5763-S2.EAMHCODYAMH3058.3E2SSB 5763H AMDBy Representative CodyADOPTED AS AMENDED 04/14/2005 Strike everything after the enacting clause and insert thefollowing:"PART IGENERAL PROVISIONSNEW SECTION.Sec. The legislature finds that persons withmental disorders, chemical dependency disorders, or cooccurring mentaland substance abuse disorders are disproportionately more likely to beconfined in a correctional institution, become homeless, becomeinvolved with child protective services or involved in a dependencyproceeding, or lose those state and federal benefits to which they maybe entitled as a result of their disorders. The legislature finds thatprior state policy of addressing mental health and chemical dependencyin isolation from each other has not been costeffective and has oftenresulted in longerterm, more costly treatment that may be lesseffective over time. The legislature finds that a substantial numberof persons have cooccurring mental and substance abuse disorders andthat identification and integrated treatment of cooccurring disordersis critical to successful outcomes and recovery. Consequently, thelegislature intends, to the extent of available funding, to: (1) Establish a process for determining which persons with mentaldisorders and substance abuse disorders have cooccurring disorders; (2) Reduce the gap between available chemical dependency treatmentand the documented need for treatment; (3) Improve treatment outcomes by shifting treatment, wherepossible, to evidencebased, researchbased, and consensusbasedtreatment practices and by removing barriers to the use of thosepractices; (4) Expand the authority for and use of therapeutic courts 1 including drug courts, mental health courts, and therapeutic courts fordependency proceedings; (5) Improve access to treatment for persons who are not enrolled inmedicaid by improving and creating consistency in the applicationprocesses, and by minimizing the numbers of eligible confined personswho leave confinement without medical assistance; (6) Improve access to inpatient treatment by creating expandedservices facilities for persons needing intensive treatment in a securesetting who do not need inpatient care, but are unable to accesstreatment under current licensing restrictions in other settings; (7) Establish secure detoxification centers for personsinvoluntarily detained as gravely disabled or presenting a likelihoodof serious harm due to chemical dependency and authorize combinedcrisis responders for both mental disorders and chemical dependencydisorders on a pilot basis and study the outcomes; (8) Slow or stop the loss of inpatient and intensive residentialbeds and children's longterm inpatient placements and refine thebalance of state hospital and community inpatient and residential beds; (9) Improve crosssystem collaboration including collaboration withfirst responders and hospital emergency rooms, schools, primary care,developmental disabilities, law enforcement and corrections, andfederally funded and licensed programs; (10) Following the receipt of outcomes from the pilot programs inPart II of this act, if directed by future legislative enactment,implement a single, comprehensive, involuntary treatment act with aunified set of standards, rights, obligations, and procedures foradults and children with mental disorders, chemical dependencydisorders, and cooccurring disorders; and (11) Amend existing state law to address organizational andstructural barriers to effective use of state funds for treatingpersons with mental and substance abuse disorders, minimize internalinconsistencies, clarify policy and requirements, and maximize theopportunity for effective and costeffective outcomes.NEW SECTION.Sec. (1) The department of social and healthservices shall explore and report to the appropriate committees of thelegislature by December 1, 2005, on the feasibility, costs, benefits, 2 and time frame to access federal medicaid funds for mental health andsubstance abuse treatment under the following provisions: (a) The optional clinic provisions; (b) Children's mental health treatment or cooccurring disorderstreatment under the early periodic screening, diagnosis, and treatmentprovisions. (2) The department shall provide the appropriate committees of thelegislature with a clear and concise explanation of the reasons forreducing state hospital capacity and the differences in costs andbenefits of treatment in state and community hospital treatment. (3) The department may not reduce the capacity of either statehospital until at least an equal number of skilled nursing,residential, expanded services facility, or supported housingplacements are available in the community to the persons displaced bythe capacity reduction.Mental Health TreatmentNEW SECTION.Sec. A new section is added to chapter 71.05RCW to read as follows: (1) Not later than January 1, 2007, all persons providing treatmentunder this chapter shall also implement the integrated comprehensivescreening and assessment process for chemical dependency and mentaldisorders adopted pursuant to section 601 of this act and shalldocument the numbers of clients with cooccurring mental and substanceabuse disorders based on a quadrant system of low and high needs. (2) Treatment providers and regional support networks who fail toimplement the integrated comprehensive screening and assessment processfor chemical dependency and mental disorders by July 1, 2007, shall besubject to contractual penalties established under section 601 of thisact.Sec. RCW 71.05.020 and 2000 c 94 s 1 are each amended to readas follows: The definitions in this section apply throughout this chapterunless the context clearly requires otherwise. (1) "Admission" or "admit" means a decision by a physician that aperson should be examined or treated as a patient in a hospital; 3 (2) "Antipsychotic medications" means that class of drugs primarilyused to treat serious manifestations of mental illness associated withthought disorders, which includes, but is not limited to atypicalantipsychotic medications; (3) "Attending staff" means any person on the staff of a public orprivate agency having responsibility for the care and treatment of apatient; (4) "Commitment" means the determination by a court that a personshould be detained for a period of either evaluation or treatment, orboth, in an inpatient or a less restrictive setting; (5) "Conditional release" means a revocable modification of acommitment, which may be revoked upon violation of any of its terms; (6) (("County designated mental health professional" means a mentalhealth professional appointed by the county to perform the dutiesspecified in this chapter; (7))) "Custody" means involuntary detention under the provisions ofthis chapter or chapter 10.77 RCW, uninterrupted by any period ofunconditional release from commitment from a facility providinginvoluntary care and treatment; (((8))) (7) "Department" means the department of social and healthservices; (((9))) (8) "Designated chemical dependency specialist" means aperson designated by the county alcoholism and other drug addictionprogram coordinator designated under RCW 70.96A.310 to perform thecommitment duties described in chapter 70.96A RCW and sections 202through 216 of this act; (9) "Designated crisis responder" means a mental healthprofessional appointed by the county or the regional support network toperform the duties specified in this chapter; (10) "Designated mental health professional" means a mental healthprofessional certified by the department per rules adopted by thesecretary and employed by or contracted with a regional support networkestablished under chapter 71.24 RCW to perform duties specified in thischapter; (11) "Detention" or "detain" means the lawful confinement of aperson, under the provisions of this chapter; (((10))) (12) "Developmental disabilities professional" means aperson who has specialized training and three years of experience in 4 directly treating or working with persons with developmentaldisabilities and is a psychiatrist, psychologist, or social worker, andsuch other developmental disabilities professionals as may be definedby rules adopted by the secretary; (((11))) (13) "Developmental disability" means that conditiondefined in RCW 71A.10.020(3); (((12))) (14) "Discharge" means the termination of hospital medicalauthority. The commitment may remain in place, be terminated, or beamended by court order; (((13))) (15) "Evaluation and treatment facility" means anyfacility which can provide directly, or by direct arrangement withother public or private agencies, emergency evaluation and treatment,outpatient care, and timely and appropriate inpatient care to personssuffering from a mental disorder, and which is certified as such by thedepartment. A physically separate and separately operated portion ofa state hospital may be designated as an evaluation and treatmentfacility. A facility which is part of, or operated by, the departmentor any federal agency will not require certification. No correctionalinstitution or facility, or jail, shall be an evaluation and treatmentfacility within the meaning of this chapter; (((14))) (16) "Gravely disabled" means a condition in which aperson, as a result of a mental disorder: (a) Is in danger of seriousphysical harm resulting from a failure to provide for his or heressential human needs of health or safety; or (b) manifests severedeterioration in routine functioning evidenced by repeated andescalating loss of cognitive or volitional control over his or heractions and is not receiving such care as is essential for his or herhealth or safety; (((15))) (17) "Habilitative services" means those services providedby program personnel to assist persons in acquiring and maintaininglife 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 shallbe undertaken with recognition of the risk to the public safetypresented by the ((individual)) person being assisted as manifested byprior charged criminal conduct; (((16))) (18) "History of one or more violent acts" refers to theperiod of time ten years prior to the filing of a petition under this 5 chapter, excluding any time spent, but not any violent acts committed,in a mental health facility or in confinement as a result of a criminalconviction; (((17))) (19) "Individualized service plan" means a plan preparedby a developmental disabilities professional with other professionalsas a team, for ((an individual)) a person with developmentaldisabilities, which shall state: (a) The nature of the person's specific problems, prior chargedcriminal behavior, and habilitation needs; (b) The conditions and strategies necessary to achieve the purposesof habilitation; (c) The intermediate and longrange goals of the habilitationprogram, with a projected timetable for the attainment; (d) The rationale for using this plan of habilitation to achievethose intermediate and longrange goals; (e) The staff responsible for carrying out the plan; (f) Where relevant in light of past criminal behavior and dueconsideration for public safety, the criteria for proposed movement tolessrestrictive settings, criteria for proposed eventual discharge orrelease, and a projected possible date for discharge or release; and (g) The type of residence immediately anticipated for the personand possible future types of residences; (((18))) (20) "Judicial commitment" means a commitment by a courtpursuant to the provisions of this chapter; (((19))) (21) "Likelihood of serious harm" means: (a) A substantial risk that: (i) Physical harm will be inflictedby ((an individual)) a person upon his or her own person, as evidencedby threats or attempts to commit suicide or inflict physical harm ononeself; (ii) physical harm will be inflicted by ((an individual)) aperson upon another, as evidenced by behavior which has caused suchharm or which places another person or persons in reasonable fear ofsustaining such harm; or (iii) physical harm will be inflicted by ((anindividual)) a person upon the property of others, as evidenced bybehavior which has caused substantial loss or damage to the property ofothers; or (b) The ((individual)) person has threatened the physical safety ofanother and has a history of one or more violent acts; 6 (((20))) (22) "Mental disorder" means any organic, mental, oremotional impairment which has substantial adverse effects on ((anindividual's)) a person's cognitive or volitional functions; (((21))) (23) "Mental health professional" means a psychiatrist,psychologist, psychiatric nurse, or social worker, and such othermental health professionals as may be defined by rules adopted by thesecretary pursuant to the provisions of this chapter; (((22))) (24) "Peace officer" means a law enforcement official ofa public agency or governmental unit, and includes persons specificallygiven peace officer powers by any state law, local ordinance, orjudicial order of appointment; (((23))) (25) "Private agency" means any person, partnership,corporation, or association that is not a public agency, whether or notfinanced in whole or in part by public funds, which constitutes anevaluation and treatment facility or private institution, orhospital((, or sanitarium)), which is conducted for, or includes adepartment or ward conducted for, the care and treatment of persons whoare mentally ill; (((24))) (26) "Professional person" means a mental healthprofessional and shall also mean a physician, registered nurse, andsuch others as may be defined by rules adopted by the secretarypursuant to the provisions of this chapter; (((25))) (27) "Psychiatrist" means a person having a license as aphysician and surgeon in this state who has in addition completed threeyears of graduate training in psychiatry in a program approved by theAmerican medical association or the American osteopathic associationand is certified or eligible to be certified by the American board ofpsychiatry and neurology; (((26))) (28) "Psychologist" means a person who has been licensedas a psychologist pursuant to chapter 18.83 RCW; (((27))) (29) "Public agency" means any evaluation and treatmentfacility or institution, or hospital((, or sanitarium)) which isconducted for, or includes a department or ward conducted for, the careand treatment of persons who are mentally ill((;[,])), if the agency isoperated directly by, federal, state, county, or municipal government,or a combination of such governments; (((28))) (30) "Registration records" include all the records of thedepartment, regional support networks, treatment facilities, and other 7 persons providing services to the department, county departments, orfacilities which identify persons who are receiving or who at any timehave received services for mental illness; (31) "Release" means legal termination of the commitment under theprovisions of this chapter; (((29))) (32) "Resource management services" has the meaning givenin chapter 71.24 RCW; (((30))) (33) "Secretary" means the secretary of the department ofsocial and health services, or his or her designee; (((31))) (34) "Social worker" means a person with a master's orfurther advanced degree from an accredited school of social work or adegree deemed equivalent under rules adopted by the secretary; (((32))) (35) "Treatment records" include registration and allother records concerning persons who are receiving or who at any timehave received services for mental illness, which are maintained by thedepartment, by regional support networks and their staffs, and bytreatment facilities. Treatment records do not include notes orrecords maintained for personal use by a person providing treatmentservices for the department, regional support networks, or a treatmentfacility 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 toproperty.Sec. RCW 71.24.025 and 2001 c 323 s 8 are each amended toread as follows: Unless the context clearly requires otherwise, the definitions inthis section apply throughout this chapter. (1) "Acutely mentally ill" means a condition which is limited to ashortterm severe crisis episode of: (a) A mental disorder as defined in RCW 71.05.020 or, in the caseof a child, as defined in RCW 71.34.020; (b) Being gravely disabled as defined in RCW 71.05.020 or, in thecase 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 RCW71.05.020 or, in the case of a child, as defined in RCW 71.34.020. 8 (2) "Available resources" means funds appropriated for the purposeof providing community mental health programs ((under RCW 71.24.045)),federal funds, except those provided according to Title XIX of theSocial Security Act, and state funds appropriated under this chapter orchapter 71.05 RCW by the legislature during any biennium for thepurpose of providing residential services, resource managementservices, community support services, and other mental health services.This does not include funds appropriated for the purpose of operatingand administering the state psychiatric hospitals, except as negotiatedaccording 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 amental disorder and meets at least one of the following criteria: (a) Has undergone two or more episodes of hospital care for amental disorder within the preceding two years; or (b) Has experienced a continuous psychiatric hospitalization orresidential treatment exceeding six months' duration within thepreceding year; or (c) Has been unable to engage in any substantial gainful activityby reason of any mental disorder which has lasted for a continuousperiod of not less than twelve months. "Substantial gainful activity"shall be defined by the department by rule consistent with Public Law92603, as amended. (5) "Community mental health program" means all mental healthservices, activities, or programs using available resources. (6) "Community mental health service delivery system" means publicor private agencies that provide services specifically to persons withmental disorders as defined under RCW 71.05.020 and receive fundingfrom public sources. (7) "Community support services" means services authorized,planned, and coordinated through resource management servicesincluding, at a minimum, assessment, diagnosis, emergency crisisintervention available twentyfour hours, seven days a week,prescreening determinations for mentally ill persons being consideredfor placement in nursing homes as required by federal law, screeningfor patients being considered for admission to residential services,diagnosis and treatment for acutely mentally ill and severelyemotionally disturbed children discovered under screening through the 9 federal Title XIX early and periodic screening, diagnosis, andtreatment program, investigation, legal, and other nonresidentialservices under chapter 71.05 RCW, case management services, psychiatrictreatment including medication supervision, counseling, psychotherapy,assuring transfer of relevant patient information between serviceproviders, recovery services, and other services determined by regionalsupport networks. (8) "County authority" means the board of county commissioners,county council, or county executive having authority to establish acommunity mental health program, or two or more of the countyauthorities specified in this subsection which have entered into anagreement to provide a community mental health program. (9) "Department" means the department of social and healthservices. (10) "Emerging best practice" or "promising practice" means apractice that presents, based on preliminary information, potential forbecoming a researchbased or consensusbased practice. (11) "Evidencebased" means a program or practice that has hadmultiple site random controlled trials across heterogeneous populationsdemonstrating that the program or practice is effective for thepopulation. (12) "Licensed service provider" means an entity licensed accordingto this chapter or chapter 71.05 RCW or an entity deemed to meet stateminimum standards as a result of accreditation by a recognizedbehavioral health accrediting body recognized and having a currentagreement with the department, that meets state minimum standards or((individuals)) persons licensed under chapter 18.57, 18.71, 18.83, or18.79 RCW, as it applies to registered nurses and advanced registerednurse practitioners. (((11))) (13) "Mental health services" means all services providedby regional support networks and other services provided by the statefor the mentally ill. (((12))) (14) "Mentally ill persons" and "the mentally ill" meanpersons 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 ableto live, work, learn, and participate fully in their communities. 10 (16) "Regional support network" means a county authority or groupof county authorities or other entity recognized by the secretary((that enter into joint operating agreements to contract with thesecretary pursuant to this chapter)) in contract in a defined area. (((14))) (17) "Registration records" include all the records of thedepartment, regional support networks, treatment facilities, and otherpersons providing services to the department, county departments, orfacilities which identify persons who are receiving or who at any timehave received services for mental illness. (18) "Residential services" means a complete range of residencesand supports authorized by resource management services and which mayinvolve a facility, a distinct part thereof, or services which supportcommunity living, for acutely mentally ill persons, chronicallymentally ill adults, severely emotionally disturbed children, orseriously disturbed adults determined by the regional support networkto be at risk of becoming acutely or chronically mentally ill. Theservices shall include at least evaluation and treatment services asdefined in chapter 71.05 RCW, acute crisis respite care, longtermadaptive and rehabilitative care, and supervised and supported livingservices, and shall also include any residential services developed toservice mentally ill persons in nursing homes, boarding homes, andadult family homes, and may include outpatient services provided as anelement in a package of services in a supported housing model.Residential services for children in outofhome placements related totheir mental disorder shall not include the costs of food and shelter,except for children's longterm residential facilities existing priorto January 1, 1991. (((15))) (19) "Researchbased" means a program or practice that hassome research demonstrating effectiveness, but that does not yet meetthe standard of evidencebased practices. (20) "Resilience" means the personal and community qualities thatenable 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 communitysupport services administered pursuant to an individual service planfor: (a) Acutely mentally ill adults and children; (b) chronicallymentally ill adults; (c) severely emotionally disturbed children; or 11 (d) seriously disturbed adults determined solely by a regional supportnetwork to be at risk of becoming acutely or chronically mentally ill.Such planning, coordination, and authorization shall include mentalhealth screening for children eligible under the federal Title XIXearly and periodic screening, diagnosis, and treatment program.Resource management services include seven day a week, twentyfour houra day availability of information regarding mentally ill adults' andchildren's enrollment in services and their individual service plan to((county))designated mental health professionals, evaluation andtreatment facilities, and others as determined by the regional supportnetwork. (((16))) (22) "Secretary" means the secretary of social and healthservices. (((17))) (23) "Seriously disturbed person" means a person who: (a) Is gravely disabled or presents a likelihood of serious harm tohimself or herself or others, or to the property of others, as a resultof a mental disorder as defined in chapter 71.05 RCW; (b) Has been on conditional release status, or under a lessrestrictive alternative order, at some time during the preceding twoyears from an evaluation and treatment facility or a state mentalhealth hospital; (c) Has a mental disorder which causes major impairment in severalareas of daily living; (d) Exhibits suicidal preoccupation or attempts; or (e) Is a child diagnosed by a mental health professional, asdefined in chapter 71.34 RCW, as experiencing a mental disorder whichis clearly interfering with the child's functioning in family or schoolor with peers or is clearly interfering with the child's personalitydevelopment and learning. (((18))) (24) "Severely emotionally disturbed child" means a childwho has been determined by the regional support network to beexperiencing a mental disorder as defined in chapter 71.34 RCW,including those mental disorders that result in a behavioral or conductdisorder, that is clearly interfering with the child's functioning infamily or school or with peers and who meets at least one of thefollowing criteria: (a) Has undergone inpatient treatment or placement outside of thehome related to a mental disorder within the last two years; 12 (b) Has undergone involuntary treatment under chapter 71.34 RCWwithin the last two years; (c) Is currently served by at least one of the following childserving systems: Juvenile justice, childprotection/welfare, specialeducation, or developmental disabilities; (d) Is at risk of escalating maladjustment due to: (i) Chronic family dysfunction involving a mentally ill orinadequate caretaker; (ii) Changes in custodial adult; (iii) Going to, residing in, or returning from any placementoutside of the home, for example, psychiatric hospital, shortterminpatient, residential treatment, group or foster home, or acorrectional facility; (iv) Subject to repeated physical abuse or neglect; (v) Drug or alcohol abuse; or (vi) Homelessness. (((19))) (25) "State minimum standards" means minimum requirementsestablished by rules adopted by the secretary and necessary toimplement this chapter for: (a) Delivery of mental health services;(b) licensed service providers for the provision of mental healthservices; (c) residential services; and (d) community support servicesand resource management services. (((20))) (26) "Treatment records" include registration and allother records concerning persons who are receiving or who at any timehave received services for mental illness, which are maintained by thedepartment, by regional support networks and their staffs, and bytreatment facilities. Treatment records do not include notes orrecords maintained for personal use by a person providing treatmentservices for the department, regional support networks, or a treatmentfacility if the notes or records are not available to others. (27) "Tribal authority," for the purposes of this section and RCW71.24.300 only, means: The federally recognized Indian tribes and themajor Indian organizations recognized by the secretary insofar as theseorganizations do not have a financial relationship with any regionalsupport network that would present a conflict of interest.Sec. RCW 10.77.010 and 2004 c 157 s 2 are each amended toread as follows: 13 As used in this chapter: (1) "Admission" means acceptance based on medical necessity, of aperson as a patient. (2) "Commitment" means the determination by a court that a personshould be detained for a period of either evaluation or treatment, orboth, in an inpatient or a lessrestrictive setting. (3) "Conditional release" means modification of a courtorderedcommitment, which may be revoked upon violation of any of its terms. (4) (("County designated mental health professional" has the samemeaning as provided in RCW 71.05.020. (5))) A "criminally insane" person means any person who has beenacquitted of a crime charged by reason of insanity, and thereupon foundto be a substantial danger to other persons or to present a substantiallikelihood of committing criminal acts jeopardizing public safety orsecurity unless kept under further control by the court or otherpersons or institutions. (((6))) (5) "Department" means the state department of social andhealth services. (6) "Designated mental health professional" has the same meaning asprovided in RCW 71.05.020. (7) "Detention" or "detain" means the lawful confinement of aperson, under the provisions of this chapter, pending evaluation. (8) "Developmental disabilities professional" means a person whohas specialized training and three years of experience in directlytreating or working with persons with developmental disabilities and isa psychiatrist or psychologist, or a social worker, and such otherdevelopmental disabilities professionals as may be defined by rulesadopted by the secretary. (9) "Developmental disability" means the condition as defined inRCW 71A.10.020(3). (10) "Discharge" means the termination of hospital medicalauthority. The commitment may remain in place, be terminated, or beamended by court order. (11) "Furlough" means an authorized leave of absence for a residentof a state institution operated by the department designated for thecustody, care, and treatment of the criminally insane, consistent withan order of conditional release from the court under this chapter, 14 without any requirement that the resident be accompanied by, or be inthe custody of, any law enforcement or institutional staff, while onsuch unescorted leave. (12) "Habilitative services" means those services provided byprogram personnel to assist persons in acquiring and maintaining lifeskills and in raising their levels of physical, mental, social, andvocational functioning. Habilitative services include education,training for employment, and therapy. The habilitative process shallbe undertaken with recognition of the risk to the public safetypresented by the ((individual)) person being assisted as manifested byprior charged criminal conduct. (13) "History of one or more violent acts" means violent actscommitted during: (a) The tenyear period of time prior to the filingof criminal charges; plus (b) the amount of time equal to time spentduring the tenyear period in a mental health facility or inconfinement as a result of a criminal conviction. (14) "Incompetency" means a person lacks the capacity to understandthe nature of the proceedings against him or her or to assist in his orher own defense as a result of mental disease or defect. (15) "Indigent" means any person who is financially unable toobtain counsel or other necessary expert or professional serviceswithout causing substantial hardship to the person or his or herfamily. (16) "Individualized service plan" means a plan prepared by adevelopmental disabilities professional with other professionals as ateam, for an individual with developmental disabilities, which shallstate: (a) The nature of the person's specific problems, prior chargedcriminal behavior, and habilitation needs; (b) The conditions and strategies necessary to achieve the purposesof habilitation; (c) The intermediate and longrange goals of the habilitationprogram, with a projected timetable for the attainment; (d) The rationale for using this plan of habilitation to achievethose intermediate and longrange goals; (e) The staff responsible for carrying out the plan; (f) Where relevant in light of past criminal behavior and due 15 consideration for public safety, the criteria for proposed movement tolessrestrictive settings, criteria for proposed eventual release, anda projected possible date for release; and (g) The type of residence immediately anticipated for the personand possible future types of residences. (17) "Professional person" means: (a) A psychiatrist licensed as a physician and surgeon in thisstate who has, in addition, completed three years of graduate trainingin psychiatry in a program approved by the American medical associationor the American osteopathic association and is certified or eligible tobe certified by the American board of psychiatry and neurology or theAmerican osteopathic board of neurology and psychiatry; (b) A psychologist licensed as a psychologist pursuant to chapter18.83 RCW; or (c) A social worker with a master's or further advanced degree froman accredited school of social work or a degree deemed equivalent underrules adopted by the secretary. (18) "Registration records" include all the records of thedepartment, regional support networks, treatment facilities, and otherpersons providing services to the department, county departments, orfacilities which identify persons who are receiving or who at any timehave received services for mental illness. (19) "Release" means legal termination of the courtorderedcommitment under the provisions of this chapter. (((19))) (20) "Secretary" means the secretary of the department ofsocial and health services or his or her designee. (((20))) (21) "Treatment" means any currently standardized medicalor mental health procedure including medication. (((21))) (22) "Treatment records" include registration and allother records concerning persons who are receiving or who at any timehave received services for mental illness, which are maintained by thedepartment, by regional support networks and their staffs, and bytreatment facilities. Treatment records do not include notes orrecords maintained for personal use by a person providing treatmentservices for the department, regional support networks, or a treatmentfacility 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 16 threatened to be carried out by a person who had the intent andopportunity 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 toanother person. As used in this subsection, "nonfatal injuries" meansphysical pain or injury, illness, or an impairment of physicalcondition. "Nonfatal injuries" shall be construed to be consistentwith the definition of "bodily injury," as defined in RCW 9A.04.110.Sec. RCW 71.05.360 and 1997 c 112 s 30 are each amended toread as follows: (1)(a) Every person involuntarily detained or committed under theprovisions of this chapter shall be entitled to all the rights setforth in this chapter, which shall be prominently posted in thefacility, and shall retain all rights not denied him or her under thischapter except as chapter 9.41 RCW may limit the right of a person topurchase or possess a firearm or to qualify for a concealed pistollicense. (b) No person shall be presumed incompetent as a consequence ofreceiving an evaluation or voluntary or involuntary treatment for amental disorder, under this chapter or any prior laws of this statedealing with mental illness. Competency shall not be determined orwithdrawn except under the provisions of chapter 10.97 or 11.88 RCW. (c) Any person who leaves a public or private agency followingevaluation or treatment for mental disorder shall be given a writtenstatement setting forth the substance of this section. (2) Each person involuntarily detained or committed pursuant tothis chapter shall have the right to adequate care and individualizedtreatment. (3) The provisions of this chapter shall not be construed to denyto any person treatment by spiritual means through prayer in accordancewith the tenets and practices of a church or religious denomination. (4) Persons receiving evaluation or treatment under this chaptershall be given a reasonable choice of an available physician or otherprofessional person qualified to provide such services. (5) Whenever any person is detained for evaluation and treatmentpursuant to this chapter, both the person and, if possible, aresponsible member of his or her immediate family, personal 17 representative, guardian, or conservator, if any, shall be advised assoon as possible in writing or orally, by the officer or person takinghim or her into custody or by personnel of the evaluation and treatmentfacility where the person is detained that unless the person isreleased or voluntarily admits himself or herself for treatment withinseventytwo hours of the initial detention: (a) A judicial hearing in a superior court, either by a judge orcourt commissioner thereof, shall be held not more than seventytwohours after the initial detention to determine whether there isprobable cause to detain the person after the seventytwo hours haveexpired for up to an additional fourteen days without further automatichearing for the reason that the person is a person whose mentaldisorder presents a likelihood of serious harm or that the person isgravely disabled; (b) The person has a right to communicate immediately with anattorney; has a right to have an attorney appointed to represent him orher 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 thatthe mental health professional has designated pursuant to this chapter; (c) The person has the right to remain silent and that anystatement he or she makes may be used against him or her; (d) The person has the right to present evidence and to crossexamine witnesses who testify against him or her at the probable causehearing; and (e) The person has the right to refuse psychiatric medications,including antipsychotic medication beginning twentyfour hours prior tothe 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 theevaluation and treatment facility the personnel of the evaluation andtreatment facility or the designated mental health professional shallserve on such person a copy of the petition for initial detention andthe name, business address, and phone number of the designated attorneyand shall forthwith commence service of a copy of the petition forinitial detention on the designated attorney. (7) The judicial hearing described in subsection (5) of thissection is hereby authorized, and shall be held according to the 18 provisions of subsection (5) of this section and rules promulgated bythe supreme court. (8) At the probable cause hearing the detained person shall havethe following rights in addition to the rights previously specified: (a) To present evidence on his or her behalf; (b) To crossexamine 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 physicianpatient privilege or the psychologistclientprivilege shall be deemed waived in proceedings under this chapterrelating to the administration of antipsychotic medications. As toother proceedings under this chapter, the privileges shall be waivedwhen a court of competent jurisdiction in its discretion determinesthat such waiver is necessary to protect either the detained person orthe public. The waiver of a privilege under this section is limited to recordsor testimony relevant to evaluation of the detained person for purposesof a proceeding under this chapter. Upon motion by the detained personor on its own motion, the court shall examine a record or testimonysought by a petitioner to determine whether it is within the scope ofthe waiver. The record maker shall not be required to testify in order tointroduce medical or psychological records of the detained person solong as the requirements of RCW 5.45.020 are met except that portionsof the record which contain opinions as to the detained person's mentalstate must be deleted from such records unless the person making suchconclusions is available for crossexamination. (10) Insofar as danger to the person or others is not created, eachperson involuntarily detained, treated in a less restrictivealternative course of treatment, or committed for treatment andevaluation pursuant to this chapter shall have, in addition to otherrights not specifically withheld by law, the following rights: (a) To wear his or her own clothes and to keep and use his or herown personal possessions, except when deprivation of same is essentialto protect the safety of the resident or other persons; (b) To keep and be allowed to spend a reasonable sum of his or herown money for canteen expenses and small purchases; 19 (c) To have access to individual storage space for his or herprivate use; (d) To have visitors at reasonable times; (e) To have reasonable access to a telephone, both to make andreceive confidential calls, consistent with an effective treatmentprogram; (f) To have ready access to letter writing materials, includingstamps, and to send and receive uncensored correspondence through themails; (g) To discuss treatment plans and decisions with professionalpersons; (h) Not to consent to the administration of antipsychoticmedications and not to thereafter be administered antipsychoticmedications unless ordered by a court under RCW 71.05.370 (asrecodified by this act) or pursuant to an administrative hearing underRCW 71.05.215; (i) Not to consent to the performance of electroconvulsant therapyor surgery, except emergency lifesaving surgery, unless ordered by acourt under RCW 71.05.370 (as recodified by this act); (j) Not to have psychosurgery performed on him or her under anycircumstances; (k) To dispose of property and sign contracts unless such personhas been adjudicated an incompetent in a court proceeding directed tothat particular issue. (11) Every person involuntarily detained shall immediately beinformed of his or her right to a hearing to review the legality of hisor her detention and of his or her right to counsel, by theprofessional person in charge of the facility providing evaluation andtreatment, or his or her designee, and, when appropriate, by the court.If the person so elects, the court shall immediately appoint anattorney to assist him or her. (12) A person challenging his or her detention or his or herattorney, shall have the right to designate and have the court appointa reasonably available independent physician or licensed mental healthprofessional to examine the person detained, the results of whichexamination may be used in the proceeding. The person shall, if he orshe is financially able, bear the cost of such expert information,otherwise such expert examination shall be at public expense. 20 (13) Nothing contained in this chapter shall prohibit the patientfrom petitioning by writ of habeas corpus for release. (14) Nothing in this chapter shall prohibit a person committed onor prior to January 1, 1974, from exercising a right available to himor her at or prior to January 1, 1974, for obtaining release fromconfinement. (15) Nothing in this section permits any person to knowinglyviolate a nocontact order or a condition of an active judgment andsentence or an active condition of supervision by the department ofcorrections.NEW SECTION.Sec. RCW 71.05.370 is recodified as a newsection in chapter 71.05 RCW to be codified in proximity to RCW71.05.215.Sec. RCW 71.05.390 and 2004 c 166 s 6, 2004 c 157 s 5, and2004 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, thefact of admission and all information and records compiled, obtained,or maintained in the course of providing services to either voluntaryor involuntary recipients of services at public or private agenciesshall be confidential. Information and records may be disclosed only: (1) In communications between qualified professional persons tomeet the requirements of this chapter, in the provision of services orappropriate referrals, or in the course of guardianship proceedings.The consent of the ((patient)) person, or his or her personalrepresentative or guardian, shall be obtained before information orrecords may be disclosed by a professional person employed by afacility 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 wherethe person is confined or supervised; or 21 (f) Who is providing evaluation, treatment, or followup servicesunder chapter 10.77 RCW. (2) When the communications regard the special needs of a patientand the necessary circumstances giving rise to such needs and thedisclosure is made by a facility providing ((outpatient)) services tothe operator of a ((care)) facility in which the patient resides orwill reside. (3)(a) When the person receiving services, or his or her guardian,designates persons to whom information or records may be released, orif the person is a minor, when his or her parents make suchdesignation. (b) A public or private agency shall release to a person's next ofkin, attorney, personal representative, guardian, or conservator, ifany: (i) The information that the person is presently a patient in thefacility or that the person is seriously physically ill; (ii) A statement evaluating the mental and physical condition ofthe patient, and a statement of the probable duration of the patient'sconfinement, 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 orattorney as may be necessary to decide whether or not proceedingsshould be instituted to appoint a guardian or conservator. (4) To the extent necessary for a recipient to make a claim, or fora claim to be made on behalf of a recipient for aid, insurance, ormedical 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 theevaluation or research, or both. Such rules shall include, but neednot be limited to, the requirement that all evaluators and researchersmust sign an oath of confidentiality substantially as follows: "As a condition of conducting evaluation or research concerningpersons who have received services from (fill in the facility, agency,or person) I, ........., agree not to divulge, publish, orotherwise make known to unauthorized persons or the public anyinformation obtained in the course of such evaluation or researchregarding persons who have received services such that the person whoreceived such services is identifiable. 22 I recognize that unauthorized release of confidential informationmay subject me to civil liability under the provisions of state law. (b) Nothing in this chapter shall be construed to prohibit thecompilation and publication of statistical data for use by governmentor researchers under standards, including standards to assuremaintenance of confidentiality, set forth by the secretary. (6)(a) To the courts as necessary to the administration of thischapter or to a court ordering an evaluation or treatment under chapter10.77 RCW solely for the purpose of preventing the entry of anyevaluation or treatment order that is inconsistent with any orderentered under this chapter. (b) To a court or its designee in which a motion under chapter10.77 RCW has been made for involuntary medication of a defendant forthe purpose of competency restoration. (c) Disclosure under this subsection is mandatory for the purposeof the health insurance portability and accountability act. (7)(a) When a mental health professional is requested by arepresentative of a law enforcement or corrections agency, including apolice officer, sheriff, community corrections officer, a municipalattorney, or prosecuting attorney to undertake an investigation underRCW 71.05.150, the mental health professional shall, if requested to doso, advise the representative in writing of the results of theinvestigation including a statement of reasons for the decision todetain or release the person investigated. Such written report shallbe submitted within seventytwo hours of the completion of theinvestigation or the request from the law enforcement or correctionsrepresentative, whichever occurs later. (b) To law enforcement officers, public health officers, orpersonnel of the department of corrections or the indeterminatesentence review board for persons who are the subject of the recordsand who are committed to the custody or supervision of the departmentof corrections or indeterminate sentence review board which informationor records are necessary to carry out the responsibilities of theiroffice. Except for dissemination of information released pursuant to 23 RCW 71.05.425 and 4.24.550, regarding persons committed under thischapter under RCW 71.05.280(3) and 71.05.320(2)(c) after dismissal ofa sex offense as defined in RCW 9.94A.030, the extent of informationthat may be released is limited as follows: (((a))) (i) Only the fact, place, and date of involuntarycommitment, the fact and date of discharge or release, and the lastknown address shall be disclosed upon request; (((b))) (ii) The law enforcement and public health officers orpersonnel of the department of corrections or indeterminate sentencereview board shall be obligated to keep such information confidentialin accordance with this chapter; (((c))) (iii) Additional information shall be disclosed only aftergiving notice to said person and his or her counsel and upon a showingof clear, cogent, and convincing evidence that such information isnecessary and that appropriate safeguards for strict confidentialityare and will be maintained. However, in the event the said person hasescaped from custody, said notice prior to disclosure is not necessaryand that the facility from which the person escaped shall include anevaluation as to whether the person is of danger to persons or propertyand has a propensity toward violence; (((d))) (iv) Information and records shall be disclosed to thedepartment of corrections pursuant to and in compliance with theprovisions of RCW 71.05.445 for the purposes of completing presentenceinvestigations or risk assessment reports, supervision of anincarcerated offender or offender under supervision in the community,planning for and provision of supervision of an offender, or assessmentof an offender's risk to the community; and (((e))) (v) Disclosure under this subsection is mandatory for thepurposes of the health insurance portability and accountability act. (8) To the attorney of the detained person. (9) To the prosecuting attorney as necessary to carry out theresponsibilities of the office under RCW 71.05.330(2) and71.05.340(1)(b) and 71.05.335. The prosecutor shall be provided accessto records regarding the committed person's treatment and prognosis,medication, behavior problems, and other records relevant to the issueof whether treatment less restrictive than inpatient treatment is inthe best interest of the committed person or others. Information shall 24 be disclosed only after giving notice to the committed person and theperson's counsel. (10) To appropriate law enforcement agencies and to a person, whenthe identity of the person is known to the public or private agency,whose health and safety has been threatened, or who is known to havebeen repeatedly harassed, by the patient. The person may designate arepresentative to receive the disclosure. The disclosure shall be madeby the professional person in charge of the public or private agency orhis or her designee and shall include the dates of commitment,admission, discharge, or release, authorized or unauthorized absencefrom the agency's facility, and only such other information that ispertinent to the threat or harassment. The decision to disclose or notshall not result in civil liability for the agency or its employees solong as the decision was reached in good faith and without grossnegligence. (11) To appropriate corrections and law enforcement agencies allnecessary and relevant information in the event of a crisis or emergentsituation that poses a significant and imminent risk to the public.The decision to disclose or not shall not result in civil liability forthe mental health service provider or its employees so long as thedecision was reached in good faith and without gross negligence. (12) To the persons designated in RCW 71.05.425 for the purposesdescribed in that section. (13) Civil liability and immunity for the release of informationabout a particular person who is committed to the department under RCW71.05.280(3) and 71.05.320(2)(c) after dismissal of a sex offense asdefined in RCW 9.94A.030, is governed by RCW 4.24.550. (14) ((To a patient's next of kin, guardian, or conservator, ifany, in the event of death, as provided in RCW 71.05.400.)) Upon thedeath of a person, his or her next of kin, personal representative,guardian, or conservator, if any, shall be notified. Next of kin who are of legal age and competent shall be notifiedunder this section in the following order: Spouse, parents, children,brothers and sisters, and other relatives according to the degree ofrelation. Access to all records and information compiled, obtained, ormaintained in the course of providing services to a deceased patientshall be governed by RCW 70.02.140. 25 (15) To the department of health for the purposes of determiningcompliance with state or federal licensure, certification, orregistration rules or laws. However, the information and recordsobtained under this subsection are exempt from public inspection andcopying pursuant to chapter 42.17 RCW. (16) To mark headstones or otherwise memorialize patients interredat state hospital cemeteries. The department of social and healthservices shall make available the name, date of birth, and date ofdeath of patients buried in state hospital cemeteries fifty years afterthe death of a patient. (17) When a patient would otherwise be subject to the provisions ofRCW 71.05.390 and disclosure is necessary for the protection of thepatient or others due to his or her unauthorized disappearance from thefacility, and his or her whereabouts is unknown, notice of suchdisappearance, along with relevant information, may be made torelatives, the department of corrections when the person is under thesupervision of the department, and governmental law enforcementagencies designated by the physician in charge of the patient or theprofessional person in charge of the facility, or his or herprofessional designee. Except as otherwise provided in this chapter, the uniform healthcare information act, chapter 70.02 RCW, applies to all records andinformation compiled, obtained, or maintained in the course ofproviding services. (18) The fact of admission, as well as all records, files,evidence, findings, or orders made, prepared, collected, or maintainedpursuant to this chapter shall not be admissible as evidence in anylegal proceeding outside this chapter without the written consent ofthe person who was the subject of the proceeding except in a subsequentcriminal prosecution of a person committed pursuant to RCW 71.05.280(3)or 71.05.320(2)(c) on charges that were dismissed pursuant to chapter10.77 RCW due to incompetency to stand trial ((or)), in a civilcommitment proceeding pursuant to chapter 71.09 RCW, or, in the case ofa minor, a guardianship or dependency proceeding. The records andfiles maintained in any court proceeding pursuant to this chapter shallbe confidential and available subsequent to such proceedings only tothe person who was the subject of the proceeding or his or herattorney. In addition, the court may order the subsequent release or 26 use of such records or files only upon good cause shown if the courtfinds that appropriate safeguards for strict confidentiality are andwill be maintained.Sec. RCW 71.05.420 and 1990 c 3 s 113 are each amended toread as follows: Except as provided in RCW 71.05.425, when any disclosure ofinformation or records is made as authorized by RCW 71.05.390 ((through71.05.410)), the physician in charge of the patient or the professionalperson in charge of the facility shall promptly cause to be enteredinto the patient's medical record the date and circumstances underwhich said disclosure was made, the names and relationships to thepatient, if any, of the persons or agencies to whom such disclosure wasmade, and the information disclosed.Sec. RCW 71.05.620 and 1989 c 205 s 12 are each amended toread as follows: (((1) Informed consent for disclosure of information from court ortreatment records to an individual, agency, or organization must be inwriting and must contain the following information: (a) The name of the individual, agency, or organization to whichthe disclosure is to be made; (b) The name of the individual whose treatment record is beingdisclosed; (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 togive consent for the individual. (2))) The files and records of court proceedings under this chapterand chapters ((71.05)) 70.96A, 71.34, and 70. (sections 202 through216 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, resourcemanagement services, or service providers authorized to receive suchinformation by resource management services. 27 Sec. RCW 71.05.630 and 2000 c 75 s 5 are each amended to readas follows: (1) Except as otherwise provided by law, all treatment recordsshall remain confidential((. Treatment records)) and may be releasedonly to the persons designated in this section, or to other personsdesignated in an informed written consent of the patient. (2) Treatment records of ((an individual)) a person may be releasedwithout informed written consent in the following circumstances: (a) To ((an individual)) a person, organization, or agency asnecessary for management or financial audits, or program monitoring andevaluation. Information obtained under this subsection shall remainconfidential and may not be used in a manner that discloses the name orother identifying information about the ((individual)) person whoserecords are being released. (b) To the department, the director of regional support networks,or a qualified staff member designated by the director only whennecessary to be used for billing or collection purposes. Theinformation 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 directorof regional support networks, to resource management servicesresponsible for serving a patient, or to service providers designatedby resource management services as necessary to determine the progressand adequacy of treatment and to determine whether the person should betransferred to a less restrictive or more appropriate treatmentmodality or facility. The information shall remain confidential. (f) Within the treatment facility where the patient is receivingtreatment, confidential information may be disclosed to ((individuals))persons employed, serving in bona fide training programs, orparticipating in supervised volunteer programs, at the facility when itis necessary to perform their duties. (g) Within the department as necessary to coordinate treatment formental illness, developmental disabilities, alcoholism, or drug abuseof ((individuals)) persons who are under the supervision of thedepartment. (h) To a licensed physician who has determined that the life orhealth of the ((individual)) person is in danger and that treatment 28 without the information contained in the treatment records could beinjurious to the patient's health. Disclosure shall be limited to theportions of the records necessary to meet the medical emergency. (i) To a facility that is to receive ((an individual)) a person whois involuntarily committed under chapter 71.05 RCW, or upon transfer ofthe ((individual)) person from one treatment facility to another. Therelease of records under this subsection shall be limited to thetreatment records required by law, a record or summary of all somatictreatments, and a discharge summary. The discharge summary may includea statement of the patient's problem, the treatment goals, the type oftreatment which has been provided, and recommendation for futuretreatment, but may not include the patient's complete treatment record. (j) Notwithstanding the provisions of RCW 71.05.390(7), to acorrectional facility or a corrections officer who is responsible forthe supervision of ((an individual)) a person who is receivinginpatient or outpatient evaluation or treatment. Except as provided inRCW 71.05.445 and 71.34.225, release of records under this section islimited to: (i) An evaluation report provided pursuant to a written supervisionplan. (ii) The discharge summary, including a record or summary of allsomatic treatments, at the termination of any treatment provided aspart of the supervision plan. (iii) When ((an individual)) a person is returned from a treatmentfacility to a correctional facility, the information provided under(j)(iv) of this subsection. (iv) Any information necessary to establish or implement changes inthe ((individual's)) person's treatment plan or the level or kind ofsupervision as determined by resource management services. In casesinvolving 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 involuntarycommitment or recommitment proceedings, reexaminations, appeals, orother actions relating to detention, admission, commitment, orpatient's rights under chapter 71.05 RCW. (l) To staff members of the protection and advocacy agency or tostaff members of a private, nonprofit corporation for the purpose of 29 protecting and advocating the rights of persons with mental ((illness))disorders or developmental disabilities. Resource management servicesmay limit the release of information to the name, birthdate, and countyof residence of the patient, information regarding whether the patientwas voluntarily admitted, or involuntarily committed, the date andplace of admission, placement, or commitment, the name and address ofa guardian of the patient, and the date and place of the guardian'sappointment. Any staff member who wishes to obtain additionalinformation shall notify the patient's resource management services inwriting of the request and of the resource management services' rightto object. The staff member shall send the notice by mail to theguardian's address. If the guardian does not object in writing withinfifteen days after the notice is mailed, the staff member may obtainthe additional information. If the guardian objects in writing withinfifteen days after the notice is mailed, the staff member may notobtain the additional information. (3) Whenever federal law or federal regulations restrict therelease of information contained in the treatment records of anypatient who receives treatment for ((alcoholism or drug)) chemicaldependency, the department may restrict the release of the informationas necessary to comply with federal law and regulations.Sec. RCW 71.05.640 and 2000 c 94 s 11 are each amended toread as follows: (1) Procedures shall be established by resource management servicesto provide reasonable and timely access to individual treatmentrecords. However, access may not be denied at any time to records ofall medications and somatic treatments received by the ((individual))person. (2) Following discharge, the ((individual)) person shall have aright to a complete record of all medications and somatic treatmentsprescribed during evaluation, admission, or commitment and to a copy ofthe discharge summary prepared at the time of his or her discharge. Areasonable and uniform charge for reproduction may be assessed. (3) Treatment records may be modified prior to inspection toprotect the confidentiality of other patients or the names of any otherpersons referred to in the record who gave information on the condition 30 that his or her identity remain confidential. Entire documents may notbe withheld to protect such confidentiality. (4) At the time of discharge all ((individuals)) persons shall beinformed by resource management services of their rights as provided inRCW ((71.05.610)) 71.05.390 and 71.05.620 through 71.05.690.Sec. RCW 71.05.660 and 1989 c 205 s 16 are each amended toread 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 shallbe construed to interfere with communications between physicians orpsychologists and patients and attorneys and clients.NEW SECTION.Sec. A new section is added to chapter 71.05RCW to read as follows: A petition for commitment under this chapter may be joined with apetition for commitment under chapter 70.96A RCW.PART IIPILOT PROGRAMSNEW SECTION.Sec. Sections 202 through 216 of this actconstitute a new chapter in Title 70 RCW.NEW SECTION.Sec. The definitions in this section applythroughout this chapter unless the context clearly requires otherwise. (1) "Admission" or "admit" means a decision by a physician that aperson should be examined or treated as a patient in a hospital, anevaluation and treatment facility, or other inpatient facility, or adecision by a professional person in charge or his or her designee thata person should be detained as a patient for evaluation and treatmentin a secure detoxification facility or other certified chemicaldependency provider. (2) "Antipsychotic medications" means that class of drugs primarilyused to treat serious manifestations of mental illness associated withthought disorders, which includes but is not limited to atypicalantipsychotic medications. 31 (3) "Approved treatment program" means a discrete program ofchemical dependency treatment provided by a treatment program certifiedby the department as meeting standards adopted under chapter 70.96ARCW. (4) "Attending staff" means any person on the staff of a public orprivate agency having responsibility for the care and treatment of apatient. (5) "Chemical dependency" means: (a) Alcoholism; (b) Drug addiction; or (c) Dependence on alcohol and one or more other psychoactivechemicals, as the context requires. (6) "Chemical dependency professional" means a person certified asa chemical dependency professional by the department of health underchapter 18.205 RCW. (7) "Commitment" means the determination by a court that a personshould be detained for a period of either evaluation or treatment, orboth, in an inpatient or a less restrictive setting. (8) "Conditional release" means a revocable modification of acommitment that may be revoked upon violation of any of its terms. (9) "Custody" means involuntary detention under either chapter71.05 or 70.96A RCW or this chapter, uninterrupted by any period ofunconditional release from commitment from a facility providinginvoluntary care and treatment. (10) "Department" means the department of social and healthservices. (11) "Designated chemical dependency specialist" or "specialist"means a person designated by the county alcoholism and other drugaddiction program coordinator designated under RCW 70.96A.310 toperform the commitment duties described in RCW 70.96A.140 and thischapter, and qualified to do so by meeting standards adopted by thedepartment. (12) "Designated crisis responder" means a person designated by thecounty or regional support network to perform the duties specified inthis chapter. (13) "Designated mental health professional" means a mental healthprofessional certified by the department per rules adopted by the 32 secretary and employed by or contracted with a regional support networkestablished under chapter 71.24 RCW. (14) "Detention" or "detain" means the lawful confinement of aperson under this chapter, or chapter 70.96A or 71.05 RCW. (15) "Developmental disabilities professional" means a person whohas specialized training and three years of experience in directlytreating or working with individuals with developmental disabilitiesand is a psychiatrist, psychologist, or social worker, and such otherdevelopmental disabilities professionals as may be defined by rulesadopted by the secretary. (16) "Developmental disability" means that condition defined in RCW71A.10.020. (17) "Discharge" means the termination of facility authority. Thecommitment may remain in place, be terminated, or be amended by courtorder. (18) "Evaluation and treatment facility" means any facility thatcan provide directly, or by direct arrangement with other public orprivate agencies, emergency evaluation and treatment, outpatient care,and timely and appropriate inpatient care to persons suffering from amental disorder, and that is certified as such by the department. Aphysically separate and separately operated portion of a state hospitalmay be designated as an evaluation and treatment facility. A facilitythat is part of, or operated by, the department or any federal agencydoes not require certification. No correctional institution orfacility, or jail, may be an evaluation and treatment facility withinthe meaning of this chapter. (19) "Facility" means either an evaluation and treatment facilityor a secure detoxification facility. (20) "Gravely disabled" means a condition in which a person, as aresult of a mental disorder, or as a result of the use of alcohol orother psychoactive chemicals: (a) Is in danger of serious physical harm resulting from a failureto provide for his or her essential human needs of health or safety; or (b) Manifests severe deterioration in routine functioning evidencedby repeated and escalating loss of cognitive or volitional control overhis or her actions and is not receiving such care as is essential forhis or her health or safety. 33 (21) "History of one or more violent acts" refers to the period oftime ten years before the filing of a petition under this chapter, orchapter 70.96A or 71.05 RCW, excluding any time spent, but not anyviolent acts committed, in a mental health facility or a longtermalcoholism or drug treatment facility, or in confinement as a result ofa criminal conviction. (22) "Intoxicated person" means a person whose mental or physicalfunctioning is substantially impaired as a result of the use of alcoholor other psychoactive chemicals. (23) "Judicial commitment" means a commitment by a court under thischapter. (24) "Licensed physician" means a person licensed to practicemedicine or osteopathic medicine and surgery in the state ofWashington. (25) "Likelihood of serious harm" means: (a) A substantial risk that: (i) Physical harm will be inflicted by a person upon his or her ownperson, as evidenced by threats or attempts to commit suicide orinflict physical harm on oneself; (ii) Physical harm will be inflicted by a person upon another, asevidenced by behavior that has caused such harm or that places anotherperson or persons in reasonable fear of sustaining such harm; or (iii) Physical harm will be inflicted by a person upon the propertyof others, as evidenced by behavior that has caused substantial loss ordamage to the property of others; or (b) The person has threatened the physical safety of another andhas a history of one or more violent acts. (26) "Mental disorder" means any organic, mental, or emotionalimpairment that has substantial adverse effects on a person's cognitiveor volitional functions. (27) "Mental health professional" means a psychiatrist,psychologist, psychiatric nurse, or social worker, and such othermental health professionals as may be defined by rules adopted by thesecretary under the authority of chapter 71.05 RCW. (28) "Peace officer" means a law enforcement official of a publicagency or governmental unit, and includes persons specifically givenpeace officer powers by any state law, local ordinance, or judicialorder of appointment. 34 (29) "Person in charge" means a physician or chemical dependencycounselor as defined in rule by the department, who is empowered by acertified treatment program with authority to make assessment,admission, continuing care, and discharge decisions on behalf of thecertified program. (30) "Private agency" means any person, partnership, corporation,or association that is not a public agency, whether or not financed inwhole or in part by public funds, that constitutes an evaluation andtreatment facility or private institution, or hospital, or approvedtreatment program, that is conducted for, or includes a department orward conducted for, the care and treatment of persons who are mentallyill and/or chemically dependent. (31) "Professional person" means a mental health professional orchemical dependency professional and shall also mean a physician,registered nurse, and such others as may be defined by rules adopted bythe secretary pursuant to the provisions of this chapter. (32) "Psychiatrist" means a person having a license as a physicianand surgeon in this state who has in addition completed three years ofgraduate training in psychiatry in a program approved by the Americanmedical association or the American osteopathic association and iscertified or eligible to be certified by the American board ofpsychiatry and neurology. (33) "Psychologist" means a person who has been licensed as apsychologist under chapter 18.83 RCW. (34) "Public agency" means any evaluation and treatment facility orinstitution, or hospital, or approved treatment program that isconducted for, or includes a department or ward conducted for, the careand treatment of persons who are mentally ill and/or chemicallydependent, 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 thedepartment, regional support networks, treatment facilities, and otherpersons providing services to the department, county departments, orfacilities which identify persons who are receiving or who at any timehave received services for mental illness. (36) "Release" means legal termination of the commitment underchapter 70.96A or 71.05 RCW or this chapter. 35 (37) "Secretary" means the secretary of the department or thesecretary's designee. (38) "Secure detoxification facility" means a facility operated byeither a public or private agency or by the program of an agency thatserves the purpose of providing evaluation and assessment, and acuteand/or subacute detoxification services for intoxicated persons andincludes security measures sufficient to protect the patients, staff,and community. (39) "Social worker" means a person with a master's or furtheradvanced degree from an accredited school of social work or a degreedeemed equivalent under rules adopted by the secretary. (40) "Treatment records" means registration records and all otherrecords concerning persons who are receiving or who at any time havereceived services for mental illness, which are maintained by thedepartment, by regional support networks and their staffs, and bytreatment facilities. Treatment records do not include notes orrecords maintained for personal use by a person providing treatmentservices for the department, regional support networks, or a treatmentfacility 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 toproperty.NEW SECTION.Sec. (1) The secretary, after consulting withthe Washington state association of counties, shall select and contractwith regional support networks or counties to provide two integratedcrisis response and involuntary treatment pilot programs for adults andshall allocate resources for both integrated services and securedetoxification services in the pilot areas. In selecting the tworegional support networks or counties, the secretary shall endeavor tosite one in an urban and one in a rural regional support network orcounty; and to site them in counties other than those selected pursuantto section 220 of this act, to the extent necessary to facilitateevaluation of pilot project results. (2) The regional support networks or counties shall implement thepilot programs by providing integrated crisis response and involuntarytreatment to persons with a chemical dependency, a mental disorder, orboth, consistent with this chapter. The pilot programs shall: 36 (a) Combine the crisis responder functions of a designated mentalhealth professional under chapter 71.05 RCW and a designated chemicaldependency specialist under chapter 70.96A RCW by establishing a newdesignated crisis responder who is authorized to conduct investigationsand detain persons up to seventytwo hours to the proper facility; (b) Provide training to the crisis responders as required by thedepartment; (c) Provide sufficient staff and resources to ensure availabilityof an adequate number of crisis responders twentyfour hours a day,seven days a week; (d) Provide the administrative and courtrelated staff, resources,and processes necessary to facilitate the legal requirements of theinitial detention and the commitment hearings for persons with achemical dependency; (e) Participate in the evaluation and report to assess the outcomesof the pilot programs including providing data and information asrequested; (f) Provide the other services necessary to the implementation ofthe pilot programs, consistent with this chapter as determined by thesecretary in contract; and (g) Collaborate with the department of corrections where personsdetained or committed are also subject to supervision by the departmentof corrections. (3) The pilot programs established by this section shall beginproviding services by March 1, 2006.NEW SECTION.Sec. To qualify as a designated crisisresponder, a person must have received chemical dependency training asdetermined by the department and be a: (1) Psychiatrist, psychologist, psychiatric nurse, or socialworker; (2) Person with a master's degree or further advanced degree incounseling or one of the social sciences from an accredited college oruniversity and who have, in addition, at least two years of experiencein direct treatment of persons with mental illness or emotionaldisturbance, such experience gained under the direction of a mentalhealth professional; 37 (3) Person who meets the waiver criteria of RCW 71.24.260, whichwaiver was granted before 1986; (4) Person who had an approved waiver to perform the duties of amental health professional that was requested by the regional supportnetwork and granted by the department before July 1, 2001; or (5) Person who has been granted a timelimited exception of theminimum requirements of a mental health professional by the departmentconsistent with rules adopted by the secretary.NEW SECTION.Sec. In addition to the provisions of thischapter, a designated crisis responder has all the powers and duties ofa designated mental health professional as well as the powers andduties of a designated chemical dependency specialist under RCW70.96A.120.NEW SECTION.Sec. (1)(a) When a designated crisis responderreceives information alleging that a person, as a result of a mentaldisorder, chemical dependency disorder, or both, presents a likelihoodof serious harm or is gravely disabled, the designated crisis respondermay, after investigation and evaluation of the specific facts allegedand of the reliability and credibility of any person providinginformation to initiate detention, if satisfied that the allegationsare true and that the person will not voluntarily seek appropriatetreatment, file a petition for initial detention. Before filing thepetition, the designated crisis responder must personally interview theperson, unless the person refuses an interview, and determine whetherthe person will voluntarily receive appropriate evaluation andtreatment at either an evaluation and treatment facility, adetoxification facility, or other certified chemical dependencyprovider. (b)(i)(A) Whenever it appears, by petition for initial detention,to the satisfaction of a judge of the superior court that a personpresents as a result of a mental disorder, a likelihood of seriousharm, or is gravely disabled, and that the person has refused or failedto accept appropriate evaluation and treatment voluntarily, the judgemay issue an order requiring the person to appear within twenty-fourhours after service of the order at a designated evaluation and 38 treatment facility for not more than a seventy-two hour evaluation andtreatment period; or (B) Whenever it appears, by petition for initial detention, to thesatisfaction of a judge of the superior court, district court, or othercourt permitted by court rule, that a person presents as a result of achemical dependency, a likelihood of serious harm, or is gravelydisabled, and that the person has refused or failed to acceptappropriate evaluation and treatment voluntarily, the judge may issuean order requiring the person to appear within twenty-four hours afterservice of the order at a secure detoxification facility or othercertified chemical dependency provider for not more than a seventy-twohour evaluation and treatment period. (ii) The order issued under this subsection (1)(b) shall state theaddress of the evaluation and treatment facility, secure detoxificationfacility, or other certified chemical dependency provider to which theperson is to report; whether the required seventy-two hour evaluationand treatment services may be delivered on an outpatient or inpatientbasis; and that if the person named in the order fails to appear at theevaluation and treatment facility, secure detoxification facility, orother certified chemical dependency provider at or before the date andtime stated in the order, the person may be involuntarily taken intocustody for evaluation and treatment. The order shall also designateretained counsel or, if counsel is appointed from a list provided bythe court, the name, business address, and telephone number of theattorney appointed to represent the person. (c) The designated crisis responder shall then serve or cause to beserved on such person, his or her guardian, and conservator, if any, acopy of the order to appear, together with a notice of rights and apetition for initial detention. After service on the person, thedesignated crisis responder shall file the return of service in courtand provide copies of all papers in the court file to the evaluationand treatment facility or secure detoxification facility and thedesignated attorney. The designated crisis responder shall notify thecourt and the prosecuting attorney that a probable cause hearing willbe held within seventy-two hours of the date and time of outpatientevaluation or admission to the evaluation and treatment facility,secure detoxification facility, or other certified chemical dependencyprovider. The person shall be permitted to remain in his or her home 39 or other place of his or her choosing before the time of evaluation andshall be permitted to be accompanied by one or more of his or herrelatives, friends, an attorney, a personal physician, or otherprofessional or religious advisor to the place of evaluation. Anattorney accompanying the person to the place of evaluation shall bepermitted to be present during the admission evaluation. Any otherperson accompanying the person may be present during the admissionevaluation. The facility may exclude the person if his or her presencewould present a safety risk, delay the proceedings, or otherwiseinterfere with the evaluation. (d) If the person ordered to appear does appear on or before thedate and time specified, the evaluation and treatment facility, securedetoxification facility, or other certified chemical dependencyprovider may admit the person as required by subsection (3) of thissection or may provide treatment on an outpatient basis. If the personordered to appear fails to appear on or before the date and timespecified, the evaluation and treatment facility, secure detoxificationfacility, or other certified chemical dependency provider shallimmediately notify the designated crisis responder who may notify apeace officer to take the person or cause the person to be taken intocustody and placed in an evaluation and treatment facility, a securedetoxification facility, or other certified chemical dependencyprovider. Should the designated crisis responder notify a peaceofficer authorizing the officer to take a person into custody underthis subsection, the designated crisis responder shall file with thecourt a copy of the authorization and a notice of detention. At thetime the person is taken into custody there shall commence to be servedon the person, his or her guardian, and conservator, if any, a copy ofthe original order together with a notice of detention, a notice ofrights, and a petition for initial detention. (2) If a designated crisis responder receives information allegingthat a person, as the result of: (a) A mental disorder, presents an imminent likelihood of seriousharm, or is in imminent danger because of being gravely disabled, afterinvestigation and evaluation of the specific facts alleged and of thereliability and credibility of the person or persons providing theinformation if any, the designated crisis responder may take the 40 person, or cause by oral or written order the person to be taken intoemergency custody in an evaluation and treatment facility for not morethan seventy-two hours as described in this chapter; or (b) Chemical dependency, presents an imminent likelihood of seriousharm, or is in imminent danger because of being gravely disabled, afterinvestigation and evaluation of the specific facts alleged and of thereliability and credibility of the person or persons providing theinformation if any, the designated crisis responder may take theperson, or cause by oral or written order the person to be taken intoemergency custody in a secure detoxification facility for not more thanseventy-two hours as described in this chapter. (3) If the designated crisis responder petitions for detention ofa person whose actions constitute a likelihood of serious harm, or whois gravely disabled, the evaluation and treatment facility, the securedetoxification facility, or other certified chemical dependencyprovider providing seventy-two hour evaluation and treatment mustimmediately accept on a provisional basis the petition and the person.The evaluation and treatment facility, the secure detoxificationfacility, or other certified chemical dependency provider shall thenevaluate the person's condition and admit, detain, transfer, ordischarge such person in accordance with this chapter. The facilityshall notify in writing the court and the designated crisis responderof the date and time of the initial detention of each personinvoluntarily detained so that a probable cause hearing will be held nolater than seventy-two hours after detention. (4) A peace officer may, without prior notice of the proceedingsprovided for in subsection (1) of this section, take or cause theperson to be taken into custody and immediately delivered to anevaluation and treatment facility, secure detoxification facility,other certified chemical dependency treatment provider only pursuant tosubsections (1)(d) and (2) of this section. (5) Nothing in this chapter limits the power of a peace officer totake a person into custody and immediately deliver the person to theemergency department of a local hospital or to a detoxificationfacility.NEW SECTION.Sec. (1) A person or public or private entity 41 employing a person is not civilly or criminally liable for performingduties under this chapter if the duties were performed in good faithand without gross negligence. (2) This section does not relieve a person from giving the requirednotices under RCW 71.05.330(2) or 71.05.340(1)(b), or the duty to warnor to take reasonable precautions to provide protection from violentbehavior where the patient has communicated an actual threat ofphysical violence against a reasonably identifiable victim or victims.The duty to warn or to take reasonable precautions to provideprotection from violent behavior is discharged if reasonable effortsare made to communicate the threat to the victim or victims and to lawenforcement personnel.NEW SECTION.Sec. If the evaluation and treatment facility,secure detoxification facility, or other certified chemical dependencyprovider admits the person, it may detain the person for evaluation andtreatment for a period not to exceed seventy-two hours from the time ofacceptance. The computation of the seventy-two hour period excludesSaturdays, Sundays, and holidays.NEW SECTION.Sec. Whenever any person is detained forevaluation and treatment for a mental disorder under section 206 ofthis act, chapter 71.05 RCW applies.NEW SECTION.Sec. (1) A person detained for seventy-two hourevaluation and treatment under section 206 of this act or RCW70.96A.120 may be detained for not more than fourteen additional daysof involuntary chemical dependency treatment if there are bedsavailable at the secure detoxification facility and the followingconditions are met: (a) The professional person in charge of the agency or facility orthe person's designee providing evaluation and treatment services in asecure detoxification facility has assessed the person's condition andfinds that the condition is caused by chemical dependency and eitherresults in a likelihood of serious harm or in the detained person beinggravely disabled, and the professional person or his or her designee isprepared to testify those conditions are met; 42 (b) The person has been advised of the need for voluntary treatmentand the professional person in charge of the agency or facility or hisor her designee has evidence that he or she has not in good faithvolunteered for treatment; and (c) The professional person in charge of the agency or facility orthe person's designee has filed a petition for fourteen-day involuntarydetention with the superior court, district court, or other courtpermitted by court rule. The petition must be signed by the chemicaldependency professional who has examined the person. (2) The petition under subsection (1)(c) of this section shall beaccompanied by a certificate of a licensed physician who has examinedthe person, unless the person whose commitment is sought has refused tosubmit to a medical examination, in which case the fact of refusalshall be alleged in the petition. The certificate shall set forth thelicensed physician's findings in support of the allegations of thepetition. A physician employed by the petitioning program or thedepartment is eligible to be the certifying physician. (3) The petition shall state facts that support the finding thatthe person, as a result of chemical dependency, presents a likelihoodof serious harm or is gravely disabled, and that there are no lessrestrictive alternatives to detention in the best interest of theperson or others. The petition shall state specifically that lessrestrictive alternative treatment was considered and specify whytreatment 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 soughtof his or her right to contest the petition, be represented by counselat every stage of any proceedings relating to his or her commitment,and have counsel appointed by the court or provided by the court, if heor 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 himor her regardless of his or her wishes. The person shall, if he or sheis financially able, bear the costs of such legal service; otherwisesuch legal service shall be at public expense. The person whosecommitment is sought shall be informed of his or her right to be 43 examined by a licensed physician of his or her choice. If the personis unable to obtain a licensed physician and requests examination by aphysician, the court shall appoint a reasonably available licensedphysician designated by the person. (b) At the conclusion of the probable cause hearing, if the courtfinds by a preponderance of the evidence that the person, as the resultof chemical dependency, presents a likelihood of serious harm or isgravely disabled and, after considering less restrictive alternativesto involuntary detention and treatment, finds that no such alternativesare in the best interest of such person or others, the court shallorder that the person be detained for involuntary chemical dependencytreatment not to exceed fourteen days in a secure detoxificationfacility.NEW SECTION.Sec. If a person is detained for additionaltreatment beyond fourteen days under section 210 of this act, theprofessional staff of the agency or facility may petition foradditional treatment under RCW 70.96A.140.NEW SECTION.Sec. The prosecuting attorney of the county inwhich an action under this chapter is taken must represent thepetitioner in judicial proceedings under this chapter for theinvoluntary chemical dependency treatment of a person, including anyjudicial proceeding where the person sought to be treated for chemicaldependency challenges the action.NEW SECTION.Sec. (1) Every person involuntarily detained orcommitted under this chapter as a result of a mental disorder isentitled to all the rights set forth in this chapter and in chapter71.05 RCW, and retains all rights not denied him or her under thischapter or chapter 71.05 RCW. (2) Every person involuntarily detained or committed under thischapter as a result of a chemical dependency is entitled to all therights set forth in this chapter and chapter 70.96A RCW, and retainsall rights not denied him or her under this chapter or chapter 70.96ARCW. 44 NEW SECTION.Sec. (1) When a designated crisis responder isnotified by a jail that a defendant or offender who was subject to adischarge review under RCW 71.05.232 is to be released to thecommunity, the designated crisis responder shall evaluate the personwithin seventytwo hours of release. (2) When an offender is under courtordered treatment in thecommunity and the supervision of the department of corrections, and thetreatment provider becomes aware that the person is in violation of theterms of the court order, the treatment provider shall notify thedesignated crisis responder of the violation and request an evaluationfor purposes of revocation of the less restrictive alternative. (3) When a designated crisis responder becomes aware that anoffender who is under courtordered treatment in the community and thesupervision of the department of corrections is in violation of atreatment order or a condition of supervision that relates to publicsafety, or the designated crisis responder detains a person under thischapter, the designated crisis responder shall notify the person'streatment provider and the department of corrections. (4) When an offender who is confined in a state correctionalfacility or is under supervision of the department of corrections inthe community is subject to a petition for involuntary treatment underthis chapter, the petitioner shall notify the department of correctionsand the department of corrections shall provide documentation of itsrisk assessment or other concerns to the petitioner and the court ifthe department of corrections classified the offender as a high risk orhigh needs offender. (5) Nothing in this section creates a duty on any treatmentprovider or designated crisis responder to provide offendersupervision.NEW SECTION.Sec. The secretary may adopt rules to implementthis chapter.NEW SECTION.Sec. The provisions of RCW 71.05.550 apply tothis chapter.NEW SECTION.Sec. (1) The Washington state institute for 45 public policy shall evaluate the pilot programs and make a preliminaryreport 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 personsinvoluntarily detained for seventytwo hours; (ii) Is costeffective; (iii) Results in better outcomes for persons involuntarilydetained; (iv) Increased the effectiveness of the crisis response system inthe pilot catchment areas; (b) The effectiveness of providing a single chapter in the RevisedCode of Washington to address initial detention of persons with mentaldisorders or chemical dependency, in crisis response situations and thelikelihood of effectiveness of providing a single, comprehensiveinvoluntary treatment act. (3) The reports shall consider the impact of the pilot programs onthe existing mental health system and on the persons served by thesystem.Sec. RCW 71.05.550 and 1973 1st ex.s. c 142 s 60 are eachamended to read as follows: The department of social and health services, in planning andproviding funding to counties pursuant to chapter 71.24 RCW, shallrecognize the financial necessities imposed upon counties byimplementation of this chapter and chapter 70. RCW (sections 202through 216 of this act), and shall consider needs, if any, foradditional community mental health services and facilities andreduction in commitments to state hospitals for the mentally illaccomplished by individual counties, in planning and providing suchfunding. The state shall provide financial assistance to the countiesto enable the counties to meet all increased costs, if any, to thecounties resulting from their administration of the provisions ofchapter 142, Laws of 1973 1st ex. sess.NEW SECTION.Sec. Sections 202 through 216 of this actexpire July 1, 2008. 46 NEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: (1) The secretary shall select and contract with counties toprovide intensive case management for chemically dependent persons withhistories of high utilization of crisis services at two sites. Inselecting the two sites, the secretary shall endeavor to site one in anurban county, and one in a rural county; and to site them in countiesother than those selected pursuant to section 203 of this act, to theextent necessary to facilitate evaluation of pilot project results. (2) The contracted sites shall implement the pilot programs byproviding intensive case management to persons with a primary chemicaldependency diagnosis or dual primary chemical dependency and mentalhealth diagnoses, through the employment of chemical dependency casemanagers. The chemical dependency case managers shall: (a) Be trained in and use the integrated, comprehensive screeningand assessment process adopted under section 601 of this act; (b) Reduce the use of crisis medical, chemical dependency andmental health services, including but not limited to, emergency roomadmissions, hospitalizations, detoxification programs, inpatientpsychiatric admissions, involuntary treatment petitions, emergencymedical services, and ambulance services; (c) Reduce the use of emergency first responder services includingpolice, fire, emergency medical, and ambulance services; (d) Reduce the number of criminal justice interventions includingarrests, violations of conditions of supervision, bookings, jail days,prison sanction day for violations, court appearances, and prosecutorand defense costs; (e) Where appropriate and available, work with therapeutic courtsincluding drug courts and mental health courts to maximize the outcomesfor the individual and reduce the likelihood of reoffense; (f) Coordinate with local offices of the economic servicesadministration to assist the person in accessing and remaining enrolledin those programs to which the person may be entitled; (g) Where appropriate and available, coordinate with primary careand other programs operated through the federal government includingfederally qualified health centers, Indian health programs, andveterans' health programs for which the person is eligible to reduceduplication of services and conflicts in case approach; 47 (h) Where appropriate, advocate for the client's needs to assistthe person in achieving and maintaining stability and progress towardrecovery; (i) Document the numbers of persons with cooccurring mental andsubstance abuse disorders and the point of determination of the cooccurring disorder by quadrant of intensity of need; and (j) Where a program participant is under supervision by thedepartment of corrections, collaborate with the department ofcorrections to maximize treatment outcomes and reduce the likelihood ofreoffense. (3) The pilot programs established by this section shall beginproviding services by March 1, 2006. (4) This section expires June 30, 2008.PART IIITREATMENT GAPNEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: (1) The division of alcohol and substance abuse shall increase itscapacity to serve adults who meet chemical dependency treatmentcriteria and who are enrolled in medicaid as follows: (a) In fiscal year 2006, the division of alcohol and substanceabuse shall serve forty percent of the calculated need; and (b) In fiscal year 2007, the division of alcohol and substanceabuse shall serve sixty percent of the calculated need. (2) The division of alcohol and substance abuse shall increase itscapacity to serve minors who have passed their twelfth birthday and whoare not yet eighteen, who are under two hundred percent of the federalpoverty level as follows: (a) In fiscal year 2006, the division of alcohol and substanceabuse shall serve forty percent of the calculated need; and (b) In fiscal year 2007, the division of alcohol and substanceabuse shall serve sixty percent of the calculated need. (3) For purposes of this section, "calculated need" means thepercentage of the population under two hundred percent of the federalpoverty level in need of chemical dependency services as determined inthe 2003 Washington state needs assessment study. 48 NEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: (1) Not later than January 1, 2007, all persons providing treatmentunder this chapter shall also implement the integrated comprehensivescreening and assessment process for chemical dependency and mentaldisorders adopted pursuant to section 601 of this act and shalldocument the numbers of clients with cooccurring mental and substanceabuse disorders based on a quadrant system of low and high needs. (2) Treatment providers contracted to provide treatment under thischapter who fail to implement the integrated comprehensive screeningand assessment process for chemical dependency and mental disorders byJuly 1, 2007, are subject to contractual penalties established undersection 601 of this act.NEW SECTION.Sec. A new section is added to chapter 13.34RCW to read as follows: The department of social and health services and the department ofhealth shall develop and expand comprehensive services for drugaffected and alcoholaffected mothers and infants. Subject to fundsappropriated for this purpose, the expansion shall be in evidencebased, researchbased, or consensusbased practices, as those terms aredefined in section 603 of this act, and shall expand capacity inunderserved regions of the state.NEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: A petition for commitment under this chapter may be joined with apetition for commitment under chapter 71.05 RCW.NEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: (1) The department of social and health services shall contract forchemical dependency specialist services at each division of childrenand family services office to enhance the timeliness and quality ofchild protective services assessments and to better connect families toneeded treatment services. (2) The chemical dependency specialist's duties may include, butare not limited to: Conducting onsite chemical dependency screening 49 and assessment, facilitating progress reports to department socialworkers, inservice training of department social workers and staff onsubstance abuse issues, referring clients from the department totreatment providers, and providing consultation on cases to departmentsocial workers. (3) The department of social and health services shall providetraining in and ensure that each casecarrying social worker is trainedin uniform screening for mental health and chemical dependency.PART IVRESOURCESNEW SECTION.Sec. Sections 402 through 425 of this actconstitute a new chapter in Title 70 RCW.NEW SECTION.Sec. The legislature finds that there arepersons with mental disorders, including organic or traumatic braindisorders, and combinations of mental disorders with other medicalconditions or behavior histories that result in behavioral and securityissues that make these persons ineligible for, or unsuccessful in,existing types of licensed facilities, including adult residentialrehabilitation centers, boarding homes, adult family homes, grouphomes, and skilled nursing facilities. The legislature also finds thatmany of these persons have been treated on repeated occasions ininappropriate acute care facilities and released without an appropriateplacement or have been treated or detained for extended periods ininappropriate settings including state hospitals and correctionalfacilities. The legislature further finds that some of these personspresent complex safety and treatment issues that require securitymeasures that cannot be instituted under most facility licenses orsupported housing programs. These include the ability to detainpersons under involuntary treatment orders or administer court orderedmedications. Consequently, the legislature intends, to the extent of availablefunds, to establish a new type of facility licensed by the departmentof social and health services as an enhanced services facility withstandards that will provide a safe, secure treatment environment for alimited population of persons who are not appropriately served in other 50 facilities or programs. The legislature also finds that enhancedservices facilities may need to specialize in order to effectively carefor a particular segment of the identified population. An enhanced services facility may only serve individuals that meetthe criteria specified in section 405 of this act.NEW SECTION.Sec. The definitions in this section applythroughout this chapter unless the context clearly requires otherwise. (1) "Antipsychotic medications" means that class of drugs primarilyused to treat serious manifestations of mental illness associated withthought disorders, which includes but is not limited to atypicalantipsychotic medications. (2) "Attending staff" means any person on the staff of a public orprivate agency having responsibility for the care and treatment of apatient. (3) "Chemical dependency" means alcoholism, drug addiction, ordependence on alcohol and one or more other psychoactive chemicals, asthe context requires and as those terms are defined in chapter 70.96ARCW. (4) "Chemical dependency professional" means a person certified asa chemical dependency professional by the department of health underchapter 18.205 RCW. (5) "Commitment" means the determination by a court that anindividual should be detained for a period of either evaluation ortreatment, or both, in an inpatient or a less restrictive setting. (6) "Conditional release" means a modification of a commitment thatmay be revoked upon violation of any of its terms. (7) "Custody" means involuntary detention under chapter 71.05 or70.96A RCW, uninterrupted by any period of unconditional release fromcommitment from a facility providing involuntary care and treatment. (8) "Department" means the department of social and healthservices. (9) "Designated responder" means a designated mental healthprofessional, a designated chemical dependency specialist, or adesignated crisis responder as those terms are defined in chapter70.96A, 71.05, or 70. (sections 202 through 216 of this act) RCW. (10) "Detention" or "detain" means the lawful confinement of anindividual under chapter 70.96A or 71.05 RCW. 51 (11) "Discharge" means the termination of facility authority. Thecommitment may remain in place, be terminated, or be amended by courtorder. (12) "Enhanced services facility" means a facility that providestreatment and services to persons for whom acute inpatient treatment isnot medically necessary and who have been determined by the departmentto be inappropriate for placement in other licensed facilities due tothe complex needs that result in behavioral and security issues. (13) "Expanded community services program" means a nonsecureprogram of enhanced behavioral and residential support provided tolongterm and residential care providers serving specifically eligibleclients who would otherwise be at risk for hospitalization at statehospital 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 orother psychoactive chemicals, or both: (a) Is in danger of serious physical harm resulting from a failureto provide for his or her essential human needs of health or safety; or (b) Manifests severe deterioration in routine functioning evidencedby repeated and escalating loss of cognitive or volitional control overhis or her actions and is not receiving such care as is essential forhis or her health or safety. (16) "History of one or more violent acts" refers to the period oftime ten years before the filing of a petition under this chapter, orchapter 70.96A or 71.05 RCW, excluding any time spent, but not anyviolent acts committed, in a mental health facility or a longtermalcoholism or drug treatment facility, or in confinement as a result ofa criminal conviction. (17) "Licensed physician" means a person licensed to practicemedicine or osteopathic medicine and surgery in the state ofWashington. (18) "Likelihood of serious harm" means: (a) A substantial risk that: (i) Physical harm will be inflicted by an individual upon his orher own person, as evidenced by threats or attempts to commit suicideor inflict physical harm on oneself; 52 (ii) Physical harm will be inflicted by an individual upon another,as evidenced by behavior that has caused such harm or that placesanother person or persons in reasonable fear of sustaining such harm;or (iii) Physical harm will be inflicted by an individual upon theproperty of others, as evidenced by behavior that has causedsubstantial loss or damage to the property of others; or (b) The individual has threatened the physical safety of anotherand has a history of one or more violent acts. (19) "Mental disorder" means any organic, mental, or emotionalimpairment that has substantial adverse effects on an individual'scognitive or volitional functions. (20) "Mental health professional" means a psychiatrist,psychologist, psychiatric nurse, or social worker, and such othermental health professionals as may be defined by rules adopted by thesecretary under the authority of chapter 71.05 RCW. (21) "Professional person" means a mental health professional andalso means a physician, registered nurse, and such others as may bedefined in rules adopted by the secretary pursuant to the provisions ofthis chapter. (22) "Psychiatric nurse" means: (a) A registered nurse who has a bachelor's degree from anaccredited college or university and who has had, in addition, at leasttwo years of experience in the direct treatment of mentally ill oremotionally disturbed persons under the supervision of a mental healthprofessional; or (b) Any other registered nurse who has three years of suchexperience. (23) "Psychiatrist" means a person having a license as a physicianand surgeon in this state who has in addition completed three years ofgraduate training in psychiatry in a program approved by the Americanmedical association or the American osteopathic association and iscertified or eligible to be certified by the American board ofpsychiatry and neurology. (24) "Psychologist" means a person who has been licensed as apsychologist under chapter 18.83 RCW. (25) "Registration records" include all the records of thedepartment, regional support networks, treatment facilities, and other 53 persons providing services to the department, county departments, orfacilities which identify individuals who are receiving or who at anytime have received services for mental illness. (26) "Release" means legal termination of the commitment underchapter 70.96A or 71.05 RCW. (27) "Resident" means a person admitted to an enhanced servicesfacility. (28) "Secretary" means the secretary of the department or thesecretary's designee. (29) "Significant change" means: (a) A deterioration in a resident's physical, mental, orpsychosocial condition that has caused or is likely to cause clinicalcomplications or lifethreatening conditions; or (b) An improvement in the resident's physical, mental, orpsychosocial condition that may make the resident eligible for releaseor for treatment in a less intensive or less secure setting. (30) "Social worker" means a person with a master's or furtheradvanced degree from an accredited school of social work or a degreedeemed equivalent under rules adopted by the secretary. (31) "Treatment" means the broad range of emergency,detoxification, residential, inpatient, and outpatient services andcare, including diagnostic evaluation, mental health or chemicaldependency education and counseling, medical, psychiatric,psychological, and social service care, vocational rehabilitation, andcareer counseling, which may be extended to persons with mentaldisorders, chemical dependency disorders, or both, and their families. (32) "Treatment records" include registration and all other recordsconcerning individuals who are receiving or who at any time havereceived services for mental illness, which are maintained by thedepartment, by regional support networks and their staffs, and bytreatment facilities. "Treatment records" do not include notes orrecords maintained for personal use by an individual providingtreatment services for the department, regional support networks, or atreatment facility if the notes or records are not available to others. (33) "Violent act" means behavior that resulted in homicide,attempted suicide, nonfatal injuries, or substantial damage toproperty. 54 NEW SECTION.Sec. A facility shall honor an advancedirective that was validly executed pursuant to chapter 70.122 RCW anda mental health advance directive that was validly executed pursuant tochapter 71.32 RCW.NEW SECTION.Sec. A person, eighteen years old or older, maybe admitted to an enhanced services facility if he or she meets thecriteria in subsections (1) through (3) of this section: (1) The person requires: (a) Daily care by or under thesupervision of a mental health professional, chemical dependencyprofessional, or nurse; or (b) assistance with three or more activitiesof daily living; and (2) The person has: (a) A mental disorder, chemical dependencydisorder, or both; (b) an organic or traumatic brain injury; or (c) acognitive impairment that results in symptoms or behaviors requiringsupervision and facility services; (3) The person has two or more of the following: (a) Selfendangering behaviors that are frequent or difficult tomanage; (b) Aggressive, threatening, or assaultive behaviors that create arisk to the health or safety of other residents or staff, or asignificant risk to property and these behaviors are frequent ordifficult to manage; (c) Intrusive behaviors that put residents or staff at risk; (d) Complex medication needs and those needs include psychotropicmedications; (e) A history of or likelihood of unsuccessful placements in eithera licensed facility or other state facility or a history of rejectedapplications for admission to other licensed facilities based on theperson's behaviors, history, or security needs; (f) A history of frequent or protracted mental healthhospitalizations; (g) A history of offenses against a person or felony offenses thatcreated substantial damage to property. (4) The person has the right to refuse to participate in anexpanded community services program or, except where subject tocommitment, to reside at an enhanced services facility. No person 55 shall be denied other department services on the grounds that he or shehas made such a refusal. (5) Prior to assessment, the department shall notify any person forwhom referral to the enhanced community services program or an enhancedservices facility is under consideration, and shall provide that personwith an opportunity to review and comment on all information that isincluded in the assessment. All information considered in theassessment shall be made available to the person or his or her legalguardian or other legal representative, where relevant, prior to finaldetermination. (6) In determining that a person has a history of unsuccessfulplacements, the department shall document the reasons for failure, andpossible supports that could be provided that would improve the chancesof success, prior to making a determination regarding the likelihood offuture unsuccessful placement. (7) The person has a right to appeal the decision of the departmentthat he or she is eligible for placement at an enhanced servicesfacility, and shall be given notice of the right to appeal in a formatthat is accessible to the person with instructions regarding what to doif the person wants to appeal.NEW SECTION.Sec. (1)(a) Every person who is a resident ofan enhanced services facility shall be entitled to all the rights setforth in this chapter, and chapters 71.05 and 70.96A RCW, and shallretain all rights not denied him or her under these chapters. (b) No person shall be presumed incompetent as a consequence ofreceiving an evaluation or voluntary or involuntary treatment for amental disorder, chemical dependency disorder, or both, under thischapter, or chapter 71.05 or 70.96A RCW, or any prior laws of thisstate dealing with mental illness. Competency shall not be determinedor withdrawn except under the provisions of chapter 10.77 or 11.88 RCW. (c) At the time of admission, and at the time of his or hertreatment planning meeting, every resident of an enhanced servicesfacility shall be given a written statement setting forth the substanceof this section, and if he or she is not able to read or understand thestatement, shall have the statement explained in language that he orshe can understand or presented in a format that is accessible. The 56 department shall by rule develop a statement and process for informingresidents of their rights. (2) Every resident of an enhanced services facility shall have theright to adequate care and individualized treatment and shall have theright to actively participate in treatment planning and decisionmaking. (3) Treatment planning shall include planning for a safe andsuccessful discharge and reintegration into the community, and shallcommence immediately upon placement at an enhanced services facility. (4) The provisions of this chapter shall not be construed to denyto any person treatment by spiritual means through prayer in accordancewith the tenets and practices of a church or religious denomination. (5) Persons receiving evaluation or treatment under this chaptershall be given a reasonable choice of an available physician or otherprofessional person qualified to provide such services. (6) The physicianpatient privilege or the psychologistclientprivilege shall be deemed waived in proceedings under this chapterrelating to the administration of antipsychotic medications. As toother proceedings under chapter 10.77, 70.96A, or 71.05 RCW, theprivileges shall be waived when a court of competent jurisdiction inits discretion determines that such waiver is necessary to protecteither the detained person or the public. (7) Insofar as danger to the person or others is not created, eachresident of an enhanced services facility shall have, in addition toother rights not specifically withheld by law, the following rights, alist 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 herown personal possessions, except when deprivation of same is essentialto protect the safety of the resident or other persons; (b) To keep and be allowed to spend a reasonable sum of his or herown money for canteen expenses and small purchases; (c) To have access to individual storage space for his or herprivate use; (d) To have visitors at reasonable times; (e) To have reasonable access to a telephone, both to make andreceive confidential calls, consistent with an effective treatmentprogram; 57 (f) To have ready access to letter writing materials, includingstamps, and to send and receive uncensored correspondence through themails; (g) Not to consent to the administration of antipsychoticmedications beyond the hearing conducted pursuant to RCW 71.05.215 or71.05.370 (as recodified by this act), or the performance ofelectroconvulsant therapy, or surgery, except emergency lifesavingsurgery, unless ordered by a court under RCW 71.05.370 (as recodifiedby this act); (h) To discuss and actively participate in treatment plans anddecisions with professional persons; (i) Not to have psychosurgery performed on him or her under anycircumstances; (j) To dispose of property and sign contracts unless such personhas been adjudicated an incompetent in a court proceeding directed tothat particular issue; and (k) To complain about rights violations or conditions and requestthe assistance of a mental health ombudsman, representative ofWashington protection and advocacy, or other advocate of his or herchoice. (8) Nothing contained in this chapter shall prohibit a residentfrom petitioning by writ of habeas corpus for release. (9) Nothing in this section permits any person to knowingly violatea nocontact order or a condition of an active judgment and sentence oractive supervision by the department of corrections. (10) Enhanced services facilities and expanded community servicesprograms shall maintain a grievance procedure that meets therequirements of rules established by the department.NEW SECTION.Sec. A person who is gravely disabled orpresents a likelihood of serious harm as a result of a mental orchemical dependency disorder or cooccurring mental and chemicaldependency disorders has a right to refuse antipsychotic medication.Antipsychotic medication may be administered over the person'sobjections only pursuant to RCW 71.05.215 or 71.05.370 (as recodifiedby this act). 58 NEW SECTION.Sec. (1)(a) The department shall not license anenhanced services facility that serves any residents under sixtyfiveyears of age for a capacity to exceed sixteen residents. (b) The department may contract for services for the operation ofenhanced services facilities only to the extent that funds arespecifically provided for that purpose. (2) The facility shall provide an appropriate level of security forthe characteristics, behaviors, and legal status of the residents. (3) An enhanced services facility may hold only one license but, tothe extent permitted under state and federal law and medicaidrequirements, a facility may be located in the same building as anotherlicensed facility, provided that: (a) The enhanced services facility is in a location that is totallyseparate and discrete from the other licensed facility; and (b) The two facilities maintain separate staffing, unless anexception to this is permitted by the department in rule. (4) Nursing homes under chapter 18.51 RCW, boarding homes underchapter 18.20 RCW, or adult family homes under chapter 70.128 RCW, thatbecome licensed as facilities under this chapter shall be deemed tomeet the applicable state and local rules, regulations, permits, andcode requirements. All other facilities are required to meet allapplicable state and local rules, regulations, permits, and coderequirements.NEW SECTION.Sec. (1) The enhanced services facility shallcomplete a comprehensive assessment for each resident within fourteendays of admission, and the assessments shall be repeated upon asignificant change in the resident's condition or, at a minimum, everyone hundred eighty days if there is no significant change in condition. (2) The enhanced services facility shall develop an individualizedtreatment plan for each resident based on the comprehensive assessmentand any other information in the person's record. The plan shall beupdated with a full review every ninety days or sooner if clinicallynecessary, and shall include a plan for appropriate transfer ordischarge and supported reintegration into the community. Dischargeplanning shall commence immediately upon placement at an enhancedservices facility. Where the person is under the supervision of the 59 department of corrections, the facility shall collaborate with thedepartment of corrections to maximize treatment outcomes and reduce thelikelihood of reoffense. (3) The plan shall maximize the opportunities for independence,recovery, employment, the resident's participation in treatmentdecisions, and collaboration with peersupported services, and providefor care and treatment in the least restrictive manner appropriate tothe individual resident, and, where relevant, to any court orders withwhich the resident must comply.NEW SECTION.Sec. (1) An enhanced services facility musthave sufficient numbers of staff with the appropriate credentials andtraining 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 medicallyfragile persons with mental disorders, the onsite staff must includeat least one licensed nurse twentyfour hours per day. The nurse mustbe a registered nurse for at least sixteen hours per day. If the nurseis not a registered nurse, a registered nurse or a doctor must be oncall during the remaining eight hours. (3) Any employee or other individual who will have unsupervisedaccess to vulnerable adults must successfully pass a background inquirycheck.NEW SECTION.Sec. This chapter does not apply to thefollowing 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 71.12RCW; and 60 (6) Hospitals licensed under chapter 70.41 RCW.NEW SECTION.Sec. (1) The department shall establishlicensing rules for enhanced services facilities to serve thepopulations defined in this chapter. (2) No person or public or private agency may operate or maintainan enhanced services facility without a license, which must be renewedannually. (3) A licensee shall have the following readily accessible andavailable for review by the department, residents, families ofresidents, and the public: (a) Its license to operate and a copy of the department's mostrecent inspection report and any recent complaint investigation reportsissued 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 tollfree complaint number, which shall alsobe posted in a clearly visible place and manner. (4) No facility shall discriminate or retaliate in any manneragainst a resident or employee because the resident, employee, or anyother person made a complaint or provided information to thedepartment, the longterm care ombudsman, Washington protection andadvocacy system, or a mental health ombudsperson. (5) Each enhanced services facility will post in a prominent placein a common area a notice by the Washington protection and advocacysystem providing contact information.NEW SECTION.Sec. (1) In any case in which the departmentfinds that a licensee of a facility, or any partner, officer, director,owner of five percent or more of the assets of the facility, ormanaging employee failed or refused to comply with the requirements ofthis chapter or the rules established under them, the department maytake 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 alicense, assess civil monetary penalties, or both, in any case in which 61 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 orsuspended license; (b) Knowingly or with reason to know made a false statement of amaterial 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 toinspect all books, records, and files required to be maintained or anyportion of the premises of the facility; (d) Willfully prevented, interfered with, or attempted to impede inany way the work of any duly authorized representative of thedepartment and the lawful enforcement of any provision of this chapter; (e) Willfully prevented or interfered with any representative ofthe department in the preservation of evidence of any violation of anyof the provisions of this chapter or of the rules adopted under it; or (f) Failed to pay any civil monetary penalty assessed by thedepartment under this chapter within ten days after the assessmentbecomes final. (3)(a) Civil penalties collected under this chapter shall bedeposited into a special fund administered by the department. (b) Civil monetary penalties, if imposed, may be assessed andcollected, with interest, for each day the facility is or was out ofcompliance. Civil monetary penalties shall not exceed three thousanddollars per day. Each day upon which the same or a substantiallysimilar action occurs is a separate violation subject to the assessmentof a separate penalty. (4) The department may use the civil penalty monetary fund for theprotection of the health or property of residents of facilities foundto be deficient including: (a) Payment for the cost of relocation of residents to otherfacilities; (b) Payment to maintain operation of a facility pending correctionof deficiencies or closure; and (c) Reimbursement of a resident for personal funds or propertyloss. 62 (5)(a) The department may issue a stop placement order on afacility, effective upon oral or written notice, when the departmentdetermines: (i) The facility no longer substantially meets the requirements ofthis 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 adequatecare. (b) When the department has ordered a stop placement, thedepartment may approve a readmission to the facility from a hospital,residential treatment facility, or crisis intervention facility whenthe department determines the readmission would be in the best interestof the individual seeking readmission. (6) If the department determines that an emergency exists andresident health and safety is immediately jeopardized as a result of afacility's failure or refusal to comply with this chapter, thedepartment may summarily suspend the facility's license and order theimmediate closure of the facility, or the immediate transfer ofresidents, or both. (7) If the department determines that the health or safety of theresidents is immediately jeopardized as a result of a facility'sfailure or refusal to comply with requirements of this chapter, thedepartment 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 arecorrected.NEW SECTION.Sec. (1) All orders of the department denying,suspending, or revoking the license or assessing a monetary penaltyshall become final twenty days after the same has been served upon theapplicant or licensee unless a hearing is requested. (2) All orders of the department imposing stop placement, temporarymanagement, emergency closure, emergency transfer, or summary licensesuspension shall be effective immediately upon notice, pending anyhearing. 63 (3) Subject to the requirements of subsection (2) of this section,all hearings under this chapter and judicial review of suchdeterminations shall be in accordance with the administrative procedureact, chapter 34.05 RCW.NEW SECTION.Sec. Operation of a facility without a licensein violation of this chapter and discrimination against medicaidrecipients is a matter vitally affecting the public interest for thepurpose of applying the consumer protection act, chapter 19.86 RCW.Operation of an enhanced services facility without a license inviolation of this chapter is not reasonable in relation to thedevelopment and preservation of business. Such a violation is anunfair or deceptive act in trade or commerce and an unfair method ofcompetition for the purpose of applying the consumer protection act,chapter 19.86 RCW.NEW SECTION.Sec. A person operating or maintaining afacility without a license under this chapter is guilty of amisdemeanor and each day of a continuing violation after convictionshall be considered a separate offense.NEW SECTION.Sec. Notwithstanding the existence or use ofany other remedy, the department may, in the manner provided by law,maintain an action in the name of the state for an injunction, civilpenalty, or other process against a person to restrain or prevent theoperation or maintenance of a facility without a license issued underthis chapter.NEW SECTION.Sec. (1) The department shall make or cause tobe made at least one inspection of each facility prior to licensure andan unannounced full inspection of facilities at least once everyeighteen months. The statewide average interval between full facilityinspections must be fifteen months. (2) Any duly authorized officer, employee, or agent of thedepartment may enter and inspect any facility at any time to determinethat the facility is in compliance with this chapter and applicablerules, and to enforce any provision of this chapter. Complaint 64 inspections shall be unannounced and conducted in such a manner as toensure maximum effectiveness. No advance notice shall be given of anyinspection unless authorized or required by federal law. (3) During inspections, the facility must give the departmentaccess to areas, materials, and equipment used to provide care orsupport to residents, including resident and staff records, accounts,and the physical premises, including the buildings, grounds, andequipment. The department has the authority to privately interview theprovider, staff, residents, and other individuals familiar withresident care and treatment. (4) Any public employee giving advance notice of an inspection inviolation of this section shall be suspended from all duties withoutpay for a period of not less than five nor more than fifteen days. (5) The department shall prepare a written report describing theviolations found during an inspection, and shall provide a copy of theinspection report to the facility. (6) The facility shall develop a written plan of correction for anyviolations identified by the department and provide a plan ofcorrection to the department within ten working days from the receiptof the inspection report.NEW SECTION.Sec. The facility shall only admit individuals: (1) Who are over the age of eighteen; (2) Who meet the resident eligibility requirements described insection 405 of this act; and (3) Whose needs the facility can safely and appropriately meetthrough qualified and trained staff, services, equipment, security, andbuilding design.NEW SECTION.Sec. If the facility does not employ aqualified professional able to furnish needed services, the facilitymust have a written contract with a qualified professional or agencyoutside the facility to furnish the needed services.NEW SECTION.Sec. At least sixty days before the effectivedate of any change of ownership, or change of management of a facility,the current operating entity must provide written notification about 65 the proposed change separately and in writing, to the department, eachresident of the facility, or the resident's guardian or representative.NEW SECTION.Sec. The facility shall: (1) Maintain adequate resident records to enable the provision ofnecessary treatment, care, and services and to respond appropriately inemergency situations; (2) Comply with all state and federal requirements related todocumentation, confidentiality, and information sharing, includingchapters 10.77, 70.02, 70.24, 70.96A, and 71.05 RCW; and (3) Where possible, obtain signed releases of informationdesignating the department, the facility, and the department ofcorrections where the person is under its supervision, as recipients ofhealth care information.NEW SECTION.Sec. (1) Standards for fire protection and theenforcement thereof, with respect to all facilities licensed under thischapter, are the responsibility of the chief of the Washington statepatrol, through the director of fire protection, who must adoptrecognized standards as applicable to facilities for the protection oflife against the cause and spread of fire and fire hazards. If thefacility to be licensed meets with the approval of the chief of theWashington state patrol, through the director of fire protection, thedirector of fire protection must submit to the department a writtenreport approving the facility with respect to fire protection before afull license can be issued. The chief of the Washington state patrol,through the director of fire protection, shall conduct an unannouncedfull inspection of facilities at least once every eighteen months. Thestatewide average interval between full facility inspections must befifteen months. (2) Inspections of facilities by local authorities must beconsistent with the requirements adopted by the chief of the Washingtonstate patrol, through the director of fire protection. Findings of aserious nature must be coordinated with the department and the chief ofthe Washington state patrol, through the director of fire protection,for determination of appropriate actions to ensure a safe environmentfor residents. The chief of the Washington state patrol, through the 66 director of fire protection, has exclusive authority to determineappropriate corrective action under this section.NEW SECTION.Sec. No facility providing care and treatmentfor individuals placed in a facility, or agency licensing or placingresidents in a facility, acting in the course of its duties, shall becivilly or criminally liable for performing its duties under thischapter, provided that such duties were performed in good faith andwithout gross negligence.NEW SECTION.Sec. (1) The secretary shall adopt rules toimplement this chapter. (2) Such rules shall at the minimum: (a) Promote safe treatmentand necessary care of individuals residing in the facility and providefor safe and clean conditions; (b) establish licensee qualifications,licensing and enforcement, and license fees sufficient to cover thecost of licensing and enforcement.PART VFORENSIC AND CORRECTIONALDrug and Mental Health CourtsNEW SECTION.Sec. A new section is added to chapter 2.28 RCWto read as follows: (1) Counties may establish and operate mental health courts. (2) For the purposes of this section, "mental health court" meansa court that has special calendars or dockets designed to achieve areduction in recidivism and symptoms of mental illness amongnonviolent, mentally ill felony and nonfelony offenders by increasingtheir likelihood for successful rehabilitation through early,continuous, and intense judicially supervised treatment including drugtreatment for persons with cooccurring disorders; mandatory periodicreviews, including drug testing if indicated; and the use ofappropriate sanctions and other rehabilitation services. (3)(a) Any jurisdiction that seeks a state appropriation to fund amental health court program must first: 67 (i) Exhaust all federal funding that is available to support theoperations of its mental health court and associated services; and (ii) Match, on a dollarfordollar basis, state moneys allocatedfor mental health court programs with local cash or inkind resources.Moneys allocated by the state must be used to supplement, not supplant,other federal, state, and local funds for mental health courtoperations and associated services. (b) Any county that establishes a mental health court pursuant tothis section shall establish minimum requirements for the participationof offenders in the program. The mental health court may adopt localrequirements that are more stringent than the minimum. The minimumrequirements are: (i) The offender would benefit from psychiatric treatment; (ii) The offender has not previously been convicted of a seriousviolent offense or sex offense as defined in RCW 9.94A.030; and (iii) Without regard to whether proof of any of these elements isrequired to convict, the offender is not currently charged with orconvicted 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 bodilyharm or death to another person.NEW SECTION.Sec. A new section is added to chapter 2.28 RCWto read as follows: Any county that has established a drug court and a mental healthcourt under this chapter may combine the functions of both courts intoa single therapeutic court.NEW SECTION.Sec. A new section is added to chapter 26.12RCW to read as follows: (1) Every county that authorizes the tax provided in section 805 ofthis act shall, and every county may, establish and operate atherapeutic court component for dependency proceedings designed to beeffective for the court's size, location, and resources. A county witha drug court for criminal cases or with a mental health court may 68 include a therapeutic court for dependency proceedings as a componentof its existing program. (2) For the purposes of this section, "therapeutic court" means acourt that has special calendars or dockets designed for the intensejudicial supervision, coordination, and oversight of treatment providedto parents and families who have substance abuse or mental healthproblems and who are involved in the dependency and is designed toachieve a reduction in: (a) Child abuse and neglect; (b) Outofhome placement of children; (c) Termination of parental rights; and (d) Substance abuse or mental health symptoms among parents orguardians and their children. (3) To the extent possible, the therapeutic court shall provideservices for parents and families colocated with the court or as nearto the court as practicable. (4) The department of social and health services shall furnishservices to the therapeutic court unless a court contracts withproviders outside of the department. (5) Any jurisdiction that receives a state appropriation to fund atherapeutic court must first exhaust all federal funding available forthe development and operation of the therapeutic court and associatedservices. (6) Moneys allocated by the state for a therapeutic court must beused to supplement, not supplant, other federal, state, local, andprivate funding for court operations and associated services under thissection. (7) Any county that establishes a therapeutic court or receivesfunds for an existing court under this section shall: (a) Establish minimum requirements for the participation in theprogram; and (b) Develop an evaluation component of the court, includingtracking the success rates in graduating from treatment, reunifyingparents with their children, and the costs and benefits of the court.Sec. RCW 2.28.170 and 2002 c 290 s 13 are each amended toread as follows: (1) Counties may establish and operate drug courts. 69 (2) For the purposes of this section, "drug court" means a courtthat has special calendars or dockets designed to achieve a reductionin recidivism and substance abuse among nonviolent, substance abusingfelony and nonfelony offenders by increasing their likelihood forsuccessful rehabilitation through early, continuous, and intensejudicially supervised treatment; mandatory periodic drug testing; andthe use of appropriate sanctions and other rehabilitation services. (3)(a) Any jurisdiction that seeks a state appropriation to fund adrug court program must first: (i) Exhaust all federal funding ((received from the office ofnational drug control policy)) that is available to support theoperations of its drug court and associated services; and (ii) Match, on a dollarfordollar basis, state moneys allocatedfor drug court programs with local cash or inkind resources. Moneysallocated by the state must be used to supplement, not supplant, otherfederal, state, and local funds for drug court operations andassociated services. (b) Any county that establishes a drug court pursuant to thissection shall establish minimum requirements for the participation ofoffenders in the program. The drug court may adopt local requirementsthat are more stringent than the minimum. The minimum requirementsare: (i) The offender would benefit from substance abuse treatment; (ii) The offender has not previously been convicted of a seriousviolent offense or sex offense as defined in RCW 9.94A.030; and (iii) Without regard to whether proof of any of these elements isrequired to convict, the offender is not currently charged with orconvicted 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 bodilyharm or death to another person.Regional JailsNEW SECTION.Sec. (1) The joint legislative audit and reviewcommittee shall investigate and assess whether there are existing 70 facilities in the state that could be converted to use as a regionaljail for offenders who have mental or chemical dependency disorders, orboth, that need specialized housing and treatment arrangements. (2) The joint legislative audit and review committee shall considerthe feasibility of using at least the following facilities or types offacilities: (a) Stateowned or operated facilities; and (b) Closed or abandoned nursing homes. (3) The analysis shall include an assessment of when suchfacilities could be available for use as a regional jail and thepotential costs, costs avoided, and benefits of at least the followingconsiderations: (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 tothe available pool of offenders; (e) Changes in criminal justice costs, including transport, accessto 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 reportits findings and recommendations to the appropriate committees of thelegislature not later than December 15, 2005.Competency and Criminal InsanityNEW SECTION.Sec. By January 1, 2006, the department ofsocial and health services shall: (1) Reduce the waiting times for competency evaluation andrestoration to the maximum extent possible using funds appropriated forthis purpose; and (2) Report to the legislature with an analysis of severalalternative strategies for addressing increases in forensic populationand minimizing waiting periods for competency evaluation andrestoration. The report shall discuss, at a minimum, the costs andadvantages of, and barriers to colocating professional persons in 71 jails, performing restoration treatment in less restrictivealternatives than the state hospitals, and the use of regional jailfacilities to accomplish competency evaluation and restoration.ESSB 6358 Implementation IssuesSec. RCW 71.05.157 and 2004 c 166 s 16 are each amended toread as follows: (1) When a ((county)) designated mental health professional isnotified by a jail that a defendant or offender who was subject to adischarge review under RCW 71.05.232 is to be released to thecommunity, the ((county)) designated mental health professional shallevaluate the person within seventytwo hours of release. (2) When an offender is under courtordered treatment in thecommunity and the supervision of the department of corrections, and thetreatment provider becomes aware that the person is in violation of theterms of the court order, the treatment provider shall notify the((county)) designated mental health professional and the department ofcorrections of the violation and request an evaluation for purposes ofrevocation of the less restrictive alternative. (3) When a ((county)) designated mental health professional becomesaware that an offender who is under courtordered treatment in thecommunity and the supervision of the department of corrections is inviolation of a treatment order or a condition of supervision thatrelates to public safety, or the ((county)) designated mental healthprofessional detains a person under this chapter, the ((county))designated mental health professional shall notify the person'streatment provider and the department of corrections. (4) When an offender who is confined in a state correctionalfacility or is under supervision of the department of corrections inthe community is subject to a petition for involuntary treatment underthis chapter, the petitioner shall notify the department of correctionsand the department of corrections shall provide documentation of itsrisk assessment or other concerns to the petitioner and the court ifthe department of corrections classified the offender as a high risk orhigh needs offender. (5) Nothing in this section creates a duty on any treatment 72 provider or ((county)) designated mental health professional to provideoffender supervision.NEW SECTION.Sec. A new section is added to chapter 70.96ARCW to read as follows: (1) Treatment providers shall inquire of each person seekingtreatment, at intake, whether the person is subject to court orderedmental health or chemical dependency treatment, whether civil orcriminal, and document the person's response in his or her record. Ifthe person is in treatment on the effective date of this section, andthe treatment provider has not inquired whether the person is subjectto court ordered mental health or chemical dependency treatment, thetreatment provider shall inquire on the person's next treatment sessionand document the person's response in his or her record. (2) Treatment providers shall inquire of each person seekingtreatment, at intake, whether the person is subject to supervision ofany kind by the department of corrections and document the person'sresponse in his or her record. If the person is in treatment on theeffective date of this section, and the treatment provider has notinquired whether the person is subject to supervision of any kind bythe department of corrections, the treatment provider shall inquire onthe person's next treatment session and document the person's responsein his or her record. (3) For all persons who are subject to both court ordered mentalhealth or chemical dependency treatment and supervision by thedepartment of corrections, the treatment provider shall request anauthorization to release records and notify the person that, unlessexpressly excluded by the court order the law requires treatmentproviders to share information with the department of corrections andthe person's mental health treatment provider. (4) If the treatment provider has reason to believe that a personis subject to supervision by the department of corrections but theperson's record does not indicate that he or she is, the treatmentprovider may call any department of corrections office and provide theperson's name and birth date. If the person is subject to supervision,the treatment provider shall request, and the department of correctionsshall provide, the name and contact information for the person'scommunity corrections officer. 73 PART VIBEST PRACTICES AND COLLABORATIONNEW SECTION.Sec. (1) The department of social and healthservices, in consultation with the members of the team charged withdeveloping the state plan for cooccurring mental and substance abusedisorders, shall adopt, not later than January 1, 2006, an integratedand comprehensive screening and assessment process for chemicaldependency and mental disorders and cooccurring chemical dependencyand mental disorders. (a) The process adopted shall include, at a minimum: (i) An initial screening tool that can be used by intake personnelsystemwide and which will identify the most common types of cooccurring disorders; (ii) An assessment process for those cases in which assessment isindicated that provides an appropriate degree of assessment for mostsituations, which can be expanded for complex situations; (iii) Identification of triggers in the screening that indicate theneed to begin an assessment; (iv) Identification of triggers after or outside the screening thatindicate a need to begin or resume an assessment; (v) The components of an assessment process and a protocol fordetermining whether part or all of the assessment is necessary, and atwhat point; and (vi) Emphasis that the process adopted under this section is toreplace and not to duplicate existing intake, screening, and assessmenttools and processes. (b) The department shall consider existing models, including thosealready adopted by other states, and to the extent possible, adopt anestablished, proven model. (c) The integrated, comprehensive screening and assessment processshall be implemented statewide by all chemical dependency and mentalhealth treatment providers as well as all designated mental healthprofessionals, designated chemical dependency specialists, anddesignated crisis responders not later than January 1, 2007. (2) The department shall provide adequate training to effectstatewide implementation by the dates designated in this section and 74 shall report the rates of cooccurring disorders and the stage ofscreening or assessment at which the cooccurring disorder wasidentified to the appropriate committees of the legislature. (3) The department shall establish contractual penalties tocontracted treatment providers, the regional support networks, andtheir contracted providers for failure to implement the integratedscreening and assessment process by July 1, 2007.NEW SECTION.Sec. The department of corrections shall, tothe extent that resources are available for this purpose, utilize theintegrated, comprehensive screening and assessment process for chemicaldependency and mental disorders developed under section 601 of thisact.NEW SECTION.Sec. A new section is added to chapter 71.24RCW to read as follows: (1) By June 30, 2006, the department shall develop and implement amatrix or set of matrices for providing services based on the followingprinciples: (a) Maximizing evidencebased practices where these practicesexist; where no evidencebased practice exists, the use of researchbased practices, including but not limited to, the adaptation ofevidencebased practices to new situations; where no evidencebased orresearchbased practices exist the use of consensusbased practices;and, to the extent that funds are available, the use of promisingpractices; (b) Maximizing the person's independence, recovery, and employmentby consideration of the person's strengths and supports in thecommunity; (c) Maximizing the person's participation in treatment decisionsincluding, where possible, the person's awareness of, and technicalassistance in preparing, mental health advance directives; and (d) Collaboration with consumerbased support programs. (2) The matrix or set of matrices shall include both adults andchildren and persons with cooccurring mental and substance abusedisorders and shall build on the service intensity quadrant models thathave been developed in this state. 75 (3)(a) The matrix or set of matrices shall be developed incollaboration with experts in evidencebased practices for mentaldisorders, chemical dependency disorders, and cooccurring mental andchemical dependency disorders at the University of Washington, and inconsultation with representatives of the regional support networks,community mental health providers, county chemical dependencycoordinators, chemical dependency providers, consumers, familyadvocates, 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 byother states. (4)(a) The department shall require, by contract with the regionalsupport networks, that providers maximize the use of evidencebased,researchbased, and consensusbased practices and document thepercentage of clients enrolled in evidencebased, researchbased, andconsensusbased programs by program type. (b) The department shall establish a schedule by which regionalsupport networks and providers must adopt the matrix or set of matricesand a schedule of penalties for failure to adopt and implement thematrices. The department may act against the regional support networksor providers or both to enforce the provisions of this section andshall provide the appropriate committees of the legislature with theschedules adopted under this subsection by June 30, 2006. (5) The following definitions apply to this section: (a) "Evidencebased" means a program or practice that has hadmultiple site random controlled trials across heterogeneous populationsdemonstrating that the program or practice is effective for thepopulation. (b) "Researchbased" means a program or practice that has someresearch demonstrating effectiveness, but that does not yet meet thestandard of evidencebased practices. (c) "Consensusbased" means a program or practice that has generalsupport among treatment providers and experts, based on experience orprofessional literature, and may have anecdotal or case study support,or that is agreed but not possible to perform studies with randomassignment and controlled groups. (d) "Promising practice" means a practice that presents, based on 76 preliminary information, potential for becoming a researchbased orconsensusbased practice.NEW SECTION.Sec. A new section is added to chapter 71.02RCW to read as follows: (1) The department of social and health services shall collaboratewith community providers of mental health services, early learning andchild care providers, child serving agencies, and childplacingagencies to identify and utilize federal, state, and local services andproviders for children in outofhome care and other populations ofvulnerable children who are in need of an evaluation and treatment formental health services and do not qualify for medicaid or treatmentservices through the regional support networks. (2) If no appropriate mental health services are available throughfederal, state, or local services and providers for a child describedin subsection (1) of this section, the regional support network mustprovide a child, at a minimum, with a mental health evaluationconsistent with chapter 71.24 RCW. (3) The department, in collaboration with the office of thesuperintendent of public instruction, local providers, local schooldistricts, and the regional support networks, shall identify and reviewexisting programs and services as well as the unmet need for programsand services serving birth to five and schoolaged children who exhibitearly signs of behavioral or mental health disorders and who are nototherwise eligible for services through the regional support networks.The review of programs and services shall include, but not be limitedto, the utilization and effectiveness of early intervention orprevention services and the primary intervention programs. The department of social and health services shall provide abriefing on the collaboration's findings and recommendations to theappropriate committee of the legislature by December 31, 2005.PART VIIREPEALERS AND CROSSREFERENCE CORRECTIONSNEW SECTION.Sec. The following acts or parts of acts areeach repealed on the effective date of section 107 of this act: 77 RCW 71.05.060 (Rights of persons complained against) and 19731st ex.s. c 142 s 11; RCW 71.05.070 (Prayer treatment) and 1973 1st ex.s. c 142 s 12; RCW 71.05.090 (Choice of physicians) and 1973 2nd ex.s. c 24 s3 & 1973 1st ex.s. c 142 s 14; RCW 71.05.200 (Notice and statement of rightsProbable causehearing) and 1998 c 297 s 11, 1997 c 112 s 14, 1989 c 120 s 5, 1974ex.s. c 145 s 13, & 1973 1st ex.s. c 142 s 25; RCW 71.05.250 (Probable cause hearingDetained person'srightsWaiver of privilegeLimitationRecords as evidence) and 1989c 120 s 7, 1987 c 439 s 6, 1974 ex.s. c 145 s 17, & 1973 1st ex.s. c142 s 30; RCW 71.05.450 (CompetencyEffectStatement of Washington law)and 1994 sp.s. c 7 s 440 & 1973 1st ex.s. c 142 s 50; RCW 71.05.460 (Right to counsel) and 1997 c 112 s 33 & 1973 1stex.s. c 142 s 51; RCW 71.05.470 (Right to examination) and 1997 c 112 s 34 & 19731st ex.s. c 142 s 52; RCW 71.05.480 (Petitioning for releaseWrit of habeas corpus)and 1974 ex.s. c 145 s 29 & 1973 1st ex.s. c 142 s 53; and 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. The following acts or parts of acts areeach repealed on the effective date of section 109 of this act: RCW 71.05.155 (Request to mental health professional by lawenforcement agency for investigation under RCW 71.05.150Advisoryreport of results) and 1997 c 112 s 9 & 1979 ex.s. c 215 s 10; RCW 71.05.395 (Application of uniform health care informationact, chapter 70.02 RCW) and 1993 c 448 s 8; RCW 71.05.400 (Release of information to patient's next of kin,attorney, guardian, conservatorNotification of patient's death) and1993 c 448 s 7, 1974 ex.s. c 115 s 1, 1973 2nd ex.s. c 24 s 6, & 19731st ex.s. c 142 s 45; RCW 71.05.410 (Notice of disappearance of patient) and 1997 c112 s 32, 1973 2nd ex.s. c 24 s 7, & 1973 1st ex.s. c 142 s 46; and RCW 71.05.430 (Statistical data) and 1973 1st ex.s. c 142 s 48. 78 NEW SECTION.Sec. RCW 71.05.610 (Treatment recordsDefinitions) and 1989 c 205 s 11 are each repealed on the effectivedate of sections 104 through 106 of this act.NEW SECTION.Sec. The following acts or parts of acts areeach repealed: RCW 71.05.650 (Treatment recordsNotation of and access toreleased data) and 1989 c 205 s 15; and RCW 71.05.670 (Treatment recordsViolationsCivil action) and1999 c 13 s 10.Sec. RCW 5.60.060 and 2001 c 286 s 2 are each amended to readas 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 husbandwithout the consent of the husband; nor can either during marriage orafterward, be without the consent of the other, examined as to anycommunication made by one to the other during marriage. But thisexception shall not apply to a civil action or proceeding by oneagainst the other, nor to a criminal action or proceeding for a crimecommitted by one against the other, nor to a criminal action orproceeding against a spouse if the marriage occurred subsequent to thefiling of formal charges against the defendant, nor to a criminalaction or proceeding for a crime committed by said husband or wifeagainst any child of whom said husband or wife is the parent orguardian, nor to a proceeding under chapter 70.96A, 70.- (sections 202through 216 of this act), 71.05, or 71.09 RCW: PROVIDED, That thespouse 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 becompelled to testify and shall be so informed by the court prior tobeing called as a witness. (2)(a) An attorney or counselor shall not, without the consent ofhis or her client, be examined as to any communication made by theclient to him or her, or his or her advice given thereon in the courseof professional employment. (b) A parent or guardian of a minor child arrested on a criminalcharge may not be examined as to a communication between the child and 79 his or her attorney if the communication was made in the presence ofthe parent or guardian. This privilege does not extend tocommunications made prior to the arrest. (3) A member of the clergy or a priest shall not, without theconsent of a person making the confession, be examined as to anyconfession made to him or her in his or her professional character, inthe course of discipline enjoined by the church to which he or shebelongs. (4) Subject to the limitations under RCW 70.96A.140 or((71.05.250)) 71.05.360 (8) and (9), a physician or surgeon orosteopathic physician or surgeon or podiatric physician or surgeonshall not, without the consent of his or her patient, be examined in acivil action as to any information acquired in attending such patient,which was necessary to enable him or her to prescribe or act for thepatient, 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 orwrongful death, the claimant shall be deemed to waive the physicianpatient privilege. Waiver of the physicianpatient privilege for anyone physician or condition constitutes a waiver of the privilege as toall physicians or conditions, subject to such limitations as a courtmay impose pursuant to court rules. (5) A public officer shall not be examined as a witness as tocommunications made to him or her in official confidence, when thepublic interest would suffer by the disclosure. (6)(a) A peer support group counselor shall not, without consent ofthe law enforcement officer making the communication, be compelled totestify about any communication made to the counselor by the officerwhile receiving counseling. The counselor must be designated as suchby the sheriff, police chief, or chief of the Washington state patrol,prior to the incident that results in counseling. The privilege onlyapplies when the communication was made to the counselor while actingin his or her capacity as a peer support group counselor. Theprivilege does not apply if the counselor was an initial respondingofficer, a witness, or a party to the incident which prompted thedelivery of peer support group counseling services to the lawenforcement officer. 80 (b) For purposes of this section, "peer support group counselor"means a: (i) Law enforcement officer, or civilian employee of a lawenforcement agency, who has received training to provide emotional andmoral support and counseling to an officer who needs those services asa result of an incident in which the officer was involved while actingin 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 provideemotional and moral support and counseling to an officer who needsthose services as a result of an incident in which the officer wasinvolved while acting in his or her official capacity. (7) A sexual assault advocate may not, without the consent of thevictim, be examined as to any communication made by the victim to thesexual assault advocate. (a) For purposes of this section, "sexual assault advocate" meansthe employee or volunteer from a rape crisis center, victim assistanceunit, program, or association, that provides information, medical orlegal advocacy, counseling, or support to victims of sexual assault,who is designated by the victim to accompany the victim to the hospitalor other health care facility and to proceedings concerning the allegedassault, including police and prosecution interviews and courtproceedings. (b) A sexual assault advocate may disclose a confidentialcommunication without the consent of the victim if failure to discloseis likely to result in a clear, imminent risk of serious physicalinjury or death of the victim or another person. Any sexual assaultadvocate participating in good faith in the disclosing of records andcommunications under this section shall have immunity from anyliability, civil, criminal, or otherwise, that might result from theaction. In any proceeding, civil or criminal, arising out of adisclosure under this section, the good faith of the sexual assaultadvocate who disclosed the confidential communication shall bepresumed.Sec. RCW 18.83.110 and 1989 c 271 s 303 are each amended toread as follows: Confidential communications between a client and a psychologist 81 shall be privileged against compulsory disclosure to the same extentand subject to the same conditions as confidential communicationsbetween attorney and client, but this exception is subject to thelimitations under RCW 70.96A.140 and ((71.05.250)) 71.05.360 (8) and(9).Sec. RCW 18.225.105 and 2003 c 204 s 1 are each amended toread as follows: A person licensed under this chapter shall not disclose the writtenacknowledgment of the disclosure statement pursuant to RCW 18.225.100,nor any information acquired from persons consulting the individual ina professional capacity when the information was necessary to enablethe individual to render professional services to those persons except: (1) With the written authorization of that person or, in the caseof death or disability, the person's personal representative; (2) If the person waives the privilege by bringing charges againstthe person licensed under this chapter; (3) In response to a subpoena from the secretary. The secretarymay subpoena only records related to a complaint or report under RCW18.130.050; (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 chapterreasonably believes that disclosure will avoid or minimize an imminentdanger to the health or safety of the individual or any otherindividual; however, there is no obligation on the part of the providerto so disclose.Sec. RCW 71.05.235 and 2000 c 74 s 6 are each amended to readas follows: (1) If an individual is referred to a ((county)) designated mentalhealth professional under RCW 10.77.090(1)(d)(iii)(A), the ((county))designated mental health professional shall examine the individualwithin fortyeight hours. If the ((county)) designated mental healthprofessional determines it is not appropriate to detain the individualor petition for a ninetyday less restrictive alternative under RCW71.05.230(4), that decision shall be immediately presented to thesuperior court for hearing. The court shall hold a hearing to consider 82 the decision of the ((county)) designated mental health professionalnot later than the next judicial day. At the hearing the superiorcourt shall review the determination of the ((county)) designatedmental health professional and determine whether an order should beentered requiring the person to be evaluated at an evaluation andtreatment facility. No person referred to an evaluation and treatmentfacility may be held at the facility longer than seventytwo hours. (2) If an individual is placed in an evaluation and treatmentfacility under RCW 10.77.090(1)(d)(iii)(B), a professional person shallevaluate the individual for purposes of determining whether to file aninetyday inpatient or outpatient petition under chapter 71.05 RCW.Before expiration of the seventytwo hour evaluation period authorizedunder RCW 10.77.090(1)(d)(iii)(B), the professional person shall filea petition or, if the recommendation of the professional person is torelease the individual, present his or her recommendation to thesuperior court of the county in which the criminal charge wasdismissed. The superior court shall review the recommendation notlater than fortyeight hours, excluding Saturdays, Sundays, andholidays, after the recommendation is presented. If the court rejectsthe recommendation to unconditionally release the individual, the courtmay order the individual detained at a designated evaluation andtreatment facility for not more than a seventytwo hour evaluation andtreatment period and direct the individual to appear at a suretyhearing before that court within seventytwo hours, or the court mayrelease the individual but direct the individual to appear at a suretyhearing set before that court within eleven days, at which time theprosecutor may file a petition under this chapter for ninetydayinpatient or outpatient treatment. If a petition is filed by theprosecutor, the court may order that the person named in the petitionbe detained at the evaluation and treatment facility that performed theevaluation under this subsection or order the respondent to be inoutpatient treatment. If a petition is filed but the individual failsto appear in court for the surety hearing, the court shall order thata mental health professional or peace officer shall take such person orcause such person to be taken into custody and placed in an evaluationand treatment facility to be brought before the court the next judicialday after detention. Upon the individual's first appearance in courtafter a petition has been filed, proceedings under RCW 71.05.310 and 83 71.05.320 shall commence. For an individual subject to thissubsection, the prosecutor or professional person may directly file apetition for ninetyday inpatient or outpatient treatment and nopetition for initial detention or fourteenday detention is requiredbefore such a petition may be filed. The court shall conduct the hearing on the petition filed underthis subsection within five judicial days of the date the petition isfiled. The court may continue the hearing upon the written request ofthe person named in the petition or the person's attorney, for goodcause shown, which continuance shall not exceed five additionaljudicial days. If the person named in the petition requests a jurytrial, the trial shall commence within ten judicial days of the date ofthe filing of the petition. The burden of proof shall be by clear,cogent, and convincing evidence and shall be upon the petitioner. Theperson shall be present at such proceeding, which shall in all respectsaccord with the constitutional guarantees of due process of law and therules of evidence pursuant to RCW ((71.05.250)) 71.05.360 (8) and (9). During the proceeding the person named in the petition shallcontinue to be detained and treated until released by order of thecourt. If no order has been made within thirty days after the filingof the petition, not including any extensions of time requested by thedetained person or his or her attorney, the detained person shall bereleased. (3) If a ((county)) designated mental health professional or theprofessional person and prosecuting attorney for the county in whichthe criminal charge was dismissed or attorney general, as appropriate,stipulate that the individual does not present a likelihood of seriousharm or is not gravely disabled, the hearing under this section is notrequired 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. RCW 71.05.310 and 1987 c 439 s 9 are each amended toread as follows: The court shall conduct a hearing on the petition for ninety daytreatment within five judicial days of the first court appearance afterthe probable cause hearing. The court may continue the hearing uponthe written request of the person named in the petition or the person's 84 attorney, for good cause shown, which continuance shall not exceed fiveadditional judicial days. If the person named in the petition requestsa jury trial, the trial shall commence within ten judicial days of thefirst court appearance after the probable cause hearing. The burden ofproof shall be by clear, cogent, and convincing evidence and shall beupon the petitioner. The person shall be present at such proceeding,which shall in all respects accord with the constitutional guaranteesof 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 shallcontinue to be treated until released by order of the superior court.If no order has been made within thirty days after the filing of thepetition, not including extensions of time requested by the detainedperson or his or her attorney, the detained person shall be released.Sec. RCW 71.05.425 and 2000 c 94 s 10 are each amended toread as follows: (1)(a) Except as provided in subsection (2) of this section, at theearliest possible date, and in no event later than thirty days beforeconditional release, final release, authorized leave under RCW71.05.325(2), or transfer to a facility other than a state mentalhospital, the superintendent shall send written notice of conditionalrelease, release, authorized leave, or transfer of a person committedunder 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) tothe following: (i) The chief of police of the city, if any, in which the personwill 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 besent to the following, if such notice has been requested in writingabout a specific person committed under RCW 71.05.280(3) or71.05.320(2)(c) following dismissal of a sex, violent, or felonyharassment offense pursuant to RCW 10.77.090(4): (i) The victim of the sex, violent, or felony harassment offensethat was dismissed pursuant to RCW 10.77.090(4) preceding commitmentunder RCW 71.05.280(3) or 71.05.320(2)(c) or the victim's next of kinif the crime was a homicide; 85 (ii) Any witnesses who testified against the person in any courtproceedings; and (iii) Any person specified in writing by the prosecuting attorney.Information regarding victims, next of kin, or witnesses requesting thenotice, information regarding any other person specified in writing bythe prosecuting attorney to receive the notice, and the notice areconfidential and shall not be available to the person committed underthis chapter. (c) The thirtyday notice requirements contained in this subsectionshall not apply to emergency medical transfers. (d) The existence of the notice requirements in this subsectionwill not require any extension of the release date in the event therelease 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 offensepursuant to RCW 10.77.090(4) escapes, the superintendent shallimmediately notify, by the most reasonable and expedient meansavailable, the chief of police of the city and the sheriff of thecounty in which the person resided immediately before the person'sarrest. If previously requested, the superintendent shall also notifythe witnesses and the victim of the sex, violent, or felony harassmentoffense that was dismissed pursuant to RCW 10.77.090(4) precedingcommitment under RCW 71.05.280(3) or 71.05.320(2) or the victim's nextof kin if the crime was a homicide. In addition, the secretary shallalso notify appropriate parties pursuant to RCW ((71.05.410))71.05.390(18). If the person is recaptured, the superintendent shallsend notice to the persons designated in this subsection as soon aspossible but in no event later than two working days after thedepartment learns of such recapture. (3) If the victim, the victim's next of kin, or any witness isunder the age of sixteen, the notice required by this section shall besent to the parent or legal guardian of the child. (4) The superintendent shall send the notices required by thischapter to the last address provided to the department by therequesting party. The requesting party shall furnish the departmentwith a current address. (5) For purposes of this section the following terms have thefollowing meanings: 86 (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, andchildren; (d) "Felony harassment offense" means a crime of harassment asdefined in RCW 9A.46.060 that is a felony.Sec. RCW 71.05.445 and 2004 c 166 s 4 are each amended toread as follows: (1) The definitions in this subsection apply throughout thissection unless the context clearly requires otherwise. (a) "Information related to mental health services" means allinformation and records compiled, obtained, or maintained in the courseof providing services to either voluntary or involuntary recipients ofservices by a mental health service provider. This may includedocuments of legal proceedings under this chapter or chapter 71.34 or10.77 RCW, or somatic health care information. (b) "Mental health service provider" means a public or privateagency that provides services to persons with mental disorders asdefined under RCW 71.05.020 and receives funding from public sources.This includes evaluation and treatment facilities as defined in RCW71.05.020, community mental health service delivery systems, orcommunity mental health programs as defined in RCW 71.24.025, andfacilities conducting competency evaluations and restoration underchapter 10.77 RCW. (2)(a) Information related to mental health services delivered toa person subject to chapter 9.94A or 9.95 RCW shall be released, uponrequest, by a mental health service provider to department ofcorrections personnel for whom the information is necessary to carryout the responsibilities of their office. The information must beprovided only for the purposes of completing presentence investigationsor risk assessment reports, supervision of an incarcerated offender oroffender under supervision in the community, planning for and provisionof supervision of an offender, or assessment of an offender's risk tothe community. The request shall be in writing and shall not requirethe consent of the subject of the records. (b) If an offender subject to chapter 9.94A or 9.95 RCW has failedto report for department of corrections supervision or in the event of 87 an emergent situation that poses a significant risk to the public orthe offender, information related to mental health services deliveredto the offender and, if known, information regarding where the offenderis likely to be found shall be released by the mental health servicesprovider to the department of corrections upon request. The initialrequest may be written or oral. All oral requests must be subsequentlyconfirmed in writing. Information released in response to an oralrequest is limited to a statement as to whether the offender is or isnot being treated by the mental health services provider and theaddress or information about the location or whereabouts of theoffender. Information released in response to a written request mayinclude information identified by rule as provided in subsections (4)and (5) of this section. For purposes of this subsection a writtenrequest includes requests made by email or facsimile so long as therequesting person at the department of corrections is clearlyidentified. The request must specify the information being requested.Disclosure of the information requested does not require the consent ofthe subject of the records unless the offender has received relief fromdisclosure under RCW 9.94A.562, 70.96A.155, or 71.05.132. (3)(a) When a mental health service provider conducts its initialassessment for a person receiving courtordered treatment, the serviceprovider shall inquire and shall be told by the offender whether he orshe is subject to supervision by the department of corrections. (b) When a person receiving courtordered treatment or treatmentordered by the department of corrections discloses to his or her mentalhealth service provider that he or she is subject to supervision by thedepartment of corrections, the mental health services provider shallnotify the department of corrections that he or she is treating theoffender and shall notify the offender that his or her communitycorrections officer will be notified of the treatment, provided that ifthe offender has received relief from disclosure pursuant to RCW9.94A.562, 70.96A.155, or 71.05.132 and the offender has provided themental health services provider with a copy of the order grantingrelief from disclosure pursuant to RCW 9.94A.562, 70.96A.155, or71.05.132, the mental health services provider is not required tonotify the department of corrections that the mental health servicesprovider is treating the offender. The notification may be written ororal and shall not require the consent of the offender. If an oral 88 notification is made, it must be confirmed by a written notification.For purposes of this section, a written notification includesnotification by email or facsimile, so long as the notifying mentalhealth service provider is clearly identified. (4) The information to be released to the department of correctionsshall 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) ofthis section. (5) The department and the department of corrections, inconsultation with regional support networks, mental health serviceproviders as defined in subsection (1) of this section, mental healthconsumers, and advocates for persons with mental illness, shall adoptrules to implement the provisions of this section related to the typeand scope of information to be released. These rules shall: (a) Enhance and facilitate the ability of the department ofcorrections to carry out its responsibility of planning and ensuringcommunity protection with respect to persons subject to sentencingunder chapter 9.94A or 9.95 RCW, including accessing and releasing ordisclosing information of persons who received mental health servicesas a minor; and (b) Establish requirements for the notification of persons underthe supervision of the department of corrections regarding theprovisions of this section. (6) The information received by the department of corrections underthis section shall remain confidential and subject to the limitationson disclosure outlined in chapter 71.05 RCW, except as provided in RCW72.09.585. (7) No mental health service provider or individual employed by amental health service provider shall be held responsible forinformation released to or used by the department of corrections underthe provisions of this section or rules adopted under this sectionexcept under RCW ((71.05.670 and)) 71.05.440. (8) Whenever federal law or federal regulations restrict therelease of information contained in the treatment records of anypatient who receives treatment for alcoholism or drug dependency, therelease of the information may be restricted as necessary to complywith federal law and regulations. 89 (9) This section does not modify the terms and conditions ofdisclosure of information related to sexually transmitted diseasesunder chapter 70.24 RCW. (10) The department shall, subject to available resources,electronically, or by the most costeffective means available, providethe department of corrections with the names, last dates of services,and addresses of specific regional support networks and mental healthservice providers that delivered mental health services to a personsubject to chapter 9.94A or 9.95 RCW pursuant to an agreement betweenthe departments.Sec. RCW 71.05.640 and 2000 c 94 s 11 are each amended toread as follows: (1) Procedures shall be established by resource management servicesto provide reasonable and timely access to individual treatmentrecords. However, access may not be denied at any time to records ofall medications and somatic treatments received by the individual. (2) Following discharge, the individual shall have a right to acomplete record of all medications and somatic treatments prescribedduring evaluation, admission, or commitment and to a copy of thedischarge summary prepared at the time of his or her discharge. Areasonable and uniform charge for reproduction may be assessed. (3) Treatment records may be modified prior to inspection toprotect the confidentiality of other patients or the names of any otherpersons referred to in the record who gave information on the conditionthat his or her identity remain confidential. Entire documents may notbe withheld to protect such confidentiality. (4) At the time of discharge all individuals shall be informed byresource management services of their rights as provided in RCW((71.05.610)) 71.05.620 through 71.05.690.Sec. RCW 71.05.680 and 1999 c 13 s 11 are each amended toread as follows: Any person who requests or obtains confidential informationpursuant to RCW ((71.05.610)) 71.05.620 through 71.05.690 under falsepretenses shall be guilty of a gross misdemeanor. 90 Sec. RCW 71.05.690 and 1999 c 13 s 12 are each amended toread as follows: The department shall adopt rules to implement RCW ((71.05.610))71.05.620 through 71.05.680.Sec. RCW 71.24.035 and 2001 c 334 s 7 and 2001 c 323 s 10 areeach reenacted and amended to read as follows: (1) The department is designated as the state mental healthauthority. (2) The secretary shall provide for public, client, and licensedservice provider participation in developing the state mental healthprogram, developing contracts with regional support networks, and anywaiver request to the federal government under medicaid. (3) The secretary shall provide for participation in developing thestate mental health program for children and other underservedpopulations, by including representatives on any committee establishedto provide oversight to the state mental health program. (4) The secretary shall be designated as the county authority if acounty fails to meet state minimum standards or refuses to exerciseresponsibilities under RCW 71.24.045. (5) The secretary shall: (a) Develop a biennial state mental health program thatincorporates county biennial needs assessments and county mental healthservice plans and state services for mentally ill adults and children.The secretary may also develop a sixyear state mental health plan; (b) Assure that any regional or county community mental healthprogram provides access to treatment for the county's residents in thefollowing order of priority: (i) The acutely mentally ill; (ii)chronically mentally ill adults and severely emotionally disturbedchildren; and (iii) the seriously disturbed. Such programs shallprovide: (A) Outpatient services; (B) Emergency care services for twentyfour hours per day; (C) Day treatment for mentally ill persons which includes trainingin basic living and social skills, supported work, vocationalrehabilitation, and day activities. Such services may includetherapeutic treatment. In the case of a child, day treatment includes 91 ageappropriate basic living and social skills, educational andprevocational services, day activities, and therapeutic treatment; (D) Screening for patients being considered for admission to statemental health facilities to determine the appropriateness of admission; (E) Employment services, which may include supported employment,transitional work, placement in competitive employment, and other workrelated services, that result in mentally ill persons becoming engagedin meaningful and gainful full or parttime work. Other sources offunding such as the division of vocational rehabilitation may beutilized by the secretary to maximize federal funding and provide forintegration of services; (F) Consultation and education services; and (G) Community support services; (c) Develop and adopt rules establishing state minimum standardsfor the delivery of mental health services pursuant to RCW 71.24.037including, but not limited to: (i) Licensed service providers. The secretary shall provide fordeeming of compliance with state minimum standards for those entitiesaccredited by recognized behavioral health accrediting bodiesrecognized and having a current agreement with the department; (ii) Regional support networks; and (iii) Inpatient services, evaluation and treatment services andfacilities under chapter 71.05 RCW, resource management services, andcommunity support services; (d) Assure that the special needs of minorities, the elderly,disabled, children, and lowincome persons are met within thepriorities established in this section; (e) Establish a standard contract or contracts, consistent withstate minimum standards, which shall be used in contracting withregional support networks or counties. The standard contract shallinclude a maximum fund balance, which shall not exceed ten percent; (f) Establish, to the extent possible, a standardized auditingprocedure which minimizes paperwork requirements of county authoritiesand licensed service providers. The audit procedure shall focus on theoutcomes of service and not the processes for accomplishing them; (g) Develop and maintain an information system to be used by thestate, counties, and regional support networks that includes a trackingmethod which allows the department and regional support networks to 92 identify mental health clients' participation in any mental healthservice or public program on an immediate basis. The informationsystem shall not include individual patient's case history files.Confidentiality of client information and records shall be maintainedas 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 ofthe system and the data elements to be collected shall be reviewed bythe work group appointed by the secretary under section 5(1) of thisact and representing the department, regional support networks, serviceproviders, consumers, and advocates. The data elements shall bedesigned to provide information that is needed to measure performanceand achieve the service outcomes ((identified in section 5 of thisact)); (h) License service providers who meet state minimum standards; (i) Certify regional support networks that meet state minimumstandards; (j) Periodically monitor the compliance of certified regionalsupport networks and their network of licensed service providers forcompliance with the contract between the department, the regionalsupport network, and federal and state rules at reasonable times and ina reasonable manner; (k) Fix fees to be paid by evaluation and treatment centers to thesecretary for the required inspections; (l) Monitor and audit counties, regional support networks, andlicensed service providers as needed to assure compliance withcontractual agreements authorized by this chapter; and (m) Adopt such rules as are necessary to implement the department'sresponsibilities under this chapter. (6) The secretary shall use available resources only for regionalsupport networks. (7) Each certified regional support network and licensed serviceprovider shall file with the secretary, on request, such data,statistics, schedules, and information as the secretary reasonablyrequires. A certified regional support network or licensed serviceprovider which, without good cause, fails to furnish any data,statistics, schedules, or information as requested, or files fraudulentreports thereof, may have its certification or license revoked orsuspended. 93 (8) The secretary may suspend, revoke, limit, or restrict acertification or license, or refuse to grant a certification or licensefor failure to conform to: (a) The law; (b) applicable rules andregulations; (c) applicable standards; or (d) state minimum standards. (9) The superior court may restrain any regional support network orservice provider from operating without certification or a license orany 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 orlicense, and grant other relief required to enforce the provisions ofthis chapter. (10) Upon petition by the secretary, and after hearing held uponreasonable notice to the facility, the superior court may issue awarrant to an officer or employee of the secretary authorizing him orher to enter at reasonable times, and examine the records, books, andaccounts of any regional support network or service provider refusingto 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 processagainst any person or governmental unit to restrain or prevent theestablishment, conduct, or operation of a regional support network orservice provider without certification or a license under this chapter. (12) The standards for certification of evaluation and treatmentfacilities shall include standards relating to maintenance of goodphysical and mental health and other services to be afforded personspursuant to this chapter and chapters 71.05 and 71.34 RCW, and shallotherwise 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 needsassessments based on the number of persons who are acutely mentallyill, chronically mentally ill, severely emotionally disturbed children,and seriously disturbed. The formula shall take into consideration theimpact on counties of demographic factors in counties which result inconcentrations of priority populations as set forth in subsection(5)(b) of this section. These factors shall include the populationconcentrations resulting from commitments under chapters 71.05 and71.34 RCW to state psychiatric hospitals, as well as concentration in 94 urban areas, at border crossings at state boundaries, and othersignificant demographic and workload factors. (b) The formula shall also include a projection of the fundingallocations that will result for each county, which specifiesallocations according to priority populations, including the allocationfor services to children and other underserved populations. (c) After July 1, 2003, the department may allocate up to twopercent of total funds to be distributed to the regional supportnetworks for incentive payments to reward the achievement of superioroutcomes, or significantly improved outcomes, as measured by astatewide performance measurement system consistent with the frameworkrecommended in the joint legislative audit and review committee'sperformance audit of the mental health system. The department shallannually report to the legislature on its criteria and allocation ofthe incentives provided under this subsection. (14) The secretary shall assume all duties assigned to thenonparticipating counties under chapters 71.05, 71.34, and 71.24 RCW.Such responsibilities shall include those which would have beenassigned to the nonparticipating counties under regional supportnetworks. The regional support networks, or the secretary's assumption of allresponsibilities under chapters 71.05, 71.34, and 71.24 RCW, shall beincluded in all state and federal plans affecting the state mentalhealth program including at least those required by this chapter, themedicaid program, and P.L. 99660. Nothing in these plans shall beinconsistent with the intent and requirements of this chapter. (15) The secretary shall: (a) Disburse funds for the regional support networks within sixtydays of approval of the biennial contract. The department must eitherapprove 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. Nocontract shall be approved that does not include progress towardmeeting the goals of this chapter by taking responsibility for: (i)Shortterm commitments; (ii) residential care; and (iii) emergencyresponse systems. (c) Allocate one hundred percent of available resources to the 95 regional support networks in accordance with subsection (13) of thissection. Incentive payments authorized under subsection (13) of thissection may be allocated separately from other available resources. (d) Notify regional support networks of their allocation ofavailable resources at least sixty days prior to the start of a newbiennial contract period. (e) Deny funding allocations to regional support networks basedsolely upon formal findings of noncompliance with the terms of theregional support network's contract with the department. Writtennotice and at least thirty days for corrective action must precede anysuch action. In such cases, regional support networks shall have fullrights to appeal under chapter 34.05 RCW. (16) The department, in cooperation with the state congressionaldelegation, shall actively seek waivers of federal requirements andsuch modifications of federal regulations as are necessary to allowfederal medicaid reimbursement for services provided by freestandingevaluation and treatment facilities certified under chapter 71.05 RCW.The department shall periodically report its efforts to the appropriatecommittees of the senate and the house of representatives.PART VIIIMISCELLANEOUS PROVISIONSNEW SECTION.Sec. RCW 71.05.035 is recodified as a newsection in chapter 71A.12 RCW.NEW SECTION.Sec. A new section is added to chapter 43.20ARCW to read as follows: Beginning July 1, 2007, the secretary shall require, in thecontracts the department negotiates pursuant to chapters 71.24 and70.96A RCW, that any vendor rate increases provided for mental healthand chemical dependency treatment providers or programs who are partiesto the contract or subcontractors of any party to the contract shall beprioritized to those providers and programs that maximize the use ofevidencebased and researchbased practices, as those terms are definedin section 603 of this act, unless otherwise designated by thelegislature. 96 NEW SECTION.Sec. A new section is added to chapter 71.24RCW to read as follows: The department shall require each regional support network toprovide for a separately funded mental health ombudsman office in eachregional support network that is independent of the regional supportnetwork. The ombudsman office shall maximize the use of consumeradvocates.NEW SECTION.Sec. If any provision of this act or itsapplication to any person or circumstance is held invalid, theremainder of the act or the application of the provision to otherpersons or circumstances is not affected.NEW SECTION.Sec. This act shall be so applied and construedas to effectuate its general purpose to make uniform the law withrespect to the subject of this act among those states which enact it.NEW SECTION.Sec. Captions, part headings, and subheadingsused in this act are not part of the law.NEW SECTION.Sec. If specific funding for the purposes ofsections 203, 217, 220, 301, 303, 305, 505, and 601 of this act,referencing the section by section number and by bill or chapternumber, is not provided by June 30, 2005, each section not referencedis null and void.NEW SECTION.Sec. (1) The code reviser shall alphabetize andrenumber the definitions, and correct any internal references affectedby this act. (2) The code reviser shall replace all references to "countydesignated mental health professional" with "designated mental healthprofessional" in the Revised Code of Washington.NEW SECTION.Sec. (1) The secretary of the department ofsocial and health services may adopt rules as necessary to implementthe provisions of this act. (2) The secretary of corrections may adopt rules as necessary toimplement the provisions of this act. 97 NEW SECTION.Sec. (1) Except for section 503 of this act,this act is necessary for the immediate preservation of the publicpeace, health, or safety, or support of the state government and itsexisting public institutions, and takes effect July 1, 2005. (2) Section 503 of this act takes effect July 1, 2006.E2SSB 5763H AMDBy Representative CodyADOPTED AS AMENDED 04/14/2005 On page 1, line 2 of the title, after 2005; strike the remainderof the title and insert 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, and71.05.690; reenacting and amending RCW 71.05.390 and 71.24.035; addingnew sections to chapter 71.05 RCW; adding new sections to chapter70.96A RCW; adding a new section to chapter 13.34 RCW; adding newsections to chapter 2.28 RCW; adding a new section to chapter 26.12RCW; adding new sections to chapter 71.24 RCW; adding a new section tochapter 71.02 RCW; adding a new section to chapter 71A.12 RCW; addinga new section to chapter 43.20A RCW; adding new chapters to Title 70RCW; 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, and71.05.670; prescribing penalties; providing effective dates; providingexpiration dates; and declaring an emergency. --- END --- 98