing these sections by bill or chapter number,
or by RCW citation, is not provided by June 30, 2009, sections 301
through 387 of this act are null and void.
NEW SECTION. Sec. 912 The code reviser shall alphabetize and
renumber the definitions, and correct any internal references affected
by this act.
NEW SECTION. Sec. 913 This act is necessary for the immediate
preservation of the public peace, health, or safety, or support of the
state government and its existing public institutions, and takes effect
July 1, 2005, except for sections 302 through 387 of this act, which
take effect July 1, 2009.