AN
ACT Relating to dangerous mentally ill offenders; amending RCW 71.05.212,
71.24.015, and 71.24.300; adding new sections to chapter 72.09 RCW; adding new
sections to chapter 71.05 RCW; adding a new section to chapter 71.24 RCW;
creating new sections; and providing an effective date.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. The
legislature intends to improve the process of identifying, and providing
additional mental health treatment for, persons: (1) Determined to be
dangerous to themselves or others as a result of a mental disorder or a
combination of a mental disorder and chemical dependency or abuse; and (2)
under, or being released from, confinement or partial confinement of the
department of corrections.
The
legislature does not create a presumption that any person subject to the
provisions of this act is dangerous as a result of a mental disorder or
chemical dependency or abuse. The legislature intends that every person
subject to the provisions of this act retain the amount of liberty consistent
with his or her condition, behavior, and legal status and that any restraint of
liberty be done solely on the basis of forensic and clinical practices and
standards.
NEW
SECTION. Sec. 2. A
new section is added to chapter 72.09 RCW to read as follows:
(1)
The secretary shall identify offenders in confinement or partial confinement
who: (a) Are reasonably believed to be dangerous to themselves or others; and
(b) have a mental disorder. In determining an offender's dangerousness, the
secretary shall consider behavior known to the department and factors, based on
research, that are linked to an increased risk for dangerousness of mentally
ill offenders and shall include consideration of an offender's chemical
dependency or abuse.
(2)
Prior to release of an offender identified under this section, a team
consisting of representatives of the department of corrections, the division of
mental health, and, as necessary, other divisions or administrations within the
department of social and health services, specifically including the division
of alcohol and substance abuse and the division of developmental disabilities,
the appropriate regional support network, and the providers, as appropriate,
shall develop a plan, as determined necessary by the team, for delivery of
treatment and support services to the offender upon release. The team may
include a school district representative for offenders under the age of
twenty-one. The team shall consult with the offender's counsel, if any, and,
as appropriate, the offender's family and community. The team shall notify the
crime victim/witness program, which shall provide notice to all people
registered to receive notice under RCW 9.94A.155 of the proposed release plan
developed by the team. Victims, witnesses, and other interested people
notified by the department may provide information and comments to the department
on potential safety risk to specific individuals or classes of individuals
posed by the specific offender. The team may recommend: (a) That the offender
be evaluated by the county designated mental health professional, as defined in
chapter 71.05 RCW; (b) department-supervised community treatment; or (c)
voluntary community mental health or chemical dependency or abuse treatment.
(3)
Prior to release of an offender identified under this section, the team shall
determine whether or not an evaluation by a county designated mental health
professional is needed. If an evaluation is recommended, the supporting
documentation shall be immediately forwarded to the appropriate county
designated mental health professional. The supporting documentation shall
include the offender's criminal history, history of judicially required or
administratively ordered involuntary antipsychotic medication while in
confinement, and any known history of involuntary civil commitment.
(4)
If an evaluation by a county designated mental health professional is
recommended by the team, such evaluation shall occur not more than ten days,
nor less than five days, prior to release.
(5)
A second evaluation by a county designated mental health professional shall
occur on the day of release if requested by the team, based upon new
information or a change in the offender's mental condition, and the initial
evaluation did not result in an emergency detention or a summons under chapter
71.05 RCW.
(6)
If the county designated mental health professional determines an emergency
detention under chapter 71.05 RCW is necessary, the department shall release
the offender only to a state hospital or to a consenting evaluation and
treatment facility. The department shall arrange transportation of the
offender to the hospital or facility.
(7)
If the county designated mental health professional believes that a less
restrictive alternative treatment is appropriate, he or she shall seek a
summons, pursuant to the provisions of chapter 71.05 RCW, to require the
offender to appear at an evaluation and treatment facility. If a summons is
issued, the offender shall remain within the corrections facility until
completion of his or her term of confinement and be transported, by corrections
personnel on the day of completion, directly to the identified evaluation and
treatment facility.
(8)
The secretary shall adopt rules to implement this section.
NEW
SECTION. Sec. 3. A
new section is added to chapter 72.09 RCW to read as follows:
The
secretaries of the department of corrections and the department of social and
health services shall adopt rules and develop working agreements which will
ensure that offenders identified under section 2(1) of this act will be
assisted in making application for medicaid to facilitate a decision regarding
their eligibility for such entitlements prior to the end of their term of
confinement in a correctional facility.
NEW
SECTION. Sec. 4. A
new section is added to chapter 71.05 RCW to read as follows:
The
legislature intends that, when evaluating a person who is identified under
section 2(7) of this act, the professional person at the evaluation and
treatment facility shall, when appropriate after consideration of the person's
mental condition and relevant public safety concerns, file a petition for a
ninety-day less restrictive alternative in lieu of a petition for a
fourteen-day commitment.
Sec.
5. RCW
71.05.212 and 1998 c 297 s 19 are each amended to read as follows:
Whenever
a county designated mental health professional or professional person is
conducting an evaluation under this chapter, consideration shall include all
reasonably available information and records regarding: (1) Prior
recommendations for evaluation of the need for civil commitments when the
recommendation is made pursuant to an evaluation conducted under chapter 10.77
RCW; (2) history of one or more violent acts; (3) prior determinations of incompetency
or insanity under chapter 10.77 RCW; and (4) prior commitments under this
chapter.
In
addition, when conducting an evaluation for offenders identified under section
2 of this act, the county designated mental health professional or professional
person shall consider an offender's history of judicially required or
administratively ordered antipsychotic medication while in confinement.
NEW
SECTION. Sec. 6. A
new section is added to chapter 71.05 RCW to read as follows:
(1)
When making a decision under this chapter whether to require a less restrictive
alternative treatment, the court shall consider whether it is appropriate to
include or exclude time spent in confinement when determining whether the
person has committed a recent overt act.
(2)
When determining whether an offender is a danger to himself or herself or
others under this chapter, a court shall give great weight to any evidence
submitted to the court regarding an offender's recent history of judicially
required or administratively ordered involuntary antipsychotic medication while
in confinement.
Sec.
7. RCW
71.24.015 and 1991 c 306 s 1 are each amended to read as follows:
It
is the intent of the legislature to establish a community mental health program
which shall help people experiencing mental illness to retain a respected and
productive position in the community. This will be accomplished through
programs which provide for:
(1)
Access to mental health services for adults of the state who are acutely
mentally ill, chronically mentally ill, or seriously disturbed and children of
the state who are acutely mentally ill, severely emotionally disturbed, or
seriously disturbed, which services recognize the special needs of underserved
populations, including minorities, children, the elderly, disabled, and
low-income persons. Access to mental health services shall not be limited
by a person's history of confinement in a state, federal, or local correctional
facility. It is also the purpose of this chapter to promote the early
identification of mentally ill children and to ensure that they receive the
mental health care and treatment which is appropriate to their developmental
level. This care should improve home, school, and community functioning,
maintain children in a safe and nurturing home environment, and should enable
treatment decisions to be made in response to clinical needs in accordance with
sound professional judgment while also recognizing parents' rights to
participate in treatment decisions for their children;
(2)
Accountability of services through state-wide standards for monitoring and
reporting of information;
(3)
Minimum service delivery standards;
(4)
Priorities for the use of available resources for the care of the mentally ill;
(5)
Coordination of services within the department, including those divisions
within the department that provide services to children, between the department
and the office of the superintendent of public instruction, and among state
mental hospitals, county authorities, community mental health services, and
other support services, which shall to the maximum extent feasible also include
the families of the mentally ill, and other service providers; and
(6)
Coordination of services aimed at reducing duplication in service delivery and
promoting complementary services among all entities that provide mental health
services to adults and children.
It
is the policy of the state to encourage the provision of a full range of
treatment and rehabilitation services in the state for mental disorders. The
legislature intends to encourage the development of county-based and
county-managed mental health services with adequate local flexibility to assure
eligible people in need of care access to the least-restrictive treatment alternative
appropriate to their needs, and the availability of treatment components to
assure continuity of care. To this end, counties are encouraged to enter into
joint operating agreements with other counties to form regional systems of care
which integrate planning, administration, and service delivery duties assigned
to counties under chapters 71.05 and 71.24 RCW to consolidate administration,
reduce administrative layering, and reduce administrative costs.
It
is further the intent of the legislature to integrate the provision of services
to provide continuity of care through all phases of treatment. To this end the
legislature intends to promote active engagement with mentally ill persons and
collaboration between families and service providers.
Sec.
8. RCW
71.24.300 and 1994 c 204 s 2 are each amended to read as follows:
A
county authority or a group of county authorities whose combined population is
no less than forty thousand may enter into a joint operating agreement to form
a regional support network. Upon the request of a tribal authority or
authorities within a regional support network the joint operating agreement or
the county authority shall allow for the inclusion of the tribal authority to
be represented as a party to the regional support network. The roles and
responsibilities of the county and tribal authorities shall be determined by
the terms of that agreement including a determination of membership on the
governing board and advisory committees, the number of tribal representatives
to be party to the agreement, and the provisions of law and shall assure the
provision of culturally competent services to the tribes served. The state
mental health authority may not determine the roles and responsibilities of
county authorities as to each other under regional support networks by rule,
except to assure that all duties required of regional support networks are
assigned and that a single authority has final responsibility for all available
resources and performance under the regional support network's contract with
the secretary.
(1)
Regional support networks shall within three months of recognition submit an
overall six‑year operating and capital plan, timeline, and budget and
submit progress reports and an updated two‑year plan biennially
thereafter, to assume within available resources all of the following duties by
July 1, 1995, instead of those presently assigned to counties under RCW
71.24.045(1):
(a)
Administer and provide for the availability of all resource management
services, residential services, and community support services.
(b)
Administer and provide for the availability of all investigation,
transportation, court‑related, and other services provided by the state
or counties pursuant to chapter 71.05 RCW.
(c)
By July 1, 1993, provide within the boundaries of each regional support network
evaluation and treatment services for at least eighty‑five percent of
persons detained or committed for periods up to seventeen days according to
chapter 71.05 RCW. Regional support networks with populations of less than
one hundred fifty thousand may contract to purchase evaluation and treatment
services from other networks. Insofar as the original intent of serving
persons in the community is maintained, the secretary is authorized to approve
exceptions on a case-by-case basis to the requirement to provide evaluation and
treatment services within the boundaries of each regional support network.
Such exceptions are limited to contracts with neighboring or contiguous
regions. For regional support networks that are created after June 30, 1991,
the requirements of (c) of this subsection must be met by July 1, 1995.
(d)
By July 1, 1993, administer a portion of funds appropriated by the legislature
to house mentally ill persons in state institutions from counties within the
boundaries of any regional support network, with the exception of ((mentally
ill offenders)) persons currently confined at, or under the supervision
of, a state mental hospital pursuant to chapter 10.77 RCW, and provide for
the care of all persons needing evaluation and treatment services for periods
up to seventeen days according to chapter 71.05 RCW in appropriate residential
services, which may include state institutions. The regional support networks
shall reimburse the state for use of state institutions at a rate equal to that
assumed by the legislature when appropriating funds for such care at state
institutions during the biennium when reimbursement occurs. The duty of a
state hospital to accept persons for evaluation and treatment under chapter
71.05 RCW is limited by the responsibilities assigned to regional support
networks under this section. For regional support networks that are created
after June 30, 1991, the requirements of (d) of this subsection must be met by
July 1, 1995.
(e)
Administer and provide for the availability of all other mental health
services, which shall include patient counseling, day treatment, consultation,
education services, employment services as defined in RCW 71.24.035, and mental
health services to children as provided in this chapter.
(f)
Establish standards and procedures for reviewing individual service plans and
determining when that person may be discharged from resource management
services.
(2)
Regional support networks shall assume all duties assigned to county
authorities by this chapter and chapter 71.05 RCW.
(3)
A regional support network may request that any state‑owned land,
building, facility, or other capital asset which was ever purchased, deeded,
given, or placed in trust for the care of the mentally ill and which is within
the boundaries of a regional support network be made available to support the
operations of the regional support network. State agencies managing such
capital assets shall give first priority to requests for their use pursuant to
this chapter.
(4)
Each regional support network shall appoint a mental health advisory board
which shall review and provide comments on plans and policies developed under
this chapter. The composition of the board shall be broadly representative of
the demographic character of the region and the mentally ill persons served
therein. Length of terms of board members shall be determined by the regional
support network.
(5)
Regional support networks shall assume all duties specified in their plans and
joint operating agreements through biennial contractual agreements with the
secretary. Such contracts may include agreements to provide periods of stable
community living and work or other day activities for specific chronically
mentally ill persons who have completed commitments at state hospitals on
ninety‑day or one hundred eighty‑day civil commitments or who have
been residents at state hospitals for no less than one hundred eighty days
within the previous year. Periods of stable community living may involve acute
care in local evaluation and treatment facilities but may not involve use of
state hospitals.
(6)
Counties or groups of counties participating in a regional support network are
not subject to RCW 71.24.045(((7))) (6). The office of financial
management shall consider information gathered in studies required in this
chapter and information about the experience of other states to propose a
mental health services administrative cost lid to the 1993 legislature which
shall include administrative costs of licensed service providers, the state
psychiatric hospitals and the department.
(7)
By November 1, 1991, and as part of each biennial plan thereafter, each
regional support network shall establish and submit to the state, procedures
and agreements to assure access to sufficient additional local evaluation and
treatment facilities to meet the requirements of this chapter while reducing
short‑term admissions to state hospitals. These shall be commitments to
construct and operate, or contract for the operation of, freestanding
evaluation and treatment facilities or agreements with local evaluation and
treatment facilities which shall include (a) required admission and treatment
for short‑term inpatient care for any person enrolled in community
support or residential services, (b) discharge planning procedures, (c)
limitations on admissions or transfers to state hospitals, (d) adequate
psychiatric supervision, (e) prospective payment methods, and (f) contractual
assurances regarding referrals to local evaluation and treatment facilities
from regional support networks.
(8)
Regional support networks may receive technical assistance from the housing
trust fund and may identify and submit projects for housing and housing support
services to the housing trust fund established under chapter 43.185 RCW.
Projects identified or submitted under this subsection must be fully integrated
with the regional support network six‑year operating and capital plan,
timeline, and budget required by subsection (1) of this section.
NEW
SECTION. Sec. 9. A
new section is added to chapter 71.24 RCW to read as follows:
(1)
The secretary shall contract, to the extent that funds are appropriated for
this purpose, for case management services and such other services as the
secretary deems necessary to assist offenders identified under section 2 of
this act. The contracts may be with regional support networks or any other
qualified and appropriate entities.
(2)
The case manager has the authority to assist these offenders in obtaining the
services, as set forth in the plan created under section 2(2) of this act, for
up to five years. The services may include coordination of mental health
services, assistance with unfunded medical expenses, obtaining chemical
dependency treatment, housing, employment services, educational or vocational
training, independent living skills, parenting education, anger management
services, and such other services as the case manager deems necessary.
(3)
The legislature intends that funds appropriated for the purposes of sections 2
and 4 of this act, RCW 71.05.212, and this section and distributed to the
regional support networks are to supplement and not to supplant general funding.
Funds appropriated to implement sections 2 and 4 of this act, RCW 71.05.212,
and this section are not to be considered available resources as defined in RCW
71.24.025 and are not subject to the statutory distribution formula established
pursuant to RCW 71.24.035.
NEW
SECTION. Sec. 10. The
Washington state institute for public policy, in conjunction with the
University of Washington, shall conduct an evaluation of this act to determine:
(1)
Whether there is a reduction in criminal recidivism as a result of this act;
(2)
Whether this act has resulted in: (a) Increased treatment of, and services to,
dangerous mentally ill offenders, including services at the department of
corrections, and through other publicly funded services; (b) a reduction in
repeated inpatient mental health treatment by the same offender; and (c)
reduced length of stays at state hospitals;
(3)
Whether this act improves delivery and effectiveness of the treatment and
services, including mental health, drug/alcohol, case management, housing
assistance, and other provided services;
(4)
Whether services under this act should be expanded to include other
classifications of offenders, such as: Juveniles; felons not sentenced to
confinement; misdemeanants; and felons in county jails. Cost estimates for
expansion of each classification shall be included;
(5)
The validity of the risk assessment tool utilized by the department of
corrections to assess dangerousness of offenders;
(6)
Increases in early medicaid enrollment and associated cost savings; and
(7)
Any savings in bed spaces in the department of corrections as a result of this
act.
The
evaluation shall be submitted to the governor and legislature by December 1,
2004.
NEW
SECTION. Sec. 11. The
secretary of the department of corrections and the secretary of the department
of social and health services shall, in consultation with the regional support
networks and provider representatives, each adopt rules as necessary to implement
this act.
NEW
SECTION. Sec. 12.
Sections 1, 2, and 4 through 9 of this act take effect March 15, 2000.
NEW
SECTION. Sec. 13.
Section 1 of this act shall not be codified.
