SENATE BILL REPORT
SB 5074
BYSenators Talmadge, Newhouse, McCaslin, Moore, Lee and Hayner
Revising involuntary commitment procedures.
Senate Committee on Judiciary
Senate Hearing Date(s):January 27, 1987; February 12, 1987
Majority Report: That Substitute Senate Bill No. 5074 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.
Signed by Senators Talmadge, Chairman; Halsan, Vice Chairman; McCaslin, Moore, Nelson.
Senate Staff:Jon Carlson (786-7459)
February 12, 1987
Senate Committee on Ways & Means
Senate Hearing Date(s):February 25, 1987
Majority Report: That Second Substitute Senate Bill No. 5074 be substituted therefor, and the second substitute bill do pass.
Signed by Senators McDermott, Chairman; Gaspard, Vice Chairman; Bauer, Bluechel, Cantu, Deccio, Fleming, Hayner, Kreidler, Lee, McDonald, Moore, Rasmussen, Talmadge, Vognild, Wojahn, Zimmerman.
Senate Staff:Jan Sharar (786-7715)
February 26, 1987
AS REPORTED BY COMMITTEE ON WAYS & MEANS, FEBRUARY 25, 1987
BACKGROUND:
Washington State's Involuntary Treatment Act (ITA) was enacted in 1979 and underwent major changes in 1973 and 1979. The act permits, by court order, the involuntary treatment of a person who, as a result of a mental disorder, is gravely disabled or presents a likelihood of serious harm to self or others. Mental health professionals are those persons entrusted with the responsibility for commitment of individuals who fall within the scope of the act. The initial commitment period is 72 hours with additional treatment periods of 14 days, 90 days and 180 days. The ITA is administered at the state level by the Department of Social and Health Services (DSHS), and at the local level by county governments, with the majority of the funding being provided through the state general fund. Counties may provide ITA services directly or contract with private agencies.
There are several areas of concern that have been raised with respect to the ITA. During the 1986 interim, the Senate Judiciary Committee heard the testimony of mental health professionals pertaining to the ITA. Many other issues have been addressed in the joint study of the Washington State Involuntary Treatment Act (1983) conducted by the Legislative Budget Committee (LBC) and the House Office of Program Research.
SUMMARY:
The Involuntary Treatment Act is amended to reflect a more comprehensive approach to the treatment of mentally-ill adults in intensive and less-restrictive settings.
Language which prohibits a person from obtaining treatment under the ITA if proceedings are also initiated under the alcoholism treatment act is deleted.
Depending upon the initial needs of the person, cross- referral between alcohol treatment facilities and mental health facilities may be required.
A 90-day less-restrictive treatment alternative replaces the present 14-day less-restrictive treatment program.
In adopting treatment plans, the petitioner must show with specificity the less-restrictive alternative considered, and why treatment less restrictive than detention is not appropriate.
Within five days after any detention beyond the initial 72- hour evaluation and treatment period, an individualized treatment plan must be developed for the person. In addition, the court must appoint a conservator in its order. The conservator is required to monitor the person receiving treatment, ensure that the person abides by the requirements of the treatment plan, and obtain community support services for the person as provided in the Community Mental Health Services Act.
The physician-patient and psychologist-client privileges are modified. The court has the discretion to waive the privilege based solely on the need for protection of either the detained person or the public. The waiver is limited to records or testimony reasonably related to evaluation of the detained person.
If a conditionally-released person presents a likelihood of serious harm to others or himself, or is gravely disabled, the county designated mental health professional (CDMHP) or the secretary of DSHS may order that the conditionally-released person be taken into custody and detained in an evaluation and treatment facility.
If the patient does not adhere to the terms of a conditional release, the CDMHP or secretary may, in lieu of hospitalization, notify the patient to come to a hearing not less than 5 days after service of a petition for revocation.
When a less-restrictive treatment or conditional release is revoked, the subsequent treatment period may be for no longer than the period authorized in the original court order.
The time period that a person may be detained at an alcohol and treatment facility as a result of incapacitation by alcohol is increased from 48 to 72 hours.
A petition for commitment of a person alleged to be incapacitated by alcohol must be heard by the court no less than three and no more than seven days after the date the petition is filed.
The filing period for 90-day treatment and the length of continuances are shortened.
EFFECT OF PROPOSED SUBSTITUTE:
An individualized treatment plan must be developed for persons detained for involuntary evaluation and treatment. A case manager is required for persons committed to involuntary intensive treatment beyond the 72 hour evaluation and treatment period. The case manager is responsible for providing community support services as outlined in the Community Mental Health Services Act.
A case manager is required for persons committed to less restrictive alternative treatment. The case manager is responsible for: (1) the development of an individualized service plan; (2) monitoring the person receiving treatment; (3) ensuring that the person abides by the requirements of his or her individualized treatment plan; and (4) providing the person assistance with housing, finances, medication management, nutrition, and system advocacy. The case manager must be either a mental health professional or supervised by a mental health professional.
Case management terminates upon the expiration of the period of commitment. If, in the opinion of the case manager, substantial deterioration in the person's functioning occurs, then the case manager must request the county designated mental health professional to initiate revocation proceedings.
Fiscal Note: available
EFFECT OF PROPOSED SECOND SUBSTITUTE:
A pilot program is created to determine the effect of outreach case management on the involuntary treatment process. An individual treatment plan shall be developed by the evaluation and treatment facility for persons detained for involuntary intensive treatment beyond the 72-hour period. A plan is also required for persons committed to less restrictive alternative treatment. A determination of need for outreach case management services is included in the recommendation to the court.
The implementation of the pilot program begins on January 1, 1988, and terminates on June 30, 1989. A report to the Legislature on the progress of the pilot program and recommendations shall be submitted by the Legislative Budget Committee by January 1, 1989.
Fiscal Note: requested
Senate Committee - Testified: JUDICIARY: Linda Grant, Assn. of Alcoholism Programs; Jean Lough, Alliance for the Mentally Ill of Washington State; Gail Toraason, Washington State Psychological Assn.; Bruce Work, Thurston-Mason County Mental Health Clinic; Lyle Quasim, Division of Mental Health, DSHS; Eleanor Owen, Washington Advocates for the Mentally Ill; Karen Stegeman, Involuntary Treatment Services of King County; Bob Steer, King County Deputy Prosecutor; Nancy Jones, Involuntary Treatment Supervisor for Snohomish County; Bob Stalker, Evergreen Legal Services
Senate Committee - Testified: WAYS & MEANS: Doug Stevenson, King County Human Services; Eric Trupin, University of Washington Community Psychiatry Program; Lyle Quasim, Division of Mental Health, DSHS; Pat Thibaudeau, Washington Community Mental Health Council; Carl Hager, Citizens Commission on Human Rights; Donald E. Spencer