AN ACT Relating to community mental health services; amending RCW 71.24.025; creating a new section; and providing an effective date.

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

Sec. 1. Section 3, chapter 204, Laws of 1982 as amended by section 2, chapter 274, Laws of 1986 and RCW 71.24.025 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(2) or, in the case of a child, as defined in RCW 71.34.020(12);

(b) Being gravely disabled as defined in RCW 71.05.020(1) or, in the case of a child, as defined in RCW 71.34.020(8); or

(c) Presenting a likelihood of serious harm as defined in RCW 71.05.020(3) or, in the case of a child, as defined in RCW 71.34.020(11).

(2) "Available resources" means those funds which shall be appropriated under this chapter by the legislature during any biennium for the purpose of providing community mental health programs under RCW 71.24.045.

(3) "Licensed service provider" means an entity licensed by the department according to state minimum standards or individuals licensed under chapter 18.71, 18.83, or 18.88 RCW.

(4) "Child" means a person under the age of eighteen years.

(5) "Chronically mentally ill person" means a child or adult who has a mental disorder, in the case of a child as defined by chapter 71.34 RCW, 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)), including, in the case of an elderly person, hospitalization for either a mental disorder or an illness or medical condition exacerbated by an existing mental disorder;

(b) In the case of a child, has been placed by the department or its designee two or more times outside of the home, where the placements are related to a mental disorder, as defined in chapter 71.34 RCW, and where the placements progress toward a more restrictive setting. Placements by the department include but are not limited to placements by child protective services and child welfare services;

((~~(b)~~)) (c) Has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding year;

((~~(c)~~)) (d) In the case of an elderly person, has been placed in a nursing home for a condition that is significantly influenced by a mental disorder;

(e) 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, and shall include school attendance in the case of a child. In the case of persons who are retired or who are disabled due to physical impairment, "substantial gainful activity" shall be limited to the ability to personally engage in normal pursuits necessary to manage retirement or disability income and the ability to organize complex activities of daily living; ((or

~~(d)~~)) (f) In the case of a child, has been subjected to continual distress as indicated by repeated physical or sexual abuse or neglect;

(g) In the case of an elderly person, has experienced an acute episode of mental illness that is likely to evolve into a chronic mental disorder unless intervention is provided; or

(h) In the case of an elderly person, has evidence of a mental disorder that by its very nature is recognized as requiring long-term mental health care, i.e., the dementias.

(6) "Community mental health program" means all mental health services established by a county authority.

(7) "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.

(8) "Department" means the department of social and health services.

(9) "Mental health services" means community services pursuant to RCW 71.24.035(5)(b) and other services provided by the state for the mentally ill.

(10) "Mentally ill persons" and "the mentally ill" mean persons and conditions defined in subsections (1), (5), and (12) of this section.

(11) "Residential services" means a facility or distinct part thereof which provides food, clothing, and shelter, and may include day treatment services as defined in RCW 71.24.045, for acutely mentally ill, chronically mentally ill, or seriously disturbed persons as defined in this section. Such facilities include, but are not limited to, congregate care facilities providing mental health client services as stipulated by contract with the department beginning January 1, 1982.

(12) "Seriously disturbed person" means a person who:

(a) Is gravely disabled or presents a likelihood of serious harm to himself or others as a result of a mental disorder as defined in chapter 71.05 RCW;

(b) Has been on conditional release status at some time during the preceding two years from an evaluation and treatment facility or a state mental health hospital;

(d) Exhibits suicidal preoccupation or attempts; or

(e) Is a child diagnosed by a mental health professional, as defined in RCW 71.05.020, 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.

(13) "Secretary" means the secretary of social and health services.

(14) "State minimum standards" means: (a) Minimum requirements for management and delivery of mental health services as established by departmental rules and necessary to implement this chapter, including but not limited to county administration, licensing service providers, information, accountability, contracts, and services; and (b) minimum service requirements for licensed service providers for the provision of mental health services as established by departmental rules pursuant to chapter 34.04 RCW as necessary to implement this chapter, including, but not limited to: Qualifications for staff providing services directly to mentally ill persons; the intended result of each service for those priority groups identified in RCW 71.24.035(5)(b); and the rights and responsibilities of persons receiving mental health services pursuant to this chapter.

NEW SECTION. Sec. 2. During 1988, the human services committee of the house of representatives shall undertake an interim study of the community mental health program, including a review of the definitions used to categorize the different populations of the mentally ill.

The study shall consider how the different populations are currently served and what changes or additions may be necessary to enhance these services. The study shall review whether such groups as the elderly, children and youth, young adults, minorities, and the general adult population are adequately served under the current definitions of mental illness and whether the definitions need to be revised. Existing innovative approaches to serving the mentally ill shall be reviewed for their applicability to the larger state population.

NEW SECTION. Sec. 3. Section 1 of this act shall take effect on July 1, 1989.