HB 1713 creates short-term changes to the chemical dependency involuntary treatment system, integrates the involuntary mental health and involuntary chemical dependency treatment systems for minors and adults, amends the minor-initiated mental and parent-initiated mental treatment of minors, and finally and provides dates for the Washington State Institute for Public Policy to submit reports for the evaluate of the integration of the involuntary treatment systems for chemical dependency and mental health.
Short-term changes to the chemical dependency involuntary treatment system remain in effect until April 1, 2016.
- A 14-day chemical dependency commitment order replaces the current 60-day order, and will issue upon the court's finding that commitment criteria are met by a preponderance of the evidence. The ability of the petitioner to file, and of the court to order commitment, remains subject to available space in an approved treatment program.
- Upon a hearing for a 14-day or 90-day order, if the court finds that the criteria for commitment are met, but that placement in a less restrictive setting than inpatient treatment is in the best interest of the person or others, the court must enter an order for up to 90 days of the less restrictive alternative treatment and cannot order inpatient treatment. If the program designated to provide less restrictive treatment is different than the program providing initial involuntary treatment, the designated program must agree in writing to assume the responsibility.
- The list of qualified examining professionals that may sign a petition for 14-day or 90-day treatment match those in the Involuntary Treatment Act (ITA), including licensed physicians, psychiatric advanced registered nurse practitioners, and mental health professionals. An authorized combination of two professionals must sign the petition.
- Prosecutors must represent petitioners in chemical dependency commitment proceedings. Integrated Treatment System for Chemical Dependency and Mental Health.
The involuntary mental health and involuntary chemical dependency treatment systems for minors and adults are integrated, and the minor-initiated and parent-initiated mental health and chemical dependency treatment provisions are integrated, effective April 1, 2016.
The ITA and the provisions pertaining to involuntary mental health treatment for minors are amended to include commitments for chemical dependency. Statutes governing involuntary chemical dependency commitment are repealed. Chemical dependency commitment follows the same procedures, rights, requirements, and timelines as mental health commitment.
Designated mental health professionals (DMHPs) and Designated Chemical Dependency
Specialist (DCDSs) are replaced by designated crisis responders (DCRs). The Department of
Social and Health Services (DSHS), by rule, must combine the functions of a DMHP and DCDS by establishing a DCR who is authorized to conduct investigations, detain persons for up to 72 hours to the proper facility, and carry out other functions. To qualify as a DCR, a person must have received chemical dependency training as determined by the DSHS and be a:
- psychiatrist, psychologist, psychiatric nurse, or social worker;
- person with a master's or further advanced degree in counseling or social science with at least two years of experience in direct treatment of persons with mental illness or emotional disturbance;
- person who meets certain waiver criteria as identified in statute, or as approved by DSHS; or
- person who has been granted an exception of the minimum requirements of a mental health professional by the DSHS, consistent with agency rules.
Initial detentions and 14-day commitments based on chemical dependency take place at secure detoxification facilities. For longer commitments, involuntary chemical dependency treatment takes place at an approved treatment program. Involuntary commitment for chemical dependency is not dependent upon available space at a secure detoxification facility or approved treatment program. If, after examination and evaluation, examining professionals determine that the initial needs of the a person committed to an evaluation and treatment facility would be better served by placement in a secure detoxification facility, or that the initial needs of a person committed to a secure detoxification facility would be better served in an evaluation and treatment facility, then the person must be referred to the more appropriate placement.
The superior court has jurisdiction over involuntary treatment proceedings for mental health and chemical dependency. Prosecutors represent all petitioners, including petitioners for involuntary chemical dependency treatment, unless the petitioner is a state facility, in which case the Attorney General represents the petitioner.
The firearm prohibition extends to persons committed for chemical dependency treatment under the provisions for 14, 90, or 180-day commitment.
The Washington State Institute for Public Policy must evaluate the effect of the integration of the involuntary treatment systems for chemical dependency and mental health. The evaluation must include an assessment of whether the integrated system has increased efficiency of evaluation and treatment of persons involuntarily detained for chemical dependency, is cost-effective, results in better outcomes for involuntarily detained persons, and increases the effectiveness of the crisis response system statewide. Preliminary reports to the Legislature by December 1, 2018, and June 30, 2019, and a final report must be submitted by June 30, 2021.
Minor-Initiated and Parent-Initiated Treatment of Minors
Mental Health System
Currently, in the mental health system, a minor age 13 or older may, without parental consent, admit himself or herself to an evaluation and treatment facility for inpatient treatment or request and receive outpatient treatment. The administrator of a facility to which a minor has been admitted for inpatient treatment must notify the minor's parents of the admission. The minor may only be admitted if the professional person in charge of the facility believes the minor is in need of inpatient treatment. A minor voluntarily admitted to inpatient treatment may give notice of intent to leave at any time. Parental consent is needed for inpatient or outpatient treatment of a minor under 13 years old.
A parent may bring his or her minor child to an evaluation and treatment facility and request an evaluation for inpatient treatment, or to an outpatient provider and request an examination for the need for outpatient treatment. The consent of the minor is not required, and, if admitted for medically necessary inpatient treatment, the minor may not be discharged based solely on his or her request. The minor may petition the court for release from the facility.
Chemical Dependency System
The provisions for minor-initiated and parent-initiated chemical dependency treatment of minors are similar to those pertaining to mental health treatment. However, parental consent is required for inpatient chemical dependency treatment of a minor.
HB 1713 amends the provisions regarding minor-initiated mental health treatment and parent-initiated mental treatment of minors to include minor-initiated and parent-initiated chemical dependency treatment of minors. Current statutes governing minor-initiated and parent-initiated chemical dependency treatment of minors are repealed.
Substitute HB 1713, as amended:
- Provides that, from the time of integration of the treatment systems until July 1, 2019, a court's ability to commit a person for substance use disorder treatment to a secure detoxification facility or an approved substance use disorder treatment program is subject to available space in the facility or program.
- Includes the Department of Social and Health Services and the state hospitals in the list of persons and entities that may access confidential files and records of court proceedings regarding involuntary treatment cases.
- Provides that commitment based on a substance use disorder results in a firearm possession prohibition only if the substance use disorder is based on use of a controlled substance.
- Adds a null and void clause. 5. Makes other minor changes to wording for consistency and technical correction.
- Provides that the limitation on firearm rights associated with commitment for a substance use disorder applies only if the person would otherwise have his or her firearm rights limited under federal law.
Engrossed Substitute HB 1713, as amended:
Adds the text of 2SHB 1916 (Senate Ways & Means recommended striking amendment) to the Ways & Means Committee striking amendment. These provisions consolidate administrative statutes relating to the state chemical dependency program and mental health services administered by regional support networks into one chapter of code effective April 1, 2016. Terminology referring to chemical dependency, alcoholism, and drug addiction is updated to the term "substance use disorders." Chemical dependency concerns must be integrated into mental health advisory boards and mental health ombuds programs, which are renamed behavioral health advisory boards and behavioral health ombuds programs. A B&O tax exemption that applies to publicly funded mental health services provided by regional support networks and their affiliates is expanded to also apply to publicly funded chemical dependency services, and its expiration date is extended from August 1, 2016, to January 1, 2020.
Creates a study of states' processes and requirements for involuntary chemical dependency treatment and updates the analysis of Washington's integrated crisis response pilots.