6319.E AMH HS H5003.1

ESB 6319 - H COMM AMD  ADOPTED AS AMENDED BY APP. CMTE. & 400  03/11/92

By Committee on Human Services

    Strike everything after the enacting clause and insert the following:

    "Sec. 1.  RCW 72.23.025 and 1989 c 205 s 21 are each amended to read as follows:

    (1) It is the intent of the legislature to improve the quality of service at state hospitals, eliminate overcrowding, and more specifically define the role of the state hospitals.  The legislature intends that eastern and western state hospitals shall become clinical centers for handling the most complicated long-term care needs of patients with a primary diagnosis of mental disorder.  Over the next six years, their involvement in providing short-term ((and)), acute care, and less complicated long-term care shall be diminished in accordance with the revised responsibilities for mental health care under chapter 71.24 RCW.  To this end, the legislature intends that funds appropriated for mental health programs, including funds for regional support networks and the state hospitals be used for persons with primary diagnosis of mental disorder.  The legislature finds that establishment of the eastern state hospital board, the western state hospital board, and institutes for the study and treatment of mental disorders at both eastern state hospital and western state hospital will be instrumental in implementing the legislative intent.

    (2)(a) The eastern state hospital board and the western state hospital board are each established.  Members of the boards shall be appointed by the governor with the consent of the senate.  Each board shall include:

    (i) The director of the institute for the study and treatment of mental disorders established at the hospital;

    (ii) One family member of a current or recent hospital resident;

    (iii) One consumer of services;

    (iv) One community mental health service provider;

    (v) Two citizens with no financial or professional interest in mental health services;

    (vi) One representative of the regional support network in which the hospital is located;

    (vii) One representative from the staff who is a physician;

    (viii) One representative from the nursing staff;

    (ix) One representative from the other professional staff;

    (x) One representative from the nonprofessional staff; and

    (xi) One representative of a minority community.

    (b) At least one representative listed in (a) (viii), (ix), or (x) of this subsection shall be a union member.

    (c) Members shall serve four-year terms.  Members of the board shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060 and shall receive compensation as provided in RCW 43.03.240.

    (3) The boards established under this section shall:

    (a) Monitor the operation and activities of the hospital;

    (b) Review and advise on the hospital budget;

    (c) Make recommendations to the governor and the legislature for improving the quality of service provided by the hospital;

    (d) Monitor and review the activities of the hospital in implementing the intent of the legislature set forth in this section;

    (e) Report periodically to the governor and the legislature on the implementation of the legislative intent set forth in this section; and

    (f) Consult with the secretary regarding persons the secretary may select as the superintendent of the hospital whenever a vacancy occurs.

    (4)(a) There is established at eastern state hospital and western state hospital, institutes for the study and treatment of mental disorders.  The institutes shall be operated by joint operating agreements between state colleges and universities and the department of social and health services.  The institutes are intended to conduct training, research, and clinical program development activities that will directly benefit mentally ill persons receiving treatment in Washington state by performing the following activities:

    (i) Promote recruitment and retention of highly qualified professionals at the state hospitals and community mental health programs;

    (ii) Improve clinical care by exploring new, innovative, and scientifically based treatment models for persons presenting particularly difficult and complicated clinical syndromes;

    (iii) Provide expanded training opportunities for existing staff at the state hospitals and community mental health programs;

    (iv) Promote bilateral understanding of treatment orientation, possibilities, and challenges between state hospital professionals and community mental health professionals.

    (b) To accomplish these purposes the institutes may, within funds appropriated for this purpose:

    (i) Enter joint operating agreements with state universities or other institutions of higher education to accomplish the placement and training of students and faculty in psychiatry, psychology, social work, occupational therapy, nursing, and other relevant professions at the state hospitals and community mental health programs;

    (ii) Design and implement clinical research projects to improve the quality and effectiveness of state hospital services and operations;

    (iii) Enter into agreements with community mental health service providers to accomplish the exchange of professional staff between the state hospitals and community mental health service providers;

    (iv) Establish a student loan forgiveness and conditional scholarship program to retain qualified professionals at the state hospitals and community mental health providers when the ((superintendent)) secretary has determined a shortage of such professionals exists.

    (c) Notwithstanding any other provisions of law to the contrary, the institutes may enter into agreements with the department or the state hospitals which may involve changes in staffing necessary to implement improved patient care programs contemplated by this section.

    (d) The institutes are authorized to seek and accept public or private gifts, grants, contracts, or donations to accomplish their purposes under this section.

    (((5) The department shall review the diagnoses and treatment history of hospital patients and create a plan to locate inappropriately placed persons into medicaid reimbursable nursing homes or other nonhospital settings.  The plan shall be submitted to the legislature by June 30, 1990.))"

    "NEW SECTION. Sec. 2.  A new section is added to chapter 72.23 RCW to read as follows:

    The secretary shall develop a system of more integrated service delivery, including incentives to discourage the inappropriate placement of persons with developmental disabilities, head injury, and substance abuse, at state mental hospitals and encourage their care in community settings.  By December 1, 1992, the department shall submit an implementation strategy, including budget proposals, to the appropriate committees of the legislature for this system.

    Under the system, state, local, or community agencies may be given financial or other incentives to develop appropriate crisis intervention and community care arrangements.

    The secretary may establish specialized care programs for persons described in this section on the grounds of the state hospitals.  Such programs may operate according to professional standards that do not conform to existing federal or private hospital accreditation standards."

    "Sec. 3.  RCW 71.05.170 and 1989 c 205 s 10 are each amended to read as follows:

(1) Whenever the designated county mental health professional petitions for detention of a person whose actions constitute a likelihood of serious harm to himself or others, or who is gravely disabled, the facility providing seventy-two hour evaluation and treatment must immediately accept on a provisional basis the petition and the person.  The facility shall then evaluate the person's condition and admit or release such person in accordance with RCW 71.05.210.  The facility shall notify in writing the court and the designated county mental health professional of the date and time of the initial detention of each person involuntarily detained in order that a probable cause hearing shall be held no later than seventy-two hours after detention.

(2) For persons listed in RCW 71.05.040, evaluation required by this section shall be conducted by a multidisciplinary treatment team at the end of the seventy-two hour detention or fourteen-day commitment authorized in chapter 71.05 RCW to determine the person's primary and secondary, or dual diagnosis.  The department system or systems determined responsible shall assume responsibility for the care, planning, and funding for the person's needs.

(3) The duty of a state hospital to accept persons for evaluation and treatment under this section shall be limited by chapter 71.24 RCW."

    "NEW SECTION. Sec. 4.    Sections 1 and 2 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately."

    "NEW SECTION. Sec. 5.    Section 3 of this act shall take effect on July 1, 1993.  If section 3 of this act is not referenced in the omnibus operating budget by June 30, 1993, it shall be null and void."

ESB 6319 - H COMM AMD

By Committee on Human Services

    On page 1, line 1 of the title, after "disabilities;" strike the remainder of the title and insert "amending RCW 72.23.025 and 71.05.170; adding a new section to chapter 72.23 RCW; providing an effective date; and declaring an emergency."