BILL REQ. #:  H-1775.1 

Read first time 02/11/09.   Referred to Committee on Early Learning & Children's Services.

     AN ACT Relating to improving the delivery of residential and other services to adolescents who are at risk, in need of services, or in crisis; amending RCW 74.13.032, 74.13.033, and 74.13.034; reenacting and amending RCW 13.32A.130; adding a new section to chapter 74.13 RCW; creating a new section; and repealing RCW 74.13.0321.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds that a number of different programs have been created over the past two decades to provide temporary residential care and stabilization services to youth who are at risk, in need of services, or in crisis. Although these various programs share a common goal of keeping youth safe in temporary care while their needs are assessed, the restrictive program criteria relating to funding, length of stay, and youth characteristics in these programs often function as barriers to efficiently and effectively serving youth in their communities. The legislature finds further that the practice of linking individual residential care beds to restrictive and inflexible criteria results in youth being underserved or not served at all even when a residential care bed or services are readily available in the community. The legislature intends to promote a more efficient use of community-based residential care beds and other stabilization services in order to increase the ability of providers to proactively serve youth who are at risk, in need of services, or in crisis, by keeping them safely off the streets while their needs are adequately assessed and an appropriate service plan is developed.

NEW SECTION.  Sec. 2   A new section is added to chapter 74.13 RCW to read as follows:
     (1) The department shall establish, through contracts with community providers, crisis stabilization and assessment centers in each region to deliver residential stabilization services to adolescents who are at risk, in need of services, or in crisis. The crisis stabilization and assessment centers may deliver services pursuant to a license issued by the secretary under RCW 74.15.220, 74.15.230, or 74.13.032. Contracts shall utilize a block-grant model with a single provider or a consortium of providers who shall coordinate the delivery of services under the contract. The contracts shall specify a core set of outcome-based performance measures related to adolescent well-being, including, but not limited to, stabilized functioning sufficient to support return home or to former placement; completion of appropriate assessments; and development of service plans to be implemented after residence at a crisis stabilization and assessment center.
     The outcomes by which contract performance must be measured shall be identified through collaboration with licensed providers and in consultation with partners for our children and the children's mental health evidence-based practice institute at the University of Washington. The contracts for crisis stabilization and assessment center services shall be flexible enough to allow providers to:
     (a) Maximize the use of available bed space in order to provide youth with safe and temporary residential care;
     (b) Serve individual youth by selecting from an array of research-based interventions and best practices for assessing the youth's safety and health needs and engaging the youth in the development of a stabilization and transition plan; and
     (c) Coordinate service delivery and use of bed space, including colocation of facilities licensed under RCW 74.15.220, 74.15.230, and 74.13.032, in order to service youth according to their needs. The maximum length of stay in a crisis stabilization and assessment center is ninety days, unless the youth is eligible to continue receiving services under RCW 74.15.230.
     (2) Residential and other services under this section may be provided to youth meeting one or more of the following criteria:
     (a) A street youth as defined in RCW 74.15.020, or a youth who, without such services, will continue to participate in increasingly risky behavior;
     (b) A youth who self-refers for services; and
     (c) A youth who is an "at-risk youth" or a "child in need of services" as defined in RCW 13.32A.030.

NEW SECTION.  Sec. 3   RCW 74.13.0321 (Crisis residential centers--Limit on reimbursement or compensation) and 1995 c 312 s 61 are each repealed.

Sec. 4   RCW 74.13.032 and 1998 c 296 s 4 are each amended to read as follows:
     (1) The department shall establish, by contracts with private or public vendors, regional crisis residential centers with semi-secure facilities. These facilities shall be structured group care facilities licensed under rules adopted by the department and shall have, on site, an average of at least four adult staff members and in no event less than three adult staff members to every eight children. A minimum of two on-site staff members is permitted whenever five or fewer children are residing at the center.
     (2) Within available funds appropriated for this purpose, the department shall establish, by contracts with private or public vendors pursuant to sections 1 and 2 of this act, regional crisis residential centers with secure facilities. These facilities shall be facilities licensed under rules adopted by the department. These centers may also include semi-secure facilities and to such extent shall be subject to subsection (1) of this section.
     (3) The department shall, in addition to the facilities established under subsections (1) and (2) of this section, establish additional crisis residential centers pursuant to contract with licensed private group care facilities.
     (4) The staff at the facilities established under this section shall be trained so that they may effectively counsel juveniles admitted to the centers, provide treatment, supervision, and structure to the juveniles that recognize the need for support and the varying circumstances that cause children to leave their families, and carry out the responsibilities stated in RCW 13.32A.090. The responsibilities stated in RCW 13.32A.090 may, in any of the centers, be carried out by the department.
     (5) The secure facilities located within crisis residential centers shall be operated to conform with the definition in RCW 13.32A.030. The facilities shall have an average of no less than one adult staff member to every ten children. The staffing ratio shall continue to ensure the safety of the children.
     (6) If a secure crisis residential center is located in or adjacent to a secure juvenile detention facility, the center shall be operated in a manner that prevents in-person contact between the residents of the center and the persons held in such facility.

Sec. 5   RCW 74.13.033 and 2000 c 162 s 16 are each amended to read as follows:
     (1) If a resident of a center becomes by his or her behavior disruptive to the facility's program, such resident may be immediately removed to a separate area within the facility and counseled on an individual basis until such time as the child regains his or her composure. The department may set rules and regulations establishing additional procedures for dealing with severely disruptive children on the premises.
     (2) When the juvenile resides in this facility, all services deemed necessary to the juvenile's reentry to normal family life shall be made available to the juvenile as required by chapter 13.32A RCW. In assessing the child and providing these services, the facility staff shall:
     (a) Interview the juvenile as soon as possible;
     (b) Contact the juvenile's parents and arrange for a counseling interview with the juvenile and his or her parents as soon as possible;
     (c) Conduct counseling interviews with the juvenile and his or her parents, to the end that resolution of the child/parent conflict is attained and the child is returned home as soon as possible;
     (d) Provide additional crisis counseling as needed, to the end that placement of the child in the crisis residential center will be required for the shortest time possible, but not to exceed five consecutive days; and
     (e) Convene, when appropriate, a multidisciplinary team.
     (3) Based on the assessments done under subsection (2) of this section the facility staff may refer any child who, as the result of a mental or emotional disorder, or intoxication by alcohol or other drugs, is suicidal, seriously assaultive, or seriously destructive toward others, or otherwise similarly evidences an immediate need for emergency medical evaluation and possible care, for evaluation pursuant to chapter 71.34 RCW, to a mental health professional pursuant to chapter 71.05 RCW, or to a chemical dependency specialist pursuant to chapter 70.96A RCW whenever such action is deemed appropriate and consistent with law.
     (4) A juvenile taking unauthorized leave from a facility shall be apprehended and returned to it by law enforcement officers or other persons designated as having this authority as provided in RCW 13.32A.050. ((If returned to the facility after having taken unauthorized leave for a period of more than twenty-four hours a juvenile shall be supervised by such a facility for a period, pursuant to this chapter, which, unless where otherwise provided, may not exceed five consecutive days on the premises. Costs of housing juveniles admitted to crisis residential centers shall be assumed by the department for a period not to exceed five consecutive days.))

Sec. 6   RCW 74.13.034 and 2000 c 162 s 17 are each amended to read as follows:
     (1) A child taken into custody and taken to a crisis residential center established pursuant to RCW 74.13.032 may, if the center is unable to provide appropriate treatment, supervision, and structure to the child, be taken at department expense to another crisis residential center, the nearest regional secure crisis residential center, or a secure facility with which it is collocated under RCW 74.13.032. ((Placement in both locations shall not exceed five consecutive days from the point of intake as provided in RCW 13.32A.130.))
     (2) A child taken into custody and taken to a crisis residential center established by this chapter may be placed physically by the department or the department's designee and, at departmental expense and approval, in a secure juvenile detention facility operated by the county in which the center is located for a maximum of forty-eight hours, including Saturdays, Sundays, and holidays, if the child has taken unauthorized leave from the center and the person in charge of the center determines that the center cannot provide supervision and structure adequate to ensure that the child will not again take unauthorized leave. Juveniles placed in such a facility pursuant to this section may not, to the extent possible, come in contact with alleged or convicted juvenile or adult offenders.
     (3) Any child placed in secure detention pursuant to this section shall, during the period of confinement, be provided with appropriate treatment by the department or the department's designee, which shall include the services defined in RCW 74.13.033(2). If the child placed in secure detention is not returned home or if an alternative living arrangement agreeable to the parent and the child is not made within twenty-four hours after the child's admission, the child shall be taken at the department's expense to a crisis residential center. ((Placement in the crisis residential center or centers plus placement in juvenile detention shall not exceed five consecutive days from the point of intake as provided in RCW 13.32A.130.))
     (4) Juvenile detention facilities used pursuant to this section shall first be certified by the department to ensure that juveniles placed in the facility pursuant to this section are provided with living conditions suitable to the well-being of the child. Where space is available, juvenile courts, when certified by the department to do so, shall provide secure placement for juveniles pursuant to this section, at department expense.

Sec. 7   RCW 13.32A.130 and 2000 c 162 s 13 and 2000 c 123 s 15 are each reenacted and amended to read as follows:
     (1) A child admitted to a secure facility shall remain in the facility for at least twenty-four hours after admission ((but for not more than five consecutive days. If the child admitted under this section is transferred between secure and semi-secure facilities, the aggregate length of time spent in all such centers or facilities may not exceed five consecutive days per admission)).
     (2)(a)(i) The facility administrator shall determine within twenty-four hours after a child's admission to a secure facility whether the child is likely to remain in a semi-secure facility and may transfer the child to a semi-secure facility or release the child to the department. The determination shall be based on: (A) The need for continued assessment, protection, and treatment of the child in a secure facility; and (B) the likelihood the child would remain at a semi-secure facility until his or her parents can take the child home or a petition can be filed under this title.
     (ii) In making the determination the administrator shall consider the following information if known: (A) The child's age and maturity; (B) the child's condition upon arrival at the center; (C) the circumstances that led to the child's being taken to the center; (D) whether the child's behavior endangers the health, safety, or welfare of the child or any other person; (E) the child's history of running away; and (F) the child's willingness to cooperate in the assessment.
     (b) If the administrator of a secure facility determines the child is unlikely to remain in a semi-secure facility, the administrator shall keep the child in the secure facility pursuant to this chapter and in order to provide for space for the child may transfer another child who has been in the facility for at least seventy-two hours to a semi-secure facility. The administrator shall only make a transfer of a child after determining that the child who may be transferred is likely to remain at the semi-secure facility.
     (c) A crisis residential center administrator is authorized to transfer a child to a crisis residential center in the area where the child's parents reside or where the child's lawfully prescribed residence is located.
     (d) An administrator may transfer a child from a semi-secure facility to a secure facility whenever he or she reasonably believes that the child is likely to leave the semi-secure facility and not return and after full consideration of all factors in (a)(i) and (ii) of this subsection.
     (3) If no parent is available or willing to remove the child during the first seventy-two hours following admission, the department shall consider the filing of a petition under RCW 13.32A.140.
     (4) Notwithstanding the provisions of subsection (1) of this section, the parents may remove the child at any time during the five- day period unless the staff of the crisis residential center has reasonable cause to believe that the child is absent from the home because he or she is abused or neglected or if allegations of abuse or neglect have been made against the parents. The department or any agency legally charged with the supervision of a child may remove a child from a crisis residential center at any time after the first twenty-four-hour period after admission has elapsed and only after full consideration by all parties of the factors in subsection (2)(a) of this section.
     (5) Crisis residential center staff shall make reasonable efforts to protect the child and achieve a reconciliation of the family. If a reconciliation and voluntary return of the child has not been achieved within forty-eight hours from the time of admission, and if the administrator of the center does not consider it likely that reconciliation will be achieved within ((the five-day period, then)) a reasonable time period or without further intervention, the administrator shall inform the parent and child of: (a) The availability of counseling services; (b) the right to file a child in need of services petition for an out-of-home placement, the right of a parent to file an at-risk youth petition, and the right of the parent and child to obtain assistance in filing the petition; (c) the right to request the facility administrator or his or her designee to form a multidisciplinary team; (d) the right to request a review of any out-of-home placement; (e) the right to request a mental health or chemical dependency evaluation by a county-designated professional or a private treatment facility; and (f) the right to request treatment in a program to address the child's at-risk behavior under RCW 13.32A.197.
     (6) At no time shall information regarding a parent's or child's rights be withheld. The department shall develop and distribute to all law enforcement agencies and to each crisis residential center administrator a written statement delineating the services and rights. The administrator of the facility or his or her designee shall provide every resident and parent with a copy of the statement.
     (7) A crisis residential center and any person employed at the center acting in good faith in carrying out the provisions of this section are immune from criminal or civil liability for such actions.