HOUSE BILL REPORT
2SSB 5074
As Amended by the House
BYSenate Committee on Ways & Means (originally sponsored by Senators Talmadge, Newhouse, McCaslin, Moore, Lee and Hayner)
Revising involuntary commitment procedures.
House Committe on Human Services
Majority Report: Do pass with amendments. (8)
Signed by Representatives Brekke, Chair; Scott, Vice Chair; Leonard, Moyer, Padden, Sutherland, Wang and Winsley.
House Staff:John Welsh (786-7133)
Rereferred House Committee on Ways & Means/Appropriations
Majority Report: Do pass with amendments by Committee on Human Services. (21)
Signed by Representatives Locke, Chair; Allen, Belcher, Braddock, Brekke, Bristow, Ebersole, Fuhrman, Grant, Grimm, Hine, McLean, McMullen, Niemi, Peery, Sayan, Silver, L. Smith, H. Sommers, Sprenkle and B. Williams.
House Staff: Jim Lux (786-7152)
AS PASSED HOUSE APRIL 16, 1987
BACKGROUND:
Washington State's Involuntary Treatment Act (ITA) was enacted in 1979 and underwent major changes in 1973 and 1979. The act permits, by court order, the involuntary treatment of a person who, as a result of a mental disorder, is gravely disabled or presents a likelihood of serious harm to self or others. Mental health professionals are those persons entrusted with the responsibility for commitment of individuals who fall within the scope of the act. The initial commitment period is 72 hours with additional treatment periods of 14 days, 90 days and 180 days. The ITA is administered at the state level by the Department of Social and Health Services (DSHS), and at the local level by county governments, with the majority of the funding being provided through the state general fund. Counties may provide ITA services directly or contract with private agencies.
There are several areas of concern that have been raised with respect to the ITA. During the 1986 interim, the Senate Judiciary Committee heard the testimony of mental health professionals pertaining to the ITA. Many other issues have been addressed in the joint study of the Washington State Involuntary Treatment Act (1983) conducted by the Legislative Budget Committee (LBC) and the House Office of Program Research.
SUMMARY:
The Involuntary Treatment Act (ITA) is amended to reflect a more comprehensive approach to the treatment of mentally-ill adults in intensive and less-restrictive settings.
Language which prohibits a person from obtaining treatment under the ITA if proceedings are also initiated under the Alcoholism Treatment Act is deleted.
Depending upon the initial needs of the person, cross-referral between alcohol treatment facilities and mental health facilities may be required.
A 90-day less-restrictive treatment alternative is provided as an option for the present 14-day intensive treatment program, provided that the out patient facility has agreed to assume responsibility for treatment.
In adopting treatment plans, the petitioner must show with specificity the less-restrictive alternative considered, and why treatment less restrictive than detention is not appropriate.
A pilot program is created to determine the effectiveness of outreach case management on the involuntary treatment process. The pilot program is to be conducted in at least three counties to provide case management services for persons who are conditionally released or committed to less-restrictive treatment. The treatment, according to an individualized treatment plan, is to be monitored to prevent any substantial deterioration in condition. The pilot program plan is to be developed by the department and submitted no later than November 1, 1987. January 1, 1988 is the effective date of the plan, and the pilot program will terminate June 30, 1989. On January 1, 1989, the Legislative Budget Committee is to submit a report on the progress on the pilot program.
Waiver of the physician-patient and psychologist-client confidentiality privileges are permitted. The court has the discretion to waive the privilege based solely on the need for protection of either the detained person or the public. The waiver is limited to records or testimony relevant to evaluation of the detained person.
If a conditionally-released person presents a substantial deterioration in functioning, the county designated mental health professional (CDMHP) or, or the Secretary of the Department of Social and Health Services, may order that the conditionally-released person be taken into custody and detained in an evaluation and treatment facility.
If the patient does not adhere to the terms of a conditional-release, the CDMHP or secretary may, in lieu of hospitalization, notify the patient to come to a hearing not less than five days after service of a petition for revocation.
When a conditional-release is revoked, the subsequent treatment period may be for no longer than the period authorized in the original court order. In a revocation of a less-restrictive alternative treatment, the subsequent period may be for no longer than 14 days.
The time period that a person may be detained at an alcohol and treatment facility as a result of incapacitation by alcohol is increased from 40 to 72 hours.
A petition for commitment of a person alleged to be incapacitated by alcohol must be heard by the court no less than three and no more than seven days after the date the petition is filed.
The filing period for 90-day treatment and the length of continuances are shortened.
Fiscal Note: Attached.
House Committee ‑ Testified For: (Human Services) Lyle Quasim, Director, Mental Health Services, Department of Social and Health Services; Bob Stalker, Evergreen Legal Services; Carol Greenough, King County and Washington Association of County Human Services; and Eleanor Owen, Washington Advocates for the Mentally Ill.
(Ways & Means/Appropriations) Lyle Quasim, Director, Divisions of Mental Health, Department of Social & Health Services.
House Committee - Testified Against: (Human Services) Pat Thibaudeau, Washington Community Health.
(Ways & Means/Appropriations) Pat Thibaudeau, Washington Community Health.
House Committee - Testimony For: (Human Services) A pilot program is needed to determine the effectiveness of outreach case management services in treating mentally ill persons at less-restrictive treatment settings than the state mental hospitals. Effectiveness of treating mentally ill persons may very well be improved by providing monitored treatment outside the institutional setting. There should be individual treatment plans for these patients tailored to their needs. The present system is not working that well for many persons who, after release from the 14-day period of intensive treatment, return for recommitment. There should be authority to treat mentally ill alcoholics under the Involuntary Treatment Act, and the process for committing alcohol incapacitated persons should be speeded up.
(Ways & Means/Appropriations) The department supports the pilot project proposed in legislation.
House Committee - Testimony Against: (Human Services) The community mental health setting may be inappropriate for treating acute and chronic mentally ill persons who may be dangerous to themselves or others or who are gravelly disabled. This type of individual is different from those seeking voluntary treatment through community mental health centers. Case management services will be expensive.
(Ways & Means/Appropriations) Requiring that ITA clients be made a priority will displace other clients. Funds are not provided to community mental health centers to support the additional ITA workload.