Washington State
House of Representatives
Office of Program Research
Civil Rights & Judiciary Committee
SSB 5073
Brief Description: Concerning involuntary commitment.
Sponsors: Senate Committee on Behavioral Health Subcommittee to Health & Long Term Care (originally sponsored by Senators Dhingra, Das, Kuderer, Salomon, Warnick and Wilson, C.).
Brief Summary of Substitute Bill
  • Expands less restrictive alternative treatment requirements to include a substance use disorder evaluation and consultation about the formation of a mental health advance directive.
  • Applies provisions related to video evaluations under the Involuntary Treatment Act to minors.
  • Authorizes courts to provide periodic monitoring to patients ordered to receive involuntary outpatient treatment and to modify the terms of their commitment orders.


Hearing Date: 3/24/21
Staff: Ingrid Lewis (786-7289).

Involuntary Treatment.


The Involuntary Treatment Acts (ITA) for adults and minors set forth the procedures, rights, and requirements for involuntary treatment.  The provisions governing involuntary treatment of minors over the age of 13 are parallel with the adult ITA in many respects.


Under the ITA statutes, a person may be committed by a court for involuntary treatment if he or she, due to a mental health or substance use disorder, poses a likelihood of serious harm or is gravely disabled and will not consent to voluntary treatment.


Designated crisis responders (DCR) are responsible for investigating and determining whether a person may be in need of involuntary treatment.  In the adult ITA statute, DCR evaluations may be conducted by video, provided that a licensed health care professional or professional person who can adequately and accurately assist with obtaining any necessary information is present with the person at the time of the evaluation.


The DCR may petition the court for initial detention at an evaluation and treatment facility (E&T), secure withdrawal management and stabilization facilities (SWMS), or approved substance use disorder treatment program for evaluation and treatment for up to 120 hours, excluding weekends and holidays if the person poses a likelihood of serious harm or is gravely disabled.  An E&T specializes in treating persons with mental health disorders and a SWMS specializes in treating persons with substance use disorders.  A facility may be licensed as a co-occurring disorder treatment facility specializing in treatment of all kinds of behavioral health disorders; including both mental health and substance use disorders.  If following a person's commitment to an E&T or a SWMS it appears that the person would be better served by treatment at the other kind of facility, the facility may refer the person for placement at the more appropriate facility.




Less Restrictive Alternative Treatment.


When entering an order for involuntary behavioral health treatment, if a court finds that a less restrictive alternative (LRA) to inpatient commitment is in the best interest of the person or others, the court must order an appropriate less restrictive course of treatment.  Certain services are required under a LRA order, and at a minimum require:

  • assignment of a care coordinator;
  • an intake evaluation with the provider of the LRA treatment;
  • a psychiatric evaluation;
  • a schedule of regular contacts with the treatment provider;
  • a transition plan addressing access to continued services at the expiration of the order;
  • a crisis plan; and
  • notification to the care coordinator when the person does not substantially comply with treatment requirements.


Upon request by a party, a LRA order may be modified or revoked if the person is failing to adhere to the terms and conditions of the court-ordered treatment, is substantially deteriorating or decompensating, or poses a likelihood of serious harm.


Mental Health Advance Directive.


A mental health advance directive is a legal document that a person with capacity may create to express his or her preferences and instructions about mental health treatment in the event of incapacity.


Summary of Substitute Bill:

Provisions related to video ITA evaluations by DCRs are applied to minors.


A DCR must attempt to ascertain if a person being assessed for involuntary treatment has executed a mental health advance directive.


A transfer of a patient detained for involuntary treatment between an E&T or a SWMS facility may take place at any time following the patient's initial examination and evaluation.  The detention period may only be for the remainder of the current commitment period without any need for further review from the court.


The minimum requirements for a LRA treatment order are expanded to include a substance use disorder evaluation and consultation about the formation of a mental health advance directive.


A court may supervise a person on a LRA treatment order or conditional release by conducting and requiring an appearance in court for periodic review of the LRA treatment, and modifying the order after considering input from the treatment provider.  A care coordinator may disclose information and records related to mental health services for purposes of implementing the LRA treatment.


Technical changes and updates are made.

Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill contains multiple effective dates, including Sections 24, 26, and 29 related to video evaluations for minors, which contain an emergency clause that is effective immediately.