AN ACT Relating to providing residential care to mentally ill persons; adding new sections to chapter 71.24 RCW; creating new sections; and making appropriations.

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

NEW SECTION. Sec. 1. The legislature finds that after thirty years of a policy of deinstitutionalization of mentally ill persons, many people who had been institutionalized are living independently and successfully on their own and many more are receiving adequate support services from the state. The legislature further finds, however, that the mental health system is fragmented and there are disincentives to provide the least restrictive care. Community residential capacity is seriously inadequate, and thousands of mentally ill persons in our state are homeless or without adequate residences. The federal government is divesting itself of responsibility for providing funding for mentally ill persons who reside in nursing homes and other large facilities.

The legislature intends to establish a residential care program to decentralize administration, integrate funding and program administrative responsibility, and create incentives to provide the least costly and most effective treatment. The goal of the program is to reduce the incidence of hospitalization and provide necessary community supports, including residences, to allow mentally ill persons to live in normal community situations whenever possible.

NEW SECTION. Sec. 2. Any group of counties with a combined population of six hundred thousand or more may execute a joint operating agreement to establish a regional mental health network. The network shall operate or contract for the operation of all residential services located within the region in cooperation with other mental health service providers. The network shall also establish additional community support services as needed to assure a comprehensive system of care. The network shall have the authority to negotiate contracts, determine reimbursement rates, and execute agreements with member counties to make transfers between funds provided to the network for residential services and funds provided to participating counties pursuant to this chapter and chapter 71.05 RCW. Commitments made under chapter 71.05 RCW shall be to the network and the network shall provide or contract for the provision of evaluation and treatment services. The department shall assume the responsibilities assigned to a regional mental health network under this section for any county that has not executed a joint operating agreement by July 1, 1993.

NEW SECTION. Sec. 3. The department shall transfer responsibility for providing or contracting to provide residential services for adults who are acutely mentally ill, chronically mentally ill, or seriously disturbed and who live within a region to the regional mental health network established pursuant to section 2 of this act. Contracts to be transferred shall include, but are not limited to: Nursing homes licensed under chapter 18.51 RCW; boarding homes licensed under chapter 18.20 RCW; private establishments licensed under chapter 71.12 RCW; evaluation and treatment facilities defined under chapter 71.05 RCW; and state institutions established under chapter 72.23 RCW. The administrative responsibility for existing programs shall be transferred to a regional mental health network within one year after the network is established.

NEW SECTION. Sec. 4. Each regional mental health network shall develop a plan to expand residential services, community support services, and other mental health services so that, within two years of the network's establishment, services consistent with the state minimum standards for residential care are provided within the region to all residents except mentally ill offenders. The network established in Snohomish, Island, San Juan, Skagit, and Whatcom counties shall submit a plan and proposed budget that includes operating funds for a one hundred twenty-bed long-term care facility at Sedro Wooley to the legislature by December 1, 1990.

NEW SECTION. Sec. 5. The office of financial management and each regional mental health network shall jointly determine the funds used by the department for administration of responsibilities to be transferred to the network pursuant to section 3 of this act. Funds shall be identified within at least the division of mental health, the office of aging and adult services, the office of comptroller, the office of audit, the office of research, the office of contracts management, the office of provider services, and the office of personnel. The identified funds shall be transferred to the network to cover administrative costs for responsibilities transferred to the network.

NEW SECTION. Sec. 6. The state hospital commission shall conduct a study of equitable and timely compensation for involuntary psychiatric services through a review of medical assistance rates paid to hospitals. The commission shall submit a report and recommendations to the department of social and health services and appropriate legislative committees by December 1989.

NEW SECTION. Sec. 7. The sum of .......... dollars, or as much thereof as may be necessary, is appropriated from the general fund to the department of social and health services for the biennium ending June 30, 1991, to be awarded in block grants totaling not less than one hundred percent of this appropriation for the period July 1, 1990, to June 30, 1991, to regional mental health networks established pursuant to section 2 of this act to provide funding for residential services transferred under section 3 of this act.

NEW SECTION. Sec. 8. The sum of .......... dollars, or as much thereof as may be necessary, is appropriated from the general fund to the department of social and health services for the biennium ending June 30, 1991, to be awarded in block grants totaling not less than one hundred percent of this appropriation to regional mental health networks established pursuant to section 2 of this act to provide additional residential services, additional community support services, and evaluation and treatment facilities to expand available residences by .......... beds state-wide. Additional funds shall be added to the block grant from federal Title XIX funds received by the department of social and health services for services performed by the networks.

NEW SECTION. Sec. 9. Sections 1 through 4 of this act are each added to chapter 71.24 RCW.