| Passed by the Senate March 12, 2014 YEAS 48 ________________________________________ President of the Senate Passed by the House March 12, 2014 YEAS 75 ________________________________________ Speaker of the House of Representatives | I, Hunter G. Goodman, Secretary of the Senate of the State of Washington, do hereby certify that the attached is SECOND SUBSTITUTE SENATE BILL 6312 as passed by the Senate and the House of Representatives on the dates hereon set forth. ________________________________________ Secretary | |
| Approved ________________________________________ Governor of the State of Washington | Secretary of State State of Washington |
| State of Washington | 63rd Legislature | 2014 Regular Session |
READ FIRST TIME 02/11/14.
AN ACT Relating to state purchasing of mental health and chemical dependency treatment services; amending RCW 71.24.015, 71.24.016, 71.24.025, 71.24.035, 71.24.045, 71.24.045, 71.24.100, 71.24.110, 71.24.340, 71.24.420, 70.96A.010, 70.96A.011, 70.96A.020, 70.96A.030, 70.96A.040, 70.96A.050, 70.96A.060, 70.96A.080, 70.96A.085, 70.96A.100, 70.96A.110, 70.96A.140, 70.96A.190, 70.96A.300, 70.96A.320, 70.96A.800, 71.24.049, 71.24.061, 71.24.155, 71.24.160, 71.24.250, 71.24.300, 71.24.310, 71.24.350, 71.24.370, 71.24.455, 71.24.470, 71.24.480, 71.24.845, 71.24.055, 71.24.065, 71.24.240, 71.24.320, 71.24.330, 71.24.360, 71.24.405, 71.24.430, 74.09.522, 9.41.280, 10.77.010, 10.77.065, 28A.310.202, 43.185.060, 43.185.070, 43.185.110, 43.20A.895, 43.20A.897, 43.20C.020, 43.20C.030, 44.28.800, 48.01.220, 70.02.010, 70.02.230, 70.02.250, 70.320.010, 70.96B.010, 70.96B.020, 70.96B.030, 70.96C.010, 70.97.010, 71.05.025, 71.05.026, 71.05.027, 71.05.110, 71.05.365, 71.05.445, 71.05.730, 71.05.740, 71.34.330, 71.34.415, 71.36.010, 71.36.025, 71.36.040, 72.09.350, 72.09.381, 72.10.060, 72.23.025, 72.78.020, 74.09.515, 74.09.521, 74.34.068, 82.04.4277, 70.48.100, 70.38.111, 70.320.020, and 18.205.040; amending 2013 c 338 s 1 (uncodified); reenacting and amending RCW 10.31.110, 71.05.020, 71.05.300, 72.09.370, and 74.09.555; adding new sections to chapter 43.20A RCW; adding new sections to chapter 71.24 RCW; adding a new section to chapter 70.320 RCW; providing effective dates; providing expiration dates; and declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 2013 c 338 s 1 (uncodified) is amended to read as follows:
(1)(a) Beginning ((May)) April 1, 2014, the legislature shall
convene a task force to examine reform of the adult behavioral health
system, with voting members as provided in this subsection.
(i) The president of the senate shall appoint one member and one
alternate member from each of the two largest caucuses of the senate.
(ii) The speaker of the house of representatives shall appoint one
member and one alternate member from each of the two largest caucuses
in the house of representatives.
(iii) The governor shall appoint three members consisting of the
secretary of the department of social and health services or the
secretary's designee, the director of the health care authority or the
director's designee, and a representative of the governor.
(iv) The Washington state association of counties shall appoint
three members.
(v) The governor shall request participation by a representative of
tribal governments.
(b) The task force shall choose two cochairs from among its
legislative members.
(c) The task force shall adopt a bottom-up approach and welcome
input and participation from all stakeholders interested in the
improvement of the adult behavioral health system. To that end, the
task force must invite participation from, at a minimum, the following:
The department of commerce, the department of corrections, the office
of financial management, behavioral health service recipients and their
families; local government; representatives of regional support
networks; representatives of county coordinators; law enforcement; city
and county jails; tribal representatives; behavioral health service
providers; housing providers; labor representatives; counties with
state hospitals; mental health advocates; chemical dependency
advocates; public defenders with involuntary mental health commitment
or mental health court experience; chemical dependency experts working
with drug courts; medicaid managed care plan and associated delivery
system representatives; long-term care service providers; the
Washington state hospital association; and individuals with expertise
in evidence-based and research-based behavioral health service
practices. Leadership of subcommittees formed by the task force may be
drawn from this body of invited participants.
(2) The task force shall undertake a systemwide review of the adult
behavioral health system and make recommendations for reform
concerning, but not limited to, the following:
(a) The means by which services are purchased and delivered for
adults with mental illness and chemical dependency disorders through
the department of social and health services and the health care
authority, including:
(i) Guidance for the creation of common regional service areas for
purchasing behavioral health services and medical care services by the
department of social and health services and the health care authority,
taking into consideration any proposal submitted by the Washington
state association of counties under section 2 of this act;
(ii) Identification of key issues which must be addressed by the
department of social and health services to accomplish the integration
of chemical dependency purchasing primarily with managed care contracts
by April 1, 2016, under section 5 of this act, including review of the
results of any available actuarial study to establish provider rates;
(iii) Strategies for moving towards full integration of medical and
behavioral health services by January 1, 2020, and identification of
key issues that must be addressed by the health care authority and the
department of social and health services in furtherance of this goal;
(iv) By August 1, 2014, a review of performance measures and
outcomes developed pursuant to RCW 43.20A.895 and chapter 70.320 RCW;
(v) Review criteria developed by the department of social and
health services and the health care authority concerning submission of
detailed plans and requests for early adoption of fully integrated
purchasing and incentives under section 5 of this act;
(vi) Whether a statewide behavioral health ombuds office should be
created;
(vii) Whether the state chemical dependency program should be
mandated to provide twenty-four hour detoxification services,
medication-assisted outpatient treatment, or contracts for case
management and residential treatment services for pregnant and
parenting women;
(viii) Review legal, clinical, and technological obstacles to
sharing relevant health care information related to mental health,
chemical dependency, and physical health across practice settings; and
(ix) Review the extent and causes of variations in commitment rates
in different jurisdictions across the state;
(b) Availability of effective means to promote recovery and prevent
harm associated with mental illness and chemical dependency;
(c) Availability of crisis services, including boarding of mental
health patients outside of regularly certified treatment beds;
(d) Best practices for cross-system collaboration between
behavioral health treatment providers, medical care providers, long-term care service providers, entities providing health home services to
high-risk medicaid clients, law enforcement, and criminal justice
agencies; ((and))
(e) Public safety practices involving persons with mental illness
and chemical dependency with forensic involvement.
(3) Staff support for the task force must be provided by the senate
committee services and the house of representatives office of program
research.
(4) Legislative members of the task force must be reimbursed for
travel expenses in accordance with RCW 44.04.120. Nonlegislative
members, except those representing an employer or organization, are
entitled to be reimbursed for travel expenses in accordance with RCW
43.03.050 and 43.03.060.
(5) The expenses of the task force must be paid jointly by the
senate and house of representatives. Task force expenditures are
subject to approval by the senate facilities and operations committee
and the house of representatives executive rules committee, or their
successor committees.
(6) The task force shall report ((its)) initial findings and
recommendations to the governor and the appropriate committees of the
legislature in a preliminary report by ((January 1, 2015)) December 15,
2014, and a final report by December 15, 2015. Recommendations under
subsection (2)(a)(i) of this section must be submitted to the governor
by September 1, 2014.
(7) This section expires ((June)) July 1, ((2015)) 2016.
NEW SECTION. Sec. 2 A new section is added to chapter 43.20A RCW
to read as follows:
(1) Upon receipt of guidance for the creation of common regional
service areas from the adult behavioral health system task force
established in section 1, chapter 338, Laws of 2013, the department and
the health care authority shall jointly establish regional service
areas as provided in this section.
(2) Counties, through the Washington state association of counties,
must be given the opportunity to propose the composition of regional
service areas. Each service area must:
(a) Include a sufficient number of medicaid lives to support full
financial risk managed care contracting for services included in
contracts with the department or the health care authority;
(b) Include full counties that are contiguous with one another; and
(c) Reflect natural medical and behavioral health service referral
patterns and shared clinical, health care service, behavioral health
service, and behavioral health crisis response resources.
(3) The Washington state association of counties must submit their
recommendations to the department, the health care authority, and the
task force described in section 1 of this act on or before August 1,
2014.
NEW SECTION. Sec. 3 A new section is added to chapter 43.20A RCW
to read as follows:
(1) Any agreement or contract by the department or the health care
authority to provide behavioral health services as defined under RCW
71.24.025 to persons eligible for benefits under medicaid, Title XIX of
the social security act, and to persons not eligible for medicaid must
include the following:
(a) Contractual provisions consistent with the intent expressed in
RCW 71.24.015, 71.36.005, 70.96A.010, and 70.96A.011;
(b) Standards regarding the quality of services to be provided,
including increased use of evidence-based, research-based, and
promising practices, as defined in RCW 71.24.025;
(c) Accountability for the client outcomes established in RCW
43.20A.895, 70.320.020, and 71.36.025 and performance measures linked
to those outcomes;
(d) Standards requiring behavioral health organizations to maintain
a network of appropriate providers that is supported by written
agreements sufficient to provide adequate access to all services
covered under the contract with the department or the health care
authority and to protect essential existing behavioral health system
infrastructure and capacity, including a continuum of chemical
dependency services;
(e) Provisions to require that medically necessary chemical
dependency and mental health treatment services be available to
clients;
(f) Standards requiring the use of behavioral health service
provider reimbursement methods that incentivize improved performance
with respect to the client outcomes established in RCW 43.20A.895 and
71.36.025, integration of behavioral health and primary care services
at the clinical level, and improved care coordination for individuals
with complex care needs;
(g) Standards related to the financial integrity of the responding
organization. The department shall adopt rules establishing the
solvency requirements and other financial integrity standards for
behavioral health organizations. This subsection does not limit the
authority of the department to take action under a contract upon
finding that a behavioral health organization's financial status
jeopardizes the organization's ability to meet its contractual
obligations;
(h) Mechanisms for monitoring performance under the contract and
remedies for failure to substantially comply with the requirements of
the contract including, but not limited to, financial deductions,
termination of the contract, receivership, reprocurement of the
contract, and injunctive remedies;
(i) Provisions to maintain the decision-making independence of
designated mental health professionals or designated chemical
dependency specialists; and
(j) Provisions stating that public funds appropriated by the
legislature may not be used to promote or deter, encourage, or
discourage employees from exercising their rights under Title 29,
chapter 7, subchapter II, United States Code or chapter 41.56 RCW.
(2) The following factors must be given significant weight in any
purchasing process:
(a) Demonstrated commitment and experience in serving low-income
populations;
(b) Demonstrated commitment and experience serving persons who have
mental illness, chemical dependency, or co-occurring disorders;
(c) Demonstrated commitment to and experience with partnerships
with county and municipal criminal justice systems, housing services,
and other critical support services necessary to achieve the outcomes
established in RCW 43.20A.895, 70.320.020, and 71.36.025;
(d) Recognition that meeting enrollees' physical and behavioral
health care needs is a shared responsibility of contracted behavioral
health organizations, managed health care systems, service providers,
the state, and communities;
(e) Consideration of past and current performance and participation
in other state or federal behavioral health programs as a contractor;
and
(f) The ability to meet requirements established by the department.
(3) For purposes of purchasing behavioral health services and
medical care services for persons eligible for benefits under medicaid,
Title XIX of the social security act and for persons not eligible for
medicaid, the department and the health care authority must use common
regional service areas. The regional service areas must be established
by the department and the health care authority as provided in section
2 of this act.
(4) Consideration must be given to using multiple-biennia
contracting periods.
(5) Each behavioral health organization operating pursuant to a
contract issued under this section shall enroll clients within its
regional service area who meet the department's eligibility criteria
for mental health and chemical dependency services.
NEW SECTION. Sec. 4 A new section is added to chapter 43.20A RCW
to read as follows:
The secretary shall require that behavioral health organizations
offer contracts to managed health care systems under chapter 74.09 RCW
or primary care practice settings to promote access to the services of
chemical dependency professionals under chapter 18.205 RCW and mental
health professionals, as defined by the department in rule, for the
purposes of integrating such services into primary care settings for
individuals with behavioral health and medical comorbidities.
NEW SECTION. Sec. 5 A new section is added to chapter 71.24 RCW
to read as follows:
(1) The secretary shall purchase mental health and chemical
dependency treatment services primarily through managed care
contracting, but may continue to purchase behavioral health services
directly from tribal clinics and other tribal providers.
(2)(a) The secretary shall request a detailed plan from the
entities identified in (b) of this subsection that demonstrates
compliance with the contractual elements of section 3 of this act and
federal regulations related to medicaid managed care contracting,
including, but not limited to: Having a sufficient network of
providers to provide adequate access to mental health and chemical
dependency services for residents of the regional service area that
meet eligibility criteria for services, ability to maintain and manage
adequate reserves, and maintenance of quality assurance processes. Any
responding entity that submits a detailed plan that demonstrates that
it can meet the requirements of this section must be awarded the
contract to serve as the behavioral health organization.
(b)(i) For purposes of responding to the request for a detailed
plan under (a) of this subsection, the entities from which a plan will
be requested are:
(A) A county in a single county regional service area that
currently serves as the regional support network for that area;
(B) In the event that a county has made a decision prior to January
1, 2014, not to contract as a regional support network, any private
entity that serves as the regional support network for that area;
(C) All counties within a regional service area that includes more
than one county, which shall form a responding entity through the
adoption of an interlocal agreement. The interlocal agreement must
specify the terms by which the responding entity shall serve as the
behavioral health organization within the regional service area.
(ii) In the event that a regional service area is comprised of
multiple counties including one that has made a decision prior to
January 1, 2014, not to contract as a regional support network the
counties shall adopt an interlocal agreement and may respond to the
request for a detailed plan under (a) of this subsection and the
private entity may also respond to the request for a detailed plan. If
both responding entities meet the requirements of this section, the
responding entities shall follow the department's procurement process
established in subsection (3) of this section.
(3) If an entity that has received a request under this section to
submit a detailed plan does not respond to the request, a responding
entity under subsection (1) of this section is unable to substantially
meet the requirements of the request for a detailed plan, or more than
one responding entity substantially meets the requirements for the
request for a detailed plan, the department shall use a procurement
process in which other entities recognized by the secretary may bid to
serve as the behavioral health organization in that regional service
area.
(4) Contracts for behavioral health organizations must begin on
April 1, 2016.
(5) Upon request of all of the county authorities in a regional
service area, the department and the health care authority may jointly
purchase behavioral health services through an integrated medical and
behavioral health services contract with a behavioral health
organization or a managed health care system as defined in RCW
74.09.522, pursuant to standards to be developed jointly by the
secretary and the health care authority. Any contract for such a
purchase must comply with all federal medicaid and state law
requirements related to managed health care contracting.
(6) As an incentive to county authorities to become early adopters
of fully integrated purchasing of medical and behavioral health
services, the standards adopted by the secretary and the health care
authority under subsection (5) of this section shall provide for an
incentive payment to counties which elect to move to full integration
by January 1, 2016. Subject to federal approval, the incentive payment
shall be targeted at ten percent of savings realized by the state
within the regional service area in which the fully integrated
purchasing takes place. Savings shall be calculated in alignment with
the outcome and performance measures established in RCW 43.20A.895,
70.320.020, and 71.36.025, and incentive payments for early adopter
counties shall be made available for up to a six-year period, or until
full integration of medical and behavioral health services is
accomplished statewide, whichever comes sooner, according to rules to
be developed by the secretary and health care authority.
Sec. 6 RCW 71.24.015 and 2005 c 503 s 1 are each amended to read
as follows:
It is the intent of the legislature to establish a community mental
health program which shall help people experiencing mental illness to
retain a respected and productive position in the community. This will
be accomplished through programs that focus on resilience and recovery,
and practices that are evidence-based, research-based, consensus-based,
or, where these do not exist, promising or emerging best practices,
which provide for:
(1) Access to mental health services for adults ((of the state who
are acutely mentally ill, chronically mentally ill, or seriously
disturbed)) with mental illness and children ((of the state who are
acutely mentally ill, severely emotionally disturbed, or seriously
disturbed,)) with mental illness or emotional disturbances who meet
access to care standards which services recognize the special needs of
underserved populations, including minorities, children, the elderly,
((disabled)) individuals with disabilities, and low-income persons.
Access to mental health services shall not be limited by a person's
history of confinement in a state, federal, or local correctional
facility. It is also the purpose of this chapter to promote the early
identification of ((mentally ill)) children with mental illness and to
ensure that they receive the mental health care and treatment which is
appropriate to their developmental level. This care should improve
home, school, and community functioning, maintain children in a safe
and nurturing home environment, and should enable treatment decisions
to be made in response to clinical needs in accordance with sound
professional judgment while also recognizing parents' rights to
participate in treatment decisions for their children;
(2) The involvement of persons with mental illness, their family
members, and advocates in designing and implementing mental health
services that reduce unnecessary hospitalization and incarceration and
promote the recovery and employment of persons with mental illness. To
improve the quality of services available and promote the
rehabilitation, recovery, and reintegration of persons with mental
illness, consumer and advocate participation in mental health services
is an integral part of the community mental health system and shall be
supported;
(3) Accountability of efficient and effective services through
state-of-the-art outcome and performance measures and statewide
standards for monitoring client and system outcomes, performance, and
reporting of client and system outcome information. These processes
shall be designed so as to maximize the use of available resources for
direct care of people with a mental illness and to assure uniform data
collection across the state;
(4) Minimum service delivery standards;
(5) Priorities for the use of available resources for the care of
((the mentally ill)) individuals with mental illness consistent with
the priorities defined in the statute;
(6) Coordination of services within the department, including those
divisions within the department that provide services to children,
between the department and the office of the superintendent of public
instruction, and among state mental hospitals, county authorities,
((regional support networks)) behavioral health organizations,
community mental health services, and other support services, which
shall to the maximum extent feasible also include the families of ((the
mentally ill)) individuals with mental illness, and other service
providers; and
(7) Coordination of services aimed at reducing duplication in
service delivery and promoting complementary services among all
entities that provide mental health services to adults and children.
It is the policy of the state to encourage the provision of a full
range of treatment and rehabilitation services in the state for mental
disorders including services operated by consumers and advocates. The
legislature intends to encourage the development of regional mental
health services with adequate local flexibility to assure eligible
people in need of care access to the least-restrictive treatment
alternative appropriate to their needs, and the availability of
treatment components to assure continuity of care. To this end,
counties ((are encouraged to)) must enter into joint operating
agreements with other counties to form regional systems of care that
are consistent with the regional service areas established under
section 2 of this act. Regional systems of care, whether operated by
a county, group of counties, or another entity shall integrate
planning, administration, and service delivery duties under chapters
71.05 and 71.24 RCW to consolidate administration, reduce
administrative layering, and reduce administrative costs. The
legislature hereby finds and declares that sound fiscal management
requires vigilance to ensure that funds appropriated by the legislature
for the provision of needed community mental health programs and
services are ultimately expended solely for the purpose for which they
were appropriated, and not for any other purpose.
It is further the intent of the legislature to integrate the
provision of services to provide continuity of care through all phases
of treatment. To this end, the legislature intends to promote active
engagement with ((mentally ill)) persons with mental illness and
collaboration between families and service providers.
Sec. 7 RCW 71.24.016 and 2006 c 333 s 102 are each amended to
read as follows:
(1) The legislature intends that eastern and western state
hospitals shall operate as clinical centers for handling the most
complicated long-term care needs of patients with a primary diagnosis
of mental disorder. It is further the intent of the legislature that
the community mental health service delivery system focus on
maintaining ((mentally ill)) individuals with mental illness in the
community. The program shall be evaluated and managed through a
limited number of outcome and performance measures ((designed to hold
each regional support network accountable for program success)), as
provided in RCW 43.20A.895, 70.320.020, and 71.36.025.
(2) The legislature intends to address the needs of people with
mental disorders with a targeted, coordinated, and comprehensive set of
evidence-based practices that are effective in serving individuals in
their community and will reduce the need for placements in state mental
hospitals. The legislature further intends to explicitly hold
((regional support networks)) behavioral health organizations
accountable for serving people with mental disorders within the
boundaries of their ((geographic boundaries)) regional service area and
for not exceeding their allocation of state hospital beds. ((Within
funds appropriated by the legislature for this purpose, regional
support networks shall develop the means to serve the needs of people
with mental disorders within their geographic boundaries. Elements of
the program may include:))
(a) Crisis triage;
(b) Evaluation and treatment and community hospital beds;
(c) Residential beds;
(d) Programs for community treatment teams; and
(e) Outpatient services.
(3) The regional support network shall have the flexibility, within
the funds appropriated by the legislature for this purpose, to design
the mix of services that will be most effective within their service
area of meeting the needs of people with mental disorders and avoiding
placement of such individuals at the state mental hospital. Regional
support networks are encouraged to maximize the use of evidence-based
practices and alternative resources with the goal of substantially
reducing and potentially eliminating the use of institutions for mental
diseases.
NEW SECTION. Sec. 8 A new section is added to chapter 71.24 RCW
to read as follows:
(1) By December 1, 2018, the department and the health care
authority shall report to the governor and the legislature regarding
the preparedness of each regional service area to provide mental health
services, chemical dependency services, and medical care services to
medicaid clients under a fully integrated managed care health system.
(2) By January 1, 2020, the community behavioral health program
must be fully integrated in a managed care health system that provides
mental health services, chemical dependency services, and medical care
services to medicaid clients.
NEW SECTION. Sec. 9 A new section is added to chapter 71.24 RCW
to read as follows:
(1) Within funds appropriated by the legislature for this purpose,
behavioral health organizations shall develop the means to serve the
needs of people with mental disorders residing within the boundaries of
their regional service area. Elements of the program may include:
(a) Crisis diversion services;
(b) Evaluation and treatment and community hospital beds;
(c) Residential treatment;
(d) Programs for intensive community treatment;
(e) Outpatient services;
(f) Peer support services;
(g) Community support services;
(h) Resource management services; and
(i) Supported housing and supported employment services.
(2) The behavioral health organization shall have the flexibility,
within the funds appropriated by the legislature for this purpose and
the terms of their contract, to design the mix of services that will be
most effective within their service area of meeting the needs of people
with mental disorders and avoiding placement of such individuals at the
state mental hospital. Behavioral health organizations are encouraged
to maximize the use of evidence-based practices and alternative
resources with the goal of substantially reducing and potentially
eliminating the use of institutions for mental diseases.
Sec. 10 RCW 71.24.025 and 2013 c 338 s 5 are each amended to read
as follows:
Unless the context clearly requires otherwise, the definitions in
this section apply throughout this chapter.
(1) "Acutely mentally ill" means a condition which is limited to a
short-term severe crisis episode of:
(a) A mental disorder as defined in RCW 71.05.020 or, in the case
of a child, as defined in RCW 71.34.020;
(b) Being gravely disabled as defined in RCW 71.05.020 or, in the
case of a child, a gravely disabled minor as defined in RCW 71.34.020;
or
(c) Presenting a likelihood of serious harm as defined in RCW
71.05.020 or, in the case of a child, as defined in RCW 71.34.020.
(2) "Available resources" means funds appropriated for the purpose
of providing community mental health programs, federal funds, except
those provided according to Title XIX of the Social Security Act, and
state funds appropriated under this chapter or chapter 71.05 RCW by the
legislature during any biennium for the purpose of providing
residential services, resource management services, community support
services, and other mental health services. This does not include
funds appropriated for the purpose of operating and administering the
state psychiatric hospitals.
(3) "Child" means a person under the age of eighteen years.
(4) "Chronically mentally ill adult" or "adult who is chronically
mentally ill" means an adult who has a mental disorder and meets at
least one of the following criteria:
(a) Has undergone two or more episodes of hospital care for a
mental disorder within the preceding two years; or
(b) Has experienced a continuous psychiatric hospitalization or
residential treatment exceeding six months' duration within the
preceding year; or
(c) Has been unable to engage in any substantial gainful activity
by reason of any mental disorder which has lasted for a continuous
period of not less than twelve months. "Substantial gainful activity"
shall be defined by the department by rule consistent with Public Law
92-603, as amended.
(5) "Clubhouse" means a community-based program that provides
rehabilitation services and is certified by the department of social
and health services.
(6) "Community mental health program" means all mental health
services, activities, or programs using available resources.
(7) "Community mental health service delivery system" means public,
((or)) private, or tribal agencies that provide services specifically
to persons with mental disorders as defined under RCW 71.05.020 and
receive funding from public sources.
(8) "Community support services" means services authorized,
planned, and coordinated through resource management services
including, at a minimum, assessment, diagnosis, emergency crisis
intervention available twenty-four hours, seven days a week,
prescreening determinations for persons who are mentally ill being
considered for placement in nursing homes as required by federal law,
screening for patients being considered for admission to residential
services, diagnosis and treatment for children who are acutely mentally
ill or severely emotionally disturbed discovered under screening
through the federal Title XIX early and periodic screening, diagnosis,
and treatment program, investigation, legal, and other nonresidential
services under chapter 71.05 RCW, case management services, psychiatric
treatment including medication supervision, counseling, psychotherapy,
assuring transfer of relevant patient information between service
providers, recovery services, and other services determined by
((regional support networks)) behavioral health organizations.
(9) "Consensus-based" means a program or practice that has general
support among treatment providers and experts, based on experience or
professional literature, and may have anecdotal or case study support,
or that is agreed but not possible to perform studies with random
assignment and controlled groups.
(10) "County authority" means the board of county commissioners,
county council, or county executive having authority to establish a
community mental health program, or two or more of the county
authorities specified in this subsection which have entered into an
agreement to provide a community mental health program.
(11) "Department" means the department of social and health
services.
(12) "Designated mental health professional" means a mental health
professional designated by the county or other authority authorized in
rule to perform the duties specified in this chapter.
(13) "Emerging best practice" or "promising practice" means a
program or practice that, based on statistical analyses or a well
established theory of change, shows potential for meeting the evidence-based or research-based criteria, which may include the use of a
program that is evidence-based for outcomes other than those listed in
subsection (14) of this section.
(14) "Evidence-based" means a program or practice that has been
tested in heterogeneous or intended populations with multiple
randomized, or statistically controlled evaluations, or both; or one
large multiple site randomized, or statistically controlled evaluation,
or both, where the weight of the evidence from a systemic review
demonstrates sustained improvements in at least one outcome.
"Evidence-based" also means a program or practice that can be
implemented with a set of procedures to allow successful replication in
Washington and, when possible, is determined to be cost-beneficial.
(15) "Licensed service provider" means an entity licensed according
to this chapter or chapter 71.05 or 70.96A RCW or an entity deemed to
meet state minimum standards as a result of accreditation by a
recognized behavioral health accrediting body recognized and having a
current agreement with the department, or tribal attestation that meets
state minimum standards, or persons licensed under chapter 18.57,
18.71, 18.83, or 18.79 RCW, as it applies to registered nurses and
advanced registered nurse practitioners.
(16) "Long-term inpatient care" means inpatient services for
persons committed for, or voluntarily receiving intensive treatment
for, periods of ninety days or greater under chapter 71.05 RCW. "Long-term inpatient care" as used in this chapter does not include: (a)
Services for individuals committed under chapter 71.05 RCW who are
receiving services pursuant to a conditional release or a court-ordered
less restrictive alternative to detention; or (b) services for
individuals voluntarily receiving less restrictive alternative
treatment on the grounds of the state hospital.
(17) "Mental health services" means all services provided by
((regional support networks)) behavioral health organizations and other
services provided by the state for persons who are mentally ill.
(18) "Mentally ill persons," "persons who are mentally ill," and
"the mentally ill" mean persons and conditions defined in subsections
(1), (4), (27), and (28) of this section.
(19) "Recovery" means the process in which people are able to live,
work, learn, and participate fully in their communities.
(20) "((Regional support network)) Behavioral health organization"
means ((a)) any county authority or group of county authorities or
other entity recognized by the secretary in contract in a defined
region.
(21) "Registration records" include all the records of the
department, ((regional support networks)) behavioral health
organizations, treatment facilities, and other persons providing
services to the department, county departments, or facilities which
identify persons who are receiving or who at any time have received
services for mental illness.
(22) "Research-based" means a program or practice that has been
tested with a single randomized, or statistically controlled
evaluation, or both, demonstrating sustained desirable outcomes; or
where the weight of the evidence from a systemic review supports
sustained outcomes as described in subsection (14) of this section but
does not meet the full criteria for evidence-based.
(23) "Residential services" means a complete range of residences
and supports authorized by resource management services and which may
involve a facility, a distinct part thereof, or services which support
community living, for persons who are acutely mentally ill, adults who
are chronically mentally ill, children who are severely emotionally
disturbed, or adults who are seriously disturbed and determined by the
((regional support network)) behavioral health organization to be at
risk of becoming acutely or chronically mentally ill. The services
shall include at least evaluation and treatment services as defined in
chapter 71.05 RCW, acute crisis respite care, long-term adaptive and
rehabilitative care, and supervised and supported living services, and
shall also include any residential services developed to service
persons who are mentally ill in nursing homes, assisted living
facilities, and adult family homes, and may include outpatient services
provided as an element in a package of services in a supported housing
model. Residential services for children in out-of-home placements
related to their mental disorder shall not include the costs of food
and shelter, except for children's long-term residential facilities
existing prior to January 1, 1991.
(24) "Resilience" means the personal and community qualities that
enable individuals to rebound from adversity, trauma, tragedy, threats,
or other stresses, and to live productive lives.
(25) "Resource management services" mean the planning,
coordination, and authorization of residential services and community
support services administered pursuant to an individual service plan
for: (a) Adults and children who are acutely mentally ill; (b) adults
who are chronically mentally ill; (c) children who are severely
emotionally disturbed; or (d) adults who are seriously disturbed and
determined solely by a ((regional support network)) behavioral health
organization to be at risk of becoming acutely or chronically mentally
ill. Such planning, coordination, and authorization shall include
mental health screening for children eligible under the federal Title
XIX early and periodic screening, diagnosis, and treatment program.
Resource management services include seven day a week, twenty-four hour
a day availability of information regarding enrollment of adults and
children who are mentally ill in services and their individual service
plan to designated mental health professionals, evaluation and
treatment facilities, and others as determined by the ((regional
support network)) behavioral health organization.
(26) "Secretary" means the secretary of social and health services.
(27) "Seriously disturbed person" means a person who:
(a) Is gravely disabled or presents a likelihood of serious harm to
himself or herself or others, or to the property of others, as a result
of a mental disorder as defined in chapter 71.05 RCW;
(b) Has been on conditional release status, or under a less
restrictive alternative order, at some time during the preceding two
years from an evaluation and treatment facility or a state mental
health hospital;
(c) Has a mental disorder which causes major impairment in several
areas of daily living;
(d) Exhibits suicidal preoccupation or attempts; or
(e) Is a child diagnosed by a mental health professional, as
defined in chapter 71.34 RCW, as experiencing a mental disorder which
is clearly interfering with the child's functioning in family or school
or with peers or is clearly interfering with the child's personality
development and learning.
(28) "Severely emotionally disturbed child" or "child who is
severely emotionally disturbed" means a child who has been determined
by the ((regional support network)) behavioral health organization to
be experiencing a mental disorder as defined in chapter 71.34 RCW,
including those mental disorders that result in a behavioral or conduct
disorder, that is clearly interfering with the child's functioning in
family or school or with peers and who meets at least one of the
following criteria:
(a) Has undergone inpatient treatment or placement outside of the
home related to a mental disorder within the last two years;
(b) Has undergone involuntary treatment under chapter 71.34 RCW
within the last two years;
(c) Is currently served by at least one of the following child-serving systems: Juvenile justice, child-protection/welfare, special
education, or developmental disabilities;
(d) Is at risk of escalating maladjustment due to:
(i) Chronic family dysfunction involving a caretaker who is
mentally ill or inadequate;
(ii) Changes in custodial adult;
(iii) Going to, residing in, or returning from any placement
outside of the home, for example, psychiatric hospital, short-term
inpatient, residential treatment, group or foster home, or a
correctional facility;
(iv) Subject to repeated physical abuse or neglect;
(v) Drug or alcohol abuse; or
(vi) Homelessness.
(29) "State minimum standards" means minimum requirements
established by rules adopted by the secretary and necessary to
implement this chapter for: (a) Delivery of mental health services;
(b) licensed service providers for the provision of mental health
services; (c) residential services; and (d) community support services
and resource management services.
(30) "Treatment records" include registration and all other records
concerning persons who are receiving or who at any time have received
services for mental illness, which are maintained by the department, by
((regional support networks)) behavioral health organizations and their
staffs, and by treatment facilities. Treatment records do not include
notes or records maintained for personal use by a person providing
treatment services for the department, ((regional support networks))
behavioral health organizations, or a treatment facility if the notes
or records are not available to others.
(31) "Tribal authority," for the purposes of this section and RCW
71.24.300 only, means: The federally recognized Indian tribes and the
major Indian organizations recognized by the secretary insofar as these
organizations do not have a financial relationship with any ((regional
support network)) behavioral health organization that would present a
conflict of interest.
(32) "Behavioral health services" means mental health services as
described in this chapter and chapter 71.36 RCW and chemical dependency
treatment services as described in chapter 70.96A RCW.
Sec. 11 RCW 71.24.035 and 2013 c 200 s 24 are each amended to
read as follows:
(1) The department is designated as the state mental health
authority.
(2) The secretary shall provide for public, client, tribal, and
licensed service provider participation in developing the state mental
health program, developing contracts with ((regional support networks))
behavioral health organizations, and any waiver request to the federal
government under medicaid.
(3) The secretary shall provide for participation in developing the
state mental health program for children and other underserved
populations, by including representatives on any committee established
to provide oversight to the state mental health program.
(4) The secretary shall be designated as the ((regional support
network)) behavioral health organization if the ((regional support
network)) behavioral health organization fails to meet state minimum
standards or refuses to exercise responsibilities under its contract or
RCW 71.24.045, until such time as a new ((regional support network))
behavioral health organization is designated ((under RCW 71.24.320)).
(5) The secretary shall:
(a) Develop a biennial state mental health program that
incorporates regional biennial needs assessments and regional mental
health service plans and state services for adults and children with
mental illness((. The secretary shall also develop a six-year state
mental health plan));
(b) Assure that any ((regional)) behavioral health organization or
county community mental health program provides ((access to treatment
for the region's residents, including parents who are respondents in
dependency cases, in the following order of priority: (i) Persons with
acute mental illness; (ii) adults with chronic mental illness and
children who are severely emotionally disturbed; and (iii) persons who
are seriously disturbed. Such programs shall provide:)) medically necessary services to
medicaid recipients consistent with the state's medicaid state plan or
federal waiver authorities, and nonmedicaid services consistent with
priorities established by the department;
(A) Outpatient services;
(B) Emergency care services for twenty-four hours per day;
(C) Day treatment for persons with mental illness which includes
training in basic living and social skills, supported work, vocational
rehabilitation, and day activities. Such services may include
therapeutic treatment. In the case of a child, day treatment includes
age-appropriate basic living and social skills, educational and
prevocational services, day activities, and therapeutic treatment;
(D) Screening for patients being considered for admission to state
mental health facilities to determine the appropriateness of admission;
(E) Employment services, which may include supported employment,
transitional work, placement in competitive employment, and other work-related services, that result in persons with mental illness becoming
engaged in meaningful and gainful full or part-time work. Other
sources of funding such as the division of vocational rehabilitation
may be utilized by the secretary to maximize federal funding and
provide for integration of services;
(F) Consultation and education services; and
(G) Community support services
(c) Develop and adopt rules establishing state minimum standards
for the delivery of mental health services pursuant to RCW 71.24.037
including, but not limited to:
(i) Licensed service providers. These rules shall permit a county-operated mental health program to be licensed as a service provider
subject to compliance with applicable statutes and rules. The
secretary shall provide for deeming of compliance with state minimum
standards for those entities accredited by recognized behavioral health
accrediting bodies recognized and having a current agreement with the
department;
(ii) ((Regional support networks; and)) Inpatient services, evaluation and treatment services and
facilities under chapter 71.05 RCW, resource management services, and
community support services;
(iii)
(d) Assure that the special needs of persons who are minorities,
elderly, disabled, children, low-income, and parents who are
respondents in dependency cases are met within the priorities
established in this section;
(e) Establish a standard contract or contracts, consistent with
state minimum standards((, RCW 71.24.320 and 71.24.330,)) which shall
be used in contracting with ((regional support networks)) behavioral
health organizations. The standard contract shall include a maximum
fund balance, which shall be consistent with that required by federal
regulations or waiver stipulations;
(f) Establish, to the extent possible, a standardized auditing
procedure which is designed to assure compliance with contractual
agreements authorized by this chapter and minimizes paperwork
requirements of ((regional support networks)) behavioral health
organizations and licensed service providers. The audit procedure
shall focus on the outcomes of service ((and not the processes for
accomplishing them)) as provided in RCW 43.20A.895, 70.320.020, and
71.36.025;
(g) Develop and maintain an information system to be used by the
state and ((regional support networks)) behavioral health organizations
that includes a tracking method which allows the department and
((regional support networks)) behavioral health organizations to
identify mental health clients' participation in any mental health
service or public program on an immediate basis. The information
system shall not include individual patient's case history files.
Confidentiality of client information and records shall be maintained
as provided in this chapter and chapter 70.02 RCW;
(h) License service providers who meet state minimum standards;
(i) ((Certify regional support networks that meet state minimum
standards;)) Periodically monitor the compliance of ((
(j)certified regional
support networks)) behavioral health organizations and their network of
licensed service providers for compliance with the contract between the
department, the ((regional support network)) behavioral health
organization, and federal and state rules at reasonable times and in a
reasonable manner;
(((k))) (j) Fix fees to be paid by evaluation and treatment centers
to the secretary for the required inspections;
(((l))) (k) Monitor and audit ((regional support networks))
behavioral health organizations and licensed service providers as
needed to assure compliance with contractual agreements authorized by
this chapter;
(((m))) (l) Adopt such rules as are necessary to implement the
department's responsibilities under this chapter;
(((n) Assure the availability of an appropriate amount, as
determined by the legislature in the operating budget by amounts
appropriated for this specific purpose, of community-based,
geographically distributed residential services;)) (m) License or certify crisis stabilization units that meet
state minimum standards;
(o)
(((p))) (n) License or certify clubhouses that meet state minimum
standards; and
(((q))) (o) License or certify triage facilities that meet state
minimum standards.
(6) The secretary shall use available resources only for ((regional
support networks)) behavioral health organizations, except:
(a) To the extent authorized, and in accordance with any priorities
or conditions specified, in the biennial appropriations act; or
(b) To incentivize improved performance with respect to the client
outcomes established in RCW 43.20A.895, 70.320.020, and 71.36.025,
integration of behavioral health and medical services at the clinical
level, and improved care coordination for individuals with complex care
needs.
(7) Each ((certified regional support network)) behavioral health
organization and licensed service provider shall file with the
secretary, on request, such data, statistics, schedules, and
information as the secretary reasonably requires. A ((certified
regional support network)) behavioral health organization or licensed
service provider which, without good cause, fails to furnish any data,
statistics, schedules, or information as requested, or files fraudulent
reports thereof, may ((have its)) be subject to the behavioral health
organization contractual remedies in section 3 of this act or may have
its service provider certification or license revoked or suspended.
(8) The secretary may suspend, revoke, limit, or restrict a
certification or license, or refuse to grant a certification or license
for failure to conform to: (a) The law; (b) applicable rules and
regulations; (c) applicable standards; or (d) state minimum standards.
(9) The superior court may restrain any ((regional support
network)) behavioral health organization or service provider from
operating without a contract, certification, or a license or any other
violation of this section. The court may also review, pursuant to
procedures contained in chapter 34.05 RCW, any denial, suspension,
limitation, restriction, or revocation of certification or license, and
grant other relief required to enforce the provisions of this chapter.
(10) Upon petition by the secretary, and after hearing held upon
reasonable notice to the facility, the superior court may issue a
warrant to an officer or employee of the secretary authorizing him or
her to enter at reasonable times, and examine the records, books, and
accounts of any ((regional support network)) behavioral health
organizations or service provider refusing to consent to inspection or
examination by the authority.
(11) Notwithstanding the existence or pursuit of any other remedy,
the secretary may file an action for an injunction or other process
against any person or governmental unit to restrain or prevent the
establishment, conduct, or operation of a ((regional support network))
behavioral health organization or service provider without a contract,
certification, or a license under this chapter.
(12) The standards for certification or licensure of evaluation and
treatment facilities shall include standards relating to maintenance of
good physical and mental health and other services to be afforded
persons pursuant to this chapter and chapters 71.05 and 71.34 RCW, and
shall otherwise assure the effectuation of the purposes of these
chapters.
(13) The standards for certification or licensure of crisis
stabilization units shall include standards that:
(a) Permit location of the units at a jail facility if the unit is
physically separate from the general population of the jail;
(b) Require administration of the unit by mental health
professionals who direct the stabilization and rehabilitation efforts;
and
(c) Provide an environment affording security appropriate with the
alleged criminal behavior and necessary to protect the public safety.
(14) The standards for certification or licensure of a clubhouse
shall at a minimum include:
(a) The facilities may be peer-operated and must be
recovery-focused;
(b) Members and employees must work together;
(c) Members must have the opportunity to participate in all the
work of the clubhouse, including administration, research, intake and
orientation, outreach, hiring, training and evaluation of staff, public
relations, advocacy, and evaluation of clubhouse effectiveness;
(d) Members and staff and ultimately the clubhouse director must be
responsible for the operation of the clubhouse, central to this
responsibility is the engagement of members and staff in all aspects of
clubhouse operations;
(e) Clubhouse programs must be comprised of structured activities
including but not limited to social skills training, vocational
rehabilitation, employment training and job placement, and community
resource development;
(f) Clubhouse programs must provide in-house educational programs
that significantly utilize the teaching and tutoring skills of members
and assist members by helping them to take advantage of adult education
opportunities in the community;
(g) Clubhouse programs must focus on strengths, talents, and
abilities of its members;
(h) The work-ordered day may not include medication clinics, day
treatment, or other therapy programs within the clubhouse.
(15) The department shall distribute appropriated state and federal
funds in accordance with any priorities, terms, or conditions specified
in the appropriations act.
(16) The secretary shall assume all duties assigned to the
nonparticipating ((regional support networks)) behavioral health
organizations under chapters 71.05 and 71.34 RCW and this chapter.
Such responsibilities shall include those which would have been
assigned to the nonparticipating counties in regions where there are
not participating ((regional support networks)) behavioral health
organizations.
The ((regional support networks)) behavioral health organizations,
or the secretary's assumption of all responsibilities under chapters
71.05 and 71.34 RCW and this chapter, shall be included in all state
and federal plans affecting the state mental health program including
at least those required by this chapter, the medicaid program, and P.L.
99-660. Nothing in these plans shall be inconsistent with the intent
and requirements of this chapter.
(17) The secretary shall:
(a) Disburse funds for the ((regional support networks)) behavioral
health organizations within sixty days of approval of the biennial
contract. The department must either approve or reject the biennial
contract within sixty days of receipt.
(b) Enter into biennial contracts with ((regional support
networks)) behavioral health organizations. The contracts shall be
consistent with available resources. No contract shall be approved
that does not include progress toward meeting the goals of this chapter
by taking responsibility for: (i) Short-term commitments; (ii)
residential care; and (iii) emergency response systems.
(c) Notify ((regional support networks)) behavioral health
organizations of their allocation of available resources at least sixty
days prior to the start of a new biennial contract period.
(d) Deny all or part of the funding allocations to ((regional
support networks)) behavioral health organizations based solely upon
formal findings of noncompliance with the terms of the ((regional
support network's)) behavioral health organization's contract with the
department. ((Regional support networks)) Behavioral health
organizations disputing the decision of the secretary to withhold
funding allocations are limited to the remedies provided in the
department's contracts with the ((regional support networks))
behavioral health organizations.
(18) The department, in cooperation with the state congressional
delegation, shall actively seek waivers of federal requirements and
such modifications of federal regulations as are necessary to allow
federal medicaid reimbursement for services provided by freestanding
evaluation and treatment facilities certified under chapter 71.05 RCW.
The department shall periodically report its efforts to the appropriate
committees of the senate and the house of representatives.
Sec. 12 RCW 71.24.045 and 2006 c 333 s 105 are each amended to
read as follows:
The regional support network shall:
(1) Contract as needed with licensed service providers. The
regional support network may, in the absence of a licensed service
provider entity, become a licensed service provider entity pursuant to
minimum standards required for licensing by the department for the
purpose of providing services not available from licensed service
providers;
(2) Operate as a licensed service provider if it deems that doing
so is more efficient and cost effective than contracting for services.
When doing so, the regional support network shall comply with rules
promulgated by the secretary that shall provide measurements to
determine when a regional support network provided service is more
efficient and cost effective;
(3) Monitor and perform biennial fiscal audits of licensed service
providers who have contracted with the regional support network to
provide services required by this chapter. The monitoring and audits
shall be performed by means of a formal process which insures that the
licensed service providers and professionals designated in this
subsection meet the terms of their contracts;
(4) Establish reasonable limitations on administrative costs for
agencies that contract with the behavioral health organization;
(5) Assure that the special needs of minorities, ((the elderly))
older adults, ((disabled)) individuals with disabilities, children, and
low-income persons are met within the priorities established in this
chapter;
(((5))) (6) Maintain patient tracking information in a central
location as required for resource management services and the
department's information system;
(((6))) (7) Collaborate to ensure that policies do not result in an
adverse shift of ((mentally ill)) persons with mental illness into
state and local correctional facilities;
(((7))) (8) Work with the department to expedite the enrollment or
re-enrollment of eligible persons leaving state or local correctional
facilities and institutions for mental diseases;
(((8))) (9) If a regional support network is not operated by the
county, work closely with the county designated mental health
professional or county designated crisis responder to maximize
appropriate placement of persons into community services; and
(((9))) (10) Coordinate services for individuals who have received
services through the community mental health system and who become
patients at a state ((mental)) psychiatric hospital to ensure they are
transitioned into the community in accordance with mutually agreed upon
discharge plans and upon determination by the medical director of the
state ((mental)) psychiatric hospital that they no longer need
intensive inpatient care.
Sec. 13 RCW 71.24.045 and 2014 c . . . s 11 (section 12 of this
act) are each amended to read as follows:
The ((regional support network)) behavioral health organization
shall:
(1) Contract as needed with licensed service providers. The
((regional support network)) behavioral health organization may, in the
absence of a licensed service provider entity, become a licensed
service provider entity pursuant to minimum standards required for
licensing by the department for the purpose of providing services not
available from licensed service providers;
(2) Operate as a licensed service provider if it deems that doing
so is more efficient and cost effective than contracting for services.
When doing so, the ((regional support network)) behavioral health
organization shall comply with rules promulgated by the secretary that
shall provide measurements to determine when a ((regional support
network)) behavioral health organization provided service is more
efficient and cost effective;
(3) Monitor and perform biennial fiscal audits of licensed service
providers who have contracted with the ((regional support network))
behavioral health organization to provide services required by this
chapter. The monitoring and audits shall be performed by means of a
formal process which insures that the licensed service providers and
professionals designated in this subsection meet the terms of their
contracts;
(4) Establish reasonable limitations on administrative costs for
agencies that contract with the behavioral health organization;
(5) Assure that the special needs of minorities, older adults,
individuals with disabilities, children, and low-income persons are met
within the priorities established in this chapter;
(6) Maintain patient tracking information in a central location as
required for resource management services and the department's
information system;
(7) Collaborate to ensure that policies do not result in an adverse
shift of persons with mental illness into state and local correctional
facilities;
(8) Work with the department to expedite the enrollment or re-enrollment of eligible persons leaving state or local correctional
facilities and institutions for mental diseases;
(9) ((If a regional support network is not operated by the
county,)) Work closely with the county designated mental health
professional or county designated crisis responder to maximize
appropriate placement of persons into community services; and
(10) Coordinate services for individuals who have received services
through the community mental health system and who become patients at
a state psychiatric hospital to ensure they are transitioned into the
community in accordance with mutually agreed upon discharge plans and
upon determination by the medical director of the state psychiatric
hospital that they no longer need intensive inpatient care.
Sec. 14 RCW 71.24.100 and 2012 c 117 s 442 are each amended to
read as follows:
A county authority or a group of county authorities may enter into
a joint operating agreement to ((form)) respond to a request for a
detailed plan and contract with the state to operate a ((regional
support network)) behavioral health organization whose boundaries are
consistent with the regional service areas established under section 2
of this act. Any agreement between two or more county authorities
((for the establishment of a regional support network)) shall provide:
(1) That each county shall bear a share of the cost of mental
health services; and
(2) That the treasurer of one participating county shall be the
custodian of funds made available for the purposes of such mental
health services, and that the treasurer may make payments from such
funds upon audit by the appropriate auditing officer of the county for
which he or she is treasurer.
Sec. 15 RCW 71.24.110 and 1999 c 10 s 7 are each amended to read
as follows:
An agreement ((for the establishment of a community mental health
program)) to contract with the state to operate a behavioral health
organization under RCW 71.24.100 may also provide:
(1) For the joint supervision or operation of services and
facilities, or for the supervision or operation of service and
facilities by one participating county under contract for the other
participating counties; and
(2) For such other matters as are necessary or proper to effectuate
the purposes of this chapter.
Sec. 16 RCW 71.24.340 and 2005 c 503 s 13 are each amended to
read as follows:
The secretary shall require the ((regional support networks))
behavioral health organizations to develop ((interlocal agreements
pursuant to RCW 74.09.555. To this end, the regional support networks
shall)) agreements with city and county jails to accept referrals for
enrollment on behalf of a confined person, prior to the person's
release.
Sec. 17 RCW 71.24.420 and 2001 c 323 s 2 are each amended to read
as follows:
The department shall operate the community mental health service
delivery system authorized under this chapter within the following
constraints:
(1) The full amount of federal funds for mental health services,
plus qualifying state expenditures as appropriated in the biennial
operating budget, shall be appropriated to the department each year in
the biennial appropriations act to carry out the provisions of the
community mental health service delivery system authorized in this
chapter.
(2) The department may expend funds defined in subsection (1) of
this section in any manner that will effectively accomplish the outcome
measures ((defined in section 5 of this act)) established in RCW
43.20A.895 and 71.36.025 and performance measures linked to those
outcomes.
(3) The department shall implement strategies that accomplish the
outcome measures ((identified in section 5 of this act that are within
the funding constraints in this section)) established in RCW
43.20A.895, 70.320.020, and 71.36.025 and performance measures linked
to those outcomes.
(4) The department shall monitor expenditures against the
appropriation levels provided for in subsection (1) of this section.
Sec. 18 RCW 70.96A.010 and 1989 c 271 s 304 are each amended to
read as follows:
It is the policy of this state that ((alcoholics)) persons with
alcoholism and intoxicated persons may not be subjected to criminal
prosecution solely because of their consumption of alcoholic beverages
but rather should, within available funds, be afforded a continuum of
treatment in order that they may lead normal lives as productive
members of society. Within available funds, treatment should also be
provided for ((drug addicts)) persons with drug addiction.
Sec. 19 RCW 70.96A.011 and 1989 c 270 s 1 are each amended to
read as follows:
The legislature finds that the use of alcohol and other drugs has
become a serious threat to the health of the citizens of the state of
Washington. The use of psychoactive chemicals has been found to be a
prime factor in the current AIDS epidemic. Therefore, a comprehensive
statute to deal with alcoholism and other drug addiction is necessary.
The legislature agrees with the 1987 resolution of the American
Medical Association that endorses the proposition that all chemical
dependencies, including alcoholism, are diseases. It is the intent of
the legislature to ((end the sharp distinctions between alcoholism
services and other drug addiction services, to)) recognize that
chemical dependency is a disease, and to insure that prevention and
treatment services are available and are of high quality. It is the
purpose of this chapter to provide the financial assistance necessary
to enable the department of social and health services to provide a
((discrete)) program of alcoholism and other drug addiction services.
Sec. 20 RCW 70.96A.020 and 2001 c 13 s 1 are each amended to read
as follows:
For the purposes of this chapter the following words and phrases
shall have the following meanings unless the context clearly requires
otherwise:
(1) (("Alcoholic" means a person who suffers from the disease of
alcoholism.)) "Alcoholism" means a disease, characterized by a dependency
on alcoholic beverages, loss of control over the amount and
circumstances of use, symptoms of tolerance, physiological or
psychological withdrawal, or both, if use is reduced or discontinued,
and impairment of health or disruption of social or economic
functioning.
(2)
(((3))) (2) "Approved treatment program" means a ((discrete))
program ((of chemical dependency treatment)) for persons with a
substance use disorder provided by a treatment program certified by the
department of social and health services as meeting standards adopted
under this chapter.
(((4))) (3) "Chemical dependency" means:
(a) Alcoholism; (b) drug addiction; or (c) dependence on alcohol
and one or more other psychoactive chemicals, as the context requires.
(((5))) (4) "Chemical dependency program" means expenditures and
activities of the department designed and conducted to prevent or treat
alcoholism and other drug addiction, including reasonable
administration and overhead.
(((6))) (5) "Department" means the department of social and health
services.
(((7))) (6) "Designated chemical dependency specialist" or
"specialist" means a person designated by the behavioral health
organization or by the county alcoholism and other drug addiction
program coordinator designated under RCW 70.96A.310 to perform the
commitment duties described in RCW 70.96A.140 and qualified to do so by
meeting standards adopted by the department.
(((8))) (7) "Director" means the person administering the
((chemical dependency)) substance use disorder program within the
department.
(((9) "Drug addict" means a person who suffers from the disease of
drug addiction.)) (8) "Drug addiction" means a disease characterized by a
dependency on psychoactive chemicals, loss of control over the amount
and circumstances of use, symptoms of tolerance, physiological or
psychological withdrawal, or both, if use is reduced or discontinued,
and impairment of health or disruption of social or economic
functioning.
(10)
(((11))) (9) "Emergency service patrol" means a patrol established
under RCW 70.96A.170.
(((12))) (10) "Gravely disabled by alcohol or other psychoactive
chemicals" or "gravely disabled" means that a person, as a result of
the use of alcohol or other psychoactive chemicals: (a) Is in danger
of serious physical harm resulting from a failure to provide for his or
her essential human needs of health or safety; or (b) manifests severe
deterioration in routine functioning evidenced by a repeated and
escalating loss of cognition or volitional control over his or her
actions and is not receiving care as essential for his or her health or
safety.
(((13))) (11) "History of one or more violent acts" refers to the
period of time ten years prior to the filing of a petition under this
chapter, excluding any time spent, but not any violent acts committed,
in a mental health facility, or a long-term alcoholism or drug
treatment facility, or in confinement.
(((14))) (12) "Incapacitated by alcohol or other psychoactive
chemicals" means that a person, as a result of the use of alcohol or
other psychoactive chemicals, is gravely disabled or presents a
likelihood of serious harm to himself or herself, to any other person,
or to property.
(((15))) (13) "Incompetent person" means a person who has been
adjudged incompetent by the superior court.
(((16))) (14) "Intoxicated person" means a person whose mental or
physical functioning is substantially impaired as a result of the use
of alcohol or other psychoactive chemicals.
(((17))) (15) "Licensed physician" means a person licensed to
practice medicine or osteopathic medicine and surgery in the state of
Washington.
(((18))) (16) "Likelihood of serious harm" means:
(a) A substantial risk that: (i) Physical harm will be inflicted
by an individual upon his or her own person, as evidenced by threats or
attempts to commit suicide or inflict physical harm on one's self; (ii)
physical harm will be inflicted by an individual upon another, as
evidenced by behavior that has caused the harm or that places another
person or persons in reasonable fear of sustaining the harm; or (iii)
physical harm will be inflicted by an individual upon the property of
others, as evidenced by behavior that has caused substantial loss or
damage to the property of others; or
(b) The individual has threatened the physical safety of another
and has a history of one or more violent acts.
(((19))) (17) "Medical necessity" for inpatient care of a minor
means a requested certified inpatient service that is reasonably
calculated to: (a) Diagnose, arrest, or alleviate a chemical
dependency; or (b) prevent the ((worsening of chemical dependency
conditions)) progression of substance use disorders that endanger life
or cause suffering and pain, or result in illness or infirmity or
threaten to cause or aggravate a handicap, or cause physical deformity
or malfunction, and there is no adequate less restrictive alternative
available.
(((20))) (18) "Minor" means a person less than eighteen years of
age.
(((21))) (19) "Parent" means the parent or parents who have the
legal right to custody of the child. Parent includes custodian or
guardian.
(((22))) (20) "Peace officer" means a law enforcement official of
a public agency or governmental unit, and includes persons specifically
given peace officer powers by any state law, local ordinance, or
judicial order of appointment.
(((23))) (21) "Person" means an individual, including a minor.
(((24))) (22) "Professional person in charge" or "professional
person" means a physician or chemical dependency counselor as defined
in rule by the department, who is empowered by a certified treatment
program with authority to make assessment, admission, continuing care,
and discharge decisions on behalf of the certified program.
(((25))) (23) "Secretary" means the secretary of the department of
social and health services.
(((26))) (24) "Treatment" means the broad range of emergency,
((detoxification)) withdrawal management, residential, and outpatient
services and care, including diagnostic evaluation, chemical dependency
education and counseling, medical, psychiatric, psychological, and
social service care, vocational rehabilitation and career counseling,
which may be extended to ((alcoholics and other drug addicts)) persons
with substance use disorders and their families, persons incapacitated
by alcohol or other psychoactive chemicals, and intoxicated persons.
(((27))) (25) "Treatment program" means an organization,
institution, or corporation, public or private, engaged in the care,
treatment, or rehabilitation of ((alcoholics or other drug addicts))
persons with substance use disorder.
(((28))) (26) "Violent act" means behavior that resulted in
homicide, attempted suicide, nonfatal injuries, or substantial damage
to property.
(27) "Behavioral health organization" means a county authority or
group of county authorities or other entity recognized by the secretary
in contract in a defined regional service area.
(28) "Behavioral health services" means mental health services as
described in chapters 71.24 and 71.36 RCW and chemical dependency
treatment services as described in this chapter.
(29) "Substance use disorder" means a cluster of cognitive,
behavioral, and physiological symptoms indicating that an individual
continues using the substance despite significant substance-related
problems. The diagnosis of a substance use disorder is based on a
pathological pattern of behaviors related to the use of the substances.
Sec. 21 RCW 70.96A.030 and 1989 c 270 s 4 are each amended to
read as follows:
A ((discrete)) program ((of chemical dependency)) for persons with
a substance use disorder is established within the department of social
and health services, to be administered by a qualified person who has
training and experience in handling alcoholism and other drug addiction
problems or the organization or administration of treatment services
for persons suffering from alcoholism or other drug addiction problems.
Sec. 22 RCW 70.96A.040 and 1989 c 270 s 5 are each amended to
read as follows:
The department, in the operation of the chemical dependency program
may:
(1) Plan, establish, and maintain prevention and treatment programs
as necessary or desirable;
(2) Make contracts necessary or incidental to the performance of
its duties and the execution of its powers, including managed care
contracts for behavioral health services, contracts entered into under
RCW 74.09.522, and contracts with public and private agencies,
organizations, and individuals to pay them for services rendered or
furnished to ((alcoholics or other drug addicts)) persons with
substance use disorders, persons incapacitated by alcohol or other
psychoactive chemicals, or intoxicated persons;
(3) Enter into agreements for monitoring of verification of
qualifications of counselors employed by approved treatment programs;
(4) Adopt rules under chapter 34.05 RCW to carry out the provisions
and purposes of this chapter and contract, cooperate, and coordinate
with other public or private agencies or individuals for those
purposes;
(5) Solicit and accept for use any gift of money or property made
by will or otherwise, and any grant of money, services, or property
from the federal government, the state, or any political subdivision
thereof or any private source, and do all things necessary to cooperate
with the federal government or any of its agencies in making an
application for any grant;
(6) Administer or supervise the administration of the provisions
relating to ((alcoholics, other drug addicts,)) persons with substance
use disorders and intoxicated persons of any state plan submitted for
federal funding pursuant to federal health, welfare, or treatment
legislation;
(7) Coordinate its activities and cooperate with chemical
dependency programs in this and other states, and make contracts and
other joint or cooperative arrangements with state, local, or private
agencies in this and other states for the treatment of ((alcoholics and
other drug addicts)) persons with substance use disorders and their
families, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons and for the common advancement of
chemical dependency programs;
(8) Keep records and engage in research and the gathering of
relevant statistics;
(9) Do other acts and things necessary or convenient to execute the
authority expressly granted to it;
(10) Acquire, hold, or dispose of real property or any interest
therein, and construct, lease, or otherwise provide treatment programs.
Sec. 23 RCW 70.96A.050 and 2001 c 13 s 2 are each amended to read
as follows:
The department shall:
(1) Develop, encourage, and foster statewide, regional, and local
plans and programs for the prevention of alcoholism and other drug
addiction, treatment of ((alcoholics and other drug addicts)) persons
with substance use disorders and their families, persons incapacitated
by alcohol or other psychoactive chemicals, and intoxicated persons in
cooperation with public and private agencies, organizations, and
individuals and provide technical assistance and consultation services
for these purposes;
(2) Assure that any behavioral health organization managed care
contract, or managed care contract under RCW 74.09.522 for behavioral
health services or programs for the treatment of persons with substance
use disorders, and their families, persons incapacitated by alcohol or
other psychoactive chemicals, and intoxicated persons provides
medically necessary services to medicaid recipients. This must include
a continuum of mental health and chemical dependency services
consistent with the state's medicaid plan or federal waiver
authorities, and nonmedicaid services consistent with priorities
established by the department;
(3) Coordinate the efforts and enlist the assistance of all public
and private agencies, organizations, and individuals interested in
prevention of alcoholism and drug addiction, and treatment of
((alcoholics and other drug addicts)) persons with substance use
disorders and their families, persons incapacitated by alcohol or other
psychoactive chemicals, and intoxicated persons;
(((3))) (4) Cooperate with public and private agencies in
establishing and conducting programs to provide treatment for
((alcoholics and other drug addicts)) persons with substance use
disorders and their families, persons incapacitated by alcohol or other
psychoactive chemicals, and intoxicated persons who are clients of the
correctional system;
(((4))) (5) Cooperate with the superintendent of public
instruction, state board of education, schools, police departments,
courts, and other public and private agencies, organizations and
individuals in establishing programs for the prevention of alcoholism
and other drug addiction, treatment of ((alcoholics or other drug
addicts)) persons with substance use disorders and their families,
persons incapacitated by alcohol or other psychoactive chemicals, and
intoxicated persons, and preparing curriculum materials thereon for use
at all levels of school education;
(((5))) (6) Prepare, publish, evaluate, and disseminate educational
material dealing with the nature and effects of alcohol and other
psychoactive chemicals and the consequences of their use;
(((6))) (7) Develop and implement, as an integral part of treatment
programs, an educational program for use in the treatment of
((alcoholics or other drug addicts)) persons with substance use
disorders, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons, which program shall include the
dissemination of information concerning the nature and effects of
alcohol and other psychoactive chemicals, the consequences of their
use, the principles of recovery, and HIV and AIDS;
(((7))) (8) Organize and foster training programs for persons
engaged in treatment of ((alcoholics or other drug addicts)) persons
with substance use disorders, persons incapacitated by alcohol or other
psychoactive chemicals, and intoxicated persons;
(((8))) (9) Sponsor and encourage research into the causes and
nature of alcoholism and other drug addiction, treatment of
((alcoholics and other drug addicts)) persons with substance use
disorders, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons, and serve as a clearinghouse for
information relating to alcoholism or other drug addiction;
(((9))) (10) Specify uniform methods for keeping statistical
information by public and private agencies, organizations, and
individuals, and collect and make available relevant statistical
information, including number of persons treated, frequency of
admission and readmission, and frequency and duration of treatment;
(((10))) (11) Advise the governor in the preparation of a
comprehensive plan for treatment of ((alcoholics and other drug
addicts)) persons with substance use disorders, persons incapacitated
by alcohol or other psychoactive chemicals, and intoxicated persons for
inclusion in the state's comprehensive health plan;
(((11))) (12) Review all state health, welfare, and treatment plans
to be submitted for federal funding under federal legislation, and
advise the governor on provisions to be included relating to
((alcoholism and other drug addiction, persons incapacitated by alcohol
or other psychoactive chemicals, and intoxicated persons)) substance
use disorders;
(((12))) (13) Assist in the development of, and cooperate with,
programs for alcohol and other psychoactive chemical education and
treatment for employees of state and local governments and businesses
and industries in the state;
(((13))) (14) Use the support and assistance of interested persons
in the community to encourage ((alcoholics and other drug addicts))
persons with substance use disorders voluntarily to undergo treatment;
(((14))) (15) Cooperate with public and private agencies in
establishing and conducting programs designed to deal with the problem
of persons operating motor vehicles while intoxicated;
(((15))) (16) Encourage general hospitals and other appropriate
health facilities to admit without discrimination ((alcoholics and
other drug addicts)) persons with substance use disorders, persons
incapacitated by alcohol or other psychoactive chemicals, and
intoxicated persons and to provide them with adequate and appropriate
treatment;
(((16))) (17) Encourage all health and disability insurance
programs to include alcoholism and other drug addiction as a covered
illness; and
(((17))) (18) Organize and sponsor a statewide program to help
court personnel, including judges, better understand the disease of
alcoholism and other drug addiction and the uses of chemical dependency
treatment programs.
Sec. 24 RCW 70.96A.060 and 1989 c 270 s 8 are each amended to
read as follows:
(1) An interdepartmental coordinating committee is established,
composed of the superintendent of public instruction or his or her
designee, the director of licensing or his or her designee, the
executive secretary of the Washington state law enforcement training
commission or his or her designee, and one or more designees (not to
exceed three) of the secretary, one of whom shall be the director of
the chemical dependency program. The committee shall meet at least
twice annually at the call of the secretary, or his or her designee,
who shall be its chair. The committee shall provide for the
coordination of, and exchange of information on, all programs relating
to alcoholism and other drug addiction, and shall act as a permanent
liaison among the departments engaged in activities affecting
((alcoholics and other drug addicts)) persons with substance use
disorders, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons. The committee shall assist the
secretary and director in formulating a comprehensive plan for
prevention of alcoholism and other drug addiction, for treatment of
((alcoholics and other drug addicts)) persons with substance use
disorders, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons.
(2) In exercising its coordinating functions, the committee shall
assure that:
(a) The appropriate state agencies provide or assure all necessary
medical, social, treatment, and educational services for ((alcoholics
and other drug addicts)) persons with substance use disorders and their
families, persons incapacitated by alcohol or other psychoactive
chemicals, and intoxicated persons and for the prevention of alcoholism
and other chemical dependency, without unnecessary duplication of
services;
(b) The several state agencies cooperate in the use of facilities
and in the treatment of ((alcoholics and other drug addicts)) persons
with substance use disorders, persons incapacitated by alcohol or other
psychoactive chemicals, and intoxicated persons; and
(c) All state agencies adopt approaches to the prevention of
((alcoholism and other drug addiction)) substance use disorders, the
treatment of ((alcoholics and other drug addicts)) persons with
substance use disorders and their families, persons incapacitated by
alcohol or other psychoactive chemicals, and intoxicated persons
consistent with the policy of this chapter.
Sec. 25 RCW 70.96A.080 and 1989 c 270 s 18 are each amended to
read as follows:
(1) In coordination with the health care authority, the department
shall establish by ((all)) appropriate means, ((including contracting
for services,)) a comprehensive and coordinated ((discrete)) program
for the treatment of ((alcoholics and other drug addicts)) persons with
substance use disorders, and their families, persons incapacitated by
alcohol or other psychoactive chemicals, and intoxicated persons.
(2)(a) The program shall include, but not necessarily be limited
to, a continuum of chemical dependency treatment services that
includes:
(((a) Detoxification)) (i) Withdrawal management;
(((b))) (ii) Residential treatment; and
(((c))) (iii) Outpatient treatment.
(b) The program may include peer support, supported housing,
supported employment, crisis diversion, or recovery support services.
(3) All appropriate public and private resources shall be
coordinated with and used in the program when possible.
(4) The department may contract for the use of an approved
treatment program or other individual or organization if the secretary
considers this to be an effective and economical course to follow.
(5) By April 1, 2016, treatment provided under this chapter must be
purchased primarily through managed care contracts. Consistent with
RCW 70.96A.350, services and funding provided through the criminal
justice treatment account are intended to be exempted from managed care
contracting.
Sec. 26 RCW 70.96A.085 and 1989 c 270 s 12 are each amended to
read as follows:
A city, town, or county that does not have its own facility or
program for the treatment and rehabilitation of ((alcoholics and other
drug addicts)) persons with substance use disorders may share in the
use of a facility or program maintained by another city or county so
long as it contributes no less than two percent of its share of liquor
taxes and profits to the support of the facility or program.
Sec. 27 RCW 70.96A.100 and 1989 c 270 s 23 are each amended to
read as follows:
The secretary shall adopt and may amend and repeal rules for
acceptance of persons into the approved treatment program, considering
available treatment resources and facilities, for the purpose of early
and effective treatment of ((alcoholics and other drug addicts))
persons with substance use disorders, persons incapacitated by alcohol
or other psychoactive chemicals, and intoxicated persons. In
establishing the rules, the secretary shall be guided by the following
standards:
(1) If possible a patient shall be treated on a voluntary rather
than an involuntary basis.
(2) A patient shall be initially assigned or transferred to
outpatient treatment, unless he or she is found to require residential
treatment.
(3) A person shall not be denied treatment solely because he or she
has withdrawn from treatment against medical advice on a prior occasion
or because he or she has relapsed after earlier treatment.
(4) An individualized treatment plan shall be prepared and
maintained on a current basis for each patient.
(5) Provision shall be made for a continuum of coordinated
treatment services, so that a person who leaves a facility or a form of
treatment will have available and use other appropriate treatment.
Sec. 28 RCW 70.96A.110 and 1990 c 151 s 7 are each amended to
read as follows:
(1) ((An alcoholic or other drug addict)) An individual with a
substance use disorder may apply for voluntary treatment directly to an
approved treatment program. If the proposed patient is a minor or an
incompetent person, he or she, a parent, a legal guardian, or other
legal representative may make the application.
(2) Subject to rules adopted by the secretary, the administrator in
charge of an approved treatment program may determine who shall be
admitted for treatment. If a person is refused admission to an
approved treatment program, the administrator, subject to rules adopted
by the secretary, shall refer the person to another approved treatment
program for treatment if possible and appropriate.
(3) If a patient receiving inpatient care leaves an approved
treatment program, he or she shall be encouraged to consent to
appropriate outpatient treatment. If it appears to the administrator
in charge of the treatment program that the patient is ((an alcoholic
or other drug addict)) an individual with a substance use disorder who
requires help, the department may arrange for assistance in obtaining
supportive services and residential programs.
(4) If a patient leaves an approved public treatment program, with
or against the advice of the administrator in charge of the program,
the department may make reasonable provisions for his or her
transportation to another program or to his or her home. If the
patient has no home he or she should be assisted in obtaining shelter.
If the patient is less than fourteen years of age or an incompetent
person the request for discharge from an inpatient program shall be
made by a parent, legal guardian, or other legal representative or by
the minor or incompetent if he or she was the original applicant.
Sec. 29 RCW 70.96A.140 and 2001 c 13 s 3 are each amended to read
as follows:
(1) When a designated chemical dependency specialist receives
information alleging that a person presents a likelihood of serious
harm or is gravely disabled as a result of chemical dependency, the
designated chemical dependency specialist, after investigation and
evaluation of the specific facts alleged and of the reliability and
credibility of the information, may file a petition for commitment of
such person with the superior court, district court, or in another
court permitted by court rule.
If a petition for commitment is not filed in the case of a minor,
the parent, guardian, or custodian who has custody of the minor may
seek review of that decision made by the designated chemical dependency
specialist in superior or district court. The parent, guardian, or
custodian shall file notice with the court and provide a copy of the
designated chemical dependency specialist's report.
If the designated chemical dependency specialist finds that the
initial needs of such person would be better served by placement within
the mental health system, the person shall be referred to either a
((county)) designated mental health professional or an evaluation and
treatment facility as defined in RCW 71.05.020 or 71.34.020. If
placement in a chemical dependency program is available and deemed
appropriate, the petition shall allege that: The person is chemically
dependent and presents a likelihood of serious harm or is gravely
disabled by alcohol or drug addiction, or that the person has twice
before in the preceding twelve months been admitted for
((detoxification)) withdrawal management, sobering services, or
chemical dependency treatment pursuant to RCW 70.96A.110 or 70.96A.120,
and is in need of a more sustained treatment program, or that the
person is chemically dependent and has threatened, attempted, or
inflicted physical harm on another and is likely to inflict physical
harm on another unless committed. A refusal to undergo treatment, by
itself, does not constitute evidence of lack of judgment as to the need
for treatment. The petition shall be accompanied by a certificate of
a licensed physician who has examined the person within five days
before submission of the petition, unless the person whose commitment
is sought has refused to submit to a medical examination, in which case
the fact of refusal shall be alleged in the petition. The certificate
shall set forth the licensed physician's findings in support of the
allegations of the petition. A physician employed by the petitioning
program or the department is eligible to be the certifying physician.
(2) Upon filing the petition, the court shall fix a date for a
hearing no less than two and no more than seven days after the date the
petition was filed unless the person petitioned against is presently
being detained in a program, pursuant to RCW 70.96A.120, 71.05.210, or
((71.34.050)) 71.34.710, in which case the hearing shall be held within
seventy-two hours of the filing of the petition: PROVIDED, HOWEVER,
That the above specified seventy-two hours shall be computed by
excluding Saturdays, Sundays, and holidays: PROVIDED FURTHER, That,
the court may, upon motion of the person whose commitment is sought, or
upon motion of petitioner with written permission of the person whose
commitment is sought, or his or her counsel and, upon good cause shown,
extend the date for the hearing. A copy of the petition and of the
notice of the hearing, including the date fixed by the court, shall be
served by the designated chemical dependency specialist on the person
whose commitment is sought, his or her next of kin, a parent or his or
her legal guardian if he or she is a minor, and any other person the
court believes advisable. A copy of the petition and certificate shall
be delivered to each person notified.
(3) At the hearing the court shall hear all relevant testimony,
including, if possible, the testimony, which may be telephonic, of at
least one licensed physician who has examined the person whose
commitment is sought. Communications otherwise deemed privileged under
the laws of this state are deemed to be waived in proceedings under
this chapter when a court of competent jurisdiction in its discretion
determines that the waiver is necessary to protect either the detained
person or the public. The waiver of a privilege under this section is
limited to records or testimony relevant to evaluation of the detained
person for purposes of a proceeding under this chapter. Upon motion by
the detained person, or on its own motion, the court shall examine a
record or testimony sought by a petitioner to determine whether it is
within the scope of the waiver.
The record maker shall not be required to testify in order to
introduce medical, nursing, or psychological records of detained
persons so long as the requirements of RCW 5.45.020 are met, except
that portions of the record that contain opinions as to whether the
detained person is chemically dependent shall be deleted from the
records unless the person offering the opinions is available for cross-examination. The person shall be present unless the court believes
that his or her presence is likely to be injurious to him or her; in
this event the court may deem it appropriate to appoint a guardian ad
litem to represent him or her throughout the proceeding. If deemed
advisable, the court may examine the person out of courtroom. If the
person has refused to be examined by a licensed physician, he or she
shall be given an opportunity to be examined by a court appointed
licensed physician. If he or she refuses and there is sufficient
evidence to believe that the allegations of the petition are true, or
if the court believes that more medical evidence is necessary, the
court may make a temporary order committing him or her to the
department for a period of not more than five days for purposes of a
diagnostic examination.
(4) If after hearing all relevant evidence, including the results
of any diagnostic examination, the court finds that grounds for
involuntary commitment have been established by clear, cogent, and
convincing proof, it shall make an order of commitment to an approved
treatment program. It shall not order commitment of a person unless it
determines that an approved treatment program is available and able to
provide adequate and appropriate treatment for him or her.
(5) A person committed under this section shall remain in the
program for treatment for a period of sixty days unless sooner
discharged. At the end of the sixty-day period, he or she shall be
discharged automatically unless the program, before expiration of the
period, files a petition for his or her recommitment upon the grounds
set forth in subsection (1) of this section for a further period of
ninety days unless sooner discharged.
If a petition for recommitment is not filed in the case of a minor,
the parent, guardian, or custodian who has custody of the minor may
seek review of that decision made by the designated chemical dependency
specialist in superior or district court. The parent, guardian, or
custodian shall file notice with the court and provide a copy of the
treatment progress report.
If a person has been committed because he or she is chemically
dependent and likely to inflict physical harm on another, the program
shall apply for recommitment if after examination it is determined that
the likelihood still exists.
(6) Upon the filing of a petition for recommitment under subsection
(5) of this section, the court shall fix a date for hearing no less
than two and no more than seven days after the date the petition was
filed: PROVIDED, That, the court may, upon motion of the person whose
commitment is sought and upon good cause shown, extend the date for the
hearing. A copy of the petition and of the notice of hearing,
including the date fixed by the court, shall be served by the treatment
program on the person whose commitment is sought, his or her next of
kin, the original petitioner under subsection (1) of this section if
different from the petitioner for recommitment, one of his or her
parents or his or her legal guardian if he or she is a minor, and his
or her attorney and any other person the court believes advisable. At
the hearing the court shall proceed as provided in subsection (3) of
this section.
(7) The approved treatment program shall provide for adequate and
appropriate treatment of a person committed to its custody. A person
committed under this section may be transferred from one approved
public treatment program to another if transfer is medically advisable.
(8) A person committed to the custody of a program for treatment
shall be discharged at any time before the end of the period for which
he or she has been committed and he or she shall be discharged by order
of the court if either of the following conditions are met:
(a) In case of a chemically dependent person committed on the
grounds of likelihood of infliction of physical harm upon himself,
herself, or another, the likelihood no longer exists; or further
treatment will not be likely to bring about significant improvement in
the person's condition, or treatment is no longer adequate or
appropriate.
(b) In case of a chemically dependent person committed on the
grounds of the need of treatment and incapacity, that the incapacity no
longer exists.
(9) The court shall inform the person whose commitment or
recommitment is sought of his or her right to contest the application,
be represented by counsel at every stage of any proceedings relating to
his or her commitment and recommitment, and have counsel appointed by
the court or provided by the court, if he or she wants the assistance
of counsel and is unable to obtain counsel. If the court believes that
the person needs the assistance of counsel, the court shall require, by
appointment if necessary, counsel for him or her regardless of his or
her wishes. The person shall, if he or she is financially able, bear
the costs of such legal service; otherwise such legal service shall be
at public expense. The person whose commitment or recommitment is
sought shall be informed of his or her right to be examined by a
licensed physician of his or her choice. If the person is unable to
obtain a licensed physician and requests examination by a physician,
the court shall employ a licensed physician.
(10) A person committed under this chapter may at any time seek to
be discharged from commitment by writ of habeas corpus in a court of
competent jurisdiction.
(11) The venue for proceedings under this section is the county in
which person to be committed resides or is present.
(12) When in the opinion of the professional person in charge of
the program providing involuntary treatment under this chapter, the
committed patient can be appropriately served by less restrictive
treatment before expiration of the period of commitment, then the less
restrictive care may be required as a condition for early release for
a period which, when added to the initial treatment period, does not
exceed the period of commitment. If the program designated to provide
the less restrictive treatment is other than the program providing the
initial involuntary treatment, the program so designated must agree in
writing to assume such responsibility. A copy of the conditions for
early release shall be given to the patient, the designated chemical
dependency specialist of original commitment, and the court of original
commitment. The program designated to provide less restrictive care
may modify the conditions for continued release when the modifications
are in the best interests of the patient. If the program providing
less restrictive care and the designated chemical dependency specialist
determine that a conditionally released patient is failing to adhere to
the terms and conditions of his or her release, or that substantial
deterioration in the patient's functioning has occurred, then the
designated chemical dependency specialist shall notify the court of
original commitment and request a hearing to be held no less than two
and no more than seven days after the date of the request to determine
whether or not the person should be returned to more restrictive care.
The designated chemical dependency specialist shall file a petition
with the court stating the facts substantiating the need for the
hearing along with the treatment recommendations. The patient shall
have the same rights with respect to notice, hearing, and counsel as
for the original involuntary treatment proceedings. The issues to be
determined at the hearing are whether the conditionally released
patient did or did not adhere to the terms and conditions of his or her
release to less restrictive care or that substantial deterioration of
the patient's functioning has occurred and whether the conditions of
release should be modified or the person should be returned to a more
restrictive program. The hearing may be waived by the patient and his
or her counsel and his or her guardian or conservator, if any, but may
not be waived unless all such persons agree to the waiver. Upon
waiver, the person may be returned for involuntary treatment or
continued on conditional release on the same or modified conditions.
Sec. 30 RCW 70.96A.190 and 1989 c 270 s 32 are each amended to
read as follows:
(1) No county, municipality, or other political subdivision may
adopt or enforce a local law, ordinance, resolution, or rule having the
force of law that includes drinking, being ((an alcoholic or drug
addict)) an individual with a substance use disorder, or being found in
an intoxicated condition as one of the elements of the offense giving
rise to a criminal or civil penalty or sanction.
(2) No county, municipality, or other political subdivision may
interpret or apply any law of general application to circumvent the
provision of subsection (1) of this section.
(3) Nothing in this chapter affects any law, ordinance, resolution,
or rule against drunken driving, driving under the influence of alcohol
or other psychoactive chemicals, or other similar offense involving the
operation of a vehicle, aircraft, boat, machinery, or other equipment,
or regarding the sale, purchase, dispensing, possessing, or use of
alcoholic beverages or other psychoactive chemicals at stated times and
places or by a particular class of persons; nor shall evidence of
intoxication affect, other than as a defense, the application of any
law, ordinance, resolution, or rule to conduct otherwise establishing
the elements of an offense.
Sec. 31 RCW 70.96A.300 and 1989 c 270 s 15 are each amended to
read as follows:
(1) A county or combination of counties acting jointly by
agreement, referred to as "county" in this chapter, may create an
alcoholism and other drug addiction board. This board may also be
designated as a board for other related purposes.
(2) The board shall be composed of not less than seven nor more
than fifteen members, who shall be chosen for their demonstrated
concern for alcoholism and other drug addiction problems. Members of
the board shall be representative of the community, shall include at
least one-quarter recovered ((alcoholics or other recovered drug
addicts)) persons with substance use disorders, and shall include
minority group representation. No member may be a provider of
alcoholism and other drug addiction treatment services. No more than
four elected or appointed city or county officials may serve on the
board at the same time. Members of the board shall serve three-year
terms and hold office until their successors are appointed and
qualified. They shall not be compensated for the performance of their
duties as members of the board, but may be reimbursed for travel
expenses.
(3) The alcoholism and other drug addiction board shall:
(a) Conduct public hearings and other investigations to determine
the needs and priorities of county citizens;
(b) Prepare and recommend to the county legislative authority for
approval, all plans, budgets, and applications by the county to the
department and other state agencies on behalf of the county alcoholism
and other drug addiction program;
(c) Monitor the implementation of the alcoholism and other drug
addiction plan and evaluate the performance of the alcoholism and drug
addiction program at least annually;
(d) Advise the county legislative authority and county alcoholism
and other drug addiction program coordinator on matters relating to the
alcoholism and other drug addiction program, including prevention and
education;
(e) Nominate individuals to the county legislative authority for
the position of county alcoholism and other drug addiction program
coordinator. The nominees should have training and experience in the
administration of alcoholism and other drug addiction services and
shall meet the minimum qualifications established by rule of the
department;
(f) Carry out other duties that the department may prescribe by
rule.
Sec. 32 RCW 70.96A.320 and 2013 c 320 s 8 are each amended to
read as follows:
(1) A county legislative authority, or two or more counties acting
jointly, may establish an alcoholism and other drug addiction program.
If two or more counties jointly establish the program, they shall
designate one county to provide administrative and financial services.
(2) To be eligible for funds from the department for the support of
the county alcoholism and other drug addiction program, the county
legislative authority shall establish a county alcoholism and other
drug addiction board under RCW 70.96A.300 and appoint a county
alcoholism and other drug addiction program coordinator under RCW
70.96A.310.
(3) The county legislative authority may apply to the department
for financial support for the county program of alcoholism and other
drug addiction. To receive financial support, the county legislative
authority shall submit a plan that meets the following conditions:
(a) It shall describe the prevention, early intervention, or
recovery support services and activities to be provided;
(b) It shall include anticipated expenditures and revenues;
(c) It shall be prepared by the county alcoholism and other drug
addiction program board and be adopted by the county legislative
authority;
(d) It shall reflect maximum effective use of existing services and
programs; and
(e) It shall meet other conditions that the secretary may require.
(4) The county may accept and spend gifts, grants, and fees, from
public and private sources, to implement its program of alcoholism and
other drug addiction.
(5) The department shall require that any agreement to provide
financial support to a county that performs the activities of a service
coordination organization for alcoholism and other drug addiction
services must incorporate the expected outcomes and criteria to measure
the performance of service coordination organizations as provided in
chapter 70.320 RCW.
(6) The county may subcontract for ((detoxification)) withdrawal
management, residential treatment, or outpatient treatment with
treatment programs that are approved treatment programs. The county
may subcontract for other services with individuals or organizations
approved by the department.
(7) To continue to be eligible for financial support from the
department for the county alcoholism and other drug addiction program,
an increase in state financial support shall not be used to supplant
local funds from a source that was used to support the county
alcoholism and other drug addiction program before the effective date
of the increase.
Sec. 33 RCW 70.96A.800 and 2008 c 320 s 1 are each amended to
read as follows:
(1) Subject to funds appropriated for this specific purpose, the
secretary shall select and contract with counties to provide intensive
case management for chemically dependent persons with histories of high
utilization of crisis services at two sites. In selecting the two
sites, the secretary shall endeavor to site one in an urban county, and
one in a rural county; and to site them in counties other than those
selected pursuant to RCW 70.96B.020, to the extent necessary to
facilitate evaluation of pilot project results. Subject to funds
appropriated for this specific purpose, the secretary may contract with
additional counties to provide intensive case management.
(2) The contracted sites shall implement the pilot programs by
providing intensive case management to persons with a primary chemical
dependency diagnosis or dual primary chemical dependency and mental
health diagnoses, through the employment of chemical dependency case
managers. The chemical dependency case managers shall:
(a) Be trained in and use the integrated, comprehensive screening
and assessment process adopted under RCW 70.96C.010;
(b) Reduce the use of crisis medical, chemical dependency and
mental health services, including but not limited to, emergency room
admissions, hospitalizations, ((detoxification)) withdrawal management
programs, inpatient psychiatric admissions, involuntary treatment
petitions, emergency medical services, and ambulance services;
(c) Reduce the use of emergency first responder services including
police, fire, emergency medical, and ambulance services;
(d) Reduce the number of criminal justice interventions including
arrests, violations of conditions of supervision, bookings, jail days,
prison sanction day for violations, court appearances, and prosecutor
and defense costs;
(e) Where appropriate and available, work with therapeutic courts
including drug courts and mental health courts to maximize the outcomes
for the individual and reduce the likelihood of reoffense;
(f) Coordinate with local offices of the economic services
administration to assist the person in accessing and remaining enrolled
in those programs to which the person may be entitled;
(g) Where appropriate and available, coordinate with primary care
and other programs operated through the federal government including
federally qualified health centers, Indian health programs, and
veterans' health programs for which the person is eligible to reduce
duplication of services and conflicts in case approach;
(h) Where appropriate, advocate for the client's needs to assist
the person in achieving and maintaining stability and progress toward
recovery;
(i) Document the numbers of persons with co-occurring mental and
substance abuse disorders and the point of determination of the co-occurring disorder by quadrant of intensity of need; and
(j) Where a program participant is under supervision by the
department of corrections, collaborate with the department of
corrections to maximize treatment outcomes and reduce the likelihood of
reoffense.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
Sec. 34 RCW 71.24.049 and 2001 c 323 s 13 are each amended to
read as follows:
By January 1st of each odd-numbered year, the ((regional support
network)) behavioral health organization shall identify: (1) The
number of children in each priority group, as defined by this chapter,
who are receiving mental health services funded in part or in whole
under this chapter, (2) the amount of funds under this chapter used for
children's mental health services, (3) an estimate of the number of
unserved children in each priority group, and (4) the estimated cost of
serving these additional children and their families.
Sec. 35 RCW 71.24.061 and 2007 c 359 s 7 are each amended to read
as follows:
(1) The department shall provide flexibility in provider
contracting to ((regional support networks)) behavioral health
organizations for children's mental health services. Beginning with
2007-2009 biennium contracts, ((regional support network)) behavioral
health organization contracts shall authorize ((regional support
networks)) behavioral health organizations to allow and encourage
licensed community mental health centers to subcontract with individual
licensed mental health professionals when necessary to meet the need
for an adequate, culturally competent, and qualified children's mental
health provider network.
(2) To the extent that funds are specifically appropriated for this
purpose or that nonstate funds are available, a children's mental
health evidence-based practice institute shall be established at the
University of Washington division of public behavioral health and
justice policy. The institute shall closely collaborate with entities
currently engaged in evaluating and promoting the use of evidence-based, research-based, promising, or consensus-based practices in
children's mental health treatment, including but not limited to the
University of Washington department of psychiatry and behavioral
sciences, children's hospital and regional medical center, the
University of Washington school of nursing, the University of
Washington school of social work, and the Washington state institute
for public policy. To ensure that funds appropriated are used to the
greatest extent possible for their intended purpose, the University of
Washington's indirect costs of administration shall not exceed ten
percent of appropriated funding. The institute shall:
(a) Improve the implementation of evidence-based and research-based
practices by providing sustained and effective training and
consultation to licensed children's mental health providers and
child-serving agencies who are implementing evidence-based or
researched-based practices for treatment of children's emotional or
behavioral disorders, or who are interested in adapting these practices
to better serve ethnically or culturally diverse children. Efforts
under this subsection should include a focus on appropriate oversight
of implementation of evidence-based practices to ensure fidelity to
these practices and thereby achieve positive outcomes;
(b) Continue the successful implementation of the "partnerships for
success" model by consulting with communities so they may select,
implement, and continually evaluate the success of evidence-based
practices that are relevant to the needs of children, youth, and
families in their community;
(c) Partner with youth, family members, family advocacy, and
culturally competent provider organizations to develop a series of
information sessions, literature, and online resources for families to
become informed and engaged in evidence-based and research-based
practices;
(d) Participate in the identification of outcome-based performance
measures under RCW 71.36.025(2) and partner in a statewide effort to
implement statewide outcomes monitoring and quality improvement
processes; and
(e) Serve as a statewide resource to the department and other
entities on child and adolescent evidence-based, research-based,
promising, or consensus-based practices for children's mental health
treatment, maintaining a working knowledge through ongoing review of
academic and professional literature, and knowledge of other evidence-based practice implementation efforts in Washington and other states.
(3) To the extent that funds are specifically appropriated for this
purpose, the department in collaboration with the evidence-based
practice institute shall implement a pilot program to support primary
care providers in the assessment and provision of appropriate diagnosis
and treatment of children with mental and behavioral health disorders
and track outcomes of this program. The program shall be designed to
promote more accurate diagnoses and treatment through timely case
consultation between primary care providers and child psychiatric
specialists, and focused educational learning collaboratives with
primary care providers.
Sec. 36 RCW 71.24.155 and 2001 c 323 s 14 are each amended to
read as follows:
Grants shall be made by the department to ((regional support
networks)) behavioral health organizations for community mental health
programs totaling not less than ninety-five percent of available
resources. The department may use up to forty percent of the remaining
five percent to provide community demonstration projects, including
early intervention or primary prevention programs for children, and the
remainder shall be for emergency needs and technical assistance under
this chapter.
Sec. 37 RCW 71.24.160 and 2011 c 343 s 6 are each amended to read
as follows:
The ((regional support networks)) behavioral health organizations
shall make satisfactory showing to the secretary that state funds shall
in no case be used to replace local funds from any source being used to
finance mental health services prior to January 1, 1990. Maintenance
of effort funds devoted to judicial services related to involuntary
commitment reimbursed under RCW 71.05.730 must be expended for other
purposes that further treatment for mental health and chemical
dependency disorders.
Sec. 38 RCW 71.24.250 and 2001 c 323 s 16 are each amended to
read as follows:
The ((regional support network)) behavioral health organization may
accept and expend gifts and grants received from private, county,
state, and federal sources.
Sec. 39 RCW 71.24.300 and 2008 c 261 s 4 are each amended to read
as follows:
(1) Upon the request of a tribal authority or authorities within a
((regional support network)) behavioral health organization the joint
operating agreement or the county authority shall allow for the
inclusion of the tribal authority to be represented as a party to the
((regional support network)) behavioral health organization.
(2) The roles and responsibilities of the county and tribal
authorities shall be determined by the terms of that agreement
including a determination of membership on the governing board and
advisory committees, the number of tribal representatives to be party
to the agreement, and the provisions of law and shall assure the
provision of culturally competent services to the tribes served.
(3) The state mental health authority may not determine the roles
and responsibilities of county authorities as to each other under
((regional support networks)) behavioral health organizations by rule,
except to assure that all duties required of ((regional support
networks)) behavioral health organizations are assigned and that
counties and the ((regional support network)) behavioral health
organization do not duplicate functions and that a single authority has
final responsibility for all available resources and performance under
the ((regional support network's)) behavioral health organization's
contract with the secretary.
(4) If a ((regional support network)) behavioral health
organization is a private entity, the department shall allow for the
inclusion of the tribal authority to be represented as a party to the
((regional support network)) behavioral health organization.
(5) The roles and responsibilities of the private entity and the
tribal authorities shall be determined by the department, through
negotiation with the tribal authority.
(6) ((Regional support networks)) Behavioral health organizations
shall submit an overall six-year operating and capital plan, timeline,
and budget and submit progress reports and an updated two-year plan
biennially thereafter, to assume within available resources all of the
following duties:
(a) Administer and provide for the availability of all resource
management services, residential services, and community support
services.
(b) Administer and provide for the availability of all
investigation, transportation, court-related, and other services
provided by the state or counties pursuant to chapter 71.05 RCW.
(c) Provide within the boundaries of each ((regional support
network)) behavioral health organization evaluation and treatment
services for at least ninety percent of persons detained or committed
for periods up to seventeen days according to chapter 71.05 RCW.
((Regional support networks)) Behavioral health organizations may
contract to purchase evaluation and treatment services from other
((networks)) organizations if they are unable to provide for
appropriate resources within their boundaries. Insofar as the original
intent of serving persons in the community is maintained, the secretary
is authorized to approve exceptions on a case-by-case basis to the
requirement to provide evaluation and treatment services within the
boundaries of each ((regional support network)) behavioral health
organization. Such exceptions are limited to:
(i) Contracts with neighboring or contiguous regions; or
(ii) Individuals detained or committed for periods up to seventeen
days at the state hospitals at the discretion of the secretary.
(d) Administer and provide for the availability of all other mental
health services, which shall include patient counseling, day treatment,
consultation, education services, employment services as ((defined))
described in RCW 71.24.035, and mental health services to children.
(e) Establish standards and procedures for reviewing individual
service plans and determining when that person may be discharged from
resource management services.
(7) A ((regional support network)) behavioral health organization
may request that any state-owned land, building, facility, or other
capital asset which was ever purchased, deeded, given, or placed in
trust for the care of the persons with mental illness and which is
within the boundaries of a ((regional support network)) behavioral
health organization be made available to support the operations of the
((regional support network)) behavioral health organization. State
agencies managing such capital assets shall give first priority to
requests for their use pursuant to this chapter.
(8) Each ((regional support network)) behavioral health
organization shall appoint a mental health advisory board which shall
review and provide comments on plans and policies developed under this
chapter, provide local oversight regarding the activities of the
((regional support network)) behavioral health organization, and work
with the ((regional support network)) behavioral health organization to
resolve significant concerns regarding service delivery and outcomes.
The department shall establish statewide procedures for the operation
of regional advisory committees including mechanisms for advisory board
feedback to the department regarding ((regional support network))
behavioral health organization performance. The composition of the
board shall be broadly representative of the demographic character of
the region and shall include, but not be limited to, representatives of
consumers and families, law enforcement, and where the county is not
the ((regional support network)) behavioral health organization, county
elected officials. Composition and length of terms of board members
may differ between ((regional support networks)) behavioral health
organizations but shall be included in each ((regional support
network's)) behavioral health organization's contract and approved by
the secretary.
(9) ((Regional support networks)) Behavioral health organizations
shall assume all duties specified in their plans and joint operating
agreements through biennial contractual agreements with the secretary.
(10) ((Regional support networks)) Behavioral health organizations
may receive technical assistance from the housing trust fund and may
identify and submit projects for housing and housing support services
to the housing trust fund established under chapter 43.185 RCW.
Projects identified or submitted under this subsection must be fully
integrated with the ((regional support network)) behavioral health
organization six-year operating and capital plan, timeline, and budget
required by subsection (6) of this section.
Sec. 40 RCW 71.24.310 and 2013 2nd sp.s. c 4 s 994 are each
amended to read as follows:
The legislature finds that administration of chapter 71.05 RCW and
this chapter can be most efficiently and effectively implemented as
part of the ((regional support network)) behavioral health organization
defined in RCW 71.24.025. For this reason, the legislature intends
that the department and the ((regional support networks)) behavioral
health organizations shall work together to implement chapter 71.05 RCW
as follows:
(1) By June 1, 2006, ((regional support networks)) behavioral
health organizations shall recommend to the department the number of
state hospital beds that should be allocated for use by each ((regional
support network)) behavioral health organization. The statewide total
allocation shall not exceed the number of state hospital beds offering
long-term inpatient care, as defined in this chapter, for which funding
is provided in the biennial appropriations act.
(2) If there is consensus among the ((regional support networks))
behavioral health organizations regarding the number of state hospital
beds that should be allocated for use by each ((regional support
network)) behavioral health organization, the department shall contract
with each ((regional support network)) behavioral health organization
accordingly.
(3) If there is not consensus among the ((regional support
networks)) behavioral health organizations regarding the number of beds
that should be allocated for use by each ((regional support network))
behavioral health organization, the department shall establish by
emergency rule the number of state hospital beds that are available for
use by each ((regional support network)) behavioral health
organization. The emergency rule shall be effective September 1, 2006.
The primary factor used in the allocation shall be the estimated number
of adults with acute and chronic mental illness in each ((regional
support network)) behavioral health organization area, based upon
population-adjusted incidence and utilization.
(4) The allocation formula shall be updated at least every three
years to reflect demographic changes, and new evidence regarding the
incidence of acute and chronic mental illness and the need for long-term inpatient care. In the updates, the statewide total allocation
shall include (a) all state hospital beds offering long-term inpatient
care for which funding is provided in the biennial appropriations act;
plus (b) the estimated equivalent number of beds or comparable
diversion services contracted in accordance with subsection (5) of this
section.
(5) The department is encouraged to enter performance-based
contracts with ((regional support networks)) behavioral health
organizations to provide some or all of the ((regional support
network's)) behavioral health organization's allocated long-term
inpatient treatment capacity in the community, rather than in the state
hospital. The performance contracts shall specify the number of
patient days of care available for use by the ((regional support
network)) behavioral health organization in the state hospital.
(6) If a ((regional support network)) behavioral health
organization uses more state hospital patient days of care than it has
been allocated under subsection (3) or (4) of this section, or than it
has contracted to use under subsection (5) of this section, whichever
is less, it shall reimburse the department for that care, except during
the period of July 1, 2012, through December 31, 2013, where
reimbursements may be temporarily altered per section 204, chapter 4,
Laws of 2013 2nd sp. sess. The reimbursement rate per day shall be the
hospital's total annual budget for long-term inpatient care, divided by
the total patient days of care assumed in development of that budget.
(7) One-half of any reimbursements received pursuant to subsection
(6) of this section shall be used to support the cost of operating the
state hospital and, during the 2007-2009 fiscal biennium, implementing
new services that will enable a ((regional support network)) behavioral
health organization to reduce its utilization of the state hospital.
The department shall distribute the remaining half of such
reimbursements among ((regional support networks)) behavioral health
organizations that have used less than their allocated or contracted
patient days of care at that hospital, proportional to the number of
patient days of care not used.
Sec. 41 RCW 71.24.350 and 2013 c 23 s 189 are each amended to
read as follows:
The department shall require each ((regional support network))
behavioral health organization to provide for a separately funded
mental health ombuds office in each ((regional support network))
behavioral health organization that is independent of the ((regional
support network)) behavioral health organization. The ombuds office
shall maximize the use of consumer advocates.
Sec. 42 RCW 71.24.370 and 2006 c 333 s 103 are each amended to
read as follows:
(1) Except for monetary damage claims which have been reduced to
final judgment by a superior court, this section applies to all claims
against the state, state agencies, state officials, or state employees
that exist on or arise after March 29, 2006.
(2) Except as expressly provided in contracts entered into between
the department and the ((regional support networks)) behavioral health
organizations after March 29, 2006, the entities identified in
subsection (3) of this section shall have no claim for declaratory
relief, injunctive relief, judicial review under chapter 34.05 RCW, or
civil liability against the state or state agencies for actions or
inactions performed pursuant to the administration of this chapter with
regard to the following: (a) The allocation or payment of federal or
state funds; (b) the use or allocation of state hospital beds; or (c)
financial responsibility for the provision of inpatient mental health
care.
(3) This section applies to counties, ((regional support networks))
behavioral health organizations, and entities which contract to provide
((regional support network)) behavioral health organization services
and their subcontractors, agents, or employees.
Sec. 43 RCW 71.24.455 and 1997 c 342 s 2 are each amended to read
as follows:
(1) The secretary shall select and contract with a ((regional
support network)) behavioral health organization or private provider to
provide specialized access and services to ((mentally ill)) offenders
with mental illness upon release from total confinement within the
department of corrections who have been identified by the department of
corrections and selected by the ((regional support network)) behavioral
health organization or private provider as high-priority clients for
services and who meet service program entrance criteria. The program
shall enroll no more than twenty-five offenders at any one time, or a
number of offenders that can be accommodated within the appropriated
funding level, and shall seek to fill any vacancies that occur.
(2) Criteria shall include a determination by department of
corrections staff that:
(a) The offender suffers from a major mental illness and needs
continued mental health treatment;
(b) The offender's previous crime or crimes have been determined by
either the court or department of corrections staff to have been
substantially influenced by the offender's mental illness;
(c) It is believed the offender will be less likely to commit
further criminal acts if provided ongoing mental health care;
(d) The offender is unable or unlikely to obtain housing and/or
treatment from other sources for any reason; and
(e) The offender has at least one year remaining before his or her
sentence expires but is within six months of release to community
housing and is currently housed within a work release facility or any
department of corrections' division of prisons facility.
(3) The ((regional support network)) behavioral health organization
or private provider shall provide specialized access and services to
the selected offenders. The services shall be aimed at lowering the
risk of recidivism. An oversight committee composed of a
representative of the department, a representative of the selected
((regional support network)) behavioral health organization or private
provider, and a representative of the department of corrections shall
develop policies to guide the pilot program, provide dispute resolution
including making determinations as to when entrance criteria or
required services may be waived in individual cases, advise the
department of corrections and the ((regional support network))
behavioral health organization or private provider on the selection of
eligible offenders, and set minimum requirements for service contracts.
The selected ((regional support network)) behavioral health
organization or private provider shall implement the policies and
service contracts. The following services shall be provided:
(a) Intensive case management to include a full range of intensive
community support and treatment in client-to-staff ratios of not more
than ten offenders per case manager including: (i) A minimum of weekly
group and weekly individual counseling; (ii) home visits by the program
manager at least two times per month; and (iii) counseling focusing on
relapse prevention and past, current, or future behavior of the
offender.
(b) The case manager shall attempt to locate and procure housing
appropriate to the living and clinical needs of the offender and as
needed to maintain the psychiatric stability of the offender. The
entire range of emergency, transitional, and permanent housing and
involuntary hospitalization must be considered as available housing
options. A housing subsidy may be provided to offenders to defray
housing costs up to a maximum of six thousand six hundred dollars per
offender per year and be administered by the case manager. Additional
funding sources may be used to offset these costs when available.
(c) The case manager shall collaborate with the assigned prison,
work release, or community corrections staff during release planning,
prior to discharge, and in ongoing supervision of the offender while
under the authority of the department of corrections.
(d) Medications including the full range of psychotropic
medications including atypical antipsychotic medications may be
required as a condition of the program. Medication prescription,
medication monitoring, and counseling to support offender
understanding, acceptance, and compliance with prescribed medication
regimens must be included.
(e) A systematic effort to engage offenders to continuously involve
themselves in current and long-term treatment and appropriate
habilitative activities shall be made.
(f) Classes appropriate to the clinical and living needs of the
offender and appropriate to his or her level of understanding.
(g) The case manager shall assist the offender in the application
and qualification for entitlement funding, including medicaid, state
assistance, and other available government and private assistance at
any point that the offender is qualified and resources are available.
(h) The offender shall be provided access to daily activities such
as drop-in centers, prevocational and vocational training and jobs, and
volunteer activities.
(4) Once an offender has been selected into the pilot program, the
offender shall remain in the program until the end of his or her
sentence or unless the offender is released from the pilot program
earlier by the department of corrections.
(5) Specialized training in the management and supervision of high-crime risk ((mentally ill)) offenders with mental illness shall be
provided to all participating mental health providers by the department
and the department of corrections prior to their participation in the
program and as requested thereafter.
(6) The pilot program provided for in this section must be
providing services by July 1, 1998.
Sec. 44 RCW 71.24.470 and 2009 c 319 s 1 are each amended to read
as follows:
(1) The secretary shall contract, to the extent that funds are
appropriated for this purpose, for case management services and such
other services as the secretary deems necessary to assist offenders
identified under RCW 72.09.370 for participation in the offender
reentry community safety program. The contracts may be with ((regional
support networks)) behavioral health organizations or any other
qualified and appropriate entities.
(2) The case manager has the authority to assist these offenders in
obtaining the services, as set forth in the plan created under RCW
72.09.370(2), for up to five years. The services may include
coordination of mental health services, assistance with unfunded
medical expenses, obtaining chemical dependency treatment, housing,
employment services, educational or vocational training, independent
living skills, parenting education, anger management services, and such
other services as the case manager deems necessary.
(3) The legislature intends that funds appropriated for the
purposes of RCW 72.09.370, 71.05.145, and 71.05.212, and this section
and distributed to the ((regional support networks)) behavioral health
organizations are to supplement and not to supplant general funding.
Funds appropriated to implement RCW 72.09.370, 71.05.145, and
71.05.212, and this section are not to be considered available
resources as defined in RCW 71.24.025 and are not subject to the
priorities, terms, or conditions in the appropriations act established
pursuant to RCW 71.24.035.
(4) The offender reentry community safety program was formerly
known as the community integration assistance program.
Sec. 45 RCW 71.24.480 and 2009 c 319 s 2 are each amended to read
as follows:
(1) A licensed service provider or ((regional support network))
behavioral health organization, acting in the course of the provider's
or ((network's)) organization's duties under this chapter, is not
liable for civil damages resulting from the injury or death of another
caused by a participant in the offender reentry community safety
program who is a client of the provider or ((network)) organization,
unless the act or omission of the provider or ((network)) organization
constitutes:
(a) Gross negligence;
(b) Willful or wanton misconduct; or
(c) A breach of the duty to warn of and protect from a client's
threatened violent behavior if the client has communicated a serious
threat of physical violence against a reasonably ascertainable victim
or victims.
(2) In addition to any other requirements to report violations, the
licensed service provider and ((regional support network)) behavioral
health organization shall report an offender's expressions of intent to
harm or other predatory behavior, regardless of whether there is an
ascertainable victim, in progress reports and other established
processes that enable courts and supervising entities to assess and
address the progress and appropriateness of treatment.
(3) A licensed service provider's or ((regional support network's))
behavioral health organization's mere act of treating a participant in
the offender reentry community safety program is not negligence.
Nothing in this subsection alters the licensed service provider's or
((regional support network's)) behavioral health organization's normal
duty of care with regard to the client.
(4) The limited liability provided by this section applies only to
the conduct of licensed service providers and ((regional support
networks)) behavioral health organizations and does not apply to
conduct of the state.
(5) For purposes of this section, "participant in the offender
reentry community safety program" means a person who has been
identified under RCW 72.09.370 as an offender who: (a) Is reasonably
believed to be dangerous to himself or herself or others; and (b) has
a mental disorder.
Sec. 46 RCW 71.24.845 and 2013 c 230 s 1 are each amended to read
as follows:
The ((regional support networks)) behavioral health organizations
shall jointly develop a uniform transfer agreement to govern the
transfer of clients between ((regional support networks)) behavioral
health organizations. By September 1, 2013, the ((regional support
networks)) behavioral health organizations shall submit the uniform
transfer agreement to the department. By December 1, 2013, the
department shall establish guidelines to implement the uniform transfer
agreement and may modify the uniform transfer agreement as necessary to
avoid impacts on state administrative systems.
Sec. 47 RCW 71.24.055 and 2007 c 359 s 4 are each amended to read
as follows:
As part of the system transformation initiative, the department of
social and health services shall undertake the following activities
related specifically to children's mental health services:
(1) The development of recommended revisions to the access to care
standards for children. The recommended revisions shall reflect the
policies and principles set out in RCW 71.36.005, 71.36.010, and
71.36.025, and recognize that early identification, intervention and
prevention services, and brief intervention services may be provided
outside of the ((regional support network)) behavioral health
organization system. Revised access to care standards shall assess a
child's need for mental health services based upon the child's
diagnosis and its negative impact upon his or her persistent impaired
functioning in family, school, or the community, and should not solely
condition the receipt of services upon a determination that a child is
engaged in high risk behavior or is in imminent need of hospitalization
or out-of-home placement. Assessment and diagnosis for children under
five years of age shall be determined using a nationally accepted
assessment tool designed specifically for children of that age. The
recommendations shall also address whether amendments to RCW 71.24.025
(((26) and)) (27) and (28) and 71.24.035(5) are necessary to implement
revised access to care standards;
(2) Development of a revised children's mental health benefit
package. The department shall ensure that services included in the
children's mental health benefit package reflect the policies and
principles included in RCW 71.36.005 and 71.36.025, to the extent
allowable under medicaid, Title XIX of the federal social security act.
Strong consideration shall be given to developmentally appropriate
evidence-based and research-based practices, family-based
interventions, the use of natural and peer supports, and community
support services. This effort shall include a review of other states'
efforts to fund family-centered children's mental health services
through their medicaid programs;
(3) Consistent with the timeline developed for the system
transformation initiative, recommendations for revisions to the
children's access to care standards and the children's mental health
services benefits package shall be presented to the legislature by
January 1, 2009.
Sec. 48 RCW 71.24.065 and 2007 c 359 s 10 are each amended to
read as follows:
To the extent funds are specifically appropriated for this purpose,
the department of social and health services shall contract for
implementation of a wraparound model of integrated children's mental
health services delivery in up to four ((regional support network))
behavioral health organization regions in Washington state in which
wraparound programs are not currently operating, and in up to two
((regional support network)) behavioral health organization regions in
which wraparound programs are currently operating. Contracts in
regions with existing wraparound programs shall be for the purpose of
expanding the number of children served.
(1) Funding provided may be expended for: Costs associated with a
request for proposal and contracting process; administrative costs
associated with successful bidders' operation of the wraparound model;
the evaluation under subsection (5) of this section; and funding for
services needed by children enrolled in wraparound model sites that are
not otherwise covered under existing state programs. The services
provided through the wraparound model sites shall include, but not be
limited to, services covered under the medicaid program. The
department shall maximize the use of medicaid and other existing state-funded programs as a funding source. However, state funds provided may
be used to develop a broader service package to meet needs identified
in a child's care plan. Amounts provided shall supplement, and not
supplant, state, local, or other funding for services that a child
being served through a wraparound site would otherwise be eligible to
receive.
(2) The wraparound model sites shall serve children with serious
emotional or behavioral disturbances who are at high risk of
residential or correctional placement or psychiatric hospitalization,
and who have been referred for services from the department, a county
juvenile court, a tribal court, a school, or a licensed mental health
provider or agency.
(3) Through a request for proposal process, the department shall
contract, with ((regional support networks)) behavioral health
organizations, alone or in partnership with either educational service
districts or entities licensed to provide mental health services to
children with serious emotional or behavioral disturbances, to operate
the wraparound model sites. The contractor shall provide care
coordination and facilitate the delivery of services and other supports
to families using a strength-based, highly individualized wraparound
process. The request for proposal shall require that:
(a) The ((regional support network)) behavioral health organization
agree to use its medicaid revenues to fund services included in the
existing ((regional support network's)) behavioral health
organization's benefit package that a medicaid-eligible child
participating in the wraparound model site is determined to need;
(b) The contractor provide evidence of commitments from at least
the following entities to participate in wraparound care plan
development and service provision when appropriate: Community mental
health agencies, schools, the department of social and health services
children's administration, juvenile courts, the department of social
and health services juvenile rehabilitation administration, and managed
health care systems contracting with the department under RCW
74.09.522; and
(c) The contractor will operate the wraparound model site in a
manner that maintains fidelity to the wraparound process as defined in
RCW 71.36.010.
(4) Contracts for operation of the wraparound model sites shall be
executed on or before April 1, 2008, with enrollment and service
delivery beginning on or before July 1, 2008.
(5) The evidence-based practice institute established in RCW
71.24.061 shall evaluate the wraparound model sites, measuring outcomes
for children served. Outcomes measured shall include, but are not
limited to: Decreased out-of-home placement, including residential,
group, and foster care, and increased stability of such placements,
school attendance, school performance, recidivism, emergency room
utilization, involvement with the juvenile justice system, decreased
use of psychotropic medication, and decreased hospitalization.
(6) The evidence-based practice institute shall provide a report
and recommendations to the appropriate committees of the legislature by
December 1, 2010.
Sec. 49 RCW 71.24.240 and 2005 c 503 s 10 are each amended to
read as follows:
In order to establish eligibility for funding under this chapter,
any ((regional support network)) behavioral health organization seeking
to obtain federal funds for the support of any aspect of a community
mental health program as defined in this chapter shall submit program
plans to the secretary for prior review and approval before such plans
are submitted to any federal agency.
Sec. 50 RCW 71.24.320 and 2008 c 261 s 5 are each amended to read
as follows:
(1) If an existing ((regional support network)) behavioral health
organization chooses not to respond to a request for ((qualifications))
a detailed plan, or is unable to substantially meet the requirements of
a request for ((qualifications)) a detailed plan, or notifies the
department of social and health services it will no longer serve as a
((regional support network)) behavioral health organization, the
department shall utilize a procurement process in which other entities
recognized by the secretary may bid to serve as the ((regional support
network)) behavioral health organization.
(a) The request for proposal shall include a scoring factor for
proposals that include additional financial resources beyond that
provided by state appropriation or allocation.
(b) The department shall provide detailed briefings to all bidders
in accordance with department and state procurement policies.
(c) The request for proposal shall also include a scoring factor
for proposals submitted by nonprofit entities that include a component
to maximize the utilization of state provided resources and the
leverage of other funds for the support of mental health services to
persons with mental illness.
(2) A ((regional support network)) behavioral health organization
that voluntarily terminates, refuses to renew, or refuses to sign a
mandatory amendment to its contract to act as a ((regional support
network)) behavioral health organization is prohibited from responding
to a procurement under this section or serving as a ((regional support
network)) behavioral health organization for five years from the date
that the department signs a contract with the entity that will serve as
the ((regional support network)) behavioral health organization.
Sec. 51 RCW 71.24.330 and 2013 c 320 s 9 are each amended to read
as follows:
(1)(a) Contracts between a ((regional support network)) behavioral
health organization and the department shall include mechanisms for
monitoring performance under the contract and remedies for failure to
substantially comply with the requirements of the contract including,
but not limited to, financial penalties, termination of the contract,
and reprocurement of the contract.
(b) The department shall incorporate the criteria to measure the
performance of service coordination organizations into contracts with
((regional support networks)) behavioral health organizations as
provided in chapter 70.320 RCW.
(2) The ((regional support network)) behavioral health organization
procurement processes shall encourage the preservation of
infrastructure previously purchased by the community mental health
service delivery system, the maintenance of linkages between other
services and delivery systems, and maximization of the use of available
funds for services versus profits. However, a ((regional support
network)) behavioral health organization selected through the
procurement process is not required to contract for services with any
county-owned or operated facility. The ((regional support network))
behavioral health organization procurement process shall provide that
public funds appropriated by the legislature shall not be used to
promote or deter, encourage, or discourage employees from exercising
their rights under Title 29, chapter 7, subchapter II, United States
Code or chapter 41.56 RCW.
(3) In addition to the requirements of RCW 71.24.035, contracts
shall:
(a) Define administrative costs and ensure that the ((regional
support network)) behavioral health organization does not exceed an
administrative cost of ten percent of available funds;
(b) Require effective collaboration with law enforcement, criminal
justice agencies, and the chemical dependency treatment system;
(c) Require substantial implementation of department adopted
integrated screening and assessment process and matrix of best
practices;
(d) Maintain the decision-making independence of designated mental
health professionals;
(e) Except at the discretion of the secretary or as specified in
the biennial budget, require ((regional support networks)) behavioral
health organizations to pay the state for the costs associated with
individuals who are being served on the grounds of the state hospitals
and who are not receiving long-term inpatient care as defined in RCW
71.24.025;
(f) Include a negotiated alternative dispute resolution clause; and
(g) Include a provision requiring either party to provide one
hundred eighty days' notice of any issue that may cause either party to
voluntarily terminate, refuse to renew, or refuse to sign a mandatory
amendment to the contract to act as a ((regional support network))
behavioral health organization. If either party decides to voluntarily
terminate, refuse to renew, or refuse to sign a mandatory amendment to
the contract to serve as a ((regional support network)) behavioral
health organization they shall provide ninety days' advance notice in
writing to the other party.
Sec. 52 RCW 71.24.360 and 2012 c 91 s 1 are each amended to read
as follows:
(1) The department may establish new ((regional support network))
behavioral health organization boundaries in any part of the state:
(a) Where more than one ((network)) organization chooses not to
respond to, or is unable to substantially meet the requirements of, the
request for ((qualifications)) a detailed plan under RCW 71.24.320;
(b) Where a ((regional support network)) behavioral health
organization is subject to reprocurement under RCW 71.24.330; or
(c) Where two or more ((regional support networks)) behavioral
health organizations propose to reconfigure themselves to achieve
consolidation, in which case the procurement process described in RCW
71.24.320 and 71.24.330(2) does not apply.
(2) The department may establish no fewer than six and no more than
fourteen ((regional support networks)) behavioral health organizations
under this chapter. No entity shall be responsible for more than three
((regional support networks)) behavioral health organizations.
Sec. 53 RCW 71.24.405 and 2001 c 323 s 19 are each amended to
read as follows:
The department shall establish a comprehensive and collaborative
effort within ((regional support networks)) behavioral health
organizations and with local mental health service providers aimed at
creating innovative and streamlined community mental health service
delivery systems, in order to carry out the purposes set forth in RCW
71.24.400 and to capture the diversity of the community mental health
service delivery system.
The department must accomplish the following:
(1) Identification, review, and cataloging of all rules,
regulations, duplicative administrative and monitoring functions, and
other requirements that currently lead to inefficiencies in the
community mental health service delivery system and, if possible,
eliminate the requirements;
(2) The systematic and incremental development of a single system
of accountability for all federal, state, and local funds provided to
the community mental health service delivery system. Systematic
efforts should be made to include federal and local funds into the
single system of accountability;
(3) The elimination of process regulations and related contract and
reporting requirements. In place of the regulations and requirements,
a set of outcomes for mental health adult and children clients
according to chapter 71.24 RCW must be used to measure the performance
of mental health service providers and ((regional support networks))
behavioral health organizations. Such outcomes shall focus on
stabilizing out-of-home and hospital care, increasing stable community
living, increasing age-appropriate activities, achieving family and
consumer satisfaction with services, and system efficiencies;
(4) Evaluation of the feasibility of contractual agreements between
the department of social and health services and ((regional support
networks)) behavioral health organizations and mental health service
providers that link financial incentives to the success or failure of
mental health service providers and ((regional support networks))
behavioral health organizations to meet outcomes established for mental
health service clients;
(5) The involvement of mental health consumers and their
representatives. Mental health consumers and their representatives
will be involved in the development of outcome standards for mental
health clients under section 5 of this act; and
(6) An independent evaluation component to measure the success of
the department in fully implementing the provisions of RCW 71.24.400
and this section.
Sec. 54 RCW 71.24.430 and 2001 c 323 s 3 are each amended to read
as follows:
(1) The department shall ensure the coordination of allied services
for mental health clients. The department shall implement strategies
for resolving organizational, regulatory, and funding issues at all
levels of the system, including the state, the ((regional support
networks)) behavioral health organizations, and local service
providers.
(2) The department shall propose, in operating budget requests,
transfers of funding among programs to support collaborative service
delivery to persons who require services from multiple department
programs. The department shall report annually to the appropriate
committees of the senate and house of representatives on actions and
projects it has taken to promote collaborative service delivery.
Sec. 55 RCW 74.09.522 and 2013 2nd sp.s. c 17 s 13 are each
amended to read as follows:
(1) For the purposes of this section:
(a) "Managed health care system" means any health care
organization, including health care providers, insurers, health care
service contractors, health maintenance organizations, health insuring
organizations, or any combination thereof, that provides directly or by
contract health care services covered under this chapter and rendered
by licensed providers, on a prepaid capitated basis and that meets the
requirements of section 1903(m)(1)(A) of Title XIX of the federal
social security act or federal demonstration waivers granted under
section 1115(a) of Title XI of the federal social security act;
(b) "Nonparticipating provider" means a person, health care
provider, practitioner, facility, or entity, acting within their scope
of practice, that does not have a written contract to participate in a
managed health care system's provider network, but provides health care
services to enrollees of programs authorized under this chapter whose
health care services are provided by the managed health care system.
(2) The authority shall enter into agreements with managed health
care systems to provide health care services to recipients of temporary
assistance for needy families under the following conditions:
(a) Agreements shall be made for at least thirty thousand
recipients statewide;
(b) Agreements in at least one county shall include enrollment of
all recipients of temporary assistance for needy families;
(c) To the extent that this provision is consistent with section
1903(m) of Title XIX of the federal social security act or federal
demonstration waivers granted under section 1115(a) of Title XI of the
federal social security act, recipients shall have a choice of systems
in which to enroll and shall have the right to terminate their
enrollment in a system: PROVIDED, That the authority may limit
recipient termination of enrollment without cause to the first month of
a period of enrollment, which period shall not exceed twelve months:
AND PROVIDED FURTHER, That the authority shall not restrict a
recipient's right to terminate enrollment in a system for good cause as
established by the authority by rule;
(d) To the extent that this provision is consistent with section
1903(m) of Title XIX of the federal social security act, participating
managed health care systems shall not enroll a disproportionate number
of medical assistance recipients within the total numbers of persons
served by the managed health care systems, except as authorized by the
authority under federal demonstration waivers granted under section
1115(a) of Title XI of the federal social security act;
(e)(i) In negotiating with managed health care systems the
authority shall adopt a uniform procedure to enter into contractual
arrangements, to be included in contracts issued or renewed on or after
January 1, 2015, including:
(A) Standards regarding the quality of services to be provided;
(B) The financial integrity of the responding system;
(C) Provider reimbursement methods that incentivize chronic care
management within health homes, including comprehensive medication
management services for patients with multiple chronic conditions
consistent with the findings and goals established in RCW 74.09.5223;
(D) Provider reimbursement methods that reward health homes that,
by using chronic care management, reduce emergency department and
inpatient use;
(E) Promoting provider participation in the program of training and
technical assistance regarding care of people with chronic conditions
described in RCW 43.70.533, including allocation of funds to support
provider participation in the training, unless the managed care system
is an integrated health delivery system that has programs in place for
chronic care management;
(F) Provider reimbursement methods within the medical billing
processes that incentivize pharmacists or other qualified providers
licensed in Washington state to provide comprehensive medication
management services consistent with the findings and goals established
in RCW 74.09.5223; ((and))
(G) Evaluation and reporting on the impact of comprehensive
medication management services on patient clinical outcomes and total
health care costs, including reductions in emergency department
utilization, hospitalization, and drug costs; and
(H) Established consistent processes to incentivize integration of
behavioral health services in the primary care setting, promoting care
that is integrated, collaborative, co-located, and preventive.
(ii)(A) Health home services contracted for under this subsection
may be prioritized to enrollees with complex, high cost, or multiple
chronic conditions.
(B) Contracts that include the items in (e)(i)(C) through (G) of
this subsection must not exceed the rates that would be paid in the
absence of these provisions;
(f) The authority shall seek waivers from federal requirements as
necessary to implement this chapter;
(g) The authority shall, wherever possible, enter into prepaid
capitation contracts that include inpatient care. However, if this is
not possible or feasible, the authority may enter into prepaid
capitation contracts that do not include inpatient care;
(h) The authority shall define those circumstances under which a
managed health care system is responsible for out-of-plan services and
assure that recipients shall not be charged for such services;
(i) Nothing in this section prevents the authority from entering
into similar agreements for other groups of people eligible to receive
services under this chapter; and
(j) The authority must consult with the federal center for medicare
and medicaid innovation and seek funding opportunities to support
health homes.
(3) The authority shall ensure that publicly supported community
health centers and providers in rural areas, who show serious intent
and apparent capability to participate as managed health care systems
are seriously considered as contractors. The authority shall
coordinate its managed care activities with activities under chapter
70.47 RCW.
(4) The authority shall work jointly with the state of Oregon and
other states in this geographical region in order to develop
recommendations to be presented to the appropriate federal agencies and
the United States congress for improving health care of the poor, while
controlling related costs.
(5) The legislature finds that competition in the managed health
care marketplace is enhanced, in the long term, by the existence of a
large number of managed health care system options for medicaid
clients. In a managed care delivery system, whose goal is to focus on
prevention, primary care, and improved enrollee health status,
continuity in care relationships is of substantial importance, and
disruption to clients and health care providers should be minimized.
To help ensure these goals are met, the following principles shall
guide the authority in its healthy options managed health care
purchasing efforts:
(a) All managed health care systems should have an opportunity to
contract with the authority to the extent that minimum contracting
requirements defined by the authority are met, at payment rates that
enable the authority to operate as far below appropriated spending
levels as possible, consistent with the principles established in this
section.
(b) Managed health care systems should compete for the award of
contracts and assignment of medicaid beneficiaries who do not
voluntarily select a contracting system, based upon:
(i) Demonstrated commitment to or experience in serving low-income
populations;
(ii) Quality of services provided to enrollees;
(iii) Accessibility, including appropriate utilization, of services
offered to enrollees;
(iv) Demonstrated capability to perform contracted services,
including ability to supply an adequate provider network;
(v) Payment rates; and
(vi) The ability to meet other specifically defined contract
requirements established by the authority, including consideration of
past and current performance and participation in other state or
federal health programs as a contractor.
(c) Consideration should be given to using multiple year
contracting periods.
(d) Quality, accessibility, and demonstrated commitment to serving
low-income populations shall be given significant weight in the
contracting, evaluation, and assignment process.
(e) All contractors that are regulated health carriers must meet
state minimum net worth requirements as defined in applicable state
laws. The authority shall adopt rules establishing the minimum net
worth requirements for contractors that are not regulated health
carriers. This subsection does not limit the authority of the
Washington state health care authority to take action under a contract
upon finding that a contractor's financial status seriously jeopardizes
the contractor's ability to meet its contract obligations.
(f) Procedures for resolution of disputes between the authority and
contract bidders or the authority and contracting carriers related to
the award of, or failure to award, a managed care contract must be
clearly set out in the procurement document.
(6) The authority may apply the principles set forth in subsection
(5) of this section to its managed health care purchasing efforts on
behalf of clients receiving supplemental security income benefits to
the extent appropriate.
(7) By April 1, 2016, any contract with a managed health care
system to provide services to medical assistance enrollees shall
require that managed health care systems offer contracts to behavioral
health organizations, mental health providers, or chemical dependency
treatment providers to provide access to primary care services
integrated into behavioral health clinical settings, for individuals
with behavioral health and medical comorbidities.
(8) Managed health care system contracts effective on or after
April 1, 2016, shall serve geographic areas that correspond to the
regional service areas established in section 2 of this act.
(9) A managed health care system shall pay a nonparticipating
provider that provides a service covered under this chapter to the
system's enrollee no more than the lowest amount paid for that service
under the managed health care system's contracts with similar providers
in the state.
(((8))) (10) For services covered under this chapter to medical
assistance or medical care services enrollees and provided on or after
August 24, 2011, nonparticipating providers must accept as payment in
full the amount paid by the managed health care system under subsection
(7) of this section in addition to any deductible, coinsurance, or
copayment that is due from the enrollee for the service provided. An
enrollee is not liable to any nonparticipating provider for covered
services, except for amounts due for any deductible, coinsurance, or
copayment under the terms and conditions set forth in the managed
health care system contract to provide services under this section.
(((9))) (11) Pursuant to federal managed care access standards, 42
C.F.R. Sec. 438, managed health care systems must maintain a network of
appropriate providers that is supported by written agreements
sufficient to provide adequate access to all services covered under the
contract with the authority, including hospital-based physician
services. The authority will monitor and periodically report on the
proportion of services provided by contracted providers and
nonparticipating providers, by county, for each managed health care
system to ensure that managed health care systems are meeting network
adequacy requirements. No later than January 1st of each year, the
authority will review and report its findings to the appropriate policy
and fiscal committees of the legislature for the preceding state fiscal
year.
(((10))) (12) Payments under RCW 74.60.130 are exempt from this
section.
(((11))) (13) Subsections (((7))) (9) through (((9))) (11) of this
section expire July 1, 2016.
Sec. 56 RCW 9.41.280 and 2009 c 453 s 1 are each amended to read
as follows:
(1) It is unlawful for a person to carry onto, or to possess on,
public or private elementary or secondary school premises, school-provided transportation, or areas of facilities while being used
exclusively by public or private schools:
(a) Any firearm;
(b) Any other dangerous weapon as defined in RCW 9.41.250;
(c) Any device commonly known as "nun-chu-ka sticks", consisting of
two or more lengths of wood, metal, plastic, or similar substance
connected with wire, rope, or other means;
(d) Any device, commonly known as "throwing stars", which are
multi-pointed, metal objects designed to embed upon impact from any
aspect;
(e) Any air gun, including any air pistol or air rifle, designed to
propel a BB, pellet, or other projectile by the discharge of compressed
air, carbon dioxide, or other gas; or
(f)(i) Any portable device manufactured to function as a weapon and
which is commonly known as a stun gun, including a projectile stun gun
which projects wired probes that are attached to the device that emit
an electrical charge designed to administer to a person or an animal an
electric shock, charge, or impulse; or
(ii) Any device, object, or instrument which is used or intended to
be used as a weapon with the intent to injure a person by an electric
shock, charge, or impulse.
(2) Any such person violating subsection (1) of this section is
guilty of a gross misdemeanor. If any person is convicted of a
violation of subsection (1)(a) of this section, the person shall have
his or her concealed pistol license, if any revoked for a period of
three years. Anyone convicted under this subsection is prohibited from
applying for a concealed pistol license for a period of three years.
The court shall send notice of the revocation to the department of
licensing, and the city, town, or county which issued the license.
Any violation of subsection (1) of this section by elementary or
secondary school students constitutes grounds for expulsion from the
state's public schools in accordance with RCW 28A.600.010. An
appropriate school authority shall promptly notify law enforcement and
the student's parent or guardian regarding any allegation or indication
of such violation.
Upon the arrest of a person at least twelve years of age and not
more than twenty-one years of age for violating subsection (1)(a) of
this section, the person shall be detained or confined in a juvenile or
adult facility for up to seventy-two hours. The person shall not be
released within the seventy-two hours until after the person has been
examined and evaluated by the designated mental health professional
unless the court in its discretion releases the person sooner after a
determination regarding probable cause or on probation bond or bail.
Within twenty-four hours of the arrest, the arresting law
enforcement agency shall refer the person to the designated mental
health professional for examination and evaluation under chapter 71.05
or 71.34 RCW and inform a parent or guardian of the person of the
arrest, detention, and examination. The designated mental health
professional shall examine and evaluate the person subject to the
provisions of chapter 71.05 or 71.34 RCW. The examination shall occur
at the facility in which the person is detained or confined. If the
person has been released on probation, bond, or bail, the examination
shall occur wherever is appropriate.
The designated mental health professional may determine whether to
refer the person to the county-designated chemical dependency
specialist for examination and evaluation in accordance with chapter
70.96A RCW. The county-designated chemical dependency specialist shall
examine the person subject to the provisions of chapter 70.96A RCW.
The examination shall occur at the facility in which the person is
detained or confined. If the person has been released on probation,
bond, or bail, the examination shall occur wherever is appropriate.
Upon completion of any examination by the designated mental health
professional or the county-designated chemical dependency specialist,
the results of the examination shall be sent to the court, and the
court shall consider those results in making any determination about
the person.
The designated mental health professional and county-designated
chemical dependency specialist shall, to the extent permitted by law,
notify a parent or guardian of the person that an examination and
evaluation has taken place and the results of the examination. Nothing
in this subsection prohibits the delivery of additional, appropriate
mental health examinations to the person while the person is detained
or confined.
If the designated mental health professional determines it is
appropriate, the designated mental health professional may refer the
person to the local ((regional support network)) behavioral health
organization for follow-up services or the department of social and
health services or other community providers for other services to the
family and individual.
(3) Subsection (1) of this section does not apply to:
(a) Any student or employee of a private military academy when on
the property of the academy;
(b) Any person engaged in military, law enforcement, or school
district security activities. However, a person who is not a
commissioned law enforcement officer and who provides school security
services under the direction of a school administrator may not possess
a device listed in subsection (1)(f) of this section unless he or she
has successfully completed training in the use of such devices that is
equivalent to the training received by commissioned law enforcement
officers;
(c) Any person who is involved in a convention, showing,
demonstration, lecture, or firearms safety course authorized by school
authorities in which the firearms of collectors or instructors are
handled or displayed;
(d) Any person while the person is participating in a firearms or
air gun competition approved by the school or school district;
(e) Any person in possession of a pistol who has been issued a
license under RCW 9.41.070, or is exempt from the licensing requirement
by RCW 9.41.060, while picking up or dropping off a student;
(f) Any nonstudent at least eighteen years of age legally in
possession of a firearm or dangerous weapon that is secured within an
attended vehicle or concealed from view within a locked unattended
vehicle while conducting legitimate business at the school;
(g) Any nonstudent at least eighteen years of age who is in lawful
possession of an unloaded firearm, secured in a vehicle while
conducting legitimate business at the school; or
(h) Any law enforcement officer of the federal, state, or local
government agency.
(4) Subsections (1)(c) and (d) of this section do not apply to any
person who possesses nun-chu-ka sticks, throwing stars, or other
dangerous weapons to be used in martial arts classes authorized to be
conducted on the school premises.
(5) Subsection (1)(f)(i) of this section does not apply to any
person who possesses a device listed in subsection (1)(f)(i) of this
section, if the device is possessed and used solely for the purpose
approved by a school for use in a school authorized event, lecture, or
activity conducted on the school premises.
(6) Except as provided in subsection (3)(b), (c), (f), and (h) of
this section, firearms are not permitted in a public or private school
building.
(7) "GUN-FREE ZONE" signs shall be posted around school facilities
giving warning of the prohibition of the possession of firearms on
school grounds.
Sec. 57 RCW 10.31.110 and 2011 c 305 s 7 and 2011 c 148 s 3 are
each reenacted and amended to read as follows:
(1) When a police officer has reasonable cause to believe that the
individual has committed acts constituting a nonfelony crime that is
not a serious offense as identified in RCW 10.77.092 and the individual
is known by history or consultation with the ((regional support
network)) behavioral health organization to suffer from a mental
disorder, the arresting officer may:
(a) Take the individual to a crisis stabilization unit as defined
in RCW 71.05.020(6). Individuals delivered to a crisis stabilization
unit pursuant to this section may be held by the facility for a period
of up to twelve hours. The individual must be examined by a mental
health professional within three hours of arrival;
(b) Take the individual to a triage facility as defined in RCW
71.05.020. An individual delivered to a triage facility which has
elected to operate as an involuntary facility may be held up to a
period of twelve hours. The individual must be examined by a mental
health professional within three hours of arrival;
(c) Refer the individual to a mental health professional for
evaluation for initial detention and proceeding under chapter 71.05
RCW; or
(d) Release the individual upon agreement to voluntary
participation in outpatient treatment.
(2) If the individual is released to the community, the mental
health provider shall inform the arresting officer of the release
within a reasonable period of time after the release if the arresting
officer has specifically requested notification and provided contact
information to the provider.
(3) In deciding whether to refer the individual to treatment under
this section, the police officer shall be guided by standards mutually
agreed upon with the prosecuting authority, which address, at a
minimum, the length, seriousness, and recency of the known criminal
history of the individual, the mental health history of the individual,
where available, and the circumstances surrounding the commission of
the alleged offense.
(4) Any agreement to participate in treatment shall not require
individuals to stipulate to any of the alleged facts regarding the
criminal activity as a prerequisite to participation in a mental health
treatment alternative. The agreement is inadmissible in any criminal
or civil proceeding. The agreement does not create immunity from
prosecution for the alleged criminal activity.
(5) If an individual violates such agreement and the mental health
treatment alternative is no longer appropriate:
(a) The mental health provider shall inform the referring law
enforcement agency of the violation; and
(b) The original charges may be filed or referred to the
prosecutor, as appropriate, and the matter may proceed accordingly.
(6) The police officer is immune from liability for any good faith
conduct under this section.
Sec. 58 RCW 10.77.010 and 2011 c 89 s 4 are each amended to read
as follows:
As used in this chapter:
(1) "Admission" means acceptance based on medical necessity, of a
person as a patient.
(2) "Commitment" means the determination by a court that a person
should be detained for a period of either evaluation or treatment, or
both, in an inpatient or a less-restrictive setting.
(3) "Conditional release" means modification of a court-ordered
commitment, which may be revoked upon violation of any of its terms.
(4) A "criminally insane" person means any person who has been
acquitted of a crime charged by reason of insanity, and thereupon found
to be a substantial danger to other persons or to present a substantial
likelihood of committing criminal acts jeopardizing public safety or
security unless kept under further control by the court or other
persons or institutions.
(5) "Department" means the state department of social and health
services.
(6) "Designated mental health professional" has the same meaning as
provided in RCW 71.05.020.
(7) "Detention" or "detain" means the lawful confinement of a
person, under the provisions of this chapter, pending evaluation.
(8) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with persons with developmental disabilities and is
a psychiatrist or psychologist, or a social worker, and such other
developmental disabilities professionals as may be defined by rules
adopted by the secretary.
(9) "Developmental disability" means the condition as defined in
RCW 71A.10.020(((3)))(4).
(10) "Discharge" means the termination of hospital medical
authority. The commitment may remain in place, be terminated, or be
amended by court order.
(11) "Furlough" means an authorized leave of absence for a resident
of a state institution operated by the department designated for the
custody, care, and treatment of the criminally insane, consistent with
an order of conditional release from the court under this chapter,
without any requirement that the resident be accompanied by, or be in
the custody of, any law enforcement or institutional staff, while on
such unescorted leave.
(12) "Habilitative services" means those services provided by
program personnel to assist persons in acquiring and maintaining life
skills and in raising their levels of physical, mental, social, and
vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the person being assisted as manifested by prior charged
criminal conduct.
(13) "History of one or more violent acts" means violent acts
committed during: (a) The ten-year period of time prior to the filing
of criminal charges; plus (b) the amount of time equal to time spent
during the ten-year period in a mental health facility or in
confinement as a result of a criminal conviction.
(14) "Immediate family member" means a spouse, child, stepchild,
parent, stepparent, grandparent, sibling, or domestic partner.
(15) "Incompetency" means a person lacks the capacity to understand
the nature of the proceedings against him or her or to assist in his or
her own defense as a result of mental disease or defect.
(16) "Indigent" means any person who is financially unable to
obtain counsel or other necessary expert or professional services
without causing substantial hardship to the person or his or her
family.
(17) "Individualized service plan" means a plan prepared by a
developmental disabilities professional with other professionals as a
team, for an individual with developmental disabilities, which shall
state:
(a) The nature of the person's specific problems, prior charged
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
(e) The staff responsible for carrying out the plan;
(f) Where relevant in light of past criminal behavior and due
consideration for public safety, the criteria for proposed movement to
less-restrictive settings, criteria for proposed eventual release, and
a projected possible date for release; and
(g) The type of residence immediately anticipated for the person
and possible future types of residences.
(18) "Professional person" means:
(a) A psychiatrist licensed as a physician and surgeon in this
state who has, in addition, completed three years of graduate training
in psychiatry in a program approved by the American medical association
or the American osteopathic association and is certified or eligible to
be certified by the American board of psychiatry and neurology or the
American osteopathic board of neurology and psychiatry;
(b) A psychologist licensed as a psychologist pursuant to chapter
18.83 RCW; or
(c) A social worker with a master's or further advanced degree from
a social work educational program accredited and approved as provided
in RCW 18.320.010.
(19) "Registration records" include all the records of the
department, ((regional support networks)) behavioral health
organizations, treatment facilities, and other persons providing
services to the department, county departments, or facilities which
identify persons who are receiving or who at any time have received
services for mental illness.
(20) "Release" means legal termination of the court-ordered
commitment under the provisions of this chapter.
(21) "Secretary" means the secretary of the department of social
and health services or his or her designee.
(22) "Treatment" means any currently standardized medical or mental
health procedure including medication.
(23) "Treatment records" include registration and all other records
concerning persons who are receiving or who at any time have received
services for mental illness, which are maintained by the department, by
((regional support networks)) behavioral health organizations and their
staffs, and by treatment facilities. Treatment records do not include
notes or records maintained for personal use by a person providing
treatment services for the department, ((regional support networks))
behavioral health organizations, or a treatment facility if the notes
or records are not available to others.
(24) "Violent act" means behavior that: (a)(i) Resulted in; (ii)
if completed as intended would have resulted in; or (iii) was
threatened to be carried out by a person who had the intent and
opportunity to carry out the threat and would have resulted in,
homicide, nonfatal injuries, or substantial damage to property; or (b)
recklessly creates an immediate risk of serious physical injury to
another person. As used in this subsection, "nonfatal injuries" means
physical pain or injury, illness, or an impairment of physical
condition. "Nonfatal injuries" shall be construed to be consistent
with the definition of "bodily injury," as defined in RCW 9A.04.110.
Sec. 59 RCW 10.77.065 and 2013 c 214 s 1 are each amended to read
as follows:
(1)(a)(i) The expert conducting the evaluation shall provide his or
her report and recommendation to the court in which the criminal
proceeding is pending. For a competency evaluation of a defendant who
is released from custody, if the evaluation cannot be completed within
twenty-one days due to a lack of cooperation by the defendant, the
evaluator shall notify the court that he or she is unable to complete
the evaluation because of such lack of cooperation.
(ii) A copy of the report and recommendation shall be provided to
the designated mental health professional, the prosecuting attorney,
the defense attorney, and the professional person at the local
correctional facility where the defendant is being held, or if there is
no professional person, to the person designated under (a)(iv) of this
subsection. Upon request, the evaluator shall also provide copies of
any source documents relevant to the evaluation to the designated
mental health professional.
(iii) Any facility providing inpatient services related to
competency shall discharge the defendant as soon as the facility
determines that the defendant is competent to stand trial. Discharge
shall not be postponed during the writing and distribution of the
evaluation report. Distribution of an evaluation report by a facility
providing inpatient services shall ordinarily be accomplished within
two working days or less following the final evaluation of the
defendant. If the defendant is discharged to the custody of a local
correctional facility, the local correctional facility must continue
the medication regimen prescribed by the facility, when clinically
appropriate, unless the defendant refuses to cooperate with medication.
(iv) If there is no professional person at the local correctional
facility, the local correctional facility shall designate a
professional person as defined in RCW 71.05.020 or, in cooperation with
the ((regional support network)) behavioral health organization, a
professional person at the ((regional support network)) behavioral
health organization to receive the report and recommendation.
(v) Upon commencement of a defendant's evaluation in the local
correctional facility, the local correctional facility must notify the
evaluator of the name of the professional person, or person designated
under (a)(iv) of this subsection, to receive the report and
recommendation.
(b) If the evaluator concludes, under RCW 10.77.060(3)(f), the
person should be evaluated by a designated mental health professional
under chapter 71.05 RCW, the court shall order such evaluation be
conducted prior to release from confinement when the person is
acquitted or convicted and sentenced to confinement for twenty-four
months or less, or when charges are dismissed pursuant to a finding of
incompetent to stand trial.
(2) The designated mental health professional shall provide written
notification within twenty-four hours of the results of the
determination whether to commence proceedings under chapter 71.05 RCW.
The notification shall be provided to the persons identified in
subsection (1)(a) of this section.
(3) The prosecuting attorney shall provide a copy of the results of
any proceedings commenced by the designated mental health professional
under subsection (2) of this section to the secretary.
(4) A facility conducting a civil commitment evaluation under RCW
10.77.086(4) or 10.77.088(1)(b)(ii) that makes a determination to
release the person instead of filing a civil commitment petition must
provide written notice to the prosecutor and defense attorney at least
twenty-four hours prior to release. The notice may be given by
electronic mail, facsimile, or other means reasonably likely to
communicate the information immediately.
(5) The fact of admission and all information and records compiled,
obtained, or maintained in the course of providing services under this
chapter may also be disclosed to the courts solely to prevent the entry
of any evaluation or treatment order that is inconsistent with any
order entered under chapter 71.05 RCW.
Sec. 60 RCW 28A.310.202 and 2007 c 359 s 9 are each amended to
read as follows:
Educational service district boards may partner with ((regional
support networks)) behavioral health organizations to respond to a
request for proposal for operation of a wraparound model site under
chapter 359, Laws of 2007 and, if selected, may contract for the
provision of services to coordinate care and facilitate the delivery of
services and other supports under a wraparound model.
Sec. 61 RCW 43.185.060 and 1994 c 160 s 2 are each amended to
read as follows:
Organizations that may receive assistance from the department under
this chapter are local governments, local housing authorities,
((regional support networks)) behavioral health organizations
established under chapter 71.24 RCW, nonprofit community or
neighborhood-based organizations, federally recognized Indian tribes in
the state of Washington, and regional or statewide nonprofit housing
assistance organizations.
Eligibility for assistance from the department under this chapter
also requires compliance with the revenue and taxation laws, as
applicable to the recipient, at the time the grant is made.
Sec. 62 RCW 43.185.070 and 2013 c 145 s 3 are each amended to
read as follows:
(1) During each calendar year in which funds from the housing trust
fund or other legislative appropriations are available for use by the
department for the housing assistance program, the department must
announce to all known interested parties, and through major media
throughout the state, a grant and loan application period of at least
ninety days' duration. This announcement must be made as often as the
director deems appropriate for proper utilization of resources. The
department must then promptly grant as many applications as will
utilize available funds less appropriate administrative costs of the
department as provided in RCW 43.185.050.
(2) In awarding funds under this chapter, the department must:
(a) Provide for a geographic distribution on a statewide basis; and
(b) Until June 30, 2013, consider the total cost and per-unit cost
of each project for which an application is submitted for funding under
RCW 43.185.050(2) (a) and (j), as compared to similar housing projects
constructed or renovated within the same geographic area.
(3) The department, with advice and input from the affordable
housing advisory board established in RCW 43.185B.020, or a
subcommittee of the affordable housing advisory board, must report
recommendations for awarding funds in a cost-effective manner. The
report must include an implementation plan, timeline, and any other
items the department identifies as important to consider to the
legislature by December 1, 2012.
(4) The department must give first priority to applications for
projects and activities which utilize existing privately owned housing
stock including privately owned housing stock purchased by nonprofit
public development authorities and public housing authorities as
created in chapter 35.82 RCW. As used in this subsection, privately
owned housing stock includes housing that is acquired by a federal
agency through a default on the mortgage by the private owner. Such
projects and activities must be evaluated under subsection (5) of this
section. Second priority must be given to activities and projects
which utilize existing publicly owned housing stock. All projects and
activities must be evaluated by some or all of the criteria under
subsection (5) of this section, and similar projects and activities
shall be evaluated under the same criteria.
(5) The department must give preference for applications based on
some or all of the criteria under this subsection, and similar projects
and activities must be evaluated under the same criteria:
(a) The degree of leveraging of other funds that will occur;
(b) The degree of commitment from programs to provide necessary
habilitation and support services for projects focusing on special
needs populations;
(c) Recipient contributions to total project costs, including
allied contributions from other sources such as professional, craft and
trade services, and lender interest rate subsidies;
(d) Local government project contributions in the form of
infrastructure improvements, and others;
(e) Projects that encourage ownership, management, and other
project-related responsibility opportunities;
(f) Projects that demonstrate a strong probability of serving the
original target group or income level for a period of at least twenty-five years;
(g) The applicant has the demonstrated ability, stability and
resources to implement the project;
(h) Projects which demonstrate serving the greatest need;
(i) Projects that provide housing for persons and families with the
lowest incomes;
(j) Projects serving special needs populations which are under
statutory mandate to develop community housing;
(k) Project location and access to employment centers in the region
or area;
(l) Projects that provide employment and training opportunities for
disadvantaged youth under a youthbuild or youthbuild-type program as
defined in RCW 50.72.020; and
(m) Project location and access to available public transportation
services.
(6) The department may only approve applications for projects for
persons with mental illness that are consistent with a ((regional
support network)) behavioral health organization six-year capital and
operating plan.
Sec. 63 RCW 43.185.110 and 1993 c 478 s 15 are each amended to
read as follows:
The affordable housing advisory board established in RCW
43.185B.020 shall advise the director on housing needs in this state,
including housing needs for persons ((who are mentally ill or
developmentally disabled)) with mental illness or developmental
disabilities or youth who are blind or deaf or otherwise disabled,
operational aspects of the grant and loan program or revenue collection
programs established by this chapter, and implementation of the policy
and goals of this chapter. Such advice shall be consistent with
policies and plans developed by ((regional support networks))
behavioral health organizations according to chapter 71.24 RCW for
((the mentally ill)) individuals with mental illness and the
developmental disabilities planning council for ((the developmentally
disabled)) individuals with developmental disabilities.
Sec. 64 RCW 43.20A.895 and 2013 c 338 s 2 are each amended to
read as follows:
(1) The systems responsible for financing, administration, and
delivery of publicly funded mental health and chemical dependency
services to adults must be designed and administered to achieve
improved outcomes for adult clients served by those systems through
increased use and development of evidence-based, research-based, and
promising practices, as defined in RCW 71.24.025. For purposes of this
section, client outcomes include: Improved health status; increased
participation in employment and education; reduced involvement with the
criminal justice system; enhanced safety and access to treatment for
forensic patients; reduction in avoidable utilization of and costs
associated with hospital, emergency room, and crisis services;
increased housing stability; improved quality of life, including
measures of recovery and resilience; and decreased population level
disparities in access to treatment and treatment outcomes.
(2) The department and the health care authority must implement a
strategy for the improvement of the adult behavioral health system.
(a) The department must establish a steering committee that
includes at least the following members: Behavioral health service
recipients and their families; local government; representatives of
((regional support networks)) behavioral health organizations;
representatives of county coordinators; law enforcement; city and
county jails; tribal representatives; behavioral health service
providers, including at least one chemical dependency provider and at
least one psychiatric advanced registered nurse practitioner; housing
providers; medicaid managed care plan representatives; long-term care
service providers; organizations representing health care professionals
providing services in mental health settings; the Washington state
hospital association; the Washington state medical association;
individuals with expertise in evidence-based and research-based
behavioral health service practices; and the health care authority.
(b) The adult behavioral health system improvement strategy must
include:
(i) An assessment of the capacity of the current publicly funded
behavioral health services system to provide evidence-based, research-based, and promising practices;
(ii) Identification, development, and increased use of evidence-based, research-based, and promising practices;
(iii) Design and implementation of a transparent quality management
system, including analysis of current system capacity to implement
outcomes reporting and development of baseline and improvement targets
for each outcome measure provided in this section;
(iv) Identification and phased implementation of service delivery,
financing, or other strategies that will promote improvement of the
behavioral health system as described in this section and incentivize
the medical care, behavioral health, and long-term care service
delivery systems to achieve the improvements described in this section
and collaborate across systems. The strategies must include phased
implementation of public reporting of outcome and performance measures
in a form that allows for comparison of performance and levels of
improvement between geographic regions of Washington; and
(v) Identification of effective methods for promoting workforce
capacity, efficiency, stability, diversity, and safety.
(c) The department must seek private foundation and federal grant
funding to support the adult behavioral health system improvement
strategy.
(d) By May 15, 2014, the Washington state institute for public
policy, in consultation with the department, the University of
Washington evidence-based practice institute, the University of
Washington alcohol and drug abuse institute, and the Washington
institute for mental health research and training, shall prepare an
inventory of evidence-based, research-based, and promising practices
for prevention and intervention services pursuant to subsection (1) of
this section. The department shall use the inventory in preparing the
behavioral health improvement strategy. The department shall provide
the institute with data necessary to complete the inventory.
(e) By August 1, 2014, the department must report to the governor
and the relevant fiscal and policy committees of the legislature on the
status of implementation of the behavioral health improvement strategy,
including strategies developed or implemented to date, timelines, and
costs to accomplish phased implementation of the adult behavioral
health system improvement strategy.
(3) The department must contract for the services of an independent
consultant to review the provision of forensic mental health services
in Washington state and provide recommendations as to whether and how
the state's forensic mental health system should be modified to provide
an appropriate treatment environment for individuals with mental
disorders who have been charged with a crime while enhancing the safety
and security of the public and other patients and staff at forensic
treatment facilities. By August 1, 2014, the department must submit a
report regarding the recommendations of the independent consultant to
the governor and the relevant fiscal and policy committees of the
legislature.
Sec. 65 RCW 43.20A.897 and 2013 c 338 s 7 are each amended to
read as follows:
(1) By November 30, 2013, the department and the health care
authority must report to the governor and the relevant fiscal and
policy committees of the legislature, consistent with RCW 43.01.036, a
plan that establishes a tribal-centric behavioral health system
incorporating both mental health and chemical dependency services. The
plan must assure that child, adult, and older adult American Indians
and Alaskan Natives eligible for medicaid have increased access to
culturally appropriate mental health and chemical dependency services.
The plan must:
(a) Include implementation dates, major milestones, and fiscal
estimates as needed;
(b) Emphasize the use of culturally appropriate evidence-based and
promising practices;
(c) Address equitable access to crisis services, outpatient care,
voluntary and involuntary hospitalization, and behavioral health care
coordination;
(d) Identify statutory changes necessary to implement the tribal-centric behavioral health system; and
(e) Be developed with the department's Indian policy advisory
committee and the American Indian health commission, in consultation
with Washington's federally recognized tribes.
(2) The department shall enter into agreements with the tribes and
urban Indian health programs and modify ((regional support network))
behavioral health organization contracts as necessary to develop a
tribal-centric behavioral health system that better serves the needs of
the tribes.
Sec. 66 RCW 43.20C.020 and 2012 c 232 s 3 are each amended to
read as follows:
The department of social and health services shall accomplish the
following in consultation and collaboration with the Washington state
institute for public policy, the evidence-based practice institute at
the University of Washington, a university-based child welfare
partnership and research entity, other national experts in the delivery
of evidence-based services, and organizations representing Washington
practitioners:
(1) By September 30, 2012, the Washington state institute for
public policy, the University of Washington evidence-based practice
institute, in consultation with the department shall publish
descriptive definitions of evidence-based, research-based, and
promising practices in the areas of child welfare, juvenile
rehabilitation, and children's mental health services.
(a) In addition to descriptive definitions, the Washington state
institute for public policy and the University of Washington evidence-based practice institute must prepare an inventory of evidence-based,
research-based, and promising practices for prevention and intervention
services that will be used for the purpose of completing the baseline
assessment described in subsection (2) of this section. The inventory
shall be periodically updated as more practices are identified.
(b) In identifying evidence-based and research-based services, the
Washington state institute for public policy and the University of
Washington evidence-based practice institute must:
(i) Consider any available systemic evidence-based assessment of a
program's efficacy and cost-effectiveness; and
(ii) Attempt to identify assessments that use valid and reliable
evidence.
(c) Using state, federal, or private funds, the department shall
prioritize the assessment of promising practices identified in (a) of
this subsection with the goal of increasing the number of such
practices that meet the standards for evidence-based and research-based
practices.
(2) By June 30, 2013, the department and the health care authority
shall complete a baseline assessment of utilization of evidence-based
and research-based practices in the areas of child welfare, juvenile
rehabilitation, and children's mental health services. The assessment
must include prevention and intervention services provided through
medicaid fee-for-service and healthy options managed care contracts.
The assessment shall include estimates of:
(a) The number of children receiving each service;
(b) For juvenile rehabilitation and child welfare services, the
total amount of state and federal funds expended on the service;
(c) For children's mental health services, the number and
percentage of encounters using these services that are provided to
children served by ((regional support networks)) behavioral health
organizations and children receiving mental health services through
medicaid fee-for-service or healthy options;
(d) The relative availability of the service in the various regions
of the state; and
(e) To the extent possible, the unmet need for each service.
(3)(a) By December 30, 2013, the department and the health care
authority shall report to the governor and to the appropriate fiscal
and policy committees of the legislature on recommended strategies,
timelines, and costs for increasing the use of evidence-based and
research-based practices. The report must distinguish between a
reallocation of existing funding to support the recommended strategies
and new funding needed to increase the use of the practices.
(b) The department shall provide updated recommendations to the
governor and the legislature by December 30, 2014, and by December 30,
2015.
(4)(a) The report required under subsection (3) of this section
must include recommendations for the reallocation of resources for
evidence-based and research-based practices and substantial increases
above the baseline assessment of the use of evidence-based and
research-based practices for the 2015-2017 and the 2017-2019 biennia.
The recommendations for increases shall be consistent with subsection
(2) of this section.
(b) If the department or health care authority anticipates that it
will not meet its recommended levels for an upcoming biennium as set
forth in its report, it must report to the legislature by November 1st
of the year preceding the biennium. The report shall include:
(i) The identified impediments to meeting the recommended levels;
(ii) The current and anticipated performance level; and
(iii) Strategies that will be undertaken to improve performance.
(5) Recommendations made pursuant to subsections (3) and (4) of
this section must include strategies to identify programs that are
effective with ethnically diverse clients and to consult with tribal
governments, experts within ethnically diverse communities, and
community organizations that serve diverse communities.
Sec. 67 RCW 43.20C.030 and 2012 c 232 s 4 are each amended to
read as follows:
The department of social and health services, in consultation with
a university-based evidence-based practice institute entity in
Washington, the Washington partnership council on juvenile justice, the
child mental health systems of care planning committee, the children,
youth, and family advisory committee, the Washington state racial
disproportionality advisory committee, a university-based child welfare
research entity in Washington state, ((regional support networks))
behavioral health organizations, the Washington association of juvenile
court administrators, and the Washington state institute for public
policy, shall:
(1) Develop strategies to use unified and coordinated case plans
for children, youth, and their families who are or are likely to be
involved in multiple systems within the department;
(2) Use monitoring and quality control procedures designed to
measure fidelity with evidence-based and research-based prevention and
treatment programs; and
(3) Utilize any existing data reporting and system of quality
management processes at the state and local level for monitoring the
quality control and fidelity of the implementation of evidence-based
and research-based practices.
Sec. 68 RCW 44.28.800 and 1998 c 297 s 61 are each amended to
read as follows:
The joint legislative audit and review committee shall conduct an
evaluation of the efficiency and effectiveness of chapter 297, Laws of
1998 in meeting its stated goals. Such an evaluation shall include the
operation of the state mental hospitals and the ((regional support
networks)) behavioral health organizations, as well as any other
appropriate entity. The joint legislative audit and review committee
shall prepare an interim report of its findings which shall be
delivered to the appropriate legislative committees of the house of
representatives and the senate no later than September 1, 2000. In
addition, the joint legislative audit and review committee shall
prepare a final report of its findings which shall be delivered to the
appropriate legislative committees of the house of representatives and
the senate no later than January 1, 2001.
Sec. 69 RCW 48.01.220 and 1993 c 462 s 104 are each amended to
read as follows:
The activities and operations of mental health ((regional support
networks)) behavioral health organizations, to the extent they pertain
to the operation of a medical assistance managed care system in
accordance with chapters 71.24 and 74.09 RCW, are exempt from the
requirements of this title.
Sec. 70 RCW 70.02.010 and 2013 c 200 s 1 are each amended to read
as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Admission" has the same meaning as in RCW 71.05.020.
(2) "Audit" means an assessment, evaluation, determination, or
investigation of a health care provider by a person not employed by or
affiliated with the provider to determine compliance with:
(a) Statutory, regulatory, fiscal, medical, or scientific
standards;
(b) A private or public program of payments to a health care
provider; or
(c) Requirements for licensing, accreditation, or certification.
(3) "Commitment" has the same meaning as in RCW 71.05.020.
(4) "Custody" has the same meaning as in RCW 71.05.020.
(5) "Deidentified" means health information that does not identify
an individual and with respect to which there is no reasonable basis to
believe that the information can be used to identify an individual.
(6) "Department" means the department of social and health
services.
(7) "Designated mental health professional" has the same meaning as
in RCW 71.05.020 or 71.34.020, as applicable.
(8) "Detention" or "detain" has the same meaning as in RCW
71.05.020.
(9) "Directory information" means information disclosing the
presence, and for the purpose of identification, the name, location
within a health care facility, and the general health condition of a
particular patient who is a patient in a health care facility or who is
currently receiving emergency health care in a health care facility.
(10) "Discharge" has the same meaning as in RCW 71.05.020.
(11) "Evaluation and treatment facility" has the same meaning as in
RCW 71.05.020 or 71.34.020, as applicable.
(12) "Federal, state, or local law enforcement authorities" means
an officer of any agency or authority in the United States, a state, a
tribe, a territory, or a political subdivision of a state, a tribe, or
a territory who is empowered by law to: (a) Investigate or conduct an
official inquiry into a potential criminal violation of law; or (b)
prosecute or otherwise conduct a criminal proceeding arising from an
alleged violation of law.
(13) "General health condition" means the patient's health status
described in terms of "critical," "poor," "fair," "good," "excellent,"
or terms denoting similar conditions.
(14) "Health care" means any care, service, or procedure provided
by a health care provider:
(a) To diagnose, treat, or maintain a patient's physical or mental
condition; or
(b) That affects the structure or any function of the human body.
(15) "Health care facility" means a hospital, clinic, nursing home,
laboratory, office, or similar place where a health care provider
provides health care to patients.
(16) "Health care information" means any information, whether oral
or recorded in any form or medium, that identifies or can readily be
associated with the identity of a patient and directly relates to the
patient's health care, including a patient's deoxyribonucleic acid and
identified sequence of chemical base pairs. The term includes any
required accounting of disclosures of health care information.
(17) "Health care operations" means any of the following activities
of a health care provider, health care facility, or third-party payor
to the extent that the activities are related to functions that make an
entity a health care provider, a health care facility, or a third-party
payor:
(a) Conducting: Quality assessment and improvement activities,
including outcomes evaluation and development of clinical guidelines,
if the obtaining of generalizable knowledge is not the primary purpose
of any studies resulting from such activities; population-based
activities relating to improving health or reducing health care costs,
protocol development, case management and care coordination, contacting
of health care providers and patients with information about treatment
alternatives; and related functions that do not include treatment;
(b) Reviewing the competence or qualifications of health care
professionals, evaluating practitioner and provider performance and
third-party payor performance, conducting training programs in which
students, trainees, or practitioners in areas of health care learn
under supervision to practice or improve their skills as health care
providers, training of nonhealth care professionals, accreditation,
certification, licensing, or credentialing activities;
(c) Underwriting, premium rating, and other activities relating to
the creation, renewal, or replacement of a contract of health insurance
or health benefits, and ceding, securing, or placing a contract for
reinsurance of risk relating to claims for health care, including stop-loss insurance and excess of loss insurance, if any applicable legal
requirements are met;
(d) Conducting or arranging for medical review, legal services, and
auditing functions, including fraud and abuse detection and compliance
programs;
(e) Business planning and development, such as conducting cost-management and planning-related analyses related to managing and
operating the health care facility or third-party payor, including
formulary development and administration, development, or improvement
of methods of payment or coverage policies; and
(f) Business management and general administrative activities of
the health care facility, health care provider, or third-party payor
including, but not limited to:
(i) Management activities relating to implementation of and
compliance with the requirements of this chapter;
(ii) Customer service, including the provision of data analyses for
policy holders, plan sponsors, or other customers, provided that health
care information is not disclosed to such policy holder, plan sponsor,
or customer;
(iii) Resolution of internal grievances;
(iv) The sale, transfer, merger, or consolidation of all or part of
a health care provider, health care facility, or third-party payor with
another health care provider, health care facility, or third-party
payor or an entity that following such activity will become a health
care provider, health care facility, or third-party payor, and due
diligence related to such activity; and
(v) Consistent with applicable legal requirements, creating
deidentified health care information or a limited dataset for the
benefit of the health care provider, health care facility, or third-party payor.
(18) "Health care provider" means a person who is licensed,
certified, registered, or otherwise authorized by the law of this state
to provide health care in the ordinary course of business or practice
of a profession.
(19) "Human immunodeficiency virus" or "HIV" has the same meaning
as in RCW 70.24.017.
(20) "Imminent" has the same meaning as in RCW 71.05.020.
(21) "Information and records related to mental health services"
means a type of health care information that relates to all information
and records, including mental health treatment records, compiled,
obtained, or maintained in the course of providing services by a mental
health service agency, as defined in this section. This may include
documents of legal proceedings under chapter 71.05, 71.34, or 10.77
RCW, or somatic health care information. For health care information
maintained by a hospital as defined in RCW 70.41.020 or a health care
facility or health care provider that participates with a hospital in
an organized health care arrangement defined under federal law,
"information and records related to mental health services" is limited
to information and records of services provided by a mental health
professional or information and records of services created by a
hospital-operated community mental health program as defined in RCW
71.24.025(6).
(22) "Information and records related to sexually transmitted
diseases" means a type of health care information that relates to the
identity of any person upon whom an HIV antibody test or other sexually
transmitted infection test is performed, the results of such tests, and
any information relating to diagnosis of or treatment for any confirmed
sexually transmitted infections.
(23) "Institutional review board" means any board, committee, or
other group formally designated by an institution, or authorized under
federal or state law, to review, approve the initiation of, or conduct
periodic review of research programs to assure the protection of the
rights and welfare of human research subjects.
(24) "Legal counsel" has the same meaning as in RCW 71.05.020.
(25) "Local public health officer" has the same meaning as in RCW
70.24.017.
(26) "Maintain," as related to health care information, means to
hold, possess, preserve, retain, store, or control that information.
(27) "Mental health professional" has the same meaning as in RCW
71.05.020.
(28) "Mental health service agency" means a public or private
agency that provides services to persons with mental disorders as
defined under RCW 71.05.020 or 71.34.020 and receives funding from
public sources. This includes evaluation and treatment facilities as
defined in RCW 71.34.020, community mental health service delivery
systems, or community mental health programs, as defined in RCW
71.24.025, and facilities conducting competency evaluations and
restoration under chapter 10.77 RCW.
(29) "Mental health treatment records" include registration
records, as defined in RCW 71.05.020, and all other records concerning
persons who are receiving or who at any time have received services for
mental illness, which are maintained by the department, by ((regional
support networks)) behavioral health organizations and their staffs,
and by treatment facilities. "Mental health treatment records" include
mental health information contained in a medical bill including, but
not limited to, mental health drugs, a mental health diagnosis,
provider name, and dates of service stemming from a medical service.
"Mental health treatment records" do not include notes or records
maintained for personal use by a person providing treatment services
for the department, ((regional support networks)) behavioral health
organizations, or a treatment facility if the notes or records are not
available to others.
(30) "Minor" has the same meaning as in RCW 71.34.020.
(31) "Parent" has the same meaning as in RCW 71.34.020.
(32) "Patient" means an individual who receives or has received
health care. The term includes a deceased individual who has received
health care.
(33) "Payment" means:
(a) The activities undertaken by:
(i) A third-party payor to obtain premiums or to determine or
fulfill its responsibility for coverage and provision of benefits by
the third-party payor; or
(ii) A health care provider, health care facility, or third-party
payor, to obtain or provide reimbursement for the provision of health
care; and
(b) The activities in (a) of this subsection that relate to the
patient to whom health care is provided and that include, but are not
limited to:
(i) Determinations of eligibility or coverage, including
coordination of benefits or the determination of cost-sharing amounts,
and adjudication or subrogation of health benefit claims;
(ii) Risk adjusting amounts due based on enrollee health status and
demographic characteristics;
(iii) Billing, claims management, collection activities, obtaining
payment under a contract for reinsurance, including stop-loss insurance
and excess of loss insurance, and related health care data processing;
(iv) Review of health care services with respect to medical
necessity, coverage under a health plan, appropriateness of care, or
justification of charges;
(v) Utilization review activities, including precertification and
preauthorization of services, and concurrent and retrospective review
of services; and
(vi) Disclosure to consumer reporting agencies of any of the
following health care information relating to collection of premiums or
reimbursement:
(A) Name and address;
(B) Date of birth;
(C) Social security number;
(D) Payment history;
(E) Account number; and
(F) Name and address of the health care provider, health care
facility, and/or third-party payor.
(34) "Person" means an individual, corporation, business trust,
estate, trust, partnership, association, joint venture, government,
governmental subdivision or agency, or any other legal or commercial
entity.
(35) "Professional person" has the same meaning as in RCW
71.05.020.
(36) "Psychiatric advanced registered nurse practitioner" has the
same meaning as in RCW 71.05.020.
(37) "Reasonable fee" means the charges for duplicating or
searching the record, but shall not exceed sixty-five cents per page
for the first thirty pages and fifty cents per page for all other
pages. In addition, a clerical fee for searching and handling may be
charged not to exceed fifteen dollars. These amounts shall be adjusted
biennially in accordance with changes in the consumer price index, all
consumers, for Seattle-Tacoma metropolitan statistical area as
determined by the secretary of health. However, where editing of
records by a health care provider is required by statute and is done by
the provider personally, the fee may be the usual and customary charge
for a basic office visit.
(38) "Release" has the same meaning as in RCW 71.05.020.
(39) "Resource management services" has the same meaning as in RCW
71.05.020.
(40) "Serious violent offense" has the same meaning as in RCW
71.05.020.
(41) "Sexually transmitted infection" or "sexually transmitted
disease" has the same meaning as "sexually transmitted disease" in RCW
70.24.017.
(42) "Test for a sexually transmitted disease" has the same meaning
as in RCW 70.24.017.
(43) "Third-party payor" means an insurer regulated under Title 48
RCW authorized to transact business in this state or other
jurisdiction, including a health care service contractor, and health
maintenance organization; or an employee welfare benefit plan,
excluding fitness or wellness plans; or a state or federal health
benefit program.
(44) "Treatment" means the provision, coordination, or management
of health care and related services by one or more health care
providers or health care facilities, including the coordination or
management of health care by a health care provider or health care
facility with a third party; consultation between health care providers
or health care facilities relating to a patient; or the referral of a
patient for health care from one health care provider or health care
facility to another.
Sec. 71 RCW 70.02.230 and 2013 c 200 s 7 are each amended to read
as follows:
(1) Except as provided in this section, RCW 70.02.050, 71.05.445,
70.96A.150, 74.09.295, 70.02.210, 70.02.240, 70.02.250, and 70.02.260,
or pursuant to a valid authorization under RCW 70.02.030, the fact of
admission to a provider for mental health services and all information
and records compiled, obtained, or maintained in the course of
providing mental health services to either voluntary or involuntary
recipients of services at public or private agencies must be
confidential.
(2) Information and records related to mental health services,
other than those obtained through treatment under chapter 71.34 RCW,
may be disclosed only:
(a) In communications between qualified professional persons to
meet the requirements of chapter 71.05 RCW, in the provision of
services or appropriate referrals, or in the course of guardianship
proceedings if provided to a professional person:
(i) Employed by the facility;
(ii) Who has medical responsibility for the patient's care;
(iii) Who is a designated mental health professional;
(iv) Who is providing services under chapter 71.24 RCW;
(v) Who is employed by a state or local correctional facility where
the person is confined or supervised; or
(vi) Who is providing evaluation, treatment, or follow-up services
under chapter 10.77 RCW;
(b) When the communications regard the special needs of a patient
and the necessary circumstances giving rise to such needs and the
disclosure is made by a facility providing services to the operator of
a facility in which the patient resides or will reside;
(c)(i) When the person receiving services, or his or her guardian,
designates persons to whom information or records may be released, or
if the person is a minor, when his or her parents make such a
designation;
(ii) A public or private agency shall release to a person's next of
kin, attorney, personal representative, guardian, or conservator, if
any:
(A) The information that the person is presently a patient in the
facility or that the person is seriously physically ill;
(B) A statement evaluating the mental and physical condition of the
patient, and a statement of the probable duration of the patient's
confinement, if such information is requested by the next of kin,
attorney, personal representative, guardian, or conservator; and
(iii) Other information requested by the next of kin or attorney as
may be necessary to decide whether or not proceedings should be
instituted to appoint a guardian or conservator;
(d)(i) To the courts as necessary to the administration of chapter
71.05 RCW or to a court ordering an evaluation or treatment under
chapter 10.77 RCW solely for the purpose of preventing the entry of any
evaluation or treatment order that is inconsistent with any order
entered under chapter 71.05 RCW.
(ii) To a court or its designee in which a motion under chapter
10.77 RCW has been made for involuntary medication of a defendant for
the purpose of competency restoration.
(iii) Disclosure under this subsection is mandatory for the purpose
of the federal health insurance portability and accountability act;
(e)(i) When a mental health professional is requested by a
representative of a law enforcement or corrections agency, including a
police officer, sheriff, community corrections officer, a municipal
attorney, or prosecuting attorney to undertake an investigation or
provide treatment under RCW 71.05.150, 10.31.110, or 71.05.153, the
mental health professional shall, if requested to do so, advise the
representative in writing of the results of the investigation including
a statement of reasons for the decision to detain or release the person
investigated. The written report must be submitted within seventy-two
hours of the completion of the investigation or the request from the
law enforcement or corrections representative, whichever occurs later.
(ii) Disclosure under this subsection is mandatory for the purposes
of the federal health insurance portability and accountability act;
(f) To the attorney of the detained person;
(g) To the prosecuting attorney as necessary to carry out the
responsibilities of the office under RCW 71.05.330(2), 71.05.340(1)(b),
and 71.05.335. The prosecutor must be provided access to records
regarding the committed person's treatment and prognosis, medication,
behavior problems, and other records relevant to the issue of whether
treatment less restrictive than inpatient treatment is in the best
interest of the committed person or others. Information must be
disclosed only after giving notice to the committed person and the
person's counsel;
(h)(i) To appropriate law enforcement agencies and to a person,
when the identity of the person is known to the public or private
agency, whose health and safety has been threatened, or who is known to
have been repeatedly harassed, by the patient. The person may
designate a representative to receive the disclosure. The disclosure
must be made by the professional person in charge of the public or
private agency or his or her designee and must include the dates of
commitment, admission, discharge, or release, authorized or
unauthorized absence from the agency's facility, and only any other
information that is pertinent to the threat or harassment. The agency
or its employees are not civilly liable for the decision to disclose or
not, so long as the decision was reached in good faith and without
gross negligence.
(ii) Disclosure under this subsection is mandatory for the purposes
of the federal health insurance portability and accountability act;
(i)(i) To appropriate corrections and law enforcement agencies all
necessary and relevant information in the event of a crisis or emergent
situation that poses a significant and imminent risk to the public.
The mental health service agency or its employees are not civilly
liable for the decision to disclose or not so long as the decision was
reached in good faith and without gross negligence.
(ii) Disclosure under this subsection is mandatory for the purposes
of the health insurance portability and accountability act;
(j) To the persons designated in RCW 71.05.425 for the purposes
described in those sections;
(k) Upon the death of a person. The person's next of kin, personal
representative, guardian, or conservator, if any, must be notified.
Next of kin who are of legal age and competent must be notified under
this section in the following order: Spouse, parents, children,
brothers and sisters, and other relatives according to the degree of
relation. Access to all records and information compiled, obtained, or
maintained in the course of providing services to a deceased patient
are governed by RCW 70.02.140;
(l) To mark headstones or otherwise memorialize patients interred
at state hospital cemeteries. The department of social and health
services shall make available the name, date of birth, and date of
death of patients buried in state hospital cemeteries fifty years after
the death of a patient;
(m) To law enforcement officers and to prosecuting attorneys as are
necessary to enforce RCW 9.41.040(2)(a)(ii). The extent of information
that may be released is limited as follows:
(i) Only the fact, place, and date of involuntary commitment, an
official copy of any order or orders of commitment, and an official
copy of any written or oral notice of ineligibility to possess a
firearm that was provided to the person pursuant to RCW 9.41.047(1),
must be disclosed upon request;
(ii) The law enforcement and prosecuting attorneys may only release
the information obtained to the person's attorney as required by court
rule and to a jury or judge, if a jury is waived, that presides over
any trial at which the person is charged with violating RCW
9.41.040(2)(a)(ii);
(iii) Disclosure under this subsection is mandatory for the
purposes of the federal health insurance portability and accountability
act;
(n) When a patient would otherwise be subject to the provisions of
this section and disclosure is necessary for the protection of the
patient or others due to his or her unauthorized disappearance from the
facility, and his or her whereabouts is unknown, notice of the
disappearance, along with relevant information, may be made to
relatives, the department of corrections when the person is under the
supervision of the department, and governmental law enforcement
agencies designated by the physician or psychiatric advanced registered
nurse practitioner in charge of the patient or the professional person
in charge of the facility, or his or her professional designee;
(o) Pursuant to lawful order of a court;
(p) To qualified staff members of the department, to the director
of ((regional support networks)) behavioral health organizations, to
resource management services responsible for serving a patient, or to
service providers designated by resource management services as
necessary to determine the progress and adequacy of treatment and to
determine whether the person should be transferred to a less
restrictive or more appropriate treatment modality or facility;
(q) Within the treatment facility where the patient is receiving
treatment, confidential information may be disclosed to persons
employed, serving in bona fide training programs, or participating in
supervised volunteer programs, at the facility when it is necessary to
perform their duties;
(r) Within the department as necessary to coordinate treatment for
mental illness, developmental disabilities, alcoholism, or drug abuse
of persons who are under the supervision of the department;
(s) To a licensed physician or psychiatric advanced registered
nurse practitioner who has determined that the life or health of the
person is in danger and that treatment without the information
contained in the mental health treatment records could be injurious to
the patient's health. Disclosure must be limited to the portions of
the records necessary to meet the medical emergency;
(t) Consistent with the requirements of the federal health
information portability and accountability act, to a licensed mental
health professional or a health care professional licensed under
chapter 18.71, 18.71A, 18.57, 18.57A, 18.79, or 18.36A RCW who is
providing care to a person, or to whom a person has been referred for
evaluation or treatment, to assure coordinated care and treatment of
that person. Psychotherapy notes, as defined in 45 C.F.R. Sec.
164.501, may not be released without authorization of the person who is
the subject of the request for release of information;
(u) To administrative and office support staff designated to obtain
medical records for those licensed professionals listed in (t) of this
subsection;
(v) To a facility that is to receive a person who is involuntarily
committed under chapter 71.05 RCW, or upon transfer of the person from
one treatment facility to another. The release of records under this
subsection is limited to the mental health treatment records required
by law, a record or summary of all somatic treatments, and a discharge
summary. The discharge summary may include a statement of the
patient's problem, the treatment goals, the type of treatment which has
been provided, and recommendation for future treatment, but may not
include the patient's complete treatment record;
(w) To the person's counsel or guardian ad litem, without
modification, at any time in order to prepare for involuntary
commitment or recommitment proceedings, reexaminations, appeals, or
other actions relating to detention, admission, commitment, or
patient's rights under chapter 71.05 RCW;
(x) To staff members of the protection and advocacy agency or to
staff members of a private, nonprofit corporation for the purpose of
protecting and advocating the rights of persons with mental disorders
or developmental disabilities. Resource management services may limit
the release of information to the name, birthdate, and county of
residence of the patient, information regarding whether the patient was
voluntarily admitted, or involuntarily committed, the date and place of
admission, placement, or commitment, the name and address of a guardian
of the patient, and the date and place of the guardian's appointment.
Any staff member who wishes to obtain additional information must
notify the patient's resource management services in writing of the
request and of the resource management services' right to object. The
staff member shall send the notice by mail to the guardian's address.
If the guardian does not object in writing within fifteen days after
the notice is mailed, the staff member may obtain the additional
information. If the guardian objects in writing within fifteen days
after the notice is mailed, the staff member may not obtain the
additional information;
(y) To all current treating providers of the patient with
prescriptive authority who have written a prescription for the patient
within the last twelve months. For purposes of coordinating health
care, the department may release without written authorization of the
patient, information acquired for billing and collection purposes as
described in RCW 70.02.050(1)(e). The department shall notify the
patient that billing and collection information has been released to
named providers, and provide the substance of the information released
and the dates of such release. The department may not release
counseling, inpatient psychiatric hospitalization, or drug and alcohol
treatment information without a signed written release from the client;
(z)(i) To the secretary of social and health services for either
program evaluation or research, or both so long as the secretary adopts
rules for the conduct of the evaluation or research, or both. Such
rules must include, but need not be limited to, the requirement that
all evaluators and researchers sign an oath of confidentiality
substantially as follows:
"As a condition of conducting evaluation or research concerning
persons who have received services from (fill in the facility, agency,
or person) I, . . . . . ., agree not to divulge, publish, or otherwise
make known to unauthorized persons or the public any information
obtained in the course of such evaluation or research regarding persons
who have received services such that the person who received such
services is identifiable.
I recognize that unauthorized release of confidential information
may subject me to civil liability under the provisions of state law.
/s/ . . . . . ."
(ii) Nothing in this chapter may be construed to prohibit the
compilation and publication of statistical data for use by government
or researchers under standards, including standards to assure
maintenance of confidentiality, set forth by the secretary.
(3) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for chemical dependency, the department
may restrict the release of the information as necessary to comply with
federal law and regulations.
(4) Civil liability and immunity for the release of information
about a particular person who is committed to the department of social
and health services under RCW 71.05.280(3) and 71.05.320(3)(c) after
dismissal of a sex offense as defined in RCW 9.94A.030, is governed by
RCW 4.24.550.
(5) The fact of admission to a provider of mental health services,
as well as all records, files, evidence, findings, or orders made,
prepared, collected, or maintained pursuant to chapter 71.05 RCW are
not admissible as evidence in any legal proceeding outside that chapter
without the written authorization of the person who was the subject of
the proceeding except as provided in RCW 70.02.260, in a subsequent
criminal prosecution of a person committed pursuant to RCW 71.05.280(3)
or 71.05.320(3)(c) on charges that were dismissed pursuant to chapter
10.77 RCW due to incompetency to stand trial, in a civil commitment
proceeding pursuant to chapter 71.09 RCW, or, in the case of a minor,
a guardianship or dependency proceeding. The records and files
maintained in any court proceeding pursuant to chapter 71.05 RCW must
be confidential and available subsequent to such proceedings only to
the person who was the subject of the proceeding or his or her
attorney. In addition, the court may order the subsequent release or
use of such records or files only upon good cause shown if the court
finds that appropriate safeguards for strict confidentiality are and
will be maintained.
(6)(a) Except as provided in RCW 4.24.550, any person may bring an
action against an individual who has willfully released confidential
information or records concerning him or her in violation of the
provisions of this section, for the greater of the following amounts:
(i) One thousand dollars; or
(ii) Three times the amount of actual damages sustained, if any.
(b) It is not a prerequisite to recovery under this subsection that
the plaintiff suffered or was threatened with special, as contrasted
with general, damages.
(c) Any person may bring an action to enjoin the release of
confidential information or records concerning him or her or his or her
ward, in violation of the provisions of this section, and may in the
same action seek damages as provided in this subsection.
(d) The court may award to the plaintiff, should he or she prevail
in any action authorized by this subsection, reasonable attorney fees
in addition to those otherwise provided by law.
(e) If an action is brought under this subsection, no action may be
brought under RCW 70.02.170.
Sec. 72 RCW 70.02.250 and 2013 c 200 s 9 are each amended to read
as follows:
(1) Information and records related to mental health services
delivered to a person subject to chapter 9.94A or 9.95 RCW must be
released, upon request, by a mental health service agency to department
of corrections personnel for whom the information is necessary to carry
out the responsibilities of their office. The information must be
provided only for the purpose of completing presentence investigations,
supervision of an incarcerated person, planning for and provision of
supervision of a person, or assessment of a person's risk to the
community. The request must be in writing and may not require the
consent of the subject of the records.
(2) The information to be released to the department of corrections
must 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 (1) of
this section.
(3) The department shall, subject to available resources,
electronically, or by the most cost-effective means available, provide
the department of corrections with the names, last dates of services,
and addresses of specific ((regional support networks)) behavioral
health organizations and mental health service agencies that delivered
mental health services to a person subject to chapter 9.94A or 9.95 RCW
pursuant to an agreement between the departments.
(4) The department and the department of corrections, in
consultation with ((regional support networks)) behavioral health
organizations, mental health service agencies as defined in RCW
70.02.010, mental health consumers, and advocates for persons with
mental illness, shall adopt rules to implement the provisions of this
section related to the type and scope of information to be released.
These rules must:
(a) Enhance and facilitate the ability of the department of
corrections to carry out its responsibility of planning and ensuring
community protection with respect to persons subject to sentencing
under chapter 9.94A or 9.95 RCW, including accessing and releasing or
disclosing information of persons who received mental health services
as a minor; and
(b) Establish requirements for the notification of persons under
the supervision of the department of corrections regarding the
provisions of this section.
(5) The information received by the department of corrections under
this section must remain confidential and subject to the limitations on
disclosure outlined in chapter 71.34 RCW, except as provided in RCW
72.09.585.
(6) No mental health service agency or individual employed by a
mental health service agency may be held responsible for information
released to or used by the department of corrections under the
provisions of this section or rules adopted under this section.
(7) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for alcoholism or drug dependency, the
release of the information may be restricted as necessary to comply
with federal law and regulations.
(8) This section does not modify the terms and conditions of
disclosure of information related to sexually transmitted diseases
under this chapter.
Sec. 73 RCW 70.320.010 and 2013 c 320 s 1 are each amended to
read as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Authority" means the health care authority.
(2) "Department" means the department of social and health
services.
(3) "Emerging best practice" or "promising practice" means a
program or practice that, based on statistical analyses or a well-established theory of change, shows potential for meeting the evidence-based or research-based criteria, which may include the use of a
program that is evidence-based for outcomes other than those listed in
this section.
(4) "Evidence-based" means a program or practice that has been
tested in heterogeneous or intended populations with multiple
randomized, or statistically controlled evaluations, or both; or one
large multiple site randomized, or statistically controlled evaluation,
or both, where the weight of the evidence from a systemic review
demonstrates sustained improvements in at least one outcome.
"Evidence-based" also means a program or practice that can be
implemented with a set of procedures to allow successful replication in
Washington and, when possible, is determined to be cost-beneficial.
(5) "Research-based" means a program or practice that has been
tested with a single randomized, or statistically controlled
evaluation, or both, demonstrating sustained desirable outcomes; or
where the weight of the evidence from a systemic review supports
sustained outcomes as described in this subsection but does not meet
the full criteria for evidence-based.
(6) "Service coordination organization" or "service contracting
entity" means the authority and department, or an entity that may
contract with the state to provide, directly or through subcontracts,
a comprehensive delivery system of medical, behavioral, long-term care,
or social support services, including entities such as ((regional
support networks)) behavioral health organizations as defined in RCW
71.24.025, managed care organizations that provide medical services to
clients under chapter 74.09 RCW, counties providing chemical dependency
services under chapters 74.50 and 70.96A RCW, and area agencies on
aging providing case management services under chapter 74.39A RCW.
Sec. 74 RCW 70.96B.010 and 2011 c 89 s 10 are each amended to
read as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Admission" or "admit" means a decision by a physician that a
person should be examined or treated as a patient in a hospital, an
evaluation and treatment facility, or other inpatient facility, or a
decision by a professional person in charge or his or her designee that
a person should be detained as a patient for evaluation and treatment
in a secure detoxification facility or other certified chemical
dependency provider.
(2) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes but is not limited to atypical
antipsychotic medications.
(3) "Approved treatment program" means a discrete program of
chemical dependency treatment provided by a treatment program certified
by the department as meeting standards adopted under chapter 70.96A
RCW.
(4) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient.
(5) "Chemical dependency" means:
(a) Alcoholism;
(b) Drug addiction; or
(c) Dependence on alcohol and one or more other psychoactive
chemicals, as the context requires.
(6) "Chemical dependency professional" means a person certified as
a chemical dependency professional by the department of health under
chapter 18.205 RCW.
(7) "Commitment" means the determination by a court that a person
should be detained for a period of either evaluation or treatment, or
both, in an inpatient or a less restrictive setting.
(8) "Conditional release" means a revocable modification of a
commitment that may be revoked upon violation of any of its terms.
(9) "Custody" means involuntary detention under either chapter
71.05 or 70.96A RCW or this chapter, uninterrupted by any period of
unconditional release from commitment from a facility providing
involuntary care and treatment.
(10) "Department" means the department of social and health
services.
(11) "Designated chemical dependency specialist" or "specialist"
means a person designated by the county alcoholism and other drug
addiction program coordinator designated under RCW 70.96A.310 to
perform the commitment duties described in RCW 70.96A.140 and this
chapter, and qualified to do so by meeting standards adopted by the
department.
(12) "Designated crisis responder" means a person designated by the
county or ((regional support network)) behavioral health organization
to perform the duties specified in this chapter.
(13) "Designated mental health professional" means a mental health
professional designated by the county or other authority authorized in
rule to perform the duties specified in this chapter.
(14) "Detention" or "detain" means the lawful confinement of a
person under this chapter, or chapter 70.96A or 71.05 RCW.
(15) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with individuals with developmental disabilities
and is a psychiatrist, psychologist, or social worker, and such other
developmental disabilities professionals as may be defined by rules
adopted by the secretary.
(16) "Developmental disability" means that condition defined in RCW
71A.10.020.
(17) "Discharge" means the termination of facility authority. The
commitment may remain in place, be terminated, or be amended by court
order.
(18) "Evaluation and treatment facility" means any facility that
can provide directly, or by direct arrangement with other public or
private agencies, emergency evaluation and treatment, outpatient care,
and timely and appropriate inpatient care to persons suffering from a
mental disorder, and that is certified as such by the department. A
physically separate and separately operated portion of a state hospital
may be designated as an evaluation and treatment facility. A facility
that is part of, or operated by, the department or any federal agency
does not require certification. No correctional institution or
facility, or jail, may be an evaluation and treatment facility within
the meaning of this chapter.
(19) "Facility" means either an evaluation and treatment facility
or a secure detoxification facility.
(20) "Gravely disabled" means a condition in which a person, as a
result of a mental disorder, or as a result of the use of alcohol or
other psychoactive chemicals:
(a) Is in danger of serious physical harm resulting from a failure
to provide for his or her essential human needs of health or safety; or
(b) Manifests severe deterioration in routine functioning evidenced
by repeated and escalating loss of cognitive or volitional control over
his or her actions and is not receiving such care as is essential for
his or her health or safety.
(21) "History of one or more violent acts" refers to the period of
time ten years before the filing of a petition under this chapter, or
chapter 70.96A or 71.05 RCW, excluding any time spent, but not any
violent acts committed, in a mental health facility or a long-term
alcoholism or drug treatment facility, or in confinement as a result of
a criminal conviction.
(22) "Imminent" means the state or condition of being likely to
occur at any moment or near at hand, rather than distant or remote.
(23) "Intoxicated person" means a person whose mental or physical
functioning is substantially impaired as a result of the use of alcohol
or other psychoactive chemicals.
(24) "Judicial commitment" means a commitment by a court under this
chapter.
(25) "Licensed physician" means a person licensed to practice
medicine or osteopathic medicine and surgery in the state of
Washington.
(26) "Likelihood of serious harm" means:
(a) A substantial risk that:
(i) Physical harm will be inflicted by a person upon his or her own
person, as evidenced by threats or attempts to commit suicide or
inflict physical harm on oneself;
(ii) Physical harm will be inflicted by a person upon another, as
evidenced by behavior that has caused such harm or that places another
person or persons in reasonable fear of sustaining such harm; or
(iii) Physical harm will be inflicted by a person upon the property
of others, as evidenced by behavior that has caused substantial loss or
damage to the property of others; or
(b) The person has threatened the physical safety of another and
has a history of one or more violent acts.
(27) "Mental disorder" means any organic, mental, or emotional
impairment that has substantial adverse effects on a person's cognitive
or volitional functions.
(28) "Mental health professional" means a psychiatrist,
psychologist, psychiatric nurse, or social worker, and such other
mental health professionals as may be defined by rules adopted by the
secretary under the authority of chapter 71.05 RCW.
(29) "Peace officer" means a law enforcement official of a public
agency or governmental unit, and includes persons specifically given
peace officer powers by any state law, local ordinance, or judicial
order of appointment.
(30) "Person in charge" means a physician or chemical dependency
counselor as defined in rule by the department, who is empowered by a
certified treatment program with authority to make assessment,
admission, continuing care, and discharge decisions on behalf of the
certified program.
(31) "Private agency" means any person, partnership, corporation,
or association that is not a public agency, whether or not financed in
whole or in part by public funds, that constitutes an evaluation and
treatment facility or private institution, or hospital, or approved
treatment program, that is conducted for, or includes a department or
ward conducted for, the care and treatment of persons who are mentally
ill and/or chemically dependent.
(32) "Professional person" means a mental health professional or
chemical dependency professional and shall also mean a physician,
registered nurse, and such others as may be defined by rules adopted by
the secretary pursuant to the provisions of this chapter.
(33) "Psychiatrist" means a person having a license as a physician
and surgeon in this state who has in addition completed three years of
graduate training in psychiatry in a program approved by the American
medical association or the American osteopathic association and is
certified or eligible to be certified by the American board of
psychiatry and neurology.
(34) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(35) "Public agency" means any evaluation and treatment facility or
institution, or hospital, or approved treatment program that is
conducted for, or includes a department or ward conducted for, the care
and treatment of persons who are mentally ill and/or chemically
dependent, if the agency is operated directly by federal, state,
county, or municipal government, or a combination of such governments.
(36) "Registration records" means all the records of the
department, ((regional support networks)) behavioral health
organizations, treatment facilities, and other persons providing
services to the department, county departments, or facilities which
identify persons who are receiving or who at any time have received
services for mental illness.
(37) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW or this chapter.
(38) "Secretary" means the secretary of the department or the
secretary's designee.
(39) "Secure detoxification facility" means a facility operated by
either a public or private agency or by the program of an agency that
serves the purpose of providing evaluation and assessment, and acute
and/or subacute detoxification services for intoxicated persons and
includes security measures sufficient to protect the patients, staff,
and community.
(40) "Social worker" means a person with a master's or further
advanced degree from a social work educational program accredited and
approved as provided in RCW 18.320.010.
(41) "Treatment records" means registration records and all other
records concerning persons who are receiving or who at any time have
received services for mental illness, which are maintained by the
department, by ((regional support networks)) behavioral health
organizations and their staffs, and by treatment facilities. Treatment
records do not include notes or records maintained for personal use by
a person providing treatment services for the department, ((regional
support networks)) behavioral health organizations, or a treatment
facility if the notes or records are not available to others.
(42) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
Sec. 75 RCW 70.96B.020 and 2005 c 504 s 203 are each amended to
read as follows:
(1) The secretary, after consulting with the Washington state
association of counties, shall select and contract with ((regional
support networks)) behavioral health organizations or counties to
provide two integrated crisis response and involuntary treatment pilot
programs for adults and shall allocate resources for both integrated
services and secure detoxification services in the pilot areas. In
selecting the two ((regional support networks)) behavioral health
organizations or counties, the secretary shall endeavor to site one in
an urban and one in a rural ((regional support network)) behavioral
health organization or county; and to site them in counties other than
those selected pursuant to RCW 70.96A.800, to the extent necessary to
facilitate evaluation of pilot project results.
(2) The ((regional support networks)) behavioral health
organizations or counties shall implement the pilot programs by
providing integrated crisis response and involuntary treatment to
persons with a chemical dependency, a mental disorder, or both,
consistent with this chapter. The pilot programs shall:
(a) Combine the crisis responder functions of a designated mental
health professional under chapter 71.05 RCW and a designated chemical
dependency specialist under chapter 70.96A RCW by establishing a new
designated crisis responder who is authorized to conduct investigations
and detain persons up to seventy-two hours to the proper facility;
(b) Provide training to the crisis responders as required by the
department;
(c) Provide sufficient staff and resources to ensure availability
of an adequate number of crisis responders twenty-four hours a day,
seven days a week;
(d) Provide the administrative and court-related staff, resources,
and processes necessary to facilitate the legal requirements of the
initial detention and the commitment hearings for persons with a
chemical dependency;
(e) Participate in the evaluation and report to assess the outcomes
of the pilot programs including providing data and information as
requested;
(f) Provide the other services necessary to the implementation of
the pilot programs, consistent with this chapter as determined by the
secretary in contract; and
(g) Collaborate with the department of corrections where persons
detained or committed are also subject to supervision by the department
of corrections.
(3) The pilot programs established by this section shall begin
providing services by March 1, 2006.
Sec. 76 RCW 70.96B.030 and 2005 c 504 s 204 are each amended to
read as follows:
To qualify as a designated crisis responder, a person must have
received chemical dependency training as determined by the department
and be a:
(1) Psychiatrist, psychologist, psychiatric nurse, or social
worker;
(2) Person with a master's degree or further advanced degree in
counseling or one of the social sciences from an accredited college or
university and who have, in addition, at least two years of experience
in direct treatment of persons with mental illness or emotional
disturbance, such experience gained under the direction of a mental
health professional;
(3) Person who meets the waiver criteria of RCW 71.24.260, which
waiver was granted before 1986;
(4) Person who had an approved waiver to perform the duties of a
mental health professional that was requested by the ((regional support
network)) behavioral health organization and granted by the department
before July 1, 2001; or
(5) Person who has been granted a time-limited exception of the
minimum requirements of a mental health professional by the department
consistent with rules adopted by the secretary.
Sec. 77 RCW 70.96C.010 and 2005 c 504 s 601 are each amended to
read as follows:
(1) The department of social and health services, in consultation
with the members of the team charged with developing the state plan for
co-occurring mental and substance abuse disorders, shall adopt, not
later than January 1, 2006, an integrated and comprehensive screening
and assessment process for chemical dependency and mental disorders and
co-occurring chemical dependency and mental disorders.
(a) The process adopted shall include, at a minimum:
(i) An initial screening tool that can be used by intake personnel
system-wide and which will identify the most common types of co-occurring disorders;
(ii) An assessment process for those cases in which assessment is
indicated that provides an appropriate degree of assessment for most
situations, which can be expanded for complex situations;
(iii) Identification of triggers in the screening that indicate the
need to begin an assessment;
(iv) Identification of triggers after or outside the screening that
indicate a need to begin or resume an assessment;
(v) The components of an assessment process and a protocol for
determining whether part or all of the assessment is necessary, and at
what point; and
(vi) Emphasis that the process adopted under this section is to
replace and not to duplicate existing intake, screening, and assessment
tools and processes.
(b) The department shall consider existing models, including those
already adopted by other states, and to the extent possible, adopt an
established, proven model.
(c) The integrated, comprehensive screening and assessment process
shall be implemented statewide by all chemical dependency and mental
health treatment providers as well as all designated mental health
professionals, designated chemical dependency specialists, and
designated crisis responders not later than January 1, 2007.
(2) The department shall provide adequate training to effect
statewide implementation by the dates designated in this section and
shall report the rates of co-occurring disorders and the stage of
screening or assessment at which the co-occurring disorder was
identified to the appropriate committees of the legislature.
(3) The department shall establish contractual penalties to
contracted treatment providers, the ((regional support networks))
behavioral health organizations, and their contracted providers for
failure to implement the integrated screening and assessment process by
July 1, 2007.
Sec. 78 RCW 70.97.010 and 2011 c 89 s 11 are each amended to read
as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes but is not limited to atypical
antipsychotic medications.
(2) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient.
(3) "Chemical dependency" means alcoholism, drug addiction, or
dependence on alcohol and one or more other psychoactive chemicals, as
the context requires and as those terms are defined in chapter 70.96A
RCW.
(4) "Chemical dependency professional" means a person certified as
a chemical dependency professional by the department of health under
chapter 18.205 RCW.
(5) "Commitment" means the determination by a court that an
individual should be detained for a period of either evaluation or
treatment, or both, in an inpatient or a less restrictive setting.
(6) "Conditional release" means a modification of a commitment that
may be revoked upon violation of any of its terms.
(7) "Custody" means involuntary detention under chapter 71.05 or
70.96A RCW, uninterrupted by any period of unconditional release from
commitment from a facility providing involuntary care and treatment.
(8) "Department" means the department of social and health
services.
(9) "Designated responder" means a designated mental health
professional, a designated chemical dependency specialist, or a
designated crisis responder as those terms are defined in chapter
70.96A, 71.05, or 70.96B RCW.
(10) "Detention" or "detain" means the lawful confinement of an
individual under chapter 70.96A or 71.05 RCW.
(11) "Discharge" means the termination of facility authority. The
commitment may remain in place, be terminated, or be amended by court
order.
(12) "Enhanced services facility" means a facility that provides
treatment and services to persons for whom acute inpatient treatment is
not medically necessary and who have been determined by the department
to be inappropriate for placement in other licensed facilities due to
the complex needs that result in behavioral and security issues.
(13) "Expanded community services program" means a nonsecure
program of enhanced behavioral and residential support provided to
long-term and residential care providers serving specifically eligible
clients who would otherwise be at risk for hospitalization at state
hospital geriatric units.
(14) "Facility" means an enhanced services facility.
(15) "Gravely disabled" means a condition in which an individual,
as a result of a mental disorder, as a result of the use of alcohol or
other psychoactive chemicals, or both:
(a) Is in danger of serious physical harm resulting from a failure
to provide for his or her essential human needs of health or safety; or
(b) Manifests severe deterioration in routine functioning evidenced
by repeated and escalating loss of cognitive or volitional control over
his or her actions and is not receiving such care as is essential for
his or her health or safety.
(16) "History of one or more violent acts" refers to the period of
time ten years before the filing of a petition under this chapter, or
chapter 70.96A or 71.05 RCW, excluding any time spent, but not any
violent acts committed, in a mental health facility or a long-term
alcoholism or drug treatment facility, or in confinement as a result of
a criminal conviction.
(17) "Licensed physician" means a person licensed to practice
medicine or osteopathic medicine and surgery in the state of
Washington.
(18) "Likelihood of serious harm" means:
(a) A substantial risk that:
(i) Physical harm will be inflicted by an individual upon his or
her own person, as evidenced by threats or attempts to commit suicide
or inflict physical harm on oneself;
(ii) Physical harm will be inflicted by an individual upon another,
as evidenced by behavior that has caused such harm or that places
another person or persons in reasonable fear of sustaining such harm;
or
(iii) Physical harm will be inflicted by an individual upon the
property of others, as evidenced by behavior that has caused
substantial loss or damage to the property of others; or
(b) The individual has threatened the physical safety of another
and has a history of one or more violent acts.
(19) "Mental disorder" means any organic, mental, or emotional
impairment that has substantial adverse effects on an individual's
cognitive or volitional functions.
(20) "Mental health professional" means a psychiatrist,
psychologist, psychiatric nurse, or social worker, and such other
mental health professionals as may be defined by rules adopted by the
secretary under the authority of chapter 71.05 RCW.
(21) "Professional person" means a mental health professional and
also means a physician, registered nurse, and such others as may be
defined in rules adopted by the secretary pursuant to the provisions of
this chapter.
(22) "Psychiatrist" means a person having a license as a physician
and surgeon in this state who has in addition completed three years of
graduate training in psychiatry in a program approved by the American
medical association or the American osteopathic association and is
certified or eligible to be certified by the American board of
psychiatry and neurology.
(23) "Psychologist" means a person who has been licensed as a
psychologist under chapter 18.83 RCW.
(24) "Registration records" include all the records of the
department, ((regional support networks)) behavioral health
organizations, treatment facilities, and other persons providing
services to the department, county departments, or facilities which
identify individuals who are receiving or who at any time have received
services for mental illness.
(25) "Release" means legal termination of the commitment under
chapter 70.96A or 71.05 RCW.
(26) "Resident" means a person admitted to an enhanced services
facility.
(27) "Secretary" means the secretary of the department or the
secretary's designee.
(28) "Significant change" means:
(a) A deterioration in a resident's physical, mental, or
psychosocial condition that has caused or is likely to cause clinical
complications or life-threatening conditions; or
(b) An improvement in the resident's physical, mental, or
psychosocial condition that may make the resident eligible for release
or for treatment in a less intensive or less secure setting.
(29) "Social worker" means a person with a master's or further
advanced degree from a social work educational program accredited and
approved as provided in RCW 18.320.010.
(30) "Treatment" means the broad range of emergency,
detoxification, residential, inpatient, and outpatient services and
care, including diagnostic evaluation, mental health or chemical
dependency education and counseling, medical, psychiatric,
psychological, and social service care, vocational rehabilitation, and
career counseling, which may be extended to persons with mental
disorders, chemical dependency disorders, or both, and their families.
(31) "Treatment records" include registration and all other records
concerning individuals who are receiving or who at any time have
received services for mental illness, which are maintained by the
department, by ((regional support networks)) behavioral health
organizations and their staffs, and by treatment facilities.
"Treatment records" do not include notes or records maintained for
personal use by an individual providing treatment services for the
department, ((regional support networks)) behavioral health
organizations, or a treatment facility if the notes or records are not
available to others.
(32) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
Sec. 79 RCW 71.05.020 and 2011 c 148 s 1 and 2011 c 89 s 14 are
each reenacted and amended to read as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Admission" or "admit" means a decision by a physician or
psychiatric advanced registered nurse practitioner that a person should
be examined or treated as a patient in a hospital;
(2) "Antipsychotic medications" means that class of drugs primarily
used to treat serious manifestations of mental illness associated with
thought disorders, which includes, but is not limited to atypical
antipsychotic medications;
(3) "Attending staff" means any person on the staff of a public or
private agency having responsibility for the care and treatment of a
patient;
(4) "Commitment" means the determination by a court that a person
should be detained for a period of either evaluation or treatment, or
both, in an inpatient or a less restrictive setting;
(5) "Conditional release" means a revocable modification of a
commitment, which may be revoked upon violation of any of its terms;
(6) "Crisis stabilization unit" means a short-term facility or a
portion of a facility licensed by the department of health and
certified by the department of social and health services under RCW
71.24.035, such as an evaluation and treatment facility or a hospital,
which has been designed to assess, diagnose, and treat individuals
experiencing an acute crisis without the use of long-term
hospitalization;
(7) "Custody" means involuntary detention under the provisions of
this chapter or chapter 10.77 RCW, uninterrupted by any period of
unconditional release from commitment from a facility providing
involuntary care and treatment;
(8) "Department" means the department of social and health
services;
(9) "Designated chemical dependency specialist" means a person
designated by the county alcoholism and other drug addiction program
coordinator designated under RCW 70.96A.310 to perform the commitment
duties described in chapters 70.96A and 70.96B RCW;
(10) "Designated crisis responder" means a mental health
professional appointed by the county or the ((regional support
network)) behavioral health organization to perform the duties
specified in this chapter;
(11) "Designated mental health professional" means a mental health
professional designated by the county or other authority authorized in
rule to perform the duties specified in this chapter;
(12) "Detention" or "detain" means the lawful confinement of a
person, under the provisions of this chapter;
(13) "Developmental disabilities professional" means a person who
has specialized training and three years of experience in directly
treating or working with persons with developmental disabilities and is
a psychiatrist, psychologist, psychiatric advanced registered nurse
practitioner, or social worker, and such other developmental
disabilities professionals as may be defined by rules adopted by the
secretary;
(14) "Developmental disability" means that condition defined in RCW
71A.10.020(((3)))(4);
(15) "Discharge" means the termination of hospital medical
authority. The commitment may remain in place, be terminated, or be
amended by court order;
(16) "Evaluation and treatment facility" means any facility which
can provide directly, or by direct arrangement with other public or
private agencies, emergency evaluation and treatment, outpatient care,
and timely and appropriate inpatient care to persons suffering from a
mental disorder, and which is certified as such by the department. A
physically separate and separately operated portion of a state hospital
may be designated as an evaluation and treatment facility. A facility
which is part of, or operated by, the department or any federal agency
will not require certification. No correctional institution or
facility, or jail, shall be an evaluation and treatment facility within
the meaning of this chapter;
(17) "Gravely disabled" means a condition in which a person, as a
result of a mental disorder: (a) Is in danger of serious physical harm
resulting from a failure to provide for his or her essential human
needs of health or safety; or (b) manifests severe deterioration in
routine functioning evidenced by repeated and escalating loss of
cognitive or volitional control over his or her actions and is not
receiving such care as is essential for his or her health or safety;
(18) "Habilitative services" means those services provided by
program personnel to assist persons in acquiring and maintaining life
skills and in raising their levels of physical, mental, social, and
vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the person being assisted as manifested by prior charged
criminal conduct;
(19) "History of one or more violent acts" refers to the period of
time ten years prior to the filing of a petition under this chapter,
excluding any time spent, but not any violent acts committed, in a
mental health facility or in confinement as a result of a criminal
conviction;
(20) "Imminent" means the state or condition of being likely to
occur at any moment or near at hand, rather than distant or remote;
(21) "Individualized service plan" means a plan prepared by a
developmental disabilities professional with other professionals as a
team, for a person with developmental disabilities, which shall state:
(a) The nature of the person's specific problems, prior charged
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
(e) The staff responsible for carrying out the plan;
(f) Where relevant in light of past criminal behavior and due
consideration for public safety, the criteria for proposed movement to
less-restrictive settings, criteria for proposed eventual discharge or
release, and a projected possible date for discharge or release; and
(g) The type of residence immediately anticipated for the person
and possible future types of residences;
(22) "Information related to mental health services" means all
information and records compiled, obtained, or maintained in the course
of providing services to either voluntary or involuntary recipients of
services by a mental health service provider. This may include
documents of legal proceedings under this chapter or chapter 71.34 or
10.77 RCW, or somatic health care information;
(23) "Judicial commitment" means a commitment by a court pursuant
to the provisions of this chapter;
(24) "Legal counsel" means attorneys and staff employed by county
prosecutor offices or the state attorney general acting in their
capacity as legal representatives of public mental health service
providers under RCW 71.05.130;
(25) "Likelihood of serious harm" means:
(a) A substantial risk that: (i) Physical harm will be inflicted
by a person upon his or her own person, as evidenced by threats or
attempts to commit suicide or inflict physical harm on oneself; (ii)
physical harm will be inflicted by a person upon another, as evidenced
by behavior which has caused such harm or which places another person
or persons in reasonable fear of sustaining such harm; or (iii)
physical harm will be inflicted by a person upon the property of
others, as evidenced by behavior which has caused substantial loss or
damage to the property of others; or
(b) The person has threatened the physical safety of another and
has a history of one or more violent acts;
(26) "Mental disorder" means any organic, mental, or emotional
impairment which has substantial adverse effects on a person's
cognitive or volitional functions;
(27) "Mental health professional" means a psychiatrist,
psychologist, psychiatric advanced registered nurse practitioner,
psychiatric nurse, or social worker, and such other mental health
professionals as may be defined by rules adopted by the secretary
pursuant to the provisions of this chapter;
(28) "Mental health service provider" means a public or private
agency that provides mental health services to persons with mental
disorders as defined under this section and receives funding from
public sources. This includes, but is not limited to, hospitals
licensed under chapter 70.41 RCW, evaluation and treatment facilities
as defined in this section, community mental health service delivery
systems or community mental health programs as defined in RCW
71.24.025, facilities conducting competency evaluations and restoration
under chapter 10.77 RCW, and correctional facilities operated by state
and local governments;
(29) "Peace officer" means a law enforcement official of a public
agency or governmental unit, and includes persons specifically given
peace officer powers by any state law, local ordinance, or judicial
order of appointment;
(30) "Private agency" means any person, partnership, corporation,
or association that is not a public agency, whether or not financed in
whole or in part by public funds, which constitutes an evaluation and
treatment facility or private institution, or hospital, which is
conducted for, or includes a department or ward conducted for, the care
and treatment of persons who are mentally ill;
(31) "Professional person" means a mental health professional and
shall also mean a physician, psychiatric advanced registered nurse
practitioner, registered nurse, and such others as may be defined by
rules adopted by the secretary pursuant to the provisions of this
chapter;
(32) "Psychiatric advanced registered nurse practitioner" means a
person who is licensed as an advanced registered nurse practitioner
pursuant to chapter 18.79 RCW; and who is board certified in advanced
practice psychiatric and mental health nursing;
(33) "Psychiatrist" means a person having a license as a physician
and surgeon in this state who has in addition completed three years of
graduate training in psychiatry in a program approved by the American
medical association or the American osteopathic association and is
certified or eligible to be certified by the American board of
psychiatry and neurology;
(34) "Psychologist" means a person who has been licensed as a
psychologist pursuant to chapter 18.83 RCW;
(35) "Public agency" means any evaluation and treatment facility or
institution, or hospital which is conducted for, or includes a
department or ward conducted for, the care and treatment of persons
with mental illness, if the agency is operated directly by, federal,
state, county, or municipal government, or a combination of such
governments;
(36) "Registration records" include all the records of the
department, ((regional support networks)) behavioral health
organizations, treatment facilities, and other persons providing
services to the department, county departments, or facilities which
identify persons who are receiving or who at any time have received
services for mental illness;
(37) "Release" means legal termination of the commitment under the
provisions of this chapter;
(38) "Resource management services" has the meaning given in
chapter 71.24 RCW;
(39) "Secretary" means the secretary of the department of social
and health services, or his or her designee;
(40) "Serious violent offense" has the same meaning as provided in
RCW 9.94A.030;
(41) "Social worker" means a person with a master's or further
advanced degree from a social work educational program accredited and
approved as provided in RCW 18.320.010;
(42) "Therapeutic court personnel" means the staff of a mental
health court or other therapeutic court which has jurisdiction over
defendants who are dually diagnosed with mental disorders, including
court personnel, probation officers, a court monitor, prosecuting
attorney, or defense counsel acting within the scope of therapeutic
court duties;
(43) "Triage facility" means a short-term facility or a portion of
a facility licensed by the department of health and certified by the
department of social and health services under RCW 71.24.035, which is
designed as a facility to assess and stabilize an individual or
determine the need for involuntary commitment of an individual, and
must meet department of health residential treatment facility
standards. A triage facility may be structured as a voluntary or
involuntary placement facility;
(44) "Treatment records" include registration and all other records
concerning persons who are receiving or who at any time have received
services for mental illness, which are maintained by the department, by
((regional support networks)) behavioral health organizations and their
staffs, and by treatment facilities. Treatment records include mental
health information contained in a medical bill including but not
limited to mental health drugs, a mental health diagnosis, provider
name, and dates of service stemming from a medical service. Treatment
records do not include notes or records maintained for personal use by
a person providing treatment services for the department, ((regional
support networks)) behavioral health organizations, or a treatment
facility if the notes or records are not available to others;
(45) "Violent act" means behavior that resulted in homicide,
attempted suicide, nonfatal injuries, or substantial damage to
property.
Sec. 80 RCW 71.05.025 and 2000 c 94 s 2 are each amended to read
as follows:
The legislature intends that the procedures and services authorized
in this chapter be integrated with those in chapter 71.24 RCW to the
maximum extent necessary to assure a continuum of care to persons ((who
are mentally ill)) with mental illness or who have mental disorders, as
defined in either or both this chapter and chapter 71.24 RCW. To this
end, ((regional support networks)) behavioral health organizations
established in accordance with chapter 71.24 RCW shall institute
procedures which require timely consultation with resource management
services by ((county-))designated mental health professionals and
evaluation and treatment facilities to assure that determinations to
admit, detain, commit, treat, discharge, or release persons with mental
disorders under this chapter are made only after appropriate
information regarding such person's treatment history and current
treatment plan has been sought from resource management services.
Sec. 81 RCW 71.05.026 and 2006 c 333 s 301 are each amended to
read as follows:
(1) Except for monetary damage claims which have been reduced to
final judgment by a superior court, this section applies to all claims
against the state, state agencies, state officials, or state employees
that exist on or arise after March 29, 2006.
(2) Except as expressly provided in contracts entered into between
the department and the ((regional support networks)) behavioral health
organizations after March 29, 2006, the entities identified in
subsection (3) of this section shall have no claim for declaratory
relief, injunctive relief, judicial review under chapter 34.05 RCW, or
civil liability against the state or state agencies for actions or
inactions performed pursuant to the administration of this chapter with
regard to the following: (a) The allocation or payment of federal or
state funds; (b) the use or allocation of state hospital beds; or (c)
financial responsibility for the provision of inpatient mental health
care.
(3) This section applies to counties, ((regional support networks))
behavioral health organizations, and entities which contract to provide
((regional support network)) behavioral health organization services
and their subcontractors, agents, or employees.
Sec. 82 RCW 71.05.027 and 2005 c 504 s 103 are each amended to
read as follows:
(1) Not later than January 1, 2007, all persons providing treatment
under this chapter shall also implement the integrated comprehensive
screening and assessment process for chemical dependency and mental
disorders adopted pursuant to RCW 70.96C.010 and shall document the
numbers of clients with co-occurring mental and substance abuse
disorders based on a quadrant system of low and high needs.
(2) Treatment providers and ((regional support networks))
behavioral health organizations who fail to implement the integrated
comprehensive screening and assessment process for chemical dependency
and mental disorders by July 1, 2007, shall be subject to contractual
penalties established under RCW 70.96C.010.
Sec. 83 RCW 71.05.110 and 2011 c 343 s 5 are each amended to read
as follows:
Attorneys appointed for persons pursuant to this chapter shall be
compensated for their services as follows: (1) The person for whom an
attorney is appointed shall, if he or she is financially able pursuant
to standards as to financial capability and indigency set by the
superior court of the county in which the proceeding is held, bear the
costs of such legal services; (2) if such person is indigent pursuant
to such standards, the ((regional support network)) behavioral health
organization shall reimburse the county in which the proceeding is held
for the direct costs of such legal services, as provided in RCW
71.05.730.
Sec. 84 RCW 71.05.300 and 2009 c 293 s 5 and 2009 c 217 s 4 are
each reenacted and amended to read as follows:
(1) The petition for ninety day treatment shall be filed with the
clerk of the superior court at least three days before expiration of
the fourteen-day period of intensive treatment. At the time of filing
such petition, the clerk shall set a time for the person to come before
the court on the next judicial day after the day of filing unless such
appearance is waived by the person's attorney, and the clerk shall
notify the designated mental health professional. The designated
mental health professional shall immediately notify the person
detained, his or her attorney, if any, and his or her guardian or
conservator, if any, the prosecuting attorney, and the ((regional
support network)) behavioral health organization administrator, and
provide a copy of the petition to such persons as soon as possible.
The ((regional support network)) behavioral health organization
administrator or designee may review the petition and may appear and
testify at the full hearing on the petition.
(2) At the time set for appearance the detained person shall be
brought before the court, unless such appearance has been waived and
the court shall advise him or her of his or her right to be represented
by an attorney, his or her right to a jury trial, and his or her loss
of firearm rights if involuntarily committed. If the detained person
is not represented by an attorney, or is indigent or is unwilling to
retain an attorney, the court shall immediately appoint an attorney to
represent him or her. The court shall, if requested, appoint a
reasonably available licensed physician, psychiatric advanced
registered nurse practitioner, psychologist, or psychiatrist,
designated by the detained person to examine and testify on behalf of
the detained person.
(3) The court may, if requested, also appoint a professional person
as defined in RCW 71.05.020 to seek less restrictive alternative
courses of treatment and to testify on behalf of the detained person.
In the case of a person with a developmental disability who has been
determined to be incompetent pursuant to RCW 10.77.086(4), then the
appointed professional person under this section shall be a
developmental disabilities professional.
(4) The court shall also set a date for a full hearing on the
petition as provided in RCW 71.05.310.
Sec. 85 RCW 71.05.365 and 2013 c 338 s 4 are each amended to read
as follows:
When a person has been involuntarily committed for treatment to a
hospital for a period of ninety or one hundred eighty days, and the
superintendent or professional person in charge of the hospital
determines that the person no longer requires active psychiatric
treatment at an inpatient level of care, the ((regional support
network)) behavioral health organization responsible for resource
management services for the person must work with the hospital to
develop an individualized discharge plan and arrange for a transition
to the community in accordance with the person's individualized
discharge plan within twenty-one days of the determination.
Sec. 86 RCW 71.05.445 and 2013 c 200 s 31 are each amended to
read as follows:
(1)(a) When a mental health service provider conducts its initial
assessment for a person receiving court-ordered treatment, the service
provider shall inquire and shall be told by the offender whether he or
she is subject to supervision by the department of corrections.
(b) When a person receiving court-ordered treatment or treatment
ordered by the department of corrections discloses to his or her mental
health service provider that he or she is subject to supervision by the
department of corrections, the mental health service provider shall
notify the department of corrections that he or she is treating the
offender and shall notify the offender that his or her community
corrections officer will be notified of the treatment, provided that if
the offender has received relief from disclosure pursuant to RCW
9.94A.562, 70.96A.155, or 71.05.132 and the offender has provided the
mental health service provider with a copy of the order granting relief
from disclosure pursuant to RCW 9.94A.562, 70.96A.155, or 71.05.132,
the mental health service provider is not required to notify the
department of corrections that the mental health service provider is
treating the offender. The notification may be written or oral and
shall not require the consent of the offender. If an oral notification
is made, it must be confirmed by a written notification. For purposes
of this section, a written notification includes notification by e-mail
or facsimile, so long as the notifying mental health service provider
is clearly identified.
(2) The information to be released to the department of corrections
shall include all relevant records and reports, as defined by rule,
necessary for the department of corrections to carry out its duties.
(3) The department and the department of corrections, in
consultation with ((regional support networks)) behavioral health
organizations, mental health service providers as defined in RCW
71.05.020, mental health consumers, and advocates for persons with
mental illness, shall adopt rules to implement the provisions of this
section related to the type and scope of information to be released.
These rules shall:
(a) Enhance and facilitate the ability of the department of
corrections to carry out its responsibility of planning and ensuring
community protection with respect to persons subject to sentencing
under chapter 9.94A or 9.95 RCW, including accessing and releasing or
disclosing information of persons who received mental health services
as a minor; and
(b) Establish requirements for the notification of persons under
the supervision of the department of corrections regarding the
provisions of this section.
(4) The information received by the department of corrections under
this section shall remain confidential and subject to the limitations
on disclosure outlined in chapter 71.05 RCW, except as provided in RCW
72.09.585.
(5) No mental health service provider or individual employed by a
mental health service provider shall be held responsible for
information released to or used by the department of corrections under
the provisions of this section or rules adopted under this section.
(6) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for alcoholism or drug dependency, the
release of the information may be restricted as necessary to comply
with federal law and regulations.
(7) This section does not modify the terms and conditions of
disclosure of information related to sexually transmitted diseases
under chapter 70.24 RCW.
(8) The department shall, subject to available resources,
electronically, or by the most cost-effective means available, provide
the department of corrections with the names, last dates of services,
and addresses of specific ((regional support networks)) behavioral
health organizations and mental health service providers that delivered
mental health services to a person subject to chapter 9.94A or 9.95 RCW
pursuant to an agreement between the departments.
Sec. 87 RCW 71.05.730 and 2011 c 343 s 2 are each amended to read
as follows:
(1) A county may apply to its ((regional support network))
behavioral health organization on a quarterly basis for reimbursement
of its direct costs in providing judicial services for civil commitment
cases under this chapter and chapter 71.34 RCW. The ((regional support
network)) behavioral health organization shall in turn be entitled to
reimbursement from the ((regional support network)) behavioral health
organization that serves the county of residence of the individual who
is the subject of the civil commitment case. Reimbursements under this
section shall be paid out of the ((regional support network's))
behavioral health organization's nonmedicaid appropriation.
(2) Reimbursement for judicial services shall be provided per civil
commitment case at a rate to be determined based on an independent
assessment of the county's actual direct costs. This assessment must
be based on an average of the expenditures for judicial services within
the county over the past three years. In the event that a baseline
cannot be established because there is no significant history of
similar cases within the county, the reimbursement rate shall be equal
to eighty percent of the median reimbursement rate of counties included
in the independent assessment.
(3) For the purposes of this section:
(a) "Civil commitment case" includes all judicial hearings related
to a single episode of hospitalization, or less restrictive alternative
detention in lieu of hospitalization, except that the filing of a
petition for a one hundred eighty-day commitment under this chapter or
a petition for a successive one hundred eighty-day commitment under
chapter 71.34 RCW shall be considered to be a new case regardless of
whether there has been a break in detention. "Civil commitment case"
does not include the filing of a petition for a one hundred eighty-day
commitment under this chapter on behalf of a patient at a state
psychiatric hospital.
(b) "Judicial services" means a county's reasonable direct costs in
providing prosecutor services, assigned counsel and defense services,
court services, and court clerk services for civil commitment cases
under this chapter and chapter 71.34 RCW.
(4) To the extent that resources have shared purpose, the
((regional support network)) behavioral health organization may only
reimburse counties to the extent such resources are necessary for and
devoted to judicial services as described in this section.
(5) No filing fee may be charged or collected for any civil
commitment case subject to reimbursement under this section.
Sec. 88 RCW 71.05.740 and 2013 c 216 s 2 are each amended to read
as follows:
By August 1, 2013, all ((regional support networks)) behavioral
health organizations in the state of Washington must forward historical
mental health involuntary commitment information retained by the
organization including identifying information and dates of commitment
to the department. As soon as feasible, the ((regional support
networks)) behavioral health organizations must arrange to report new
commitment data to the department within twenty-four hours. Commitment
information under this section does not need to be resent if it is
already in the possession of the department. ((Regional support
networks)) Behavioral health organizations and the department shall be
immune from liability related to the sharing of commitment information
under this section.
Sec. 89 RCW 71.34.330 and 2011 c 343 s 8 are each amended to read
as follows:
Attorneys appointed for minors under this chapter shall be
compensated for their services as follows:
(1) Responsible others shall bear the costs of such legal services
if financially able according to standards set by the court of the
county in which the proceeding is held.
(2) If all responsible others are indigent as determined by these
standards, the ((regional support network)) behavioral health
organization shall reimburse the county in which the proceeding is held
for the direct costs of such legal services, as provided in RCW
71.05.730.
Sec. 90 RCW 71.34.415 and 2011 c 343 s 4 are each amended to read
as follows:
A county may apply to its ((regional support network)) behavioral
health organization for reimbursement of its direct costs in providing
judicial services for civil commitment cases under this chapter, as
provided in RCW 71.05.730.
Sec. 91 RCW 71.36.010 and 2007 c 359 s 2 are each amended to read
as follows:
Unless the context clearly requires otherwise, the definitions in
this section apply throughout this chapter.
(1) "Agency" means a state, tribal, or local governmental entity or
a private not-for-profit organization.
(2) "Child" means a person under eighteen years of age, except as
expressly provided otherwise in state or federal law.
(3) "Consensus-based" means a program or practice that has general
support among treatment providers and experts, based on experience or
professional literature, and may have anecdotal or case study support,
or that is agreed but not possible to perform studies with random
assignment and controlled groups.
(4) "County authority" means the board of county commissioners or
county executive.
(5) "Department" means the department of social and health
services.
(6) "Early periodic screening, diagnosis, and treatment" means the
component of the federal medicaid program established pursuant to 42
U.S.C. Sec. 1396d(r), as amended.
(7) "Evidence-based" means a program or practice that has had
multiple site random controlled trials across heterogeneous populations
demonstrating that the program or practice is effective for the
population.
(8) "Family" means a child's biological parents, adoptive parents,
foster parents, guardian, legal custodian authorized pursuant to Title
26 RCW, a relative with whom a child has been placed by the department
of social and health services, or a tribe.
(9) "Promising practice" or "emerging best practice" means a
practice that presents, based upon preliminary information, potential
for becoming a research-based or consensus-based practice.
(10) "((Regional support network)) Behavioral health organization"
means a county authority or group of county authorities or other
nonprofit entity that has entered into contracts with the secretary
pursuant to chapter 71.24 RCW.
(11) "Research-based" means a program or practice that has some
research demonstrating effectiveness, but that does not yet meet the
standard of evidence-based practices.
(12) "Secretary" means the secretary of social and health services.
(13) "Wraparound process" means a family driven planning process
designed to address the needs of children and youth by the formation of
a team that empowers families to make key decisions regarding the care
of the child or youth in partnership with professionals and the
family's natural community supports. The team produces a community-based and culturally competent intervention plan which identifies the
strengths and needs of the child or youth and family and defines goals
that the team collaborates on achieving with respect for the unique
cultural values of the family. The "wraparound process" shall
emphasize principles of persistence and outcome-based measurements of
success.
Sec. 92 RCW 71.36.025 and 2007 c 359 s 3 are each amended to read
as follows:
(1) It is the goal of the legislature that, by 2012, the children's
mental health system in Washington state include the following
elements:
(a) A continuum of services from early identification,
intervention, and prevention through crisis intervention and inpatient
treatment, including peer support and parent mentoring services;
(b) Equity in access to services for similarly situated children,
including children with co-occurring disorders;
(c) Developmentally appropriate, high quality, and culturally
competent services available statewide;
(d) Treatment of each child in the context of his or her family and
other persons that are a source of support and stability in his or her
life;
(e) A sufficient supply of qualified and culturally competent
children's mental health providers;
(f) Use of developmentally appropriate evidence-based and
research-based practices;
(g) Integrated and flexible services to meet the needs of children
who, due to mental illness or emotional or behavioral disturbance, are
at risk of out-of-home placement or involved with multiple child-serving systems.
(2) The effectiveness of the children's mental health system shall
be determined through the use of outcome-based performance measures.
The department and the evidence-based practice institute established in
RCW 71.24.061, in consultation with parents, caregivers, youth,
((regional support networks)) behavioral health organizations, mental
health services providers, health plans, primary care providers,
tribes, and others, shall develop outcome-based performance measures
such as:
(a) Decreased emergency room utilization;
(b) Decreased psychiatric hospitalization;
(c) Lessening of symptoms, as measured by commonly used assessment
tools;
(d) Decreased out-of-home placement, including residential, group,
and foster care, and increased stability of such placements, when
necessary;
(e) Decreased runaways from home or residential placements;
(f) Decreased rates of chemical dependency;
(g) Decreased involvement with the juvenile justice system;
(h) Improved school attendance and performance;
(i) Reductions in school or child care suspensions or expulsions;
(j) Reductions in use of prescribed medication where cognitive
behavioral therapies are indicated;
(k) Improved rates of high school graduation and employment; and
(l) Decreased use of mental health services upon reaching adulthood
for mental disorders other than those that require ongoing treatment to
maintain stability.
Performance measure reporting for children's mental health services
should be integrated into existing performance measurement and
reporting systems developed and implemented under chapter 71.24 RCW.
Sec. 93 RCW 71.36.040 and 2003 c 281 s 2 are each amended to read
as follows:
(1) The legislature supports recommendations made in the August
2002 study of the public mental health system for children conducted by
the joint legislative audit and review committee.
(2) The department shall, within available funds:
(a) Identify internal business operation issues that limit the
agency's ability to meet legislative intent to coordinate existing
categorical children's mental health programs and funding;
(b) Collect reliable mental health cost, service, and outcome data
specific to children. This information must be used to identify best
practices and methods of improving fiscal management;
(c) Revise the early periodic screening diagnosis and treatment
plan to reflect the mental health system structure in place on July 27,
2003, and thereafter revise the plan as necessary to conform to
subsequent changes in the structure.
(3) The department and the office of the superintendent of public
instruction shall jointly identify school districts where mental health
and education systems coordinate services and resources to provide
public mental health care for children. The department and the office
of the superintendent of public instruction shall work together to
share information about these approaches with other school districts,
((regional support networks)) behavioral health organizations, and
state agencies.
Sec. 94 RCW 72.09.350 and 1993 c 459 s 1 are each amended to read
as follows:
(1) The department of corrections and the University of Washington
may enter into a collaborative arrangement to provide improved services
for ((mentally ill)) offenders with mental illness with a focus on
prevention, treatment, and reintegration into society. The
participants in the collaborative arrangement may develop a strategic
plan within sixty days after May 17, 1993, to address the management of
((mentally ill)) offenders with mental illness within the correctional
system, facilitating their reentry into the community and the mental
health system, and preventing the inappropriate incarceration of
((mentally ill)) individuals with mental illness. The collaborative
arrangement may also specify the establishment and maintenance of a
corrections mental health center located at McNeil Island corrections
center. The collaborative arrangement shall require that an advisory
panel of key stakeholders be established and consulted throughout the
development and implementation of the center. The stakeholders
advisory panel shall include a broad array of interest groups drawn
from representatives of mental health, criminal justice, and
correctional systems. The stakeholders advisory panel shall include,
but is not limited to, membership from: The department of corrections,
the department of social and health services mental health division and
division of juvenile rehabilitation, ((regional support networks))
behavioral health organizations, local and regional law enforcement
agencies, the sentencing guidelines commission, county and city jails,
mental health advocacy groups for ((the mentally ill, developmentally
disabled)) individuals with mental illness or developmental
disabilities, and the traumatically brain-injured, and the general
public. The center established by the department of corrections and
University of Washington, in consultation with the stakeholder advisory
groups, shall have the authority to:
(a) Develop new and innovative treatment approaches for corrections
mental health clients;
(b) Improve the quality of mental health services within the
department and throughout the corrections system;
(c) Facilitate mental health staff recruitment and training to meet
departmental, county, and municipal needs;
(d) Expand research activities within the department in the area of
treatment services, the design of delivery systems, the development of
organizational models, and training for corrections mental health care
professionals;
(e) Improve the work environment for correctional employees by
developing the skills, knowledge, and understanding of how to work with
offenders with special chronic mental health challenges;
(f) Establish a more positive rehabilitative environment for
offenders;
(g) Strengthen multidisciplinary mental health collaboration
between the University of Washington, other groups committed to the
intent of this section, and the department of corrections;
(h) Strengthen department linkages between institutions of higher
education, public sector mental health systems, and county and
municipal corrections;
(i) Assist in the continued formulation of corrections mental
health policies;
(j) Develop innovative and effective recruitment and training
programs for correctional personnel working with ((mentally ill))
offenders with mental illness;
(k) Assist in the development of a coordinated continuum of mental
health care capable of providing services from corrections entry to
community return; and
(l) Evaluate all current and innovative approaches developed within
this center in terms of their effective and efficient achievement of
improved mental health of inmates, development and utilization of
personnel, the impact of these approaches on the functioning of
correctional institutions, and the relationship of the corrections
system to mental health and criminal justice systems. Specific
attention should be paid to evaluating the effects of programs on the
reintegration of ((mentally ill)) offenders with mental illness into
the community and the prevention of inappropriate incarceration of
((mentally ill)) persons with mental illness.
(2) The corrections mental health center may conduct research,
training, and treatment activities for the ((mentally ill)) offender
with mental illness within selected sites operated by the department.
The department shall provide support services for the center such as
food services, maintenance, perimeter security, classification,
offender supervision, and living unit functions. The University of
Washington may develop, implement, and evaluate the clinical,
treatment, research, and evaluation components of the mentally ill
offender center. The institute of (([for])) for public policy and
management may be consulted regarding the development of the center and
in the recommendations regarding public policy. As resources permit,
training within the center shall be available to state, county, and
municipal agencies requiring the services. Other state colleges, state
universities, and mental health providers may be involved in activities
as required on a subcontract basis. Community mental health
organizations, research groups, and community advocacy groups may be
critical components of the center's operations and involved as
appropriate to annual objectives. ((Mentally ill)) Clients with mental
illness may be drawn from throughout the department's population and
transferred to the center as clinical need, available services, and
department jurisdiction permits.
(3) The department shall prepare a report of the center's progress
toward the attainment of stated goals and provide the report to the
legislature annually.
Sec. 95 RCW 72.09.370 and 2009 c 319 s 3 and 2009 c 28 s 36 are
each reenacted and amended to read as follows:
(1) The offender reentry community safety program is established to
provide intensive services to offenders identified under this
subsection and to thereby promote public safety. The secretary shall
identify offenders in confinement or partial confinement who: (a) Are
reasonably believed to be dangerous to themselves or others; and (b)
have a mental disorder. In determining an offender's dangerousness,
the secretary shall consider behavior known to the department and
factors, based on research, that are linked to an increased risk for
dangerousness of offenders with mental illnesses and shall include
consideration of an offender's chemical dependency or abuse.
(2) Prior to release of an offender identified under this section,
a team consisting of representatives of the department of corrections,
the division of mental health, and, as necessary, the indeterminate
sentence review board, other divisions or administrations within the
department of social and health services, specifically including the
division of alcohol and substance abuse and the division of
developmental disabilities, the appropriate ((regional support
network)) behavioral health organization, and the providers, as
appropriate, shall develop a plan, as determined necessary by the team,
for delivery of treatment and support services to the offender upon
release. In developing the plan, the offender shall be offered
assistance in executing a mental health directive under chapter 71.32
RCW, after being fully informed of the benefits, scope, and purposes of
such directive. The team may include a school district representative
for offenders under the age of twenty-one. The team shall consult with
the offender's counsel, if any, and, as appropriate, the offender's
family and community. The team shall notify the crime victim/witness
program, which shall provide notice to all people registered to receive
notice under RCW 72.09.712 of the proposed release plan developed by
the team. Victims, witnesses, and other interested people notified by
the department may provide information and comments to the department
on potential safety risk to specific individuals or classes of
individuals posed by the specific offender. The team may recommend:
(a) That the offender be evaluated by the designated mental health
professional, as defined in chapter 71.05 RCW; (b) department-supervised community treatment; or (c) voluntary community mental
health or chemical dependency or abuse treatment.
(3) Prior to release of an offender identified under this section,
the team shall determine whether or not an evaluation by a designated
mental health professional is needed. If an evaluation is recommended,
the supporting documentation shall be immediately forwarded to the
appropriate designated mental health professional. The supporting
documentation shall include the offender's criminal history, history of
judicially required or administratively ordered involuntary
antipsychotic medication while in confinement, and any known history of
involuntary civil commitment.
(4) If an evaluation by a designated mental health professional is
recommended by the team, such evaluation shall occur not more than ten
days, nor less than five days, prior to release.
(5) A second evaluation by a designated mental health professional
shall occur on the day of release if requested by the team, based upon
new information or a change in the offender's mental condition, and the
initial evaluation did not result in an emergency detention or a
summons under chapter 71.05 RCW.
(6) If the designated mental health professional determines an
emergency detention under chapter 71.05 RCW is necessary, the
department shall release the offender only to a state hospital or to a
consenting evaluation and treatment facility. The department shall
arrange transportation of the offender to the hospital or facility.
(7) If the designated mental health professional believes that a
less restrictive alternative treatment is appropriate, he or she shall
seek a summons, pursuant to the provisions of chapter 71.05 RCW, to
require the offender to appear at an evaluation and treatment facility.
If a summons is issued, the offender shall remain within the
corrections facility until completion of his or her term of confinement
and be transported, by corrections personnel on the day of completion,
directly to the identified evaluation and treatment facility.
(8) The secretary shall adopt rules to implement this section.
Sec. 96 RCW 72.09.381 and 1999 c 214 s 11 are each amended to
read as follows:
The secretary of the department of corrections and the secretary of
the department of social and health services shall, in consultation
with the ((regional support networks)) behavioral health organizations
and provider representatives, each adopt rules as necessary to
implement chapter 214, Laws of 1999.
Sec. 97 RCW 72.10.060 and 1998 c 297 s 48 are each amended to
read as follows:
The secretary shall, for any person committed to a state
correctional facility after July 1, 1998, inquire at the time of
commitment whether the person had received outpatient mental health
treatment within the two years preceding confinement and the name of
the person providing the treatment.
The secretary shall inquire of the treatment provider if he or she
wishes to be notified of the release of the person from confinement,
for purposes of offering treatment upon the inmate's release. If the
treatment provider wishes to be notified of the inmate's release, the
secretary shall attempt to provide such notice at least seven days
prior to release.
At the time of an inmate's release if the secretary is unable to
locate the treatment provider, the secretary shall notify the
((regional support network)) behavioral health organization in the
county the inmate will most likely reside following release.
If the secretary has, prior to the release from the facility,
evaluated the inmate and determined he or she requires postrelease
mental health treatment, a copy of relevant records and reports
relating to the inmate's mental health treatment or status shall be
promptly made available to the offender's present or future treatment
provider. The secretary shall determine which records and reports are
relevant and may provide a summary in lieu of copies of the records.
Sec. 98 RCW 72.23.025 and 2011 1st sp.s. c 21 s 1 are each
amended to read as follows:
(1) It is the intent of the legislature to improve the quality of
service at state hospitals, eliminate overcrowding, and more
specifically define the role of the state hospitals. The legislature
intends that eastern and western state hospitals shall become clinical
centers for handling the most complicated long-term care needs of
patients with a primary diagnosis of mental disorder. To this end, the
legislature intends that funds appropriated for mental health programs,
including funds for ((regional support networks)) behavioral health
organizations and the state hospitals be used for persons with primary
diagnosis of mental disorder. The legislature finds that establishment
of institutes for the study and treatment of mental disorders at both
eastern state hospital and western state hospital will be instrumental
in implementing the legislative intent.
(2)(a) There is established at eastern state hospital and western
state hospital, institutes for the study and treatment of mental
disorders. The institutes shall be operated by joint operating
agreements between state colleges and universities and the department
of social and health services. The institutes are intended to conduct
training, research, and clinical program development activities that
will directly benefit persons with mental illness who are receiving
treatment in Washington state by performing the following activities:
(i) Promote recruitment and retention of highly qualified
professionals at the state hospitals and community mental health
programs;
(ii) Improve clinical care by exploring new, innovative, and
scientifically based treatment models for persons presenting
particularly difficult and complicated clinical syndromes;
(iii) Provide expanded training opportunities for existing staff at
the state hospitals and community mental health programs;
(iv) Promote bilateral understanding of treatment orientation,
possibilities, and challenges between state hospital professionals and
community mental health professionals.
(b) To accomplish these purposes the institutes may, within funds
appropriated for this purpose:
(i) Enter joint operating agreements with state universities or
other institutions of higher education to accomplish the placement and
training of students and faculty in psychiatry, psychology, social
work, occupational therapy, nursing, and other relevant professions at
the state hospitals and community mental health programs;
(ii) Design and implement clinical research projects to improve the
quality and effectiveness of state hospital services and operations;
(iii) Enter into agreements with community mental health service
providers to accomplish the exchange of professional staff between the
state hospitals and community mental health service providers;
(iv) Establish a student loan forgiveness and conditional
scholarship program to retain qualified professionals at the state
hospitals and community mental health providers when the secretary has
determined a shortage of such professionals exists.
(c) Notwithstanding any other provisions of law to the contrary,
the institutes may enter into agreements with the department or the
state hospitals which may involve changes in staffing necessary to
implement improved patient care programs contemplated by this section.
(d) The institutes are authorized to seek and accept public or
private gifts, grants, contracts, or donations to accomplish their
purposes under this section.
Sec. 99 RCW 72.78.020 and 2007 c 483 s 102 are each amended to
read as follows:
(1) Each county or group of counties shall conduct an inventory of
the services and resources available in the county or group of counties
to assist offenders in reentering the community.
(2) In conducting its inventory, the county or group of counties
should consult with the following:
(a) The department of corrections, including community corrections
officers;
(b) The department of social and health services in applicable
program areas;
(c) Representatives from county human services departments and,
where applicable, multicounty ((regional support networks)) behavioral
health organizations;
(d) Local public health jurisdictions;
(e) City and county law enforcement;
(f) Local probation/supervision programs;
(g) Local community and technical colleges;
(h) The local worksource center operated under the statewide
workforce investment system;
(i) Faith-based and nonprofit organizations providing assistance to
offenders;
(j) Housing providers;
(k) Crime victims service providers; and
(l) Other community stakeholders interested in reentry efforts.
(3) The inventory must include, but is not limited to:
(a) A list of programs available through the entities listed in
subsection (2) of this section and services currently available in the
community for offenders including, but not limited to, housing
assistance, employment assistance, education, vocational training,
parenting education, financial literacy, treatment for substance abuse,
mental health, anger management, life skills training, specialized
treatment programs such as batterers treatment and sex offender
treatment, and any other service or program that will assist the former
offender to successfully transition into the community; and
(b) An indication of the availability of community representatives
or volunteers to assist the offender with his or her transition.
(4) No later than January 1, 2008, each county or group of counties
shall present its inventory to the policy advisory committee convened
in RCW 72.78.030(8).
Sec. 100 RCW 74.09.515 and 2011 1st sp.s. c 15 s 26 are each
amended to read as follows:
(1) The authority shall adopt rules and policies providing that
when youth who were enrolled in a medical assistance program
immediately prior to confinement are released from confinement, their
medical assistance coverage will be fully reinstated on the day of
their release, subject to any expedited review of their continued
eligibility for medical assistance coverage that is required under
federal or state law.
(2) The authority, in collaboration with the department, county
juvenile court administrators, and ((regional support networks))
behavioral health organizations, shall establish procedures for
coordination between department field offices, juvenile rehabilitation
administration institutions, and county juvenile courts that result in
prompt reinstatement of eligibility and speedy eligibility
determinations for youth who are likely to be eligible for medical
assistance services upon release from confinement. Procedures
developed under this subsection must address:
(a) Mechanisms for receiving medical assistance services'
applications on behalf of confined youth in anticipation of their
release from confinement;
(b) Expeditious review of applications filed by or on behalf of
confined youth and, to the extent practicable, completion of the review
before the youth is released; and
(c) Mechanisms for providing medical assistance services' identity
cards to youth eligible for medical assistance services immediately
upon their release from confinement.
(3) For purposes of this section, "confined" or "confinement" means
detained in a facility operated by or under contract with the
department of social and health services, juvenile rehabilitation
administration, or detained in a juvenile detention facility operated
under chapter 13.04 RCW.
(4) The authority shall adopt standardized statewide screening and
application practices and forms designed to facilitate the application
of a confined youth who is likely to be eligible for a medical
assistance program.
Sec. 101 RCW 74.09.521 and 2011 1st sp.s. c 15 s 28 are each
amended to read as follows:
(1) To the extent that funds are specifically appropriated for this
purpose the authority shall revise its medicaid healthy options managed
care and fee-for-service program standards under medicaid, Title XIX of
the federal social security act to improve access to mental health
services for children who do not meet the ((regional support network))
behavioral health organization access to care standards. The program
standards shall be revised to allow outpatient therapy services to be
provided by licensed mental health professionals, as defined in RCW
71.34.020, or by a mental health professional regulated under Title 18
RCW who is under the direct supervision of a licensed mental health
professional, and up to twenty outpatient therapy hours per calendar
year, including family therapy visits integral to a child's treatment.
This section shall be administered in a manner consistent with federal
early and periodic screening, diagnosis, and treatment requirements
related to the receipt of medically necessary services when a child's
need for such services is identified through developmental screening.
(2) The authority and the children's mental health evidence-based
practice institute established in RCW 71.24.061 shall collaborate to
encourage and develop incentives for the use of prescribing practices
and evidence-based and research-based treatment practices developed
under RCW 74.09.490 by mental health professionals serving children
under this section.
Sec. 102 RCW 74.09.555 and 2011 1st sp.s. c 36 s 32 and 2011 1st
sp.s c 15 s 34 are each reenacted and amended to read as follows:
(1) The authority shall adopt rules and policies providing that
when persons with a mental disorder, who were enrolled in medical
assistance immediately prior to confinement, are released from
confinement, their medical assistance coverage will be fully reinstated
on the day of their release, subject to any expedited review of their
continued eligibility for medical assistance coverage that is required
under federal or state law.
(2) The authority, in collaboration with the Washington association
of sheriffs and police chiefs, the department of corrections, and the
((regional support networks)) behavioral health organizations, shall
establish procedures for coordination between the authority and
department field offices, institutions for mental disease, and
correctional institutions, as defined in RCW 9.94.049, that result in
prompt reinstatement of eligibility and speedy eligibility
determinations for persons who are likely to be eligible for medical
assistance services upon release from confinement. Procedures
developed under this subsection must address:
(a) Mechanisms for receiving medical assistance services
applications on behalf of confined persons in anticipation of their
release from confinement;
(b) Expeditious review of applications filed by or on behalf of
confined persons and, to the extent practicable, completion of the
review before the person is released;
(c) Mechanisms for providing medical assistance services identity
cards to persons eligible for medical assistance services immediately
upon their release from confinement; and
(d) Coordination with the federal social security administration,
through interagency agreements or otherwise, to expedite processing of
applications for federal supplemental security income or social
security disability benefits, including federal acceptance of
applications on behalf of confined persons.
(3) Where medical or psychiatric examinations during a person's
confinement indicate that the person is disabled, the correctional
institution or institution for mental diseases shall provide the
authority with that information for purposes of making medical
assistance eligibility and enrollment determinations prior to the
person's release from confinement. The authority shall, to the maximum
extent permitted by federal law, use the examination in making its
determination whether the person is disabled and eligible for medical
assistance.
(4) For purposes of this section, "confined" or "confinement" means
incarcerated in a correctional institution, as defined in RCW 9.94.049,
or admitted to an institute for mental disease, as defined in 42 C.F.R.
part 435, Sec. 1009 on July 24, 2005.
(5) For purposes of this section, "likely to be eligible" means
that a person:
(a) Was enrolled in medicaid or supplemental security income or the
medical care services program immediately before he or she was confined
and his or her enrollment was terminated during his or her confinement;
or
(b) Was enrolled in medicaid or supplemental security income or the
medical care services program at any time during the five years before
his or her confinement, and medical or psychiatric examinations during
the person's confinement indicate that the person continues to be
disabled and the disability is likely to last at least twelve months
following release.
(6) The economic services administration within the department
shall adopt standardized statewide screening and application practices
and forms designed to facilitate the application of a confined person
who is likely to be eligible for medicaid.
Sec. 103 RCW 74.34.068 and 2001 c 233 s 2 are each amended to
read as follows:
(1) After the investigation is complete, the department may provide
a written report of the outcome of the investigation to an agency or
program described in this subsection when the department determines
from its investigation that an incident of abuse, abandonment,
financial exploitation, or neglect occurred. Agencies or programs that
may be provided this report are home health, hospice, or home care
agencies, or after January 1, 2002, any in-home services agency
licensed under chapter 70.127 RCW, a program authorized under chapter
71A.12 RCW, an adult day care or day health program, ((regional support
networks)) behavioral health organizations authorized under chapter
71.24 RCW, or other agencies. The report may contain the name of the
vulnerable adult and the alleged perpetrator. The report shall not
disclose the identity of the person who made the report or any witness
without the written permission of the reporter or witness. The
department shall notify the alleged perpetrator regarding the outcome
of the investigation. The name of the vulnerable adult must not be
disclosed during this notification.
(2) The department may also refer a report or outcome of an
investigation to appropriate state or local governmental authorities
responsible for licensing or certification of the agencies or programs
listed in subsection (1) of this section.
(3) The department shall adopt rules necessary to implement this
section.
Sec. 104 RCW 82.04.4277 and 2011 1st sp.s. c 19 s 1 are each
amended to read as follows:
(1) A health or social welfare organization may deduct from the
measure of tax amounts received as compensation for providing mental
health services under a government-funded program.
(2) A ((regional support network)) behavioral health organization
may deduct from the measure of tax amounts received from the state of
Washington for distribution to a health or social welfare organization
that is eligible to deduct the distribution under subsection (1) of
this section.
(3) A person claiming a deduction under this section must file a
complete annual report with the department under RCW 82.32.534.
(4) The definitions in this subsection apply to this section.
(a) "Health or social welfare organization" has the meaning
provided in RCW 82.04.431.
(b) "Mental health services" and "((regional support network))
behavioral health organization" have the meanings provided in RCW
71.24.025.
(5) This section expires August 1, 2016.
Sec. 105 RCW 70.48.100 and 1990 c 3 s 130 are each amended to
read as follows:
(1) A department of corrections or chief law enforcement officer
responsible for the operation of a jail shall maintain a jail register,
open to the public, into which shall be entered in a timely basis:
(a) The name of each person confined in the jail with the hour,
date and cause of the confinement; and
(b) The hour, date and manner of each person's discharge.
(2) Except as provided in subsection (3) of this section the
records of a person confined in jail shall be held in confidence and
shall be made available only to criminal justice agencies as defined in
RCW 43.43.705; or
(a) For use in inspections made pursuant to RCW 70.48.070;
(b) In jail certification proceedings;
(c) For use in court proceedings upon the written order of the
court in which the proceedings are conducted; ((or))
(d) To the Washington association of sheriffs and police chiefs;
(e) To the Washington institute for public policy, research and
data analysis division of the department of social and health services,
higher education institutions of Washington state, Washington state
health care authority, state auditor's office, caseload forecast
council, office of financial management, or the successor entities of
these organizations, for the purpose of research in the public
interest. Data disclosed for research purposes must comply with
relevant state and federal statutes; or
(f) Upon the written permission of the person.
(3)(a) Law enforcement may use booking photographs of a person
arrested or confined in a local or state penal institution to assist
them in conducting investigations of crimes.
(b) Photographs and information concerning a person convicted of a
sex offense as defined in RCW 9.94A.030 may be disseminated as provided
in RCW 4.24.550, 9A.44.130, 9A.44.140, 10.01.200, 43.43.540, 43.43.745,
46.20.187, 70.48.470, 72.09.330, and section 401, chapter 3, Laws of
1990.
Sec. 106 RCW 70.38.111 and 2012 c 10 s 48 are each amended to
read as follows:
(1) The department shall not require a certificate of need for the
offering of an inpatient tertiary health service by:
(a) A health maintenance organization or a combination of health
maintenance organizations if (i) the organization or combination of
organizations has, in the service area of the organization or the
service areas of the organizations in the combination, an enrollment of
at least fifty thousand individuals, (ii) the facility in which the
service will be provided is or will be geographically located so that
the service will be reasonably accessible to such enrolled individuals,
and (iii) at least seventy-five percent of the patients who can
reasonably be expected to receive the tertiary health service will be
individuals enrolled with such organization or organizations in the
combination;
(b) A health care facility if (i) the facility primarily provides
or will provide inpatient health services, (ii) the facility is or will
be controlled, directly or indirectly, by a health maintenance
organization or a combination of health maintenance organizations which
has, in the service area of the organization or service areas of the
organizations in the combination, an enrollment of at least fifty
thousand individuals, (iii) the facility is or will be geographically
located so that the service will be reasonably accessible to such
enrolled individuals, and (iv) at least seventy-five percent of the
patients who can reasonably be expected to receive the tertiary health
service will be individuals enrolled with such organization or
organizations in the combination; or
(c) A health care facility (or portion thereof) if (i) the facility
is or will be leased by a health maintenance organization or
combination of health maintenance organizations which has, in the
service area of the organization or the service areas of the
organizations in the combination, an enrollment of at least fifty
thousand individuals and, on the date the application is submitted
under subsection (2) of this section, at least fifteen years remain in
the term of the lease, (ii) the facility is or will be geographically
located so that the service will be reasonably accessible to such
enrolled individuals, and (iii) at least seventy-five percent of the
patients who can reasonably be expected to receive the tertiary health
service will be individuals enrolled with such organization;
if, with respect to such offering or obligation by a nursing home, the
department has, upon application under subsection (2) of this section,
granted an exemption from such requirement to the organization,
combination of organizations, or facility.
(2) A health maintenance organization, combination of health
maintenance organizations, or health care facility shall not be exempt
under subsection (1) of this section from obtaining a certificate of
need before offering a tertiary health service unless:
(a) It has submitted at least thirty days prior to the offering of
services reviewable under RCW 70.38.105(4)(d) an application for such
exemption; and
(b) The application contains such information respecting the
organization, combination, or facility and the proposed offering or
obligation by a nursing home as the department may require to determine
if the organization or combination meets the requirements of subsection
(1) of this section or the facility meets or will meet such
requirements; and
(c) The department approves such application. The department shall
approve or disapprove an application for exemption within thirty days
of receipt of a completed application. In the case of a proposed
health care facility (or portion thereof) which has not begun to
provide tertiary health services on the date an application is
submitted under this subsection with respect to such facility (or
portion), the facility (or portion) shall meet the applicable
requirements of subsection (1) of this section when the facility first
provides such services. The department shall approve an application
submitted under this subsection if it determines that the applicable
requirements of subsection (1) of this section are met.
(3) A health care facility (or any part thereof) with respect to
which an exemption was granted under subsection (1) of this section may
not be sold or leased and a controlling interest in such facility or in
a lease of such facility may not be acquired and a health care facility
described in (1)(c) which was granted an exemption under subsection (1)
of this section may not be used by any person other than the lessee
described in (1)(c) unless:
(a) The department issues a certificate of need approving the sale,
lease, acquisition, or use; or
(b) The department determines, upon application, that (i) the
entity to which the facility is proposed to be sold or leased, which
intends to acquire the controlling interest, or which intends to use
the facility is a health maintenance organization or a combination of
health maintenance organizations which meets the requirements of
(1)(a)(i), and (ii) with respect to such facility, meets the
requirements of (1)(a)(ii) or (iii) or the requirements of (1)(b)(i)
and (ii).
(4) In the case of a health maintenance organization, an ambulatory
care facility, or a health care facility, which ambulatory or health
care facility is controlled, directly or indirectly, by a health
maintenance organization or a combination of health maintenance
organizations, the department may under the program apply its
certificate of need requirements to the offering of inpatient tertiary
health services to the extent that such offering is not exempt under
the provisions of this section or RCW 70.38.105(7).
(5)(a) The department shall not require a certificate of need for
the construction, development, or other establishment of a nursing
home, or the addition of beds to an existing nursing home, that is
owned and operated by a continuing care retirement community that:
(i) Offers services only to contractual members;
(ii) Provides its members a contractually guaranteed range of
services from independent living through skilled nursing, including
some assistance with daily living activities;
(iii) Contractually assumes responsibility for the cost of services
exceeding the member's financial responsibility under the contract, so
that no third party, with the exception of insurance purchased by the
retirement community or its members, but including the medicaid
program, is liable for costs of care even if the member depletes his or
her personal resources;
(iv) Has offered continuing care contracts and operated a nursing
home continuously since January 1, 1988, or has obtained a certificate
of need to establish a nursing home;
(v) Maintains a binding agreement with the state assuring that
financial liability for services to members, including nursing home
services, will not fall upon the state;
(vi) Does not operate, and has not undertaken a project that would
result in a number of nursing home beds in excess of one for every four
living units operated by the continuing care retirement community,
exclusive of nursing home beds; and
(vii) Has obtained a professional review of pricing and long-term
solvency within the prior five years which was fully disclosed to
members.
(b) A continuing care retirement community shall not be exempt
under this subsection from obtaining a certificate of need unless:
(i) It has submitted an application for exemption at least thirty
days prior to commencing construction of, is submitting an application
for the licensure of, or is commencing operation of a nursing home,
whichever comes first; and
(ii) The application documents to the department that the
continuing care retirement community qualifies for exemption.
(c) The sale, lease, acquisition, or use of part or all of a
continuing care retirement community nursing home that qualifies for
exemption under this subsection shall require prior certificate of need
approval to qualify for licensure as a nursing home unless the
department determines such sale, lease, acquisition, or use is by a
continuing care retirement community that meets the conditions of (a)
of this subsection.
(6) A rural hospital, as defined by the department, reducing the
number of licensed beds to become a rural primary care hospital under
the provisions of Part A Title XVIII of the Social Security Act Section
1820, 42 U.S.C., 1395c et seq. may, within three years of the reduction
of beds licensed under chapter 70.41 RCW, increase the number of
licensed beds to no more than the previously licensed number without
being subject to the provisions of this chapter.
(7) A rural health care facility licensed under RCW 70.175.100
formerly licensed as a hospital under chapter 70.41 RCW may, within
three years of the effective date of the rural health care facility
license, apply to the department for a hospital license and not be
subject to the requirements of RCW 70.38.105(4)(a) as the construction,
development, or other establishment of a new hospital, provided there
is no increase in the number of beds previously licensed under chapter
70.41 RCW and there is no redistribution in the number of beds used for
acute care or long-term care, the rural health care facility has been
in continuous operation, and the rural health care facility has not
been purchased or leased.
(8)(a) A nursing home that voluntarily reduces the number of its
licensed beds to provide assisted living, licensed assisted living
facility care, adult day care, adult day health, respite care, hospice,
outpatient therapy services, congregate meals, home health, or senior
wellness clinic, or to reduce to one or two the number of beds per room
or to otherwise enhance the quality of life for residents in the
nursing home, may convert the original facility or portion of the
facility back, and thereby increase the number of nursing home beds to
no more than the previously licensed number of nursing home beds
without obtaining a certificate of need under this chapter, provided
the facility has been in continuous operation and has not been
purchased or leased. Any conversion to the original licensed bed
capacity, or to any portion thereof, shall comply with the same life
and safety code requirements as existed at the time the nursing home
voluntarily reduced its licensed beds; unless waivers from such
requirements were issued, in which case the converted beds shall
reflect the conditions or standards that then existed pursuant to the
approved waivers.
(b) To convert beds back to nursing home beds under this
subsection, the nursing home must:
(i) Give notice of its intent to preserve conversion options to the
department of health no later than thirty days after the effective date
of the license reduction; and
(ii) Give notice to the department of health and to the department
of social and health services of the intent to convert beds back. If
construction is required for the conversion of beds back, the notice of
intent to convert beds back must be given, at a minimum, one year prior
to the effective date of license modification reflecting the restored
beds; otherwise, the notice must be given a minimum of ninety days
prior to the effective date of license modification reflecting the
restored beds. Prior to any license modification to convert beds back
to nursing home beds under this section, the licensee must demonstrate
that the nursing home meets the certificate of need exemption
requirements of this section.
The term "construction," as used in (b)(ii) of this subsection, is
limited to those projects that are expected to equal or exceed the
expenditure minimum amount, as determined under this chapter.
(c) Conversion of beds back under this subsection must be completed
no later than four years after the effective date of the license
reduction. However, for good cause shown, the four-year period for
conversion may be extended by the department of health for one
additional four-year period.
(d) Nursing home beds that have been voluntarily reduced under this
section shall be counted as available nursing home beds for the purpose
of evaluating need under RCW 70.38.115(2) (a) and (k) so long as the
facility retains the ability to convert them back to nursing home use
under the terms of this section.
(e) When a building owner has secured an interest in the nursing
home beds, which are intended to be voluntarily reduced by the licensee
under (a) of this subsection, the applicant shall provide the
department with a written statement indicating the building owner's
approval of the bed reduction.
(9)(a) The department shall not require a certificate of need for
a hospice agency if:
(i) The hospice agency is designed to serve the unique religious or
cultural needs of a religious group or an ethnic minority and commits
to furnishing hospice services in a manner specifically aimed at
meeting the unique religious or cultural needs of the religious group
or ethnic minority;
(ii) The hospice agency is operated by an organization that:
(A) Operates a facility, or group of facilities, that offers a
comprehensive continuum of long-term care services, including, at a
minimum, a licensed, medicare-certified nursing home, assisted living,
independent living, day health, and various community-based support
services, designed to meet the unique social, cultural, and religious
needs of a specific cultural and ethnic minority group;
(B) Has operated the facility or group of facilities for at least
ten continuous years prior to the establishment of the hospice agency;
(iii) The hospice agency commits to coordinating with existing
hospice programs in its community when appropriate;
(iv) The hospice agency has a census of no more than forty
patients;
(v) The hospice agency commits to obtaining and maintaining
medicare certification;
(vi) The hospice agency only serves patients located in the same
county as the majority of the long-term care services offered by the
organization that operates the agency; and
(vii) The hospice agency is not sold or transferred to another
agency.
(b) The department shall include the patient census for an agency
exempted under this subsection (9) in its calculations for future
certificate of need applications.
(10) To alleviate the need to board psychiatric patients in
emergency departments, for fiscal year 2015 the department shall
suspend the certificate of need requirement for a hospital licensed
under chapter 70.41 RCW that changes the use of licensed beds to
increase the number of beds to provide psychiatric services, including
involuntary treatment services. A certificate of need exemption under
this section shall be valid for two years.
Sec. 107 RCW 70.320.020 and 2013 c 320 s 2 are each amended to
read as follows:
(1) The authority and the department shall base contract
performance measures developed under RCW 70.320.030 on the following
outcomes when contracting with service contracting entities:
Improvements in client health status and wellness; increases in client
participation in meaningful activities; reductions in client
involvement with criminal justice systems; reductions in avoidable
costs in hospitals, emergency rooms, crisis services, and jails and
prisons; increases in stable housing in the community; improvements in
client satisfaction with quality of life; and reductions in population-level health disparities.
(2) The performance measures must demonstrate the manner in which
the following principles are achieved within each of the outcomes under
subsection (1) of this section:
(a) Maximization of the use of evidence-based practices will be
given priority over the use of research-based and promising practices,
and research-based practices will be given priority over the use of
promising practices. The agencies will develop strategies to identify
programs that are effective with ethnically diverse clients and to
consult with tribal governments, experts within ethnically diverse
communities and community organizations that serve diverse communities;
(b) The maximization of the client's independence, recovery, and
employment;
(c) The maximization of the client's participation in treatment
decisions; and
(d) The collaboration between consumer-based support programs in
providing services to the client.
(3) In developing performance measures under RCW 70.320.030, the
authority and the department shall consider expected outcomes relevant
to the general populations that each agency serves. The authority and
the department may adapt the outcomes to account for the unique needs
and characteristics of discrete subcategories of populations receiving
services, including ethnically diverse communities.
(4) The authority and the department shall coordinate the
establishment of the expected outcomes and the performance measures
between each agency as well as each program to identify expected
outcomes and performance measures that are common to the clients
enrolled in multiple programs and to eliminate conflicting standards
among the agencies and programs.
(5)(a) The authority and the department shall establish timelines
and mechanisms for service contracting entities to report data related
to performance measures and outcomes, including phased implementation
of public reporting of outcome and performance measures in a form that
allows for comparison of performance measures and levels of improvement
between geographic regions of Washington.
(b) The authority and the department may not release any public
reports of client outcomes unless the data have been deidentified and
aggregated in such a way that the identity of individual clients cannot
be determined through directly identifiable data or the combination of
multiple data elements.
Sec. 108 RCW 18.205.040 and 2008 c 135 s 17 are each amended to
read as follows:
(1) Except as provided in subsection (2) of this section, nothing
in this chapter shall be construed to authorize the use of the title
"certified chemical dependency professional" or "certified chemical
dependency professional trainee" when treating patients in settings
other than programs approved under chapter 70.96A RCW.
(2) A person who holds a credential as a "certified chemical
dependency professional" or a "certified chemical dependency
professional trainee" may use such title when treating patients in
settings other than programs approved under chapter 70.96A RCW if the
person also holds a license as: An advanced registered nurse
practitioner under chapter 18.79 RCW; a marriage and family therapist,
mental health counselor, advanced social worker, or independent
clinical social health worker under chapter 18.225 RCW; a psychologist
under chapter 18.83 RCW; an osteopathic physician under chapter 18.57
RCW; an osteopathic physician assistant under chapter 18.57A RCW; a
physician under chapter 18.71 RCW; or a physician assistant under
chapter 18.71A RCW.
NEW SECTION. Sec. 109 A new section is added to chapter 70.320
RCW to read as follows:
The authority, the department, and service contracting entities
shall establish record retention schedules for maintaining data
reported by service contracting entities under RCW 70.320.020. For
data elements related to the identity of individual clients, the
schedules may not allow the retention of data for longer than required
by law unless the authority, the department, or service contracting
entities require the data for purposes contemplated by RCW 70.320.020
or to meet other service requirements. Regardless of how long data
reported by service contracting entities under RCW 70.320.020 is kept,
it must be protected in a way that prevents improper use or disclosure
of confidential client information.
NEW SECTION. Sec. 110 A new section is added to chapter 71.24
RCW to read as follows:
(1) The department and the health care authority shall develop a
plan to provide integrated managed health and mental health care for
foster children receiving care through the medical assistance program.
The plan shall detail the steps necessary to implement and operate a
fully integrated program for foster children, including development of
a service delivery system, benefit design, reimbursement mechanisms,
and standards for contracting with health plans. The plan must be
designed so that all of the requirements for providing mental health
services to children under the T.R. v. Dreyfus and Porter settlement
are met. The plan shall include an implementation timeline and funding
estimate. The department and the health care authority shall submit
the plan to the legislature by December 1, 2014.
(2) This section expires July 1, 2015.
NEW SECTION. Sec. 111 Section 1 of this act is necessary for the
immediate preservation of the public peace, health, or safety, or
support of the state government and its existing public institutions,
and takes effect immediately.
NEW SECTION. Sec. 112 Sections 7, 10, 13 through 54, 56 through
84, and 86 through 104 of this act take effect April 1, 2016.
NEW SECTION. Sec. 113 Section 85 of this act takes effect July
1, 2018.