BILL REQ. #:  H-4478.2 

Read first time 01/16/08.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to the intensive case management and integrated response pilot programs; amending RCW 70.96A.800, 70.96B.020, 70.96B.800, and 70.96B.900; and providing an expiration date.

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

Sec. 1   RCW 70.96A.800 and 2005 c 504 s 220 are each amended to read as follows:
     (1) The secretary shall select and contract with counties to provide intensive case management for chemically dependent persons with histories of high utilization of crisis services at two sites. In selecting the two sites, the secretary shall endeavor to site one in an urban county, and one in a rural county; and to site them in counties other than those selected pursuant to RCW 70.96B.020, to the extent necessary to facilitate evaluation of pilot project results.
     (2) The contracted sites shall implement the pilot programs by providing intensive case management to persons with a primary chemical dependency diagnosis or dual primary chemical dependency and mental health diagnoses, through the employment of chemical dependency case managers. The chemical dependency case managers shall:
     (a) Be trained in and use the integrated, comprehensive screening and assessment process adopted under RCW 70.96C.010;
     (b) Reduce the use of crisis medical, chemical dependency and mental health services, including but not limited to, emergency room admissions, hospitalizations, detoxification programs, inpatient psychiatric admissions, involuntary treatment petitions, emergency medical services, and ambulance services;
     (c) Reduce the use of emergency first responder services including police, fire, emergency medical, and ambulance services;
     (d) Reduce the number of criminal justice interventions including arrests, violations of conditions of supervision, bookings, jail days, prison sanction day for violations, court appearances, and prosecutor and defense costs;
     (e) Where appropriate and available, work with therapeutic courts including drug courts and mental health courts to maximize the outcomes for the individual and reduce the likelihood of reoffense;
     (f) Coordinate with local offices of the economic services administration to assist the person in accessing and remaining enrolled in those programs to which the person may be entitled;
     (g) Where appropriate and available, coordinate with primary care and other programs operated through the federal government including federally qualified health centers, Indian health programs, and veterans' health programs for which the person is eligible to reduce duplication of services and conflicts in case approach;
     (h) Where appropriate, advocate for the client's needs to assist the person in achieving and maintaining stability and progress toward recovery;
     (i) Document the numbers of persons with co-occurring mental and substance abuse disorders and the point of determination of the co-occurring disorder by quadrant of intensity of need; and
     (j) Where a program participant is under supervision by the department of corrections, collaborate with the department of corrections to maximize treatment outcomes and reduce the likelihood of reoffense.
     (3) The pilot programs established by this section shall begin providing services by March 1, 2006.
     (4) This section expires June 30, ((2008)) 2009.

Sec. 2   RCW 70.96B.020 and 2005 c 504 s 203 are each amended to read as follows:
     (1) The secretary, after consulting with the Washington state association of counties, shall select and contract with regional support networks or counties to provide two integrated crisis response and involuntary treatment pilot programs for adults and shall allocate resources for both integrated services and secure detoxification services in the pilot areas. In selecting the two regional support networks or counties, the secretary shall endeavor to site one in an urban and one in a rural regional support network or county; and to site them in counties other than those selected pursuant to RCW 70.96A.800, to the extent necessary to facilitate evaluation of pilot project results. During state fiscal year 2009, contracts for pilot programs under this section must be limited to those counties that have contracted with the department to act as a regional support network. To the extent that this limitation results in the termination of a pilot program at the end of state fiscal year 2008, the department shall select an alternative regional support network to operate the pilot program in a different county during state fiscal year 2009. In making the selection, the secretary shall offer a contract to a single county regional support network in an urban area east of the Cascade mountains. If that regional support network chooses not to operate the pilot program, the secretary may select another regional support network in an urban area.
     (2) The regional support networks or counties shall implement the pilot programs by providing integrated crisis response and involuntary treatment to persons with a chemical dependency, a mental disorder, or both, consistent with this chapter. The pilot programs shall:
     (a) Combine the crisis responder functions of a designated mental health professional under chapter 71.05 RCW and a designated chemical dependency specialist under chapter 70.96A RCW by establishing a new designated crisis responder who is authorized to conduct investigations and detain persons up to seventy-two hours to the proper facility;
     (b) Provide training to the crisis responders as required by the department;
     (c) Provide sufficient staff and resources to ensure availability of an adequate number of crisis responders twenty-four hours a day, seven days a week;
     (d) Provide the administrative and court-related staff, resources, and processes necessary to facilitate the legal requirements of the initial detention and the commitment hearings for persons with a chemical dependency;
     (e) Participate in the evaluation and report to assess the outcomes of the pilot programs including providing data and information as requested;
     (f) Provide the other services necessary to the implementation of the pilot programs, consistent with this chapter as determined by the secretary in contract; and
     (g) Collaborate with the department of corrections where persons detained or committed are also subject to supervision by the department of corrections.
     (3) The pilot programs established by this section shall begin providing services by March 1, 2006. Any alternative pilot program location established under subsection (1) of this section shall begin providing services by September 1, 2008.

Sec. 3   RCW 70.96B.800 and 2005 c 504 s 217 are each amended to read as follows:
     (1) The Washington state institute for public policy shall evaluate the pilot programs and make ((a)) preliminary reports to appropriate committees of the legislature by December 1, 2007, and June 30, 2008, and a final report by ((September 30, 2008)) June 30, 2010.
     (2) The evaluation of the pilot programs shall include:
     (a) Whether the designated crisis responder pilot program:
     (i) Has increased efficiency of evaluation and treatment of persons involuntarily detained for seventy-two hours;
     (ii) Is cost-effective;
     (iii) Results in better outcomes for persons involuntarily detained;
     (iv) Increased the effectiveness of the crisis response system in the pilot catchment areas;
     (b) The effectiveness of providing a single chapter in the Revised Code of Washington to address initial detention of persons with mental disorders or chemical dependency, in crisis response situations and the likelihood of effectiveness of providing a single, comprehensive involuntary treatment act.
     (3) The reports shall consider the impact of the pilot programs on the existing mental health system and on the persons served by the system.

Sec. 4   RCW 70.96B.900 and 2005 c 504 s 219 are each amended to read as follows:
     Sections 202 through 216 of this act expire ((July 1, 2008)) June 30, 2009.