BILL REQ. #: S-5265.5
State of Washington | 59th Legislature | 2006 Regular Session |
READ FIRST TIME 02/23/06.
AN ACT Relating to specifying roles and responsibilities with respect to the treatment of persons with mental disorders; amending RCW 71.24.016, 71.24.045, 71.24.300, 71.24.310, 71.24.320, 71.24.3201, 71.24.330, 71.24.360, 72.23.010, 72.23.025, 71.05.120, 71.05.230, 71.05.300, and 71.05.320; reenacting and amending RCW 71.24.025 and 71.24.035; adding a new section to chapter 71.24 RCW; creating new sections; providing an effective date; 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 did not intend to create
statutory causes of actions for regional support networks with the
provisions of chapters 71.05 and 71.24 RCW. The purpose of this act is
to make retroactive, remedial, curative, and technical amendments in
order to resolve any ambiguity about the legislature's intent prior to
September 9, 2005.
Sec. 102 RCW 71.24.016 and 2001 c 323 s 4 are each amended to
read as follows:
(1) The legislature intends that eastern and western state
hospitals shall become clinical centers for handling the most
complicated long-term care needs of patients with a primary diagnosis
of mental disorder. It is further the intent of the legislature that
the community mental health service delivery system focus on
maintaining mentally ill individuals in the community. The program
shall be evaluated and managed through a limited number of performance
measures designed to hold each regional support network accountable for
program success.
(2) The legislature intends to address the needs of people with
mental disorders with a targeted, coordinated, and comprehensive set of
evidence-based practices that are effective in serving individuals in
their community and will reduce the need for placements in state mental
hospitals. The legislature further intends to explicitly hold regional
support networks accountable for serving people with mental disorders
within their geographic boundaries and for not exceeding their
allocation of state hospital beds. Within funds appropriated by the
legislature for this purpose, regional support networks shall develop
the means to serve the needs of people with mental disorders within
their geographic boundaries. Elements of the program may include:
(a) Crisis triage;
(b) Evaluation and treatment and community hospital beds;
(c) Residential beds;
(d) Program for community treatment teams; and
(e) Outpatient services.
(3) The regional support network shall have the flexibility, within
the funds appropriated by the legislature for this purpose, to design
the mix of services that will be most effective within their service
area of meeting the needs of people with mental disorders and avoiding
placement of such individuals at the state mental hospital. Regional
support networks are encouraged to maximize the use of evidence-based
practices and alternative resources with the goal of eliminating the
use of institutions for mental diseases.
NEW SECTION. Sec. 103 A new section is added to chapter 71.24
RCW to read as follows:
Regional support networks have no claim for declaratory relief,
injunctive relief, administrative review, civil liability, or other
relief against the state, state officials, state agencies, or state
employees for actions or inactions performed pursuant to the
administration of this chapter.
Sec. 104 RCW 71.24.025 and 2005 c 504 s 105 and 2005 c 503 s 2
are each reenacted and amended to read as follows:
Unless the context clearly requires otherwise, the definitions in
this section apply throughout this chapter.
(1) "Acutely mentally ill" means a condition which is limited to a
short-term severe crisis episode of:
(a) A mental disorder as defined in RCW 71.05.020 or, in the case
of a child, as defined in RCW 71.34.020;
(b) Being gravely disabled as defined in RCW 71.05.020 or, in the
case of a child, a gravely disabled minor as defined in RCW 71.34.020;
or
(c) Presenting a likelihood of serious harm as defined in RCW
71.05.020 or, in the case of a child, as defined in RCW 71.34.020.
(2) "Available resources" means funds appropriated for the purpose
of providing community mental health programs, federal funds, except
those provided according to Title XIX of the Social Security Act, and
state funds appropriated under this chapter or chapter 71.05 RCW by the
legislature during any biennium for the purpose of providing
residential services, resource management services, community support
services, and other mental health services. This does not include
funds appropriated for the purpose of operating and administering the
state psychiatric hospitals((, except as negotiated according to RCW
71.24.300(1)(d))).
(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, recovery services, and other services determined by regional
support networks.
(8) "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.
(9) "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.
(10) "Department" means the department of social and health
services.
(11) "Designated mental health professional" means a mental health
professional designated by the county or other authority authorized in
rule to perform the duties specified in this chapter.
(12) "Emerging best practice" or "promising practice" means a
practice that presents, based on preliminary information, potential for
becoming a research-based or consensus-based practice.
(13) "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.
(14) "Licensed service provider" means an entity licensed according
to this chapter or chapter 71.05 RCW or an entity deemed to meet state
minimum standards as a result of accreditation by a recognized
behavioral health accrediting body recognized and having a current
agreement with the department, that meets state minimum standards or
persons licensed under chapter 18.57, 18.71, 18.83, or 18.79 RCW, as it
applies to registered nurses and advanced registered nurse
practitioners.
(15) "Mental health services" means all services provided by
regional support networks and other services provided by the state for
the mentally ill.
(16) "Mentally ill persons" and "the mentally ill" mean persons and
conditions defined in subsections (1), (4), (25), and (26) of this
section.
(17) "Recovery" means the process in which people are able to live,
work, learn, and participate fully in their communities.
(18) "Regional support network" means a county authority or group
of county authorities or other nonprofit entity recognized by the
secretary in contract in a defined region.
(19) "Registration records" include all the records of the
department, regional support networks, treatment facilities, and other
persons providing services to the department, county departments, or
facilities which identify persons who are receiving or who at any time
have received services for mental illness.
(20) "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, boarding homes, and
adult family homes, and may include outpatient services provided as an
element in a package of services in a supported housing model.
Residential services for children in out-of-home placements related to
their mental disorder shall not include the costs of food and shelter,
except for children's long-term residential facilities existing prior
to January 1, 1991.
(21) "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.
(22) "Resilience" means the personal and community qualities that
enable individuals to rebound from adversity, trauma, tragedy, threats,
or other stresses, and to live productive lives.
(23) "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
designated mental health professionals, evaluation and treatment
facilities, and others as determined by the regional support network.
(24) "Secretary" means the secretary of social and health services.
(25) "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.
(26) "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.
(27) "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.
(28) "Treatment records" include registration and all other records
concerning persons who are receiving or who at any time have received
services for mental illness, which are maintained by the department, by
regional support networks and their staffs, and by treatment
facilities. Treatment records do not include notes or records
maintained for personal use by a person providing treatment services
for the department, regional support networks, or a treatment facility
if the notes or records are not available to others.
(29) "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. 105 RCW 71.24.045 and 2005 c 503 s 8 are each amended to
read as follows:
The regional support network shall:
(1) Contract as needed with licensed service providers. The
regional support network may, in the absence of a licensed service
provider entity, become a licensed service provider entity pursuant to
minimum standards required for licensing by the department for the
purpose of providing services not available from licensed service
providers;
(2) Operate as a licensed service provider if it deems that doing
so is more efficient and cost effective than contracting for services.
When doing so, the regional support network shall comply with rules
promulgated by the secretary that shall provide measurements to
determine when a regional support network provided service is more
efficient and cost effective;
(3) Monitor and perform biennial fiscal audits of licensed service
providers who have contracted with the regional support network to
provide services required by this chapter. The monitoring and audits
shall be performed by means of a formal process which insures that the
licensed service providers and professionals designated in this
subsection meet the terms of their contracts;
(4) Assure that the special needs of minorities, the elderly,
disabled, children, and low-income persons are met within the
priorities established in this chapter;
(5) Maintain patient tracking information in a central location as
required for resource management services and the department's
information system;
(6) ((Use not more than two percent of state-appropriated community
mental health funds, which shall not include federal funds, to
administer community mental health programs under RCW 71.24.155:
PROVIDED, That county authorities serving a county or combination of
counties whose population is one hundred twenty-five thousand or more
may be entitled to sufficient state-appropriated community mental
health funds to employ up to one full-time employee or the equivalent
thereof in addition to the two percent limit established in this
subsection when such employee is providing staff services to a county
mental health advisory board;)) Collaborate to ensure that policies do not result in an
adverse shift of mentally ill persons into state and local correctional
facilities;
(7)
(((8))) (7) Work with the department to expedite the enrollment or
re-enrollment of eligible persons leaving state or local correctional
facilities and institutions for mental diseases;
(((9))) (8) If a regional support network is not operated by the
county, work closely with the county designated mental health
professional or county designated crisis responder to maximize
appropriate placement of persons into community services; ((and)) (9) Coordinate services for individuals who have received
services through the community mental health system and who become
patients at a state mental hospital to ensure they are transitioned
into the community upon mutual determination by the medical director of
the state mental hospital, or designee and the regional support network
administration that they no longer need intensive inpatient care; and
(10)
(10) Review all initial petitions for long-term inpatient care
under RCW 71.05.280 to determine whether the needs of the individual
can be met through community support services in a less restrictive
alternative to detention. Documentation of the review and the less
restrictive alternative considered must be provided to the state mental
hospital whenever it is determined that a less restrictive alternative
is not available. Regional support networks must provide a less
restrictive alternative to detention whenever it is determined that the
needs of the individual can be met through community support services.
Sec. 106 RCW 71.24.300 and 2005 c 503 s 11 are each amended to
read as follows:
(1) Upon the request of a tribal authority or authorities within a
regional support network the joint operating agreement or the county
authority shall allow for the inclusion of the tribal authority to be
represented as a party to the regional support network.
(2) The roles and responsibilities of the county and tribal
authorities shall be determined by the terms of that agreement
including a determination of membership on the governing board and
advisory committees, the number of tribal representatives to be party
to the agreement, and the provisions of law and shall assure the
provision of culturally competent services to the tribes served.
(3) The state mental health authority may not determine the roles
and responsibilities of county authorities as to each other under
regional support networks by rule, except to assure that all duties
required of regional support networks are assigned and that counties
and the regional support network do not duplicate functions and that a
single authority has final responsibility for all available resources
and performance under the regional support network's contract with the
secretary.
(4) If a regional support network is a private nonprofit entity,
the department shall allow for the inclusion of the tribal authority to
be represented as a party to the regional support network.
(5) The roles and responsibilities of the private nonprofit entity
and the tribal authorities shall be determined by the department,
through negotiation with the tribal authority.
(((1))) (6) Regional support networks shall submit an overall six-
year operating and capital plan, timeline, and budget and submit
progress reports and an updated two-year plan biennially thereafter, to
assume within available resources all of the following duties:
(a) Administer and provide for the availability of all resource
management services, residential services, and community support
services.
(b) Administer and provide for the availability of all
investigation, transportation, court-related, and other services
provided by the state or counties pursuant to chapter 71.05 RCW.
(c) Provide within the boundaries of each regional support network
evaluation and treatment services for ((at least eighty-five percent
of)) all persons detained or committed for periods up to seventeen days
according to chapter 71.05 RCW. Regional support networks ((with
populations of less than one hundred fifty thousand)) may contract to
purchase evaluation and treatment services from other networks if they
are unable to provide for appropriate less restrictive resources within
their boundaries. Insofar as the original intent of serving persons in
the community is maintained, the secretary is authorized to approve
exceptions on a case-by-case basis to the requirement to provide
evaluation and treatment services within the boundaries of each
regional support network. Such exceptions are limited to:
(i) Contracts with neighboring or contiguous regions; or
(ii) Individuals detained or committed for periods up to seventeen
days at the state hospitals at the discretion of the secretary.
(d) ((Administer a portion of funds appropriated by the legislature
to house mentally ill persons in state institutions from counties
within the boundaries of any regional support network, with the
exception of persons currently confined at, or under the supervision
of, a state mental hospital pursuant to chapter 10.77 RCW, and provide
for the care of all persons needing evaluation and treatment services
for periods up to seventeen days according to chapter 71.05 RCW in
appropriate residential services, which may include state institutions.
The regional support networks shall reimburse the state for use of
state institutions at a rate equal to that assumed by the legislature
when appropriating funds for such care at state institutions during the
biennium when reimbursement occurs. The secretary shall submit a
report to the appropriate committees of the senate and house of
representatives on the efforts to implement this section by October 1,
2002. The duty of a state hospital to accept persons for evaluation
and treatment under chapter 71.05 RCW is limited by the
responsibilities assigned to regional support networks under this
section.)) Administer and provide for the availability of all other
mental health services, which shall include patient counseling, day
treatment, consultation, education services, employment services as
defined in RCW 71.24.035, and mental health services to children.
(e)
(((f))) (e) Establish standards and procedures for reviewing
individual service plans and determining when that person may be
discharged from resource management services.
(((2))) (7) A regional support network may request that any state-owned land, building, facility, or other capital asset which was ever
purchased, deeded, given, or placed in trust for the care of the
mentally ill and which is within the boundaries of a regional support
network be made available to support the operations of the regional
support network. State agencies managing such capital assets shall
give first priority to requests for their use pursuant to this chapter.
(((3))) (8) Each regional support network shall appoint a mental
health advisory board which shall review and provide comments on plans
and policies developed under this chapter, provide local oversight
regarding the activities of the regional support network, and work with
the regional support network to resolve significant concerns regarding
service delivery and outcomes. The department shall establish
statewide procedures for the operation of regional advisory committees
including mechanisms for advisory board feedback to the department
regarding regional support network performance. The composition of the
board shall be broadly representative of the demographic character of
the region and shall include, but not be limited to, representatives of
consumers and families, law enforcement, and where the county is not
the regional support network, county elected officials. Composition
and length of terms of board members may differ between regional
support networks but shall be included in each regional support
network's contract and approved by the secretary.
(((4))) (9) Regional support networks shall assume all duties
specified in their plans and joint operating agreements through
biennial contractual agreements with the secretary.
(((5))) (10) Regional support networks may receive technical
assistance from the housing trust fund and may identify and submit
projects for housing and housing support services to the housing trust
fund established under chapter 43.185 RCW. Projects identified or
submitted under this subsection must be fully integrated with the
regional support network six-year operating and capital plan, timeline,
and budget required by subsection (((1))) (6) of this section.
Sec. 107 RCW 71.24.310 and 1989 c 205 s 6 are each amended to
read as follows:
The legislature finds that administration of chapter 71.05 RCW and
this chapter can be most efficiently and effectively implemented as
part of the regional support network defined in RCW 71.24.025. For
this reason, the legislature intends that any enhanced program funding
for implementation of chapter 71.05 RCW or this chapter((, except for
funds allocated for implementation of mandatory statewide programs as
required by federal statute, be made available primarily to those
counties participating in regional support networks)) shall be used
primarily for provision of community alternatives to state and local
hospitalization, and administered by regional support networks, in
accordance with the following:
(1) The department shall establish in rule a formula for allocating
intensive long-term treatment resources among the regional support
networks. The statewide total allocation shall include (a) all state
hospital beds offering long-term inpatient care, as defined in chapter
72.23 RCW, for which funding is provided in the biennial appropriations
act; plus (b) the estimated equivalent number of beds contracted in
accordance with subsection (3) of this section.
(2) The primary factor used in the allocation of intensive long-term treatment resources shall be the estimated number of acutely and
chronically mentally ill adults in each regional support network area.
The allocation formula shall be updated at least every four years to
reflect demographic changes and new evidence regarding the incidence of
acute and chronic mental illness.
(3) The department is encouraged to enter performance-based
contracts with regional support networks to provide some or all of the
regional support network's allocated intensive long-term treatment
capacity in the community, rather than in the state hospital. The
performance contracts shall specify the number of patient days of care
available for use by the regional support network in the state
hospital.
(4) If a regional support network uses more state hospital patient
days of care than it has been allocated under subsection (1) of this
section, or than it has contracted to use under subsection (3) of this
section, whichever is less, it shall reimburse the department for that
care. The reimbursement rate per day shall be the hospital's total
annual budget, divided by the total patient days of care assumed in
development of that budget.
(5) One-half of any reimbursements received pursuant to subsection
(4) of this section shall be used to support the cost of operating the
state hospital. The department shall distribute the remaining half of
such reimbursements among regional support networks that have used less
than their allocated or contracted patient days of care at that
hospital, proportional to the number of patient days of care not used.
Sec. 201 RCW 71.24.320 and 2005 c 503 s 4 are each amended to
read as follows:
(1) The secretary shall initiate a procurement process for regional
support networks in 2005. In the first step of the procurement
process, existing regional support networks may respond to a request
for qualifications developed by the department. The secretary shall
issue the request for qualifications not later than October 1, 2005.
The request for ((qualifications)) proposals shall be based on: (a)
Cost-effectiveness, (b) adequate residential and service capabilities,
(c) effective collaboration with criminal justice agencies and the
chemical dependency treatment system, ((and)) (d) the ability to
provide the full array of services as stated in the mental health state
plan, ((and shall)) (e) the ability of the entity to supplement the
financial resources provided by the state, and (f) the ability of the
entity to meet all applicable federal and state regulations and
standards.
An existing regional support network shall be awarded the contract
with the department if it substantially meets the requirements of the
request for qualifications developed by the department.
(2) If an existing regional support network ((chooses not to
respond to the request for qualifications, or)) is unable to
substantially meet the requirements of the request for qualifications,
the department shall proceed as follows:
(a) The department shall first provide any regional support network
that has substantially met the requirements of the request for
qualifications the opportunity to submit a mutually agreed upon
proposal for consolidating with regional support networks that did not
substantially meet the requirements of the request for qualifications.
(b) If the department does not receive an acceptable proposal for
consolidation, for those regional support networks which did not
substantially meet the requirements of the request for qualifications,
the department shall utilize a procurement process in which ((other))
county authorities and nonprofit entities recognized by the secretary
may bid to serve as the regional support network in that region. The
procurement process shall begin with a request for proposals issued
((March)) April 1, 2006.
(3) The department shall host a preresponse conference on or about
April 24, 2006.
(a) Although attendance is not mandatory, all prospective regional
support networks are encouraged to attend.
(b) If changes to the request for proposals are required as a
result of the conference, all amendments must be issued no later than
May 31, 2006.
(c) Specific questions concerning the request for procurement must
be submitted to the designated request for procurement coordinator in
writing.
(d) In order to provide accurate and consistent information to all
potential regional support networks, written responses to all questions
must be published.
(4) Interested entities shall submit proposals to the designated
request for procurement coordinator. Proposals must be delivered or
received no later than June 30, 2006.
(5) The department shall evaluate the proposals and notify the
respondents of the outcome during the month of July 2006. Prospective
regional support networks that are unsuccessful shall be provided with
a detailed briefing regarding the deficiencies in the proposal and
provided with an opportunity to clarify information previously
submitted.
(6) All documents pertaining to subsections (4) and (5) of this
section shall be retained pursuant to a schedule approved under RCW
40.14.050. Upon request, evaluations and documentation regarding a
prospective regional support network's proposal, and the evaluation
thereof, shall be made available to that prospective regional support
network.
NEW SECTION. Sec. 202 (1) The joint legislative audit and review
committee shall conduct a performance audit of the request for
qualifications process. The audit should include assessments of: (a)
The extent to which the request for qualifications requirements comport
with, exceed, or fail to address federal or state law; (b) the
consistency of scoring across regional support networks; (c) the extent
to which the evaluation criteria were uniformly applied; (d) the extent
to which the request for qualifications requirements add new
administrative costs not required by federal rules and state law; (e)
the extent to which the request for qualifications process impacted the
availability of resources for direct resources; (f) the extent to which
the implementation of the requirements has impacted the availability of
resources for direct resources; and (g) the extent to which the
department of social and health services has successfully implemented
RCW 71.24.035(5)(f).
(2) A preliminary report of the performance audit must be submitted
to the legislature by September 30, 2006. A final report must be
submitted to the legislature by December 1, 2006.
Sec. 203 RCW 71.24.3201 and 2005 c 503 s 15 are each amended to
read as follows:
(1) The department of social and health services shall enter into
a contract with regional support networks for the period ending August
31, 2006. The department shall issue a request for proposal to the
extent required by RCW 71.24.320 ((and the contract shall be effective
September 1, 2006)). Contracts between the state and the regional
support networks shall include an alternative dispute resolution
clause.
(2) This section expires June 30, ((2007)) 2008.
Sec. 204 RCW 71.24.330 and 2005 c 503 s 6 are each amended to
read as follows:
(1) Contracts between a regional support network and the department
shall include mechanisms for monitoring performance under the contract
and remedies for failure to substantially comply with the requirements
of the contract including, but not limited to, financial penalties,
termination of the contract, and reprocurement of the contract.
(2) The procurement process shall encourage the preservation of
infrastructure previously purchased by the community mental health
service delivery system, the maintenance of linkages between other
services and delivery systems, and maximization of the use of available
funds for services versus profits. The procurement process shall
provide that public funds appropriated by the legislature shall not be
used to promote or deter, encourage, or discourage employees from
exercising their rights under Title 29, chapter 7, subchapter II,
United States Code or chapter 41.56 RCW.
(3) In addition to the requirements of RCW 71.24.035, contracts
shall:
(a) Define administrative costs and ensure that the regional
support network does not exceed an administrative cost of ten percent
of available funds;
(b) Require effective collaboration with law enforcement, criminal
justice agencies, and the chemical dependency treatment system;
(c) Require substantial implementation of department adopted
integrated screening and assessment process and matrix of best
practices; ((and))
(d) Maintain the decision-making independence of designated mental
health professionals; and
(e) Except at the discretion of the secretary or as specified in
the biennial budget, require regional support networks to pay the state
for the costs associated with individuals who are being served on the
grounds of the state hospitals and who are not receiving long-term
inpatient care as defined in RCW 72.23.010.
Sec. 205 RCW 71.24.360 and 2005 c 504 s 805 are each amended to
read as follows:
The department may establish new regional support network
boundaries in any part of the state where ((more than one)) a network
chooses not to respond to, or is unable to substantially meet the
requirements of, the request for qualifications under section 4,
chapter 503, Laws of 2005 or where a regional support network is
subject to reprocurement under section 6, chapter 503, Laws of 2005.
The department may establish no fewer than eight and no more than
fourteen regional support networks under this chapter. No entity shall
be responsible for more than three regional support networks.
Sec. 301 RCW 71.24.035 and 2005 c 504 s 715 and 2005 c 503 s 7
are each reenacted and amended to read as follows:
(1) The department is designated as the state mental health
authority.
(2) The secretary shall provide for public, client, and licensed
service provider participation in developing the state mental health
program, developing contracts with regional support networks, and any
waiver request to the federal government under medicaid.
(3) The secretary shall provide for participation in developing the
state mental health program for children and other underserved
populations, by including representatives on any committee established
to provide oversight to the state mental health program.
(4) The secretary shall be designated as the regional support
network if the regional support network fails to meet state minimum
standards or refuses to exercise responsibilities under RCW 71.24.045.
(5) The secretary shall:
(a) Develop a biennial state mental health program that
incorporates regional biennial needs assessments and regional mental
health service plans and state services for mentally ill adults and
children. The secretary shall also develop a six-year state mental
health plan;
(b) Assure that any regional or county community mental health
program provides access to treatment for the region's residents in the
following order of priority: (i) The acutely mentally ill; (ii)
chronically mentally ill adults and severely emotionally disturbed
children; and (iii) the seriously disturbed. Such programs shall
provide:
(A) Outpatient services;
(B) Emergency care services for twenty-four hours per day;
(C) Day treatment for mentally ill persons which includes training
in basic living and social skills, supported work, vocational
rehabilitation, and day activities. Such services may include
therapeutic treatment. In the case of a child, day treatment includes
age-appropriate basic living and social skills, educational and
prevocational services, day activities, and therapeutic treatment;
(D) Screening for patients being considered for admission to state
mental health facilities to determine the appropriateness of admission;
(E) Employment services, which may include supported employment,
transitional work, placement in competitive employment, and other work-related services, that result in mentally ill persons becoming engaged
in meaningful and gainful full or part-time work. Other sources of
funding such as the division of vocational rehabilitation may be
utilized by the secretary to maximize federal funding and provide for
integration of services;
(F) Consultation and education services; and
(G) Community support services;
(c) Develop and adopt rules establishing state minimum standards
for the delivery of mental health services pursuant to RCW 71.24.037
including, but not limited to:
(i) Licensed service providers. These rules shall permit a county-operated mental health program to be licensed as a service provider
subject to compliance with applicable statutes and rules. The
secretary shall provide for deeming of compliance with state minimum
standards for those entities accredited by recognized behavioral health
accrediting bodies recognized and having a current agreement with the
department;
(ii) Regional support networks; and
(iii) Inpatient services, evaluation and treatment services and
facilities under chapter 71.05 RCW, resource management services, and
community support services;
(d) Assure that the special needs of minorities, the elderly,
disabled, children, and low-income persons are met within the
priorities established in this section;
(e) Establish a standard contract or contracts, consistent with
state minimum standards and RCW 71.24.320 ((and)), 71.24.330, and
71.24.3201, which shall be used in contracting with regional support
networks. The standard contract shall include a maximum fund balance,
which shall be consistent with that required by federal regulations or
waiver stipulations;
(f) Establish, to the extent possible, a standardized auditing
procedure which minimizes paperwork requirements of regional support
networks and licensed service providers. The audit procedure shall
focus on the outcomes of service and not the processes for
accomplishing them;
(g) Develop and maintain an information system to be used by the
state and regional support networks that includes a tracking method
which allows the department and regional support networks to identify
mental health clients' participation in any mental health service or
public program on an immediate basis. The information system shall not
include individual patient's case history files. Confidentiality of
client information and records shall be maintained as provided in this
chapter and in RCW 71.05.390, 71.05.420, and 71.05.440;
(h) License service providers who meet state minimum standards;
(i) Certify regional support networks that meet state minimum
standards;
(j) Periodically monitor the compliance of certified regional
support networks and their network of licensed service providers for
compliance with the contract between the department, the regional
support network, and federal and state rules at reasonable times and in
a reasonable manner;
(k) Fix fees to be paid by evaluation and treatment centers to the
secretary for the required inspections;
(l) Monitor and audit regional support networks and licensed
service providers as needed to assure compliance with contractual
agreements authorized by this chapter;
(m) Adopt such rules as are necessary to implement the department's
responsibilities under this chapter; and
(n) Assure the availability of an appropriate amount, as determined
by the legislature in the operating budget by amounts appropriated for
this specific purpose, of community-based, geographically distributed
residential services.
(6) The secretary shall use available resources only for regional
support networks, except to the extent authorized, and in accordance
with any priorities or conditions specified, in the biennial
appropriations act.
(7) Each certified regional support network and licensed service
provider shall file with the secretary, on request, such data,
statistics, schedules, and information as the secretary reasonably
requires. A certified regional support network or licensed service
provider which, without good cause, fails to furnish any data,
statistics, schedules, or information as requested, or files fraudulent
reports thereof, may have its certification or license revoked or
suspended.
(8) The secretary may suspend, revoke, limit, or restrict a
certification or license, or refuse to grant a certification or license
for failure to conform to: (a) The law; (b) applicable rules and
regulations; (c) applicable standards; or (d) state minimum standards.
(9) The superior court may restrain any regional support network or
service provider from operating without certification or a license or
any other violation of this section. The court may also review,
pursuant to procedures contained in chapter 34.05 RCW, any denial,
suspension, limitation, restriction, or revocation of certification or
license, and grant other relief required to enforce the provisions of
this chapter.
(10) Upon petition by the secretary, and after hearing held upon
reasonable notice to the facility, the superior court may issue a
warrant to an officer or employee of the secretary authorizing him or
her to enter at reasonable times, and examine the records, books, and
accounts of any regional support network or service provider refusing
to consent to inspection or examination by the authority.
(11) Notwithstanding the existence or pursuit of any other remedy,
the secretary may file an action for an injunction or other process
against any person or governmental unit to restrain or prevent the
establishment, conduct, or operation of a regional support network or
service provider without certification or a license under this chapter.
(12) The standards for certification of evaluation and treatment
facilities shall include standards relating to maintenance of good
physical and mental health and other services to be afforded persons
pursuant to this chapter and chapters 71.05 and 71.34 RCW, and shall
otherwise assure the effectuation of the purposes of these chapters.
(13)(a) The department, in consultation with affected parties,
shall establish a distribution formula that reflects regional needs
assessments based on the number of persons who are acutely mentally
ill, chronically mentally ill, severely emotionally disturbed children,
and seriously disturbed. The formula shall take into consideration the
impact on regions of demographic factors which result in concentrations
of priority populations as set forth in subsection (5)(b) of this
section. These factors shall include the population concentrations
resulting from commitments under chapters 71.05 and 71.34 RCW to state
psychiatric hospitals, as well as concentration in urban areas, at
border crossings at state boundaries, and other significant demographic
and workload factors.
(b) The formula shall also include a projection of the funding
allocations that will result for each region, which specifies
allocations according to priority populations, including the allocation
for services to children and other underserved populations.
(((c) After July 1, 2003, the department may allocate up to two
percent of total funds to be distributed to the regional support
networks for incentive payments to reward the achievement of superior
outcomes, or significantly improved outcomes, as measured by a
statewide performance measurement system consistent with the framework
recommended in the joint legislative audit and review committee's
performance audit of the mental health system. The department shall
annually report to the legislature on its criteria and allocation of
the incentives provided under this subsection.))
(14) The secretary shall assume all duties assigned to the
nonparticipating regional support networks under chapters 71.05, 71.34,
and 71.24 RCW. Such responsibilities shall include those which would
have been assigned to the nonparticipating counties in regions where
there are not participating regional support networks.
The regional support networks, or the secretary's assumption of all
responsibilities under chapters 71.05, 71.34, and 71.24 RCW, shall be
included in all state and federal plans affecting the state mental
health program including at least those required by this chapter, the
medicaid program, and P.L. 99-660. Nothing in these plans shall be
inconsistent with the intent and requirements of this chapter.
(15) The secretary shall:
(a) Disburse funds for the regional support networks within sixty
days of approval of the biennial contract. The department must either
approve or reject the biennial contract within sixty days of receipt.
(b) Enter into biennial contracts with regional support networks.
The contracts shall be consistent with available resources. No
contract shall be approved that does not include progress toward
meeting the goals of this chapter by taking responsibility for: (i)
Short-term commitments; (ii) residential care; and (iii) emergency
response systems.
(c) Notify regional support networks of their allocation of
available resources at least sixty days prior to the start of a new
biennial contract period.
(d) Deny all or part of the funding allocations to regional support
networks based solely upon formal findings of noncompliance with the
terms of the regional support network's contract with the department.
((Written notice and at least thirty days for corrective action must
precede any such action. In such cases, regional support networks
shall have full rights to appeal under chapter 34.05 RCW.)) Regional
support networks disputing the decision of the secretary to withhold
funding allocations are limited to the remedies provided in the
department's contracts with the regional support networks.
(16) The department, in cooperation with the state congressional
delegation, shall actively seek waivers of federal requirements and
such modifications of federal regulations as are necessary to allow
federal medicaid reimbursement for services provided by free-standing
evaluation and treatment facilities certified under chapter 71.05 RCW.
The department shall periodically report its efforts to the appropriate
committees of the senate and the house of representatives.
Sec. 302 RCW 72.23.010 and 2000 c 22 s 2 are each amended to read
as follows:
The definitions in this section apply throughout this chapter,
unless the context clearly requires otherwise.
(1) "Court" means the superior court of the state of Washington.
(2) "Department" means the department of social and health
services.
(3) "Employee" means an employee as defined in RCW 49.17.020.
(4) "Licensed physician" means an individual permitted to practice
as a physician under the laws of the state, or a medical officer,
similarly qualified, of the government of the United States while in
this state in performance of his or her official duties.
(5) "Long-term inpatient care" means inpatient services for persons
committed for or voluntarily receiving intensive treatment for periods
of ninety days or greater under chapter 71.05 RCW. "Long-term
inpatient care" as used in this chapter does not include: (a) Services
for individuals committed under chapter 71.05 RCW who are receiving
services pursuant to a conditional release or a court-ordered less
restrictive alternative to detention; or (b) services for individuals
voluntarily receiving less restrictive alternative treatment on the
grounds of the state hospital.
(6) "Mentally ill person" means any person who, pursuant to the
definitions contained in RCW 71.05.020, as a result of a mental
disorder presents a likelihood of serious harm to others or himself or
herself or is gravely disabled.
(((6))) (7) "Patient" means a person under observation, care, or
treatment in a state hospital, or a person found mentally ill by the
court, and not discharged from a state hospital, or other facility, to
which such person had been ordered hospitalized.
(((7))) (8) "Resident" means a resident of the state of Washington.
(((8))) (9) "Secretary" means the secretary of social and health
services.
(((9))) (10) "State hospital" means any hospital, including a child
study and treatment center, operated and maintained by the state of
Washington for the care of the mentally ill.
(((10))) (11) "Superintendent" means the superintendent of a state
hospital.
(((11))) (12) "Violence" or "violent act" means any physical
assault or attempted physical assault against an employee or patient of
a state hospital.
Wherever used in this chapter, the masculine shall include the
feminine and the singular shall include the plural.
Sec. 303 RCW 72.23.025 and 1998 c 245 s 141 are each amended to
read as follows:
(1) It is the intent of the legislature to improve the quality of
service at state hospitals, eliminate overcrowding, and more
specifically define the role of the state hospitals. The legislature
intends that eastern and western state hospitals shall become clinical
centers for handling the most complicated long-term care needs of
patients with a primary diagnosis of mental disorder. ((Over the next
six years, their involvement in providing short-term, acute care, and
less complicated long-term care shall be diminished in accordance with
the revised responsibilities for mental health care under chapter 71.24
RCW.)) To this end, the legislature intends that funds appropriated
for mental health programs, including funds for regional support
networks and the state hospitals be used for persons with primary
diagnosis of mental disorder. The legislature finds that establishment
of the eastern state hospital board, the western state hospital board,
and institutes for the study and treatment of mental disorders at both
eastern state hospital and western state hospital will be instrumental
in implementing the legislative intent.
(2)(a) The eastern state hospital board and the western state
hospital board are each established. Members of the boards shall be
appointed by the governor with the consent of the senate. Each board
shall include:
(i) The director of the institute for the study and treatment of
mental disorders established at the hospital;
(ii) One family member of a current or recent hospital resident;
(iii) One consumer of services;
(iv) One community mental health service provider;
(v) Two citizens with no financial or professional interest in
mental health services;
(vi) One representative of the regional support network in which
the hospital is located;
(vii) One representative from the staff who is a physician;
(viii) One representative from the nursing staff;
(ix) One representative from the other professional staff;
(x) One representative from the nonprofessional staff; and
(xi) One representative of a minority community.
(b) At least one representative listed in (a)(viii), (ix), or (x)
of this subsection shall be a union member.
(c) Members shall serve four-year terms. Members of the board
shall be reimbursed for travel expenses as provided in RCW 43.03.050
and 43.03.060 and shall receive compensation as provided in RCW
43.03.240.
(3) The boards established under this section shall:
(a) Monitor the operation and activities of the hospital;
(b) Review and advise on the hospital budget;
(c) Make recommendations to the governor and the legislature for
improving the quality of service provided by the hospital;
(d) Monitor and review the activities of the hospital in
implementing the intent of the legislature set forth in this section;
and
(e) Consult with the secretary regarding persons the secretary may
select as the superintendent of the hospital whenever a vacancy occurs.
(4)(a) There is established at eastern state hospital and western
state hospital, institutes for the study and treatment of mental
disorders. The institutes shall be operated by joint operating
agreements between state colleges and universities and the department
of social and health services. The institutes are intended to conduct
training, research, and clinical program development activities that
will directly benefit mentally ill persons receiving treatment in
Washington state by performing the following activities:
(i) Promote recruitment and retention of highly qualified
professionals at the state hospitals and community mental health
programs;
(ii) Improve clinical care by exploring new, innovative, and
scientifically based treatment models for persons presenting
particularly difficult and complicated clinical syndromes;
(iii) Provide expanded training opportunities for existing staff at
the state hospitals and community mental health programs;
(iv) Promote bilateral understanding of treatment orientation,
possibilities, and challenges between state hospital professionals and
community mental health professionals.
(b) To accomplish these purposes the institutes may, within funds
appropriated for this purpose:
(i) Enter joint operating agreements with state universities or
other institutions of higher education to accomplish the placement and
training of students and faculty in psychiatry, psychology, social
work, occupational therapy, nursing, and other relevant professions at
the state hospitals and community mental health programs;
(ii) Design and implement clinical research projects to improve the
quality and effectiveness of state hospital services and operations;
(iii) Enter into agreements with community mental health service
providers to accomplish the exchange of professional staff between the
state hospitals and community mental health service providers;
(iv) Establish a student loan forgiveness and conditional
scholarship program to retain qualified professionals at the state
hospitals and community mental health providers when the secretary has
determined a shortage of such professionals exists.
(c) Notwithstanding any other provisions of law to the contrary,
the institutes may enter into agreements with the department or the
state hospitals which may involve changes in staffing necessary to
implement improved patient care programs contemplated by this section.
(d) The institutes are authorized to seek and accept public or
private gifts, grants, contracts, or donations to accomplish their
purposes under this section.
Sec. 401 RCW 71.05.120 and 2000 c 94 s 4 are each amended to read
as follows:
(1) No officer of a public or private agency, nor the
superintendent, professional person in charge, his or her professional
designee, or attending staff of any such agency, nor any public
official performing functions necessary to the administration of this
chapter, nor peace officer responsible for detaining a person pursuant
to this chapter, nor any ((county)) designated mental health
professional, nor the state, a unit of local government, or an
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 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.
(3) Regional support networks have no claim for declaratory relief,
injunctive relief, administrative review, civil liability, or other
relief against the state, state officials, state agencies, or state
employees for actions or inactions performed pursuant to the
administration of this chapter.
Sec. 402 RCW 71.05.230 and 1998 c 297 s 13 are each amended to
read as follows:
A person detained for seventy-two hour evaluation and treatment may
be detained for ((not more than)) two consecutive periods of fourteen
additional days of involuntary intensive treatment or ninety additional
days of a less restrictive alternative to involuntary intensive
treatment. There shall be no fee for filing petitions for fourteen
days of involuntary intensive treatment. A petition may only be filed
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 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
((county)) designated mental health professional 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, 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,
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 ((county))
designated mental health professional may petition for an additional
period of ((either)) commitment. The period of the commitment may be
for ninety days of less restrictive alternative treatment, an
additional fourteen days of involuntary 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.
Sec. 403 RCW 71.05.300 and 1998 c 297 s 17 are each amended to
read as follows:
(1) 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 ((county)) designated mental health professional. The
((county)) designated mental health professional 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.
The designated mental health professional shall also immediately
provide a copy of the petition and documentation of the less
restrictive alternative review to the regional support network and the
state hospital pursuant to RCW 71.24.045.
(2) 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.
(3) 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.
(4) The court shall also set a date for a full hearing on the
petition as provided in RCW 71.05.310.
Sec. 404 RCW 71.05.320 and 1999 c 13 s 7 are each amended to read
as follows:
(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
(a) 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.
(b) 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.
(2) 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))) (3) 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 mental disorder or 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 or
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 or 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))) (4) 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. 501 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. 502 Part headings used in this act are not
part of the law.
NEW SECTION. Sec. 503 This act takes effect July 1, 2006, except
that sections 101 through 103, 201 through 204, and 401 of this act are
necessary for the immediate preservation of the public peace, health,
or safety, or support of the state government and its existing public
institutions, and take effect immediately.