HOUSE BILL REPORT
SSB 5362
BYSenate Committee on Health Care & Corrections (originally sponsored by Senators West, Talmadge, Niemi, Smith, Johnson, Kreidler, Wojahn and Anderson)
Regulating the administration of antipsychotic medications.
House Committe on Human Services
Majority Report: Do pass with amendments. (10)
Signed by Representatives Bristow, Chair; Scott, Vice Chair; Moyer, Ranking Republican Member; Tate, Assistant Ranking Republican Member; Anderson, Brekke, Leonard, Padden, Raiter and Winsley.
Minority Report: Do not pass. (1)
Signed by Representative Hargrove.
House Staff:John B. Welsh, Jr. (786-7133)
AS PASSED HOUSE APRIL 5, 1989
BACKGROUND:
State law provides no procedures which define the rights of mentally ill persons regarding the involuntary administration of antipsychotic medications.
Antipsychotic medications include drugs used to treat serious mental illness associated with thought disorders.
In July 1988, the Washington State Supreme Court, in Harper v. State, decided that antipsychotic medication is an invasive medical procedure and may not be administered involuntarily without a court hearing and specific determination that there is a compelling state interest in overriding the patient's will.
The ruling has been generally interpreted to make questionable the involuntary administration of antipsychotic medications in emergency situations involving persons who are believed to be a danger to themselves or others. In addition, it is interpreted to require a separate hearing on the involuntary administration of antipsychotic medications, even for persons already involuntarily committed for psychiatric treatment.
SUMMARY:
Protection of the public safety is declared as one of the purposes of the Mental Health Involuntary Treatment Act.
A person may refuse shock treatment and the administration of antipsychotic medication. However, a court may order such treatments if: it finds by clear, cogent and convincing evidence that there is a compelling state interest in so doing; the proposed treatment is necessary and effective; and medically acceptable alternatives are not available, have not been successful, or are not likely to be effective.
If the person is unable to make a rational and informed decision in these matters, the court shall make a substituted judgment for the patient.
The person is granted the right to a hearing, to be present, to present evidence and other due process rights.
A court order for the administration of antipsychotic medication is effective from the hearing through any subsequent 90 day treatment period, but the court may review, upon request, the appropriateness of the medication order.
Antipsychotic medication may be administered involuntarily to persons detained or committed under the Involuntary Treatment Act, if the person presents an imminent likelihood of serious harm to himself or others, if persons responsible for the person's treatment determine that alternatives are not available, or will not be effective, and if they determine that an emergency exists which requires treatment before a court hearing can be held.
In the case of such emergencies, a petition authorizing the administration of antipsychotic medication must be filed on the next judicial day, and a hearing must be held within two judicial days.
The requirement that physicians complete medical examinations on persons detained in evaluation and treatment facilities is modified to allow physician assistants and nurse practitioners to complete the examinations.
Gender specific terminology is deleted.
Provisions governing the administration of antipsychotic medication and shock treatment are extended to minors according to Chapter 71.34 RCW.
Fiscal Note: Available.
Effective Date:The bill contains an emergency clause and takes effect immediately.
House Committee ‑ Testified For: David Hanig, Highline Evaluation and Treatment Center; Mark Brandow, Northwest Evaluation and Treatment Center; Patrick Long, Seattle King County Public Defender; Josephine Moore, Fairfax Hospital; and Mary Barrett, Assistant Attorney General, Department of Social and Health Services.
House Committee - Testified Against: Bruce Garberding, Washington Protection in Advocacy System; Jerry Fordyse, Advocate for the Mentally Ill; Richard Warner, Citizen Commission on Human Rights; and Ira Graber, Founder, National TD Association.
House Committee - Testimony For: This legislation is necessary in light of the Supreme Court decision in order to implement new procedures for the administration of antipsychotic medication upon the refusal of a patient in state custody to consent. The emergency administration of these medications is also appropriate where there is an imminent likelihood of serious harm.
House Committee - Testimony Against: The emergency administration of antipsychotic medication prior to hearing may violate the holding of the Supreme Court. In such circumstance the harm should be at least physically life-threatening. Judges should not make any substitute judgment on behalf of a patient who has evidenced a decision not to consent, however rational or informed. Antipsychotic medication is extremely dangerous and has many serious side effects.