AN
ACT Relating to opiate substitution treatment programs; and amending RCW
70.96A.400, 70.96A.410, and 70.96A.420.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec.
1. RCW
70.96A.400 and 1995 c 321 s 1 are each amended to read as follows:
The
state of Washington declares that there is no fundamental right to opiate
substitution treatment. The state of Washington further declares that while ((methadone
and other like pharmacological)) opiate substitution drugs((,))
used in the treatment of opiate dependency are addictive substances, that they
nevertheless have several legal, important, and justified uses and that one of
their appropriate and legal uses is, in conjunction with other required
therapeutic procedures, in the treatment of persons addicted to or habituated
to opioids. Opiate substitution treatment should only be used for
participants who are deemed appropriate to need this level of intervention and
should not be the first treatment intervention for all opiate addicts.
Because
((methadone and other like pharmacological)) opiate substitution
drugs, used in the treatment of opiate dependency are addictive and are listed
as a schedule II controlled substance in chapter 69.50 RCW, the state of
Washington ((and authorizing counties on behalf of their citizens have))
has the legal obligation and right to regulate the use of opiate
substitution treatment. The state of Washington declares its authority to
control and regulate carefully, in ((cooperation)) consultation
with ((the authorizing)) counties and cities, all clinical uses
of ((methadone and other pharmacological)) opiate substitution
drugs used in the treatment of opiate addiction.
Further,
the state declares that the primary goal of opiate substitution treatment is
total abstinence from chemical dependency for the individuals who participate
in the treatment program. The state recognizes that a small percentage of
persons who participate in opiate ((substitute [substitution])) substitution
treatment programs require treatment for an extended period of time. Opiate
substitution treatment programs shall provide a comprehensive transition
program to eliminate chemical dependency((;)), including opiate
and opiate substitute addiction of program participants.
Sec.
2. RCW
70.96A.410 and 1995 c 321 s 2 are each amended to read as follows:
(1)
((A county legislative authority may prohibit opiate substitution treatment
in that county. The department shall not certify an opiate substitution
treatment program in a county where the county legislative authority has
prohibited opiate substitution treatment. If a county legislative authority
authorizes opiate substitution treatment programs, it shall limit by ordinance
the number of opiate substitution treatment programs operating in that county
by limiting the number of licenses granted in that county. If a county has
authorized opiate substitution treatment programs in that county, it shall only
license opiate substitution treatment programs that comply with the
department's operating and treatment standards under this section and RCW
70.96A.420. A county that authorizes opiate substitution treatment may operate
the programs directly or through a local health department or health district
or it may authorize certified opiate substitution treatment programs that the
county licenses to provide the services within the county. Counties shall
monitor opiate substitution treatment programs for compliance with the
department's operating and treatment regulations under this section and RCW
70.96A.420.
(2)
A county that authorizes opiate substitution treatment programs shall develop
and enact by ordinance licensing standards, consistent with this chapter and
the operating and treatment standards adopted under this chapter, that govern
the application for, issuance of, renewal of, and revocation of the licenses.
Certified programs existing before May 18, 1987, applying for renewal of
licensure in subsequent years, that maintain certification and meet all other
requirements for licensure, shall be given preference.
(3)
In certifying programs, the department shall not discriminate against an opiate
substitution treatment program on the basis of its corporate structure. In
licensing programs, the county shall not discriminate against an opiate
substitution treatment program on the basis of its corporate structure.
(4))) For
purposes of this section, "area" means the county in which an
applicant proposes to locate a certified program and counties adjacent, or near
to, the county in which the program is proposed to be located.
When
making a decision on an application for certification of a program, the
department shall:
(a)
Consult with the county legislative authorities in the area in which an
applicant proposes to locate a program and the city legislative authority in
any city in which an applicant proposes to locate a program;
(b)
Certify only programs that will be sited in accordance with the appropriate
county or city land use ordinances. Counties and cities may require
conditional or special use permits with reasonable conditions for the siting of
programs. Pursuant to RCW 36.70A.200, no local comprehensive plan or
development regulation may preclude the siting of essential public facilities;
(c)
Not discriminate in its certification decision on the basis of the corporate
structure of the applicant;
(d)
Consider the size of the population in need of treatment in the area in which
the program would be located and certify only applicants whose programs meet
the necessary treatment needs of that population;
(e)
Demonstrate a need in the community for opiate substitution treatment and not
certify more program slots than justified by the need in that community. No
program shall exceed three hundred fifty participants unless specifically
authorized by the county in which the program is certified;
(f)
Consider the availability of other certified programs near the area in which
the applicant proposes to locate the program;
(g)
Consider the transportation systems that would provide service to the program
and whether the systems will provide reasonable opportunities to access the
program for persons in need of treatment;
(h)
Consider whether the applicant has, or has demonstrated in the past, the
capability to provide the appropriate services to assist the persons who
utilize the program in meeting goals established by the legislature, including
abstinence from opiates and opiate substitutes, obtaining mental health
treatment, improving economic independence, and reducing adverse consequences
associated with illegal use of controlled substances. The department shall
prioritize certification to applicants who have demonstrated such capability;
(i)
Hold at least one public hearing in the county in which the facility is
proposed to be located and one hearing in the area in which the facility is
proposed to be located. The hearing shall be held at a time and location that
are most likely to permit the largest number of interested persons to attend
and present testimony. The department shall notify all appropriate media
outlets of the time, date, and location of the hearing at least three weeks in
advance of the hearing.
(2)
A program applying for certification from the department and a program applying
for a contract from a state agency that has been denied the certification or
contract shall be provided with a written notice specifying the rationale and
reasons for the denial. ((A program applying for a license or a contract
from a county that has been denied the license or contract shall be provided
with a written notice specifying the rationale and reasons for the denial.
(5)
A license is effective for one calendar year from the date of issuance. The
license shall be renewed in accordance with the provisions of this section for
initial approval; the goals for treatment programs under RCW 70.96A.400; the
standards set forth in RCW 70.96A.420; and the rules adopted by the secretary.
(6))) (3)
For the purpose of this chapter, opiate substitution treatment means:
(a)
Dispensing an opiate substitution drug approved by the federal drug
administration for the treatment of opiate addiction; and
(b)
Providing a comprehensive range of medical and rehabilitative services.
Sec.
3. RCW
70.96A.420 and 1998 c 245 s 135 are each amended to read as follows:
(1)
The department, in consultation with opiate substitution treatment service
providers and counties ((authorizing opiate substitution treatment programs))
and cities, shall establish statewide treatment standards for certified
opiate substitution treatment programs. The department ((and counties that
authorize opiate substitution treatment programs)) shall enforce these treatment
standards. The treatment standards shall include, but not be limited to,
reasonable provisions for all appropriate and necessary medical procedures,
counseling requirements, urinalysis, and other suitable tests as needed to
ensure compliance with this chapter. ((A opiate substitution treatment
program shall not have a caseload in excess of three hundred fifty persons.))
(2)
The department, in consultation with opiate substitution treatment programs and
counties ((authorizing opiate substitution treatment programs)), shall
establish statewide operating standards for certified opiate
substitution treatment programs. The department ((and counties that
authorize opiate substitution treatment programs)) shall enforce these
operating standards. The operating standards shall include, but not be limited
to, reasonable provisions necessary to enable the department and ((authorizing))
counties to monitor certified and licensed opiate substitution treatment
programs for compliance with this chapter and the treatment standards
authorized by this chapter and to minimize the impact of the opiate
substitution treatment programs upon the business and residential neighborhoods
in which the program is located.
(3)
The department shall establish criteria for evaluating the compliance of opiate
substitution treatment programs with the goals and standards established under
this chapter. As a condition of certification, opiate substitution programs
shall submit an annual report to the department and county legislative
authority, including data as specified by the department necessary for outcome
analysis. The department shall analyze and evaluate the data submitted by each
treatment program and take corrective action where necessary to ensure
compliance with the goals and standards enumerated under this chapter.
(4)
Before January 1st of each year, the secretary shall submit a report to the
legislature and governor. The report shall include the number of persons
enrolled in each treatment program during the period covered by the report, the
number of persons who leave each treatment program voluntarily and
involuntarily, and an outcome analysis of each treatment program. For purposes
of this subsection, "outcome analysis" shall include but not be
limited to: The number of people who, as a result of participation in the
program, are able to abstain from opiates; reduction in use of opiates;
reduction in criminal conduct; achievement of economic independence; and
reduction in utilization of health care. The report shall include information
on an annual and cumulative basis beginning on the effective date of this
section.
