Passed by the Senate April 22, 2005 YEAS 32   ________________________________________ President of the Senate Passed by the House April 21, 2005 YEAS 67   ________________________________________ Speaker of the House of Representatives | I, Thomas Hoemann, Secretary of the Senate of the State of Washington, do hereby certify that the attached is ENGROSSED SECOND SUBSTITUTE SENATE BILL 5763 as passed by the Senate and the House of Representatives on the dates hereon set forth. ________________________________________ Secretary | |
Approved ________________________________________ Governor of the State of Washington | Secretary of State State of Washington |
State of Washington | 59th Legislature | 2005 Regular Session |
READ FIRST TIME 03/08/05.
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, 71.05.420, 71.05.620, 71.05.630, 71.05.640, 71.05.660, 71.05.550, 2.28.170, 71.05.157, 5.60.060, 18.83.110, 18.225.105, 71.05.235, 71.05.310, 71.05.425, 71.05.445, 71.05.640, 71.05.680, and 71.05.690; reenacting and amending RCW 71.05.390 and 71.24.035; adding new sections to chapter 71.05 RCW; adding new sections to chapter 70.96A RCW; adding a new section to chapter 13.34 RCW; adding new sections to chapter 2.28 RCW; adding a new section to chapter 26.12 RCW; adding new sections to chapter 71.24 RCW; adding a new section to chapter 71.02 RCW; adding a new section to chapter 71A.12 RCW; adding a new section to chapter 43.20A 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, 71.05.155, 71.05.395, 71.05.400, 71.05.410, 71.05.430, 71.05.610, 71.05.650, and 71.05.670; repealing 2005 c ... (E2SHB 1290) s 5; prescribing penalties; providing effective dates; providing expiration dates; 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 the extent of available funding, 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 therapeutic courts for
dependency proceedings;
(5) Improve access to treatment for persons who are not enrolled in
medicaid by improving and creating consistency in the application
processes, and by minimizing the numbers of eligible confined persons
who leave confinement without medical assistance;
(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) 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;
(9) 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;
(10) Following the receipt of outcomes from the pilot programs in
Part II of this act, if directed by future legislative enactment,
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; 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 early periodic screening, diagnosis, and treatment
provisions.
(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.
NEW SECTION. Sec. 103 A new section is added to chapter 71.05
RCW to read as follows:
(1) Not later than January 1, 2007, all persons providing treatment
under this chapter shall also implement the integrated comprehensive
screening and assessment process for chemical dependency and mental
disorders adopted pursuant to section 601 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) 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 601 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 to perform the duties
specified in this chapter;)) "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;
(7)
(((8))) (7) "Department" means the department of social and health
services;
(((9))) (8) "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;
(9) "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;
(10) "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;
(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)) person 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)) a person 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)) a person 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)) a
person 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)) a person 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)) person 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)) a person'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, or
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, or 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 persons 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 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;
(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, recovery services, 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) "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.
(11) "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.
(12) "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)) 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.
(((11))) (13) "Mental health services" means all services provided
by regional support networks and other services provided by the state
for the mentally ill.
(((12))) (14) "Mentally ill persons" and "the mentally ill" mean
persons and conditions defined in subsections (1), (4), (((17))) (23),
and (((18))) (24) of this section.
(((13))) (15) "Recovery" means the process in which people are able
to live, work, learn, and participate fully in their communities.
(16) "Regional support network" means a county authority or group
of county authorities or other entity recognized by the secretary
((that enter into joint operating agreements to contract with the
secretary pursuant to this chapter)) in contract in a defined area.
(((14))) (17) "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.
(18) "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.
(((15))) (19) "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.
(20) "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.
(21) "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))) (22) "Secretary" means the secretary of social and health
services.
(((17))) (23) "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))) (24) "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))) (25) "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))) (26) "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.
(27) "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.)) 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.
(5)
(((6))) (5) "Department" means the state department of social and
health services.
(6) "Designated mental health professional" has the same meaning as
provided in RCW 71.05.020.
(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)) person 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 persons 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 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.
(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, which shall be prominently posted in the
facility, 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, personal
representative, 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 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 that
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 RCW 71.05.150 (2), (3), or
(4)(b), 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 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 person 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) 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) To discuss treatment plans and decisions with professional
persons;
(h) 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 (as
recodified by this act) or pursuant to an administrative hearing under
RCW 71.05.215;
(i) Not to consent to the performance of electroconvulsant therapy
or surgery, except emergency life-saving surgery, unless ordered by a
court under RCW 71.05.370 (as recodified by this act);
(j) Not to have psychosurgery performed on him or her under any
circumstances;
(k) To dispose of property and sign contracts unless such person
has been adjudicated an incompetent in a court proceeding directed to
that particular issue.
(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) Nothing in this section permits any person to knowingly
violate a no-contact order or a condition of an active judgment and
sentence or an active condition of supervision by the department of
corrections.
NEW SECTION. Sec. 108 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. 109 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)) person, or his or her personal
representative or 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 or
will reside.
(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 person's next of
kin, attorney, personal representative, 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, personal representative, 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. 110 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. 111 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 ((
(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)71.05)) 70.96A, 71.34, and 70.-- (sections 202 through
216 of this act) RCW shall be closed but shall be accessible to any
((individual)) person who is the subject of a petition and to the
((individual's)) person's attorney, guardian ad litem, resource
management services, or service providers authorized to receive such
information by resource management services.
Sec. 112 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)) a person may be released
without informed written consent in the following circumstances:
(a) To ((an individual)) a person, 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)) person 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))
persons 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)) persons who are under the supervision of the
department.
(h) To a licensed physician who has determined that the life or
health of the ((individual)) person 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)) a person who
is involuntarily committed under chapter 71.05 RCW, or upon transfer of
the ((individual)) person 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)) a person 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)) a person 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)) person'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)) person'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))
disorders 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. 113 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))
person.
(2) Following discharge, the ((individual)) person 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)) persons 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. 114 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, 71.34, 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. 115 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 a
person 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
a person 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 a person
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) "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.
(10) "Department" means the department of social and health
services.
(11) "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.
(12) "Designated crisis responder" means a person designated by the
county or regional support network to perform the duties specified in
this chapter.
(13) "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.
(14) "Detention" or "detain" means the lawful confinement of a
person 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 persons 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 a person, 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 person" means a person 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 a person 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 a person 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 a person upon the property
of others, as evidenced by behavior that has caused substantial loss or
damage to the property of others; or
(b) The person 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 a person'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) "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.
(30) "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, or hospital, or approved
treatment program, that is conducted for, or includes a department or
ward conducted for, the care and treatment of persons who are mentally
ill and/or chemically dependent.
(31) "Professional person" means a mental health professional or
chemical dependency 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.
(32) "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.
(33) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(34) "Public agency" means any evaluation and treatment facility or
institution, or hospital, or approved treatment program that is
conducted for, or includes a department or ward conducted for, the care
and treatment of persons 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.
(35) "Registration records" means 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.
(36) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW or this chapter.
(37) "Secretary" means the secretary of the department or the
secretary's designee.
(38) "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 persons and
includes security measures sufficient to protect the patients, staff,
and community.
(39) "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.
(40) "Treatment records" means registration records 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.
(41) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
NEW SECTION. Sec. 203 (1) The secretary, after consulting 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; and to site them in counties other than those selected pursuant
to section 220 of this act, to the extent necessary to facilitate
evaluation of pilot project results.
(2) The regional support networks or counties shall implement the
pilot programs by providing integrated crisis response and involuntary
treatment to persons 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 designated mental
health professional under chapter 71.05 RCW and a designated chemical
dependency specialist under chapter 70.96A RCW by establishing a new
designated crisis responder who is authorized to conduct investigations
and detain persons 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 persons 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; and
(g) Collaborate with the department of corrections where persons
detained or committed are also subject to supervision by the department
of corrections.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
NEW SECTION. Sec. 204 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;
(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 who have, in addition, at least two years of experience
in direct treatment of persons 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 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 designated crisis responder
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 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 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 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
person accompanying the person may be present during the admission
evaluation. The facility may exclude the person 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) 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 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 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 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,
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 person 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) A person detained for seventy-two hour
evaluation and treatment under section 206 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 person.
(2) The petition under subsection (1)(c) of this section shall be
accompanied by a certificate of a licensed physician who has examined
the person, unless the person 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 a person 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 a person, including any
judicial proceeding where the person 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 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 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 crisis responder of the violation and request an evaluation
for purposes of revocation of the less restrictive alternative.
(3) When a 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 crisis responder detains a person under this
chapter, the 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 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 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 persons 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 persons 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 July 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 counties to
provide intensive case management for chemically dependent persons with
histories of high utilization of crisis services at two sites. In
selecting the two sites, the secretary shall endeavor to site one in an
urban county, and one in a rural county; and to site them in counties
other than those selected pursuant to section 203 of this act, to the
extent necessary to facilitate evaluation of pilot project results.
(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 601 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, violations of conditions of supervision, bookings, jail days,
prison sanction day for violations, 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;
(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; and
(j) Where a program participant is under supervision by the
department of corrections, collaborate with the department of
corrections to maximize treatment outcomes and reduce the likelihood of
reoffense.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
(4) This section expires June 30, 2008.
NEW SECTION. Sec. 301 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. 302 A new section is added to chapter 70.96A
RCW to read as follows:
(1) Not later than January 1, 2007, all persons providing treatment
under this chapter shall also implement the integrated comprehensive
screening and assessment process for chemical dependency and mental
disorders adopted pursuant to section 601 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) 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 601 of this act.
NEW SECTION. Sec. 303 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 drug-affected and alcohol-affected mothers and infants. Subject to funds
appropriated for this purpose, the expansion shall be in evidence-based, research-based, or consensus-based practices, as those terms are
defined in section 603 of this act, and shall expand capacity in
underserved regions of the state.
NEW SECTION. Sec. 304 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. 305 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
chemical dependency specialist services at each division of children
and family services office 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 case-carrying social worker is trained
in uniform screening for mental health and chemical dependency.
NEW SECTION. Sec. 401 Sections 402 through 425 of this act
constitute a new chapter in Title
NEW SECTION. Sec. 402 The legislature finds that there are
persons with mental disorders, including organic or traumatic brain
disorders, and combinations of mental disorders with other medical
conditions or behavior histories that result in behavioral and security
issues that make these persons ineligible for, or unsuccessful in,
existing types of licensed facilities, including adult residential
rehabilitation centers, boarding homes, adult family homes, group
homes, and skilled nursing facilities. The legislature also finds that
many of these persons have been treated on repeated occasions in
inappropriate acute care facilities and released without an appropriate
placement or have been treated or detained for extended periods in
inappropriate settings including state hospitals and correctional
facilities. The legislature further finds that some of these persons
present complex safety and treatment issues that require security
measures that cannot be instituted under most facility licenses or
supported housing programs. These include the ability to detain
persons under involuntary treatment orders or administer court ordered
medications.
Consequently, the legislature intends, to the extent of available
funds, to establish a new type of facility licensed by the department
of social and health services as an enhanced services facility with
standards that will provide a safe, secure treatment environment for a
limited population of persons who are not appropriately served in other
facilities or programs. The legislature also finds that enhanced
services facilities may need to specialize in order to effectively care
for a particular segment of the identified population.
An enhanced services facility may only serve individuals that meet
the criteria specified in section 405 of this act.
NEW SECTION. Sec. 403 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "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.
(2) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient.
(3) "Chemical dependency" means alcoholism, drug addiction, or
dependence on alcohol and one or more other psychoactive chemicals, as
the context requires and as those terms are defined in chapter 70.96A
RCW.
(4) "Chemical dependency professional" means a person certified as
a chemical dependency professional by the department of health under
chapter 18.205 RCW.
(5) "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.
(6) "Conditional release" means a modification of a commitment that
may be revoked upon violation of any of its terms.
(7) "Custody" means involuntary detention under chapter 71.05 or
70.96A 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 responder" means a designated mental health
professional, a designated chemical dependency specialist, or a
designated crisis responder as those terms are defined in chapter
70.96A, 71.05, or 70.-- (sections 202 through 216 of this act) RCW.
(10) "Detention" or "detain" means the lawful confinement of an
individual under chapter 70.96A or 71.05 RCW.
(11) "Discharge" means the termination of facility authority. The
commitment may remain in place, be terminated, or be amended by court
order.
(12) "Enhanced services facility" means a facility that provides
treatment and services to persons for whom acute inpatient treatment is
not medically necessary and who have been determined by the department
to be inappropriate for placement in other licensed facilities due to
the complex needs that result in behavioral and security issues.
(13) "Expanded community services program" means a nonsecure
program of enhanced behavioral and residential support provided to
long-term and residential care providers serving specifically eligible
clients who would otherwise be at risk for hospitalization at state
hospital geriatric units.
(14) "Facility" means an enhanced services facility.
(15) "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.
(16) "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.
(17) "Licensed physician" means a person licensed to practice
medicine or osteopathic medicine and surgery in the state of
Washington.
(18) "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.
(19) "Mental disorder" means any organic, mental, or emotional
impairment that has substantial adverse effects on an individual's
cognitive or volitional functions.
(20) "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.
(21) "Professional person" means a mental health professional and
also means a physician, registered nurse, and such others as may be
defined in rules adopted by the secretary pursuant to the provisions of
this chapter.
(22) "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.
(23) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(24) "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.
(25) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW.
(26) "Resident" means a person admitted to an enhanced services
facility.
(27) "Secretary" means the secretary of the department or the
secretary's designee.
(28) "Significant change" means:
(a) A deterioration in a resident's physical, mental, or
psychosocial condition that has caused or is likely to cause clinical
complications or life-threatening conditions; or
(b) An improvement in the resident's physical, mental, or
psychosocial condition that may make the resident eligible for release
or for treatment in a less intensive or less secure setting.
(29) "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.
(30) "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
disorders, chemical dependency disorders, or both, and their families.
(31) "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.
(32) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
NEW SECTION. Sec. 404 A facility shall honor an advance
directive that was validly executed pursuant to chapter 70.122 RCW and
a mental health advance directive that was validly executed pursuant to
chapter 71.32 RCW.
NEW SECTION. Sec. 405 A person, eighteen years old or older, may
be admitted to an enhanced services facility if he or she meets the
criteria in subsections (1) through (3) of this section:
(1) The person requires: (a) Daily care by or under the
supervision of a mental health professional, chemical dependency
professional, or nurse; or (b) assistance with three or more activities
of daily living; and
(2) The person has: (a) A mental disorder, chemical dependency
disorder, or both; (b) an organic or traumatic brain injury; or (c) a
cognitive impairment that results in symptoms or behaviors requiring
supervision and facility services;
(3) The person has two or more of the following:
(a) Self-endangering behaviors that are frequent or difficult to
manage;
(b) Aggressive, threatening, or assaultive behaviors that create a
risk to the health or safety of other residents or staff, or a
significant risk to property and these behaviors are frequent or
difficult to manage;
(c) Intrusive behaviors that put residents or staff at risk;
(d) Complex medication needs and those needs include psychotropic
medications;
(e) A history of or likelihood of unsuccessful placements in either
a licensed facility or other state facility or a history of rejected
applications for admission to other licensed facilities based on the
person's behaviors, history, or security needs;
(f) A history of frequent or protracted mental health
hospitalizations;
(g) A history of offenses against a person or felony offenses that
created substantial damage to property.
NEW SECTION. Sec. 406 (1)(a) Every person who is a resident of
an enhanced services facility shall be entitled to all the rights set
forth in this chapter, and chapters 71.05 and 70.96A RCW, and shall
retain all rights not denied him or her under these chapters.
(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, or chapter 71.05 or 70.96A 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 10.77 or 11.88 RCW.
(c) At the time of his or her treatment planning meeting, every
resident of an enhanced services facility shall be given a written
statement setting forth the substance of this section. The department
shall by rule develop a statement and process for informing residents
of their rights in a manner that is likely to be understood by the
resident.
(2) Every resident of an enhanced services facility 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) 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 chapter 10.77, 70.96A, or 71.05 RCW, 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.
(6) Insofar as danger to the person or others is not created, each
resident of an enhanced services facility 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 RCW 71.05.215 or
71.05.370 (as recodified by this act), or the performance of
electroconvulsant therapy, or surgery, except emergency life-saving
surgery, unless ordered by a court under RCW 71.05.370 (as recodified
by this act);
(h) To discuss and actively participate in treatment plans and
decisions with professional persons;
(i) Not to have psychosurgery performed on him or her under any
circumstances;
(j) To dispose of property and sign contracts unless such person
has been adjudicated an incompetent in a court proceeding directed to
that particular issue; and
(k) To complain about rights violations or conditions and request
the assistance of a mental health ombudsman or representative of
Washington protection and advocacy. The facility may not prohibit or
interfere with a resident's decision to consult with an advocate of his
or her choice.
(7) Nothing contained in this chapter shall prohibit a resident
from petitioning by writ of habeas corpus for release.
(8) Nothing in this section permits any person to knowingly violate
a no-contact order or a condition of an active judgment and sentence or
active supervision by the department of corrections.
(9) A person has a right to refuse placement, except where subject
to commitment, in an enhanced services facility. No person shall be
denied other department services solely on the grounds that he or she
has made such a refusal.
(10) A person has a right to appeal the decision of the department
that he or she is eligible for placement at an enhanced services
facility, and shall be given notice of the right to appeal in a format
that is accessible to the person with instructions regarding what to do
if the person wants to appeal.
NEW SECTION. Sec. 407 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.
Antipsychotic medication may be administered over the person's
objections only pursuant to RCW 71.05.215 or 71.05.370 (as recodified
by this act).
NEW SECTION. Sec. 408 (1)(a) The department shall not license an
enhanced services facility that serves any residents under sixty-five
years of age for a capacity to exceed sixteen residents.
(b) The department may contract for services for the operation of
enhanced services facilities only to the extent that funds are
specifically provided for that purpose.
(2) The facility shall provide an appropriate level of security for
the characteristics, behaviors, and legal status of the residents.
(3) An enhanced services facility may hold only one license but, to
the extent permitted under state and federal law and medicaid
requirements, a facility may be located in the same building as another
licensed facility, provided that:
(a) The enhanced services facility is in a location that is totally
separate and discrete from the other licensed facility; and
(b) The two facilities maintain separate staffing, unless an
exception to this is permitted by the department in 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. 409 (1) The enhanced services facility shall
complete a comprehensive assessment for each resident within fourteen
days of admission, and the assessments shall be repeated upon a
significant change in the resident's condition or, at a minimum, every
one hundred eighty days if there is no significant change in condition.
(2) The enhanced services facility shall develop an individualized
treatment plan for each resident based on the comprehensive assessment
and any other information in the person's record. The plan shall be
updated as necessary, and shall include a plan for appropriate transfer
or discharge and reintegration into the community. Where the person is
under the supervision of the department of corrections, the facility
shall collaborate with the department of corrections to maximize
treatment outcomes and reduce the likelihood of reoffense.
(3) The plan shall maximize the opportunities for independence,
recovery, employment, the resident's participation in treatment
decisions, and collaboration with peer-supported services, and provide
for care and treatment in the least restrictive manner appropriate to
the individual resident, and, where relevant, to any court orders with
which the resident must comply.
NEW SECTION. Sec. 410 (1) An enhanced services facility must
have sufficient numbers of staff with the appropriate credentials and
training to provide residents with the appropriate care and treatment:
(a) Mental health treatment;
(b) Medication services;
(c) Assistance with the activities of daily living;
(d) Medical or habilitative treatment;
(e) Dietary services;
(f) Security; and
(g) Chemical dependency treatment.
(2) Where an enhanced services facility specializes in medically
fragile persons with mental disorders, the on-site staff must include
at least one licensed nurse twenty-four hours per day. The nurse must
be a registered nurse for at least sixteen hours per day. If the nurse
is not a registered nurse, a registered nurse or a doctor must be on-call during the remaining eight hours.
(3) Any employee or other individual who will have unsupervised
access to vulnerable adults must successfully pass a background inquiry
check.
NEW SECTION. Sec. 411 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. 412 (1) The department shall establish
licensing rules for enhanced services facilities to serve the
populations defined in this chapter.
(2) No person or public or private agency may operate or maintain
an enhanced services facility without a license, which must be renewed
annually.
(3) A licensee shall have the following readily accessible and
available for review by the department, residents, families of
residents, and the public:
(a) Its license to operate and a copy of the department's most
recent inspection report and any recent complaint investigation reports
issued by the department;
(b) Its written policies and procedures for all treatment, care,
and services provided directly or indirectly by the facility; and
(c) The department's toll-free complaint number, which shall also
be posted in a clearly visible place and manner.
(4) Enhanced services facilities shall maintain a grievance
procedure that meets the requirements of rules established by the
department.
(5) 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, the long-term care ombudsman, Washington protection and
advocacy system, or a mental health ombudsperson.
(6) Each enhanced services facility will post in a prominent place
in a common area a notice by the Washington protection and advocacy
system providing contact information.
NEW SECTION. Sec. 413 (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 issue or 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 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. 414 (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. 415 Operation of a facility without a license
in violation of this chapter and discrimination against medicaid
recipients is a matter vitally affecting the public interest for the
purpose of applying the consumer protection act, chapter 19.86 RCW.
Operation of an enhanced services facility without a license in
violation of this chapter is not reasonable in relation to the
development and preservation of business. Such a violation is an
unfair or deceptive act 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. 416 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. 417 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. 418 (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. 419 The facility shall only admit individuals:
(1) Who are over the age of eighteen;
(2) Who meet the resident eligibility requirements described in
section 405 of this act; and
(3) Whose needs the facility can safely and appropriately meet
through qualified and trained staff, services, equipment, security, and
building design.
NEW SECTION. Sec. 420 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. 421 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. 422 The facility shall:
(1) Maintain adequate resident records to enable the provision of
necessary treatment, care, and services and to respond appropriately in
emergency situations;
(2) Comply with all state and federal requirements related to
documentation, confidentiality, and information sharing, including
chapters 10.77, 70.02, 70.24, 70.96A, and 71.05 RCW; and
(3) Where possible, obtain signed releases of information
designating the department, the facility, and the department of
corrections where the person is under its supervision, as recipients of
health care information.
NEW SECTION. Sec. 423 (1) 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.
(2) 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. 424 No facility providing care and treatment
for individuals placed in a facility, or agency licensing or placing
residents 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. 425 (1) The secretary shall adopt rules to
implement this chapter.
(2) Such rules shall at the minimum: (a) Promote safe treatment
and necessary care of individuals residing in the facility and provide
for safe and clean conditions; (b) establish licensee qualifications,
licensing and enforcement, and license fees sufficient to cover the
cost of licensing and enforcement.
NEW SECTION. Sec. 501 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 felony and nonfelony 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. 502 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. 503 A new section is added to chapter 26.12
RCW to read as follows:
(1) Every county that authorizes the tax provided in section 804 of
this act shall, and every county may, establish and operate a
therapeutic court component for dependency proceedings 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 therapeutic court for dependency proceedings as a component
of its existing program.
(2) For the purposes of this section, "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 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 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 therapeutic court unless a court contracts with
providers outside of the department.
(5) Any jurisdiction that receives a state appropriation to fund a
therapeutic court must first exhaust all federal funding available for
the development and operation of the therapeutic court and associated
services.
(6) Moneys allocated by the state for a 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 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.
Sec. 504 RCW 2.28.170 and 2002 c 290 s 13 are each amended to
read as follows:
(1) Counties may establish and operate drug courts.
(2) For the purposes of this section, "drug court" means a court
that has special calendars or dockets designed to achieve a reduction
in recidivism and substance abuse among nonviolent, substance abusing
felony and nonfelony offenders by increasing their likelihood for
successful rehabilitation through early, continuous, and intense
judicially supervised treatment; mandatory periodic drug testing; and
the use of appropriate sanctions and other rehabilitation services.
(3)(a) Any jurisdiction that seeks a state appropriation to fund a
drug court program must first:
(i) Exhaust all federal funding ((received from the office of
national drug control policy)) that is available to support the
operations of its drug court and associated services; and
(ii) Match, on a dollar-for-dollar basis, state moneys allocated
for drug 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 drug court operations and
associated services.
(b) Any county that establishes a drug court pursuant to this
section shall establish minimum requirements for the participation of
offenders in the program. The drug court may adopt local requirements
that are more stringent than the minimum. The minimum requirements
are:
(i) The offender would benefit from substance abuse 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. 505 (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) State-owned or operated facilities; and
(b) 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. 506 By January 1, 2006, the department of
social and health services shall:
(1) Reduce the waiting times for competency evaluation and
restoration to the maximum extent possible using funds appropriated for
this purpose; and
(2) 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. 507 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 and the department of
corrections 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. 508 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. 601 (1) The department of social and health
services, in consultation with the members of the team charged with
developing the state plan for co-occurring mental and substance abuse
disorders, shall adopt, not later than January 1, 2006, an integrated
and comprehensive screening and assessment process for chemical
dependency and mental disorders and co-occurring chemical dependency
and mental disorders.
(a) The process adopted shall include, at a minimum:
(i) An initial screening tool that can be used by intake personnel
system-wide and which will identify the most common types of co-occurring disorders;
(ii) An assessment process for those cases in which assessment is
indicated that provides an appropriate degree of assessment for most
situations, which can be expanded for complex situations;
(iii) Identification of triggers in the screening that indicate the
need to begin an assessment;
(iv) Identification of triggers after or outside the screening that
indicate a need to begin or resume an assessment;
(v) The components of an assessment process and a protocol for
determining whether part or all of the assessment is necessary, and at
what point; and
(vi) Emphasis that the process adopted under this section is to
replace and not to duplicate existing intake, screening, and assessment
tools and processes.
(b) The department shall consider existing models, including those
already adopted by other states, and to the extent possible, adopt an
established, proven model.
(c) The integrated, comprehensive screening and assessment process
shall be implemented statewide by all chemical dependency and mental
health treatment providers as well as all designated mental health
professionals, designated chemical dependency specialists, and
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 appropriate committees of the legislature.
(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. 602 The department of corrections shall, to
the extent that resources are available for this purpose, utilize the
integrated, comprehensive screening and assessment process for chemical
dependency and mental disorders developed under section 601 of this
act.
NEW SECTION. Sec. 603 A new section is added to chapter 71.24
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, 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 matrix or set of matrices shall be developed in
collaboration with experts in evidence-based practices for mental
disorders, chemical dependency disorders, and co-occurring mental and
chemical dependency disorders at the University of Washington, and in
consultation with representatives of the regional support networks,
community mental health providers, county chemical dependency
coordinators, chemical dependency providers, consumers, family
advocates, and community inpatient providers.
(b) The matrix or set of matrices shall, to the extent possible,
adopt or utilize materials already prepared by the department or by
other states.
(4)(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 by which regional
support networks and providers must adopt the matrix or set of matrices
and a schedule of penalties for failure to adopt and implement the
matrices. The department may act against the regional support networks
or providers or both to enforce the provisions of this section and
shall provide the appropriate committees of the legislature with the
schedules adopted under this subsection by June 30, 2006.
(5) 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. 604 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, early learning and
child care providers, child serving agencies, and child-placing
agencies to identify and utilize federal, state, and local services and
providers 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 through
federal, state, or local services and providers 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
consistent with chapter 71.24 RCW.
(3) The department, in collaboration with the office of the
superintendent of public instruction, local providers, local school
districts, and the regional support networks, shall identify and review
existing programs and services as well as the unmet need for programs
and services serving birth to five and school-aged children who exhibit
early signs of behavioral or mental health disorders and who are not
otherwise eligible for services through the regional support networks.
The review of programs and services shall include, but not be limited
to, the utilization and effectiveness of early intervention or
prevention services and the primary intervention programs.
The department of social and health services shall provide a
briefing on the collaboration's findings and recommendations to the
appropriate committee of the legislature by December 31, 2005.
NEW SECTION. Sec. 605 The Washington state institute for public
policy shall study the net short-run and long-run fiscal savings to
state and local governments of implementing evidence-based treatment of
chemical dependency disorders, mental disorders, and co-occurring
mental and substance abuse disorders. The institute shall use the
results from its 2004 report entitled "Benefits and Costs of Prevention
and Early Intervention Programs for Youth" and its work on effective
adult corrections programs to project total fiscal impacts under
alternative implementation scenarios. In addition to fiscal outcomes,
the institute shall estimate the long-run effects that an evidence-based strategy could have on statewide education, crime, child abuse
and neglect, substance abuse, and economic outcomes. The institute
shall provide an interim report to the appropriate committees of the
legislature by January 1, 2006, and a final report by June 30, 2006.
NEW SECTION. Sec. 701 The following acts or parts of acts are
each repealed on the effective date of section 107 of this act:
(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. 702 The following acts or parts of acts are
each repealed on the effective date of section 109 of this act:
(1) RCW 71.05.155 (Request to mental health professional by law
enforcement agency for investigation under RCW 71.05.150 -- Advisory
report of results) and 1997 c 112 s 9 & 1979 ex.s. c 215 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. 703 RCW 71.05.610 (Treatment records -- Definitions) and 1989 c 205 s 11 are each repealed on the effective
date of sections 104 through 106 of this act.
NEW SECTION. Sec. 704 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.
Sec. 705 RCW 5.60.060 and 2001 c 286 s 2 are each amended to read
as follows:
(1) A husband shall not be examined for or against his wife,
without the consent of the wife, nor a wife for or against her husband
without the consent of the husband; nor can either during marriage or
afterward, be without the consent of the other, examined as to any
communication made by one to the other during marriage. But this
exception shall not apply to a civil action or proceeding by one
against the other, nor to a criminal action or proceeding for a crime
committed by one against the other, nor to a criminal action or
proceeding against a spouse if the marriage occurred subsequent to the
filing of formal charges against the defendant, nor to a criminal
action or proceeding for a crime committed by said husband or wife
against any child of whom said husband or wife is the parent or
guardian, nor to a proceeding under chapter 70.96A, 70.-- (sections 202
through 216 of this act), 71.05, or 71.09 RCW: PROVIDED, That the
spouse of a person sought to be detained under chapter 70.96A, 70.--(sections 202 through 216 of this act), 71.05, or 71.09 RCW may not be
compelled to testify and shall be so informed by the court prior to
being called as a witness.
(2)(a) An attorney or counselor shall not, without the consent of
his or her client, be examined as to any communication made by the
client to him or her, or his or her advice given thereon in the course
of professional employment.
(b) A parent or guardian of a minor child arrested on a criminal
charge may not be examined as to a communication between the child and
his or her attorney if the communication was made in the presence of
the parent or guardian. This privilege does not extend to
communications made prior to the arrest.
(3) A member of the clergy or a priest shall not, without the
consent of a person making the confession, be examined as to any
confession made to him or her in his or her professional character, in
the course of discipline enjoined by the church to which he or she
belongs.
(4) Subject to the limitations under RCW 70.96A.140 or
((71.05.250)) 71.05.360 (8) and (9), a physician or surgeon or
osteopathic physician or surgeon or podiatric physician or surgeon
shall not, without the consent of his or her patient, be examined in a
civil action as to any information acquired in attending such patient,
which was necessary to enable him or her to prescribe or act for the
patient, except as follows:
(a) In any judicial proceedings regarding a child's injury,
neglect, or sexual abuse or the cause thereof; and
(b) Ninety days after filing an action for personal injuries or
wrongful death, the claimant shall be deemed to waive the physician-patient privilege. Waiver of the physician-patient privilege for any
one physician or condition constitutes a waiver of the privilege as to
all physicians or conditions, subject to such limitations as a court
may impose pursuant to court rules.
(5) A public officer shall not be examined as a witness as to
communications made to him or her in official confidence, when the
public interest would suffer by the disclosure.
(6)(a) A peer support group counselor shall not, without consent of
the law enforcement officer making the communication, be compelled to
testify about any communication made to the counselor by the officer
while receiving counseling. The counselor must be designated as such
by the sheriff, police chief, or chief of the Washington state patrol,
prior to the incident that results in counseling. The privilege only
applies when the communication was made to the counselor while acting
in his or her capacity as a peer support group counselor. The
privilege does not apply if the counselor was an initial responding
officer, a witness, or a party to the incident which prompted the
delivery of peer support group counseling services to the law
enforcement officer.
(b) For purposes of this section, "peer support group counselor"
means a:
(i) Law enforcement officer, or civilian employee of a law
enforcement agency, who has received training to provide emotional and
moral support and counseling to an officer who needs those services as
a result of an incident in which the officer was involved while acting
in his or her official capacity; or
(ii) Nonemployee counselor who has been designated by the sheriff,
police chief, or chief of the Washington state patrol to provide
emotional and moral support and counseling to an officer who needs
those services as a result of an incident in which the officer was
involved while acting in his or her official capacity.
(7) A sexual assault advocate may not, without the consent of the
victim, be examined as to any communication made by the victim to the
sexual assault advocate.
(a) For purposes of this section, "sexual assault advocate" means
the employee or volunteer from a rape crisis center, victim assistance
unit, program, or association, that provides information, medical or
legal advocacy, counseling, or support to victims of sexual assault,
who is designated by the victim to accompany the victim to the hospital
or other health care facility and to proceedings concerning the alleged
assault, including police and prosecution interviews and court
proceedings.
(b) A sexual assault advocate may disclose a confidential
communication without the consent of the victim if failure to disclose
is likely to result in a clear, imminent risk of serious physical
injury or death of the victim or another person. Any sexual assault
advocate participating in good faith in the disclosing of records and
communications under this section shall have immunity from any
liability, civil, criminal, or otherwise, that might result from the
action. In any proceeding, civil or criminal, arising out of a
disclosure under this section, the good faith of the sexual assault
advocate who disclosed the confidential communication shall be
presumed.
Sec. 706 RCW 18.83.110 and 1989 c 271 s 303 are each amended to
read as follows:
Confidential communications between a client and a psychologist
shall be privileged against compulsory disclosure to the same extent
and subject to the same conditions as confidential communications
between attorney and client, but this exception is subject to the
limitations under RCW 70.96A.140 and ((71.05.250)) 71.05.360 (8) and
(9).
Sec. 707 RCW 18.225.105 and 2003 c 204 s 1 are each amended to
read as follows:
A person licensed under this chapter shall not disclose the written
acknowledgment of the disclosure statement pursuant to RCW 18.225.100,
nor any information acquired from persons consulting the individual in
a professional capacity when the information was necessary to enable
the individual to render professional services to those persons except:
(1) With the written authorization of that person or, in the case
of death or disability, the person's personal representative;
(2) If the person waives the privilege by bringing charges against
the person licensed under this chapter;
(3) In response to a subpoena from the secretary. The secretary
may subpoena only records related to a complaint or report under RCW
18.130.050;
(4) As required under chapter 26.44 or 74.34 RCW or RCW
((71.05.250)) 71.05.360 (8) and (9); or
(5) To any individual if the person licensed under this chapter
reasonably believes that disclosure will avoid or minimize an imminent
danger to the health or safety of the individual or any other
individual; however, there is no obligation on the part of the provider
to so disclose.
Sec. 708 RCW 71.05.235 and 2000 c 74 s 6 are each amended to read
as follows:
(1) If an individual is referred to a ((county)) designated mental
health professional under RCW 10.77.090(1)(d)(iii)(A), the ((county))
designated mental health professional shall examine the individual
within forty-eight hours. If the ((county)) designated mental health
professional 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 ((county)) designated mental health professional
not later than the next judicial day. At the hearing the superior
court shall review the determination of the ((county)) designated
mental health professional 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)) 71.05.360 (8) and (9).
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 ((county)) designated mental health professional 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)) 71.05.360 (8) and (9).
Sec. 709 RCW 71.05.310 and 1987 c 439 s 9 are each amended to
read as follows:
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)) 71.05.360 (8) and (9).
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.
Sec. 710 RCW 71.05.425 and 2000 c 94 s 10 are each amended to
read as follows:
(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))
71.05.390(18). 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.
Sec. 711 RCW 71.05.445 and 2004 c 166 s 4 are each amended to
read as follows:
(1) The definitions in this subsection apply throughout this
section unless the context clearly requires otherwise.
(a) "Information related to mental health services" means all
information and records compiled, obtained, or maintained in the course
of providing services to either voluntary or involuntary recipients of
services by a mental health service provider. This may include
documents of legal proceedings under this chapter or chapter 71.34 or
10.77 RCW, or somatic health care information.
(b) "Mental health service provider" means a public or private
agency that provides services to persons with mental disorders as
defined under RCW 71.05.020 and receives funding from public sources.
This includes evaluation and treatment facilities as defined in RCW
71.05.020, community mental health service delivery systems, or
community mental health programs as defined in RCW 71.24.025, and
facilities conducting competency evaluations and restoration under
chapter 10.77 RCW.
(2)(a) Information related to mental health services delivered to
a person subject to chapter 9.94A or 9.95 RCW shall be released, upon
request, by a mental health service provider to department of
corrections personnel for whom the information is necessary to carry
out the responsibilities of their office. The information must be
provided only for the purposes of completing presentence investigations
or risk assessment reports, supervision of an incarcerated offender or
offender under supervision in the community, planning for and provision
of supervision of an offender, or assessment of an offender's risk to
the community. The request shall be in writing and shall not require
the consent of the subject of the records.
(b) If an offender subject to chapter 9.94A or 9.95 RCW has failed
to report for department of corrections supervision or in the event of
an emergent situation that poses a significant risk to the public or
the offender, information related to mental health services delivered
to the offender and, if known, information regarding where the offender
is likely to be found shall be released by the mental health services
provider to the department of corrections upon request. The initial
request may be written or oral. All oral requests must be subsequently
confirmed in writing. Information released in response to an oral
request is limited to a statement as to whether the offender is or is
not being treated by the mental health services provider and the
address or information about the location or whereabouts of the
offender. Information released in response to a written request may
include information identified by rule as provided in subsections (4)
and (5) of this section. For purposes of this subsection a written
request includes requests made by e-mail or facsimile so long as the
requesting person at the department of corrections is clearly
identified. The request must specify the information being requested.
Disclosure of the information requested does not require the consent of
the subject of the records unless the offender has received relief from
disclosure under RCW 9.94A.562, 70.96A.155, or 71.05.132.
(3)(a) When a mental health service provider conducts its initial
assessment for a person receiving court-ordered treatment, the service
provider shall inquire and shall be told by the offender whether he or
she is subject to supervision by the department of corrections.
(b) When a person receiving court-ordered treatment or treatment
ordered by the department of corrections discloses to his or her mental
health service provider that he or she is subject to supervision by the
department of corrections, the mental health services provider shall
notify the department of corrections that he or she is treating the
offender and shall notify the offender that his or her community
corrections officer will be notified of the treatment, provided that if
the offender has received relief from disclosure pursuant to RCW
9.94A.562, 70.96A.155, or 71.05.132 and the offender has provided the
mental health services provider with a copy of the order granting
relief from disclosure pursuant to RCW 9.94A.562, 70.96A.155, or
71.05.132, the mental health services provider is not required to
notify the department of corrections that the mental health services
provider is treating the offender. The notification may be written or
oral and shall not require the consent of the offender. If an oral
notification is made, it must be confirmed by a written notification.
For purposes of this section, a written notification includes
notification by e-mail or facsimile, so long as the notifying mental
health service provider is clearly identified.
(4) The information to be released to the department of corrections
shall include all relevant records and reports, as defined by rule,
necessary for the department of corrections to carry out its duties,
including those records and reports identified in subsection (2) of
this section.
(5) The department and the department of corrections, in
consultation with regional support networks, mental health service
providers as defined in subsection (1) of this section, mental health
consumers, and advocates for persons with mental illness, shall adopt
rules to implement the provisions of this section related to the type
and scope of information to be released. These rules shall:
(a) Enhance and facilitate the ability of the department of
corrections to carry out its responsibility of planning and ensuring
community protection with respect to persons subject to sentencing
under chapter 9.94A or 9.95 RCW, including accessing and releasing or
disclosing information of persons who received mental health services
as a minor; and
(b) Establish requirements for the notification of persons under
the supervision of the department of corrections regarding the
provisions of this section.
(6) The information received by the department of corrections under
this section shall remain confidential and subject to the limitations
on disclosure outlined in chapter 71.05 RCW, except as provided in RCW
72.09.585.
(7) No mental health service provider or individual employed by a
mental health service provider shall be held responsible for
information released to or used by the department of corrections under
the provisions of this section or rules adopted under this section
except under RCW ((71.05.670 and)) 71.05.440.
(8) 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 dependency, the
release of the information may be restricted as necessary to comply
with federal law and regulations.
(9) This section does not modify the terms and conditions of
disclosure of information related to sexually transmitted diseases
under chapter 70.24 RCW.
(10) The department shall, subject to available resources,
electronically, or by the most cost-effective means available, provide
the department of corrections with the names, last dates of services,
and addresses of specific regional support networks and mental health
service providers that delivered mental health services to a person
subject to chapter 9.94A or 9.95 RCW pursuant to an agreement between
the departments.
Sec. 712 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)) 71.05.620 through 71.05.690.
Sec. 713 RCW 71.05.680 and 1999 c 13 s 11 are each amended to
read as follows:
Any person who requests or obtains confidential information
pursuant to RCW ((71.05.610)) 71.05.620 through 71.05.690 under false
pretenses shall be guilty of a gross misdemeanor.
Sec. 714 RCW 71.05.690 and 1999 c 13 s 12 are each amended to
read as follows:
The department shall adopt rules to implement RCW ((71.05.610))
71.05.620 through 71.05.680.
Sec. 715 RCW 71.24.035 and 2001 c 334 s 7 and 2001 c 323 s 10 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 county authority if a
county 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 county biennial needs assessments and county mental health
service plans and state services for mentally ill adults and children.
The secretary may 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 county'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. 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, which shall be used in contracting with
regional support networks or counties. The standard contract shall
include a maximum fund balance, which shall not exceed ten percent;
(f) Establish, to the extent possible, a standardized auditing
procedure which minimizes paperwork requirements of county authorities
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, counties, 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, ((71.05.400,
71.05.410,)) 71.05.420, ((71.05.430,)) and 71.05.440. The design of
the system and the data elements to be collected shall be reviewed by
the work group appointed by the secretary under section 5(1) of this
act and representing the department, regional support networks, service
providers, consumers, and advocates. The data elements shall be
designed to provide information that is needed to measure performance
and achieve the service outcomes ((identified in section 5 of this
act));
(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 counties, regional support networks, and
licensed service providers as needed to assure compliance with
contractual agreements authorized by this chapter; and
(m) Adopt such rules as are necessary to implement the department's
responsibilities under this chapter.
(6) The secretary shall use available resources only for regional
support networks.
(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 county 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 counties of demographic factors in counties 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 county, 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 counties under chapters 71.05, 71.34, and 71.24 RCW.
Such responsibilities shall include those which would have been
assigned to the nonparticipating counties under 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) Allocate one hundred percent of available resources to the
regional support networks in accordance with subsection (13) of this
section. Incentive payments authorized under subsection (13) of this
section may be allocated separately from other available resources.
(d) Notify regional support networks of their allocation of
available resources at least sixty days prior to the start of a new
biennial contract period.
(e) Deny 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.
(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.
NEW SECTION. Sec. 801 RCW 71.05.035 is recodified as a new
section in chapter 71A.12 RCW.
NEW SECTION. Sec. 802 A new section is added to chapter 43.20A
RCW to read as follows:
Beginning July 1, 2007, the secretary shall require, in the
contracts the department negotiates pursuant to chapters 71.24 and
70.96A RCW, that any vendor rate increases provided for mental health
and chemical dependency treatment providers or programs who are parties
to the contract or subcontractors of any party to the contract shall be
prioritized to those providers and programs that maximize the use of
evidence-based and research-based practices, as those terms are defined
in section 603 of this act, unless otherwise designated by the
legislature.
NEW SECTION. Sec. 803 A new section is added to chapter 71.24
RCW to read as follows:
The department shall require each regional support network to
provide for a separately funded mental health ombudsman office in each
regional support network that is independent of the regional support
network. The ombudsman office shall maximize the use of consumer
advocates.
NEW SECTION. Sec. 804 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 and for the operation of new or expanded
therapeutic court programs. Moneys collected under this section shall
not be used to supplant existing funding for these purposes.
NEW SECTION. Sec. 805 A new section is added to chapter 71.24
RCW to read as follows:
The department may establish new regional support network
boundaries in any part of the state where more than one network chooses
not to respond to, or is unable to substantially meet the requirements
of, the request for qualifications under 2005 c . . . (Engrossed Second
Substitute House Bill No. 1290, as amended by the Senate) s 4 or where
a regional support network is subject to reprocurement under 2005 c
. . . (Engrossed Second Substitute House Bill No. 1290, as amended by
the Senate) s 6. 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.
NEW SECTION. Sec. 806 2005 c ... (Engrossed Second Substitute
House Bill No. 1290, as amended by the Senate) s 5 is hereby repealed.
NEW SECTION. Sec. 807 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. 808 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. 809 Captions, part headings, and subheadings
used in this act are not part of the law.
NEW SECTION. Sec. 810 If specific funding for the purposes of
sections 203, 217, 220, 301, 303, 305, 505, 601, and 605 of this act,
referencing the section by section number and by bill or chapter
number, is not provided by June 30, 2005, each section not referenced
is null and void.
NEW SECTION. Sec. 811 (1) The code reviser shall alphabetize and
renumber the definitions, and correct any internal references affected
by this act.
(2) The code reviser shall replace all references to "county
designated mental health professional" with "designated mental health
professional" in the Revised Code of Washington.
NEW SECTION. Sec. 812 (1) The secretary of the department of
social and health services may adopt rules as necessary to implement
the provisions of this act.
(2) The secretary of corrections may adopt rules as necessary to
implement the provisions of this act.
NEW SECTION. Sec. 813 (1) Except for section 503 of this act,
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.
(2) Section 503 of this act takes effect July 1, 2006.