ESSB 6665

SENATE BILL REPORT
ESSB 6665

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Amended House, March 12, 2008

Title: An act relating to the intensive case management and integrated response pilot programs.

Brief Description: Regarding the intensive case management and integrated crisis response pilot programs.

Sponsors: Senate Committee on Human Services & Corrections (originally sponsored by Senators Hargrove, Stevens and Marr).

Majority Report: That Substitute Senate Bill No. 6665 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.Signed by Senators Hargrove, Chair; Regala, Vice Chair; Stevens, Ranking Minority Member; Brandland, Carrell, Marr and McAuliffe.

Majority Report: That Substitute Senate Bill No. 6665 as recommended by Committee on Human Services & Corrections be substituted therefor, and the substitute bill do pass.Signed by Senators Prentice, Chair; Fraser, Vice Chair, Capital Budget Chair; Pridemore, Vice Chair, Operating Budget; Zarelli, Ranking Minority Member; Brandland, Carrell, Hatfield, Hewitt, Hobbs, Honeyford, Keiser, Kohl-Welles, Oemig, Parlette, Rasmussen, Regala, Roach, Rockefeller, Schoesler and Tom.

Background: In 2005 the Legislature passed E2SSB 5763 (omnibus treatment of mental and substance abuse disorders act). In addition to other items, this legislation established two different types of pilot programs designed to serve people with mental illness and/or chemical dependency. The pilot programs expire in statute as of June 30, 2008. These programs were funded by the Legislature through the 2005-07 biennium and for the first fiscal year of the 2007-09 biennium, in accordance with their expiration date.

Integrated Crisis Response (ICR) Pilot Program. The ICR pilot program utilizes a different type of civil commitment option limited to the pilot program areas. This civil commitment can be used to order the involuntary treatment of an individual who is gravely disabled or a danger to self or others due to chemical dependency and/or both chemical dependency and mental illness. Funding for the ICR programs covers: (1) secure detoxification centers that offer a chemical dependency commitment alternative; and (2) designated crisis responders who are trained in both mental illness and chemical dependency disorders to act as first crisis responders.

The Department of Social and Health Services (DSHS) contracted for the ICR program in Pierce County and in Sedro Woolley (North Sound Regional Support Network). A final evaluation of the ICR programs by the Washington State Institute for Public Policy (WSIPP) is due by September 30, 2008.

Intensive Case Management (ICM) Pilot Program. In addition to the ICR pilot programs, E2SSB 5763 required DSHS to contract with two counties to provide intensive case management for chemically dependent persons with a history of high utilization of crisis services, such as hospital emergency rooms. Case managers for the ICM programs do outreach and connect individuals to treatment, housing, and support services. The two contracted sites are King County and Thurston/ Mason Counties.

Summary of Engrossed Substitute Bill: The ICR pilot program is extended by one year until June 30, 2009. DSHS may contract for additional pilot sites, subject to funding provided for that specific purpose. The dates for the WSIPP evaluation are changed to require a preliminary evaluation by June 30, 2008, and a final report by June 30, 2010. The ICR pilot program is updated to allow for a court-ordered 60-day less restrictive treatment option after a patient's release from secure detoxification. Patients violating their less restrictive option may be returned to secure detoxification. Chapter 70.96B RCW, providing for the operation of the ICR program, is updated to include a definition for the word "imminent," rules for granting of continuances, and rules for provision of involuntary psychiatric medication parallel to provisions that apply to mental health commitments under Chapter 71.05 RCW.

The ICM pilot program is also extended by one year, until June 30, 2009. DSHS may contract for additional pilot sites, subject to funding provided for that specific purpose.

Fiscal Note: Substitute bill requested on February 10, 2008. Available on HB 2784 (companion to original bill).

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony on Original Bill (Human Services & Corrections): CON: Pierce County has succeeded in achieving results intended by the pilot, and has developed strong relationships with law enforcement and other coordinated systems. Coordination and integration survives in Pierce County without the former RSN. Startup time for a secure detox unit takes 7-8 months and considerable investment. Hospitals rely heavily on secure detox as a resource. Pierce County has very high levels of drug use. Proximity to Western State Hospital creates special impact. Don't lose Pierce County's leadership in chemical dependency treatment. This is a time of significant instability in Pierce County, and closing secure detox would add more instability by reducing patient care capacity.

OTHER: We support adding secure detox service to Spokane, but not ending a program that is working well in Pierce County.

Persons Testifying (Human Services & Corrections): CON: David Stewart, David Dula, Penni Newman, Pierce County Human Services, John Pearson, Multicare Health System, Dolores Behr, Pierce County Chemical Dependency Division, Richard Towell, Jill Rogers, Greater Lakes Mental Health Care.

OTHER: Gregory Robinson, Washington Community Mental Health Council.

Staff Summary of Public Testimony on Recommended Substitute (Ways & Means): PRO: We support the substitute bill, as the changes will allow Pierce County to continue this pilot program.

Persons Testifying (Ways & Means): PRO: Dave Stewart, Pierce County Human Services.

House Amendment(s): Expiration dates are removed from chapter 70.96B RCW. Contracts for ICM and ICR pilots are made subject to budget appropriations. The section permitting administration of involuntary psychiatric medication at a secure detoxification center is removed. A null and void clause is added.