Background:

Post Institutional Medical Assistance (PIMA) System: A person is not eligible to receive Medical Assistance, including Medicaid and Supplemental Security Income, while confined in a correctional facility. The Department of Social and Health Services (DSHS) is required to adopt policies and rules to ensure that Medical Assistance coverage be fully reinstated on the date of release from confinement of a person with a mental disorder who was enrolled in Medical Assistance immediately prior to confinement. To meet this goal, the DSHS must establish procedures for coordinating the DSHS field offices, institutions for mental disease, and correctional institutions. The PIMA system is an Internet-based tool that facilitates ending and reinstating Medical Assistance benefits when a person enters or leaves an institution. The tool allows correctional facilities and other institutions to indicate when a person is admitted into or released from a facility. In addition, it indicates whether the person has received Medical Assistance in the past.

Evaluation for Commitment for a Mental Disorder: When a police officer has reasonable cause to believe a person with a mental disorder has committed a non-felony, non-serious offense, the officer may: take the person to a crisis stabilization unit, where the person may be held up to 12 hours; refer the person to a mental health professional for evaluation for involuntary commitment; or release the person upon agreement to participate in treatment.

A designated mental health professional may file a petition for 72-hour detention of a person who, because of a mental disorder, presents a likelihood of serious harm or is gravely disabled. If the person is not approved for admission but has been arrested, the evaluation and treatment facility may detain the person for up to eight hours at the request of a peace officer so the officer can take the person into custody. A designated mental health professional may also have a person taken into custody for 72-hour evaluation and treatment if the person presents an imminent likelihood of serious harm or is in imminent danger because of being gravely disabled. Under these circumstances, a peace officer may also deliver the person to an evaluation and treatment facility, a crisis stabilization unit, or an emergency room, where the person may be held for up to 12 hours.

Evaluation for Commitment for Chemical Dependency: A designated chemical dependency specialist may file a petition for involuntary commitment of a person who is chemically dependent and presents a likelihood of serious harm or is gravely disabled by addiction, or who is chemically dependent and has threatened, attempted, or inflicted physical harm and is likely to inflict physical harm unless committed. In addition, a peace officer may take a person into protective custody and deliver him or her to a treatment program if the person appears to be incapacitated or gravely disabled by alcohol or drugs and has threatened, attempted, or inflicted physical harm.

Integrated Crisis Response and Involuntary Treatment Pilot Program: A designated crisis responder may have a person taken into emergency custody for 72-hour evaluation if the person, because of a mental disorder or chemical dependency or a combination (co-occurring disorder), presents an imminent likelihood of serious harm or is in imminent danger because of being gravely disabled. A peace officer may also deliver such a person to an evaluation and treatment facility, secure detoxification facility, or other certified chemical dependency treatment provider, where the person may be held for up to 12 hours.

Commitment Due to Incompetency: A person is incompetent to stand trial if, as a result of a mental disease or defect, the person lacks the capacity to understand the nature of the proceedings or assist in the defense. If competency cannot be restored, the criminal case must be dismissed without prejudice, and the state may file a petition for civil commitment. If the person escapes from custody, the DSHS must immediately notify the chief of police and sheriff in the city and county where the person resided before arrest. If the person is due to be released from custody, the DSHS must send advance written notice to the chief of police and sheriff in the jurisdiction where the person will reside if the person committed a sex, violent, or felony harassment offense and presents a substantial likelihood of repeating similar acts. If requested, the notice must also be sent to victims, witnesses, and any person specified by the prosecutor.

Commitment Due to Criminal Insanity: If a defendant is found not guilty by reason of insanity, the court must order hospitalization or treatment in a less restrictive alternative if the person is a substantial danger to others or presents a substantial likelihood of committing criminal acts that would jeopardize public safety unless kept under further control. If the person escapes, the DSHS must notify state and local law enforcement in the city or county where the person escaped, as well as other appropriate government agencies and the person's relatives.

Federal Law on Privacy of Health Care Information: Federal law provides that records regarding treatment for substance abuse are confidential if the treatment is conducted, regulated, or directly or indirectly assisted by the federal government. If the patient does not provide written consent, such records may only be disclosed in the following situations: to medical personnel for a bona fide medical emergency; to qualified personnel for scientific research or audits if the patient is not identified; or by court order after a showing of good cause.

In addition, the federal Health Insurance Portability and Accountability Act prohibits disclosure of protected health information without a patient's authorization unless an exception applies, including the following:

to law enforcement if required by law, including a statute that compels the entity to disclose protected health information;
to law enforcement for the purpose of locating a suspect, if limited to specified information, including date and time of treatment;
to law enforcement if necessary to identify or apprehend a person who has escaped from a correctional institution or from custody;
to a correctional institution or law enforcement official with custody over a person if necessary for the provision of health care;
to a health oversight agency for oversight activities authorized by law; and
to another agency that administers a public benefits program if the information relates to eligibility and the disclosure is authorized by statute or regulation.

Summary of Bill:

Post Institutional Medical Assistance (PIMA) System: In the course of using the PIMA system to support expedited Medical Assistance determinations and suspensions, a correctional institution may be provided with the fact, place, and date of an involuntary commitment, discharge, or release without the person's consent, including involuntary commitments for mental disorders, chemical dependency, and co-occurring disorders. This disclosure is mandatory for purposes of the federal Health Insurance Portability and Accountability Act.

Evaluation for Commitment for a Mental Disorder or Chemical Dependency: If a person is not approved for admission or is released from a facility where the person is being evaluated for involuntary treatment, and a peace officer has requested notification and provided contact information, the mental health provider must inform the officer within a reasonable period of time. This notification requirement applies under the following circumstances:

the person is known to have a mental disorder, the person committed a non-felony, non-serious crime, and the officer delivered the person to a crisis stabilization unit;
the person has a mental disorder and has been arrested, but is not approved for admission to an evaluation and treatment facility;
the person has a mental disorder, and the officer delivered the person to a crisis stabilization unit, an evaluation and treatment facility, or an emergency room because the person presented an imminent likelihood of serious harm or was in imminent danger because of being gravely disabled; and
the person is chemically dependent, and the officer delivered the person to an evaluation and treatment facility, secure detoxification facility, or other certified chemical dependency treatment provider.

Release or Escape of Person Committed for Incompetence: If a person committed for incompetence is due to be released from custody, and the person committed a sex, violent, or felony harassment offense and presents a substantial likelihood of repeating similar acts, the DSHS must send written notice 30 days in advance to the chief of police and sheriff that had jurisdiction over the person on the date of the offense, if notice is requested. If such a person escapes, the DSHS must immediately notify the chief of police and sheriff in the jurisdiction where the person escaped.

Escape of Person Committed for Insanity: If a committed criminally insane person escapes from a state facility or disappears while on an authorized absence or conditional release, the DSHS must notify state and local law enforcement in the city and county that had jurisdiction over the person on the date of the offense.