SHB 1170 -
By Senators Hargrove, Stevens, Harper
ADOPTED 04/08/2011
On page 9, after line 19 of the amendment, insert the following:
"Sec. 4 RCW 71.24.035 and 2008 c 267 s 5 and 2008 c 261 s 3 are
each reenacted and amended to read as follows:
(1) The department is designated as the state mental health
authority.
(2) The secretary shall provide for public, client, and licensed
service provider participation in developing the state mental health
program, developing contracts with regional support networks, and any
waiver request to the federal government under medicaid.
(3) The secretary shall provide for participation in developing the
state mental health program for children and other underserved
populations, by including representatives on any committee established
to provide oversight to the state mental health program.
(4) The secretary shall be designated as the regional support
network if the regional support network fails to meet state minimum
standards or refuses to exercise responsibilities under RCW 71.24.045,
until such time as a new regional support network is designated under
RCW 71.24.320.
(5) The secretary shall:
(a) Develop a biennial state mental health program that
incorporates regional biennial needs assessments and regional mental
health service plans and state services for adults and children with
mental illness. The secretary shall also develop a six-year state
mental health plan;
(b) Assure that any regional or county community mental health
program provides access to treatment for the region's residents,
including parents who are respondents in dependency cases, in the
following order of priority: (i) Persons with acute mental illness;
(ii) adults with chronic mental illness and children who are severely
emotionally disturbed; and (iii) persons who are seriously disturbed.
Such programs shall provide:
(A) Outpatient services;
(B) Emergency care services for twenty-four hours per day;
(C) Day treatment for persons with mental illness which includes
training in basic living and social skills, supported work, vocational
rehabilitation, and day activities. Such services may include
therapeutic treatment. In the case of a child, day treatment includes
age-appropriate basic living and social skills, educational and
prevocational services, day activities, and therapeutic treatment;
(D) Screening for patients being considered for admission to state
mental health facilities to determine the appropriateness of admission;
(E) Employment services, which may include supported employment,
transitional work, placement in competitive employment, and other work-related services, that result in persons with mental illness becoming
engaged in meaningful and gainful full or part-time work. Other
sources of funding such as the division of vocational rehabilitation
may be utilized by the secretary to maximize federal funding and
provide for integration of services;
(F) Consultation and education services; and
(G) Community support services;
(c) Develop and adopt rules establishing state minimum standards
for the delivery of mental health services pursuant to RCW 71.24.037
including, but not limited to:
(i) Licensed service providers. These rules shall permit a county-operated mental health program to be licensed as a service provider
subject to compliance with applicable statutes and rules. The
secretary shall provide for deeming of compliance with state minimum
standards for those entities accredited by recognized behavioral health
accrediting bodies recognized and having a current agreement with the
department;
(ii) Regional support networks; and
(iii) Inpatient services, evaluation and treatment services and
facilities under chapter 71.05 RCW, resource management services, and
community support services;
(d) Assure that the special needs of persons who are minorities,
elderly, disabled, children, low-income, and parents who are
respondents in dependency cases are met within the priorities
established in this section;
(e) Establish a standard contract or contracts, consistent with
state minimum standards, RCW 71.24.320 and 71.24.330, which shall be
used in contracting with regional support networks. The standard
contract shall include a maximum fund balance, which shall be
consistent with that required by federal regulations or waiver
stipulations;
(f) Establish, to the extent possible, a standardized auditing
procedure which minimizes paperwork requirements of regional support
networks and licensed service providers. The audit procedure shall
focus on the outcomes of service and not the processes for
accomplishing them;
(g) Develop and maintain an information system to be used by the
state and regional support networks that includes a tracking method
which allows the department and regional support networks to identify
mental health clients' participation in any mental health service or
public program on an immediate basis. The information system shall not
include individual patient's case history files. Confidentiality of
client information and records shall be maintained as provided in this
chapter and in RCW 71.05.390, 71.05.420, and 71.05.440;
(h) License service providers who meet state minimum standards;
(i) Certify regional support networks that meet state minimum
standards;
(j) Periodically monitor the compliance of certified regional
support networks and their network of licensed service providers for
compliance with the contract between the department, the regional
support network, and federal and state rules at reasonable times and in
a reasonable manner;
(k) Fix fees to be paid by evaluation and treatment centers to the
secretary for the required inspections;
(l) Monitor and audit regional support networks and licensed
service providers as needed to assure compliance with contractual
agreements authorized by this chapter;
(m) Adopt such rules as are necessary to implement the department's
responsibilities under this chapter;
(n) Assure the availability of an appropriate amount, as determined
by the legislature in the operating budget by amounts appropriated for
this specific purpose, of community-based, geographically distributed
residential services;
(o) Certify crisis stabilization units that meet state minimum
standards; ((and))
(p) Certify clubhouses that meet state minimum standards; and
(q) Certify triage facilities that meet state minimum standards.
(6) The secretary shall use available resources only for regional
support networks, except to the extent authorized, and in accordance
with any priorities or conditions specified, in the biennial
appropriations act.
(7) Each certified regional support network and licensed service
provider shall file with the secretary, on request, such data,
statistics, schedules, and information as the secretary reasonably
requires. A certified regional support network or licensed service
provider which, without good cause, fails to furnish any data,
statistics, schedules, or information as requested, or files fraudulent
reports thereof, may have its certification or license revoked or
suspended.
(8) The secretary may suspend, revoke, limit, or restrict a
certification or license, or refuse to grant a certification or license
for failure to conform to: (a) The law; (b) applicable rules and
regulations; (c) applicable standards; or (d) state minimum standards.
(9) The superior court may restrain any regional support network or
service provider from operating without certification or a license or
any other violation of this section. The court may also review,
pursuant to procedures contained in chapter 34.05 RCW, any denial,
suspension, limitation, restriction, or revocation of certification or
license, and grant other relief required to enforce the provisions of
this chapter.
(10) Upon petition by the secretary, and after hearing held upon
reasonable notice to the facility, the superior court may issue a
warrant to an officer or employee of the secretary authorizing him or
her to enter at reasonable times, and examine the records, books, and
accounts of any regional support network or service provider refusing
to consent to inspection or examination by the authority.
(11) Notwithstanding the existence or pursuit of any other remedy,
the secretary may file an action for an injunction or other process
against any person or governmental unit to restrain or prevent the
establishment, conduct, or operation of a regional support network or
service provider without certification or a license under this chapter.
(12) The standards for certification of evaluation and treatment
facilities shall include standards relating to maintenance of good
physical and mental health and other services to be afforded persons
pursuant to this chapter and chapters 71.05 and 71.34 RCW, and shall
otherwise assure the effectuation of the purposes of these chapters.
(13) The standards for certification of crisis stabilization units
shall include standards that:
(a) Permit location of the units at a jail facility if the unit is
physically separate from the general population of the jail;
(b) Require administration of the unit by mental health
professionals who direct the stabilization and rehabilitation efforts;
and
(c) Provide an environment affording security appropriate with the
alleged criminal behavior and necessary to protect the public safety.
(14) The standards for certification of a clubhouse shall at a
minimum include:
(a) The facilities may be peer-operated and must be
recovery-focused;
(b) Members and employees must work together;
(c) Members must have the opportunity to participate in all the
work of the clubhouse, including administration, research, intake and
orientation, outreach, hiring, training and evaluation of staff, public
relations, advocacy, and evaluation of clubhouse effectiveness;
(d) Members and staff and ultimately the clubhouse director must be
responsible for the operation of the clubhouse, central to this
responsibility is the engagement of members and staff in all aspects of
clubhouse operations;
(e) Clubhouse programs must be comprised of structured activities
including but not limited to social skills training, vocational
rehabilitation, employment training and job placement, and community
resource development;
(f) Clubhouse programs must provide in-house educational programs
that significantly utilize the teaching and tutoring skills of members
and assist members by helping them to take advantage of adult education
opportunities in the community;
(g) Clubhouse programs must focus on strengths, talents, and
abilities of its members;
(h) The work-ordered day may not include medication clinics, day
treatment, or other therapy programs within the clubhouse.
(15) The department shall distribute appropriated state and federal
funds in accordance with any priorities, terms, or conditions specified
in the appropriations act.
(16) The secretary shall assume all duties assigned to the
nonparticipating regional support networks under chapters 71.05, 71.34,
and 71.24 RCW. Such responsibilities shall include those which would
have been assigned to the nonparticipating counties in regions where
there are not participating regional support networks.
The regional support networks, or the secretary's assumption of all
responsibilities under chapters 71.05, 71.34, and 71.24 RCW, shall be
included in all state and federal plans affecting the state mental
health program including at least those required by this chapter, the
medicaid program, and P.L. 99-660. Nothing in these plans shall be
inconsistent with the intent and requirements of this chapter.
(17) The secretary shall:
(a) Disburse funds for the regional support networks within sixty
days of approval of the biennial contract. The department must either
approve or reject the biennial contract within sixty days of receipt.
(b) Enter into biennial contracts with regional support networks.
The contracts shall be consistent with available resources. No
contract shall be approved that does not include progress toward
meeting the goals of this chapter by taking responsibility for: (i)
Short-term commitments; (ii) residential care; and (iii) emergency
response systems.
(c) Notify regional support networks of their allocation of
available resources at least sixty days prior to the start of a new
biennial contract period.
(d) Deny all or part of the funding allocations to regional support
networks based solely upon formal findings of noncompliance with the
terms of the regional support network's contract with the department.
Regional support networks disputing the decision of the secretary to
withhold funding allocations are limited to the remedies provided in
the department's contracts with the regional support networks.
(18) The department, in cooperation with the state congressional
delegation, shall actively seek waivers of federal requirements and
such modifications of federal regulations as are necessary to allow
federal medicaid reimbursement for services provided by freestanding
evaluation and treatment facilities certified under chapter 71.05 RCW.
The department shall periodically report its efforts to the appropriate
committees of the senate and the house of representatives.
Sec. 5 RCW 71.05.150 and 2007 c 375 s 7 are each amended to read
as follows:
(1) When a designated mental health professional receives
information alleging that a person, as a result of a mental disorder:
(i) Presents a likelihood of serious harm; or (ii) is gravely disabled;
the designated mental health professional may, after investigation and
evaluation of the specific facts alleged and of the reliability and
credibility of any person providing information to initiate detention,
if satisfied that the allegations are true and that the person will not
voluntarily seek appropriate treatment, file a petition for initial
detention. Before filing the petition, the designated mental health
professional must personally interview the person, unless the person
refuses an interview, and determine whether the person will voluntarily
receive appropriate evaluation and treatment at an evaluation and
treatment facility ((or in a)), crisis stabilization unit, or triage
facility.
(2)(a) An order to detain to a designated evaluation and treatment
facility for not more than a seventy-two-hour evaluation and treatment
period may be issued by a judge of the superior court upon request of
a designated mental health professional, whenever it appears to the
satisfaction of a judge of the superior court:
(i) That there is probable cause to support the petition; and
(ii) That the person has refused or failed to accept appropriate
evaluation and treatment voluntarily.
(b) The petition for initial detention, signed under penalty of
perjury, or sworn telephonic testimony may be considered by the court
in determining whether there are sufficient grounds for issuing the
order.
(c) The order shall designate retained counsel or, if counsel is
appointed from a list provided by the court, the name, business
address, and telephone number of the attorney appointed to represent
the person.
(3) The designated mental health professional shall then serve or
cause to be served on such person, his or her guardian, and
conservator, if any, a copy of the order together with a notice of
rights, and a petition for initial detention. After service on such
person the designated mental health professional shall file the return
of service in court and provide copies of all papers in the court file
to the evaluation and treatment facility and the designated attorney.
The designated mental health professional shall notify the court and
the prosecuting attorney that a probable cause hearing will be held
within seventy-two hours of the date and time of outpatient evaluation
or admission to the evaluation and treatment facility. The person
shall be permitted to be accompanied by one or more of his or her
relatives, friends, an attorney, a personal physician, or other
professional or religious advisor to the place of evaluation. An
attorney accompanying the person to the place of evaluation shall be
permitted to be present during the admission evaluation. Any other
individual accompanying the person may be present during the admission
evaluation. The facility may exclude the individual if his or her
presence would present a safety risk, delay the proceedings, or
otherwise interfere with the evaluation.
(4) The designated mental health professional may notify a peace
officer to take such person or cause such person to be taken into
custody and placed in an evaluation and treatment facility. At the
time such person is taken into custody there shall commence to be
served on such person, his or her guardian, and conservator, if any, a
copy of the original order together with a notice of rights and a
petition for initial detention."
Renumber the remaining sections consecutively and correct any internal references accordingly.
On page 9, line 20 of the amendment, strike "providing triage services" and insert "operating as triage facilities as defined in RCW 71.05.020, whether or not they are certified by the department of social and health services,"
SHB 1170 -
By Senators Hargrove, Stevens, Harper
ADOPTED 04/08/2011
On page 10, beginning on line 2 of the title amendment, after "71.05.153" strike all material through "71.05.020" on line 3 and insert ", 10.31.110, and 71.05.150; reenacting and amending RCW 71.05.020 and 71.24.035"
EFFECT: This amendment makes technical changes that clarify the duties of the Department of Social and Health Services under this legislation.