SENATE BILL REPORT
SB 5362
BYSenators West, Talmadge, Niemi, Smith, Johnson, Kreidler, Wojahn and Anderson
Regulating the administration of antipsychotic medications.
Senate Committee on Health Care & Corrections
Senate Hearing Date(s):January 31, 1989; February 14, 1989
Majority Report: That Substitute Senate Bill No. 5362 be substituted therefor, and the substitute bill do pass.
Signed by Senators West, Chairman; Smith, Vice Chairman; Amondson, Johnson, Kreidler, Niemi, Wojahn.
Senate Staff:Don Sloma (786-7414)
February 16, 1989
AS REPORTED BY COMMITTEE ON HEALTH CARE & CORRECTIONS, FEBRUARY 14, 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.
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.
The requirement that physicians complete medical examinations on persons detained in evaluation and treatment facilities is modified to allow physician assistants to complete the examinations.
Gender specific terminology is deleted.
EFFECT OF PROPOSED SUBSTITUTE:
Provisions governing the administration of antipsychotic medication and shock treatment are extended to minors according to Chapter 71.34 RCW.
Physician assistants or nurse practitioners may assist physicians in completing medical evaluations on detained persons.
Court orders for the involuntary administration of antipsychotic medication are effective for periods not to exceed 60 days.
An emergency clause is added.
Appropriation: none
Revenue: none
Fiscal Note: available
Effective Date:The bill contains an emergency clause and takes effect immediately.
Senate Committee - Testified: Fern Mortvedt, Well Mind; Gary Moore, WFSE; Josephine Moore, Fairfax Hospital (pro); Pat Thibaudeau, Washington Community Mental Health Care (pro); Robert Stier, King County (pro); James Kelly, Statewide Black Community Coalition (pro); Christos Dagadakis, Washington State Psychiatric Association (pro); Michael Shipe; Sharon Stewart Johnson, DSHS; Pam Campbell, Governor's office; Jim Audrych, Consumer Support Group Resources; Cliff Webster, WSMA (pro); Eleanor Owen, WAMI (pro); David Hanig (pro); Thelma Struck, DSHS (pro)