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Before granting an order under any of the following titles of the laws of the state of Washington, the court may consult the judicial information system or any related databases, if available, to determine criminal history or the pendency of other proceedings involving the parties:
Granting any temporary or final order establishing a parenting plan or residential schedule or directing residential placement of a child or restraining or limiting a party's contact with a child under Title 26 RCW;
Granting any order regarding a vulnerable child or adult or alleged incapacitated person irrespective of the title or where contained in the laws of the state of Washington;
Granting letters of guardianship or administration or letters testamentary under Title 11 RCW;
d.
Granting any relief in a juvenile proceeding under Title 13 RCW; or
e. Granting any order of protection, temporary order of protection, or criminal no-contact order under chapter 7.105, 9A.46, 10.99, or 26.52 RCW.
Before granting any relief under chapter 71.05 RCW, the court shall consult the judicial information system or any related databases, if available, to determine the respondent's criminal history, prior civil commitments under chapter 71.05 RCW, pendency of other proceedings involving the respondent, and the respondent's firearms history, including purchase history and any concealed pistol license history.
In the event that the court consults such a database, the court shall disclose that fact to the parties and shall disclose any particular matters relied upon by the court in rendering the decision. Upon request of a party, a copy of the document relied upon must be filed, as a confidential document, within the court file, with any confidential contact information such as addresses, phone numbers, or other information that might disclose the location or whereabouts of any person redacted from the document or documents.
In any judicial proceeding for involuntary commitment or detention except under RCW 71.05.201, or in any proceeding challenging involuntary commitment or detention, the prosecuting attorney for the county in which the proceeding was initiated shall represent the individuals or agencies petitioning for commitment or detention and shall defend all challenges to such commitment or detention, except that :
The attorney general shall represent and provide legal services and advice to state hospitals and state facilities with regard to all provisions of and proceedings under this chapter other than proceedings initiated by such hospitals and facilities seeking 14-day detention; and
In a proceeding for modification or revocation of a less restrictive alternative treatment order under RCW 71.05.590, the prosecuting attorney for the county in which the person is receiving less restrictive alternative treatment shall represent the individuals or agencies petitioning for modification or revocation of the order.
A person is in need of assisted outpatient treatment if the court finds by a preponderance of the evidence pursuant to a petition filed under this section that:
The person has a behavioral health disorder;
Based on a clinical determination and in view of the person's treatment history and current behavior, at least one of the following is true:
The person is unlikely to survive safely in the community without supervision and the person's condition is substantially deteriorating; or
The person is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would be likely to result in grave disability or a likelihood of serious harm to the person or to others;
The person has a history of lack of compliance with treatment for his or her behavioral health disorder that has:
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating hospitalization of the person, or the person's receipt of services in a forensic or other mental health unit of a state or tribal correctional facility or local correctional facility, provided that the 36-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred within the 36-month period;
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating emergency medical care or hospitalization for behavioral health-related medical conditions including overdose, infected abscesses, sepsis, endocarditis, or other maladies, or a significant factor in behavior which resulted in the person's incarceration in a state, tribal, or local correctional facility; or
Resulted in one or more violent acts, threats, or attempts to cause serious physical harm to the person or another within the 48 months prior to the filing of the petition, provided that the 48-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred during the 48-month period;
Participation in an assisted outpatient treatment program would be the least restrictive alternative necessary to ensure the person's recovery and stability; and
The person will benefit from assisted outpatient treatment.
The following individuals may directly file a petition for less restrictive alternative treatment on the basis that a person is in need of assisted outpatient treatment:
The director of a hospital where the person is hospitalized or the director's designee;
The director of a behavioral health service provider providing behavioral health care or residential services to the person or the director's designee;
The person's treating mental health professional or substance use disorder professional or one who has evaluated the person;
A designated crisis responder;
A release planner from a corrections facility; or
An emergency room physician.
A court order for less restrictive alternative treatment on the basis that the person is in need of assisted outpatient treatment may be effective for up to 18 months. The petitioner must personally interview the person, unless the person refuses an interview, to determine whether the person will voluntarily receive appropriate treatment.
The petitioner must allege specific facts based on personal observation, evaluation, or investigation, and must consider the reliability or credibility of any person providing information material to the petition.
The petition must include:
b.
The declarations of witnesses, if any, supporting the petition for assisted outpatient treatment;
c. The name of an agency, provider, or facility that agrees to provide less restrictive alternative treatment if the petition is granted by the court; and
d. If the person is detained in a state hospital, inpatient treatment facility, jail, or correctional facility at the time the petition is filed, the anticipated release date of the person and any other details needed to facilitate successful reentry and transition into the community.
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Upon receipt of a petition meeting all requirements of this section, the court shall fix a date for a hearing:
No sooner than three days or later than seven days after the date of service or as stipulated by the parties or, upon a showing of good cause, no later than 30 days after the date of service; or
If the respondent is hospitalized at the time of filing of the petition, before discharge of the respondent and in sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.
A copy of the petition and notice of hearing shall be served, in the same manner as a summons, on the petitioner, the respondent, a current provider, if any, and a surrogate decision maker or agent under chapter 71.32 RCW, if any.
If the respondent has a surrogate decision maker or agent under chapter 71.32 RCW who wishes to provide testimony at the hearing, the court shall afford the surrogate decision maker or agent an opportunity to testify.
The respondent shall be represented by counsel at all stages of the proceedings.
If the respondent fails to appear at the hearing after notice, the court may conduct the hearing in the respondent's absence; provided that the respondent's counsel is present.
If the petition does not include a declaration from a qualified professional person who has examined the respondent no more than 10 days prior to submission of the petition, the court may order a behavioral health examination of the respondentby a qualified professional .
If the respondent has refused to be examined by a qualified professional and the court finds reasonable grounds to believe that the allegations of the petition are true, the court may issue a written order directing a peace officer who has completed crisis intervention training to detain and transport the respondent to a provider for examination by a qualified professional. A respondent detained pursuant to this subsection shall be detained no longer than necessary to complete the examination and in no event longer than 24 hours.
If the petition involves a person whom the petitioner or behavioral health administrative services organization knows, or has reason to know, is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the petitioner or behavioral health administrative services organization shall notify the tribe and Indian health care provider. Notification shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan as soon as possible, but before the hearing and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The notice to the tribe or Indian health care provider must include a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene. The court clerk shall provide copies of any court orders necessary for the petitioner or the behavioral health administrative services organization to provide notice to the tribe or Indian health care provider under this section.
A petition for assisted outpatient treatment filed under this section shall be adjudicated under RCW 71.05.240.
A petition for assisted outpatient treatment must be filed on forms developed by the administrative office of the courts.
A person is in need of assisted outpatient treatment if the court finds by a preponderance of the evidence pursuant to a petition filed under this section that:
The person has a behavioral health disorder;
Based on a clinical determination and in view of the person's treatment history and current behavior, at least one of the following is true:
The person is unlikely to survive safely in the community without supervision and the person's condition is substantially deteriorating; or
The person is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would be likely to result in grave disability or a likelihood of serious harm to the person or to others;
The person has a history of lack of compliance with treatment for his or her behavioral health disorder that has:
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating hospitalization of the person, or the person's receipt of services in a forensic or other mental health unit of a state or tribal correctional facility or local correctional facility, provided that the 36-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred within the 36-month period;
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating emergency medical care or hospitalization for behavioral health-related medical conditions including overdose, infected abscesses, sepsis, endocarditis, or other maladies, or a significant factor in behavior which resulted in the person's incarceration in a state, tribal, or local correctional facility; or
Resulted in one or more violent acts, threats, or attempts to cause serious physical harm to the person or another within the 48 months prior to the filing of the petition, provided that the 48-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred during the 48-month period;
Participation in an assisted outpatient treatment program would be the least restrictive alternative necessary to ensure the person's recovery and stability; and
The person will benefit from assisted outpatient treatment.
The following individuals may directly file a petition for less restrictive alternative treatment on the basis that a person is in need of assisted outpatient treatment:
The director of a hospital where the person is hospitalized or the director's designee;
The director of a behavioral health service provider providing behavioral health care or residential services to the person or the director's designee;
The person's treating mental health professional or substance use disorder professional or one who has evaluated the person;
A designated crisis responder;
A release planner from a corrections facility; or
An emergency room physician.
A court order for less restrictive alternative treatment on the basis that the person is in need of assisted outpatient treatment may be effective for up to 18 months. The petitioner must personally interview the person, unless the person refuses an interview, to determine whether the person will voluntarily receive appropriate treatment.
The petitioner must allege specific facts based on personal observation, evaluation, or investigation, and must consider the reliability or credibility of any person providing information material to the petition.
The petition must include:
b.
The declarations of witnesses, if any, supporting the petition for assisted outpatient treatment;
c. The name of an agency, provider, or facility that agrees to provide less restrictive alternative treatment if the petition is granted by the court; and
d. If the person is detained in a state hospital, inpatient treatment facility, jail, or correctional facility at the time the petition is filed, the anticipated release date of the person and any other details needed to facilitate successful reentry and transition into the community.
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Upon receipt of a petition meeting all requirements of this section, the court shall fix a date for a hearing:
No sooner than three days or later than seven days after the date of service or as stipulated by the parties or, upon a showing of good cause, no later than 30 days after the date of service; or
If the respondent is hospitalized at the time of filing of the petition, before discharge of the respondent and in sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.
A copy of the petition and notice of hearing shall be served, in the same manner as a summons, on the petitioner, the respondent, a current provider, if any, and a surrogate decision maker or agent under chapter 71.32 RCW, if any.
If the respondent has a surrogate decision maker or agent under chapter 71.32 RCW who wishes to provide testimony at the hearing, the court shall afford the surrogate decision maker or agent an opportunity to testify.
The respondent shall be represented by counsel at all stages of the proceedings.
If the respondent fails to appear at the hearing after notice, the court may conduct the hearing in the respondent's absence; provided that the respondent's counsel is present.
If the petition does not include a declaration from a qualified professional person who has examined the respondent no more than 10 days prior to submission of the petition, the court may order a behavioral health examination of the respondentby a qualified professional .
If the respondent has refused to be examined by a qualified professional and the court finds reasonable grounds to believe that the allegations of the petition are true, the court may issue a written order directing a peace officer who has completed crisis intervention training to detain and transport the respondent to a provider for examination by a qualified professional. A respondent detained pursuant to this subsection shall be detained no longer than necessary to complete the examination and in no event longer than 24 hours.
If the petition involves a person whom the petitioner or behavioral health administrative services organization knows, or has reason to know, is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the petitioner or behavioral health administrative services organization shall notify the tribe and Indian health care provider. Notification shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan as soon as possible, but before the hearing and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The notice to the tribe or Indian health care provider must include a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene. The court clerk shall provide copies of any court orders necessary for the petitioner or the behavioral health administrative services organization to provide notice to the tribe or Indian health care provider under this section.
A petition for assisted outpatient treatment filed under this section shall be adjudicated under RCW 71.05.240.
A petition for assisted outpatient treatment must be filed on forms developed by the administrative office of the courts.
When a designated crisis responder receives information alleging that a person, as a result of a behavioral health disorder, presents a likelihood of serious harm or is gravely disabled, the designated crisis responder 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 under this section. Before filing the petition, the designated crisis responder 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, crisis stabilization unit, 23-hour crisis relief center, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program. If the person has a past history of not following through with voluntary evaluation and treatment plans or prematurely discontinuing voluntary treatment, there is a presumption that the patient will not in good faith voluntarily seek appropriate treatment. If a designated crisis responder makes a determination not to detain a person on the basis that the person will voluntarily seek appropriate treatment, the designated crisis responder shall document the reasons the designated crisis responder determined that the person in good faith will voluntarily seek appropriate evaluation and treatment. As part of the assessment, the designated crisis responder must attempt to ascertain if the person has executed a mental health advance directive under chapter 71.32 RCW. The interview performed by the designated crisis responder 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 interview.
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A superior court judge shall issue a warrant to detain a person with a behavioral health disorder to a designated evaluation and treatment facility, a secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program, for a period of not more than 120 hours for evaluation and treatment upon request of a designated crisis responder whenever it appears to the satisfaction of the judge that:
There is probable cause to support the petition; and
The person has refused or failed to accept appropriate evaluation and treatment voluntarily.
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.
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.
If the court does not issue an order to detain a person pursuant to this subsection (2), the court shall issue an order to dismiss the initial petition.
Upon issuance of a warrant by a superior court judge, a peace officer shall provide assistance in detaining a person as authorized in this section. A peace officer may decline to provide assistance if, in the judgment of the officer based on the totality of the circumstances known at the time, the officer believes there is a reasonable likelihood that the amount of force required to take the person into custody could cause greater harm than the risk of harm to the person and the community posed by the person's behavioral health condition.
The designated crisis responder shall then serve or cause to be served on such person and his or her guardian, 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 crisis responder shall file the return of service in court and provide copies of all papers in the court file to the evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program, and the designated attorney. The designated crisis responder shall notify the court and the prosecuting attorney that a probable cause hearing will be held within 120 hours of the date and time of outpatient evaluation or admission to the evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program. 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 or traditional cultural healer 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.
Upon request of the designated crisis responder , a peace officer shall take such person or cause such person to be taken into custody and placed in an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program. 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.
In any investigation and evaluation of an individual under this section or RCW 71.05.153 in which the designated crisis responder knows, or has reason to know, that the individual is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the designated crisis responder shall notify the tribe and Indian health care provider whether or not a petition for initial detention or involuntary outpatient treatment will be filed as soon as possible, but no later than three hours from the time the decision is made. If a petition for initial detention or involuntary outpatient treatment is filed, the designated crisis responder must provide the tribe and Indian health care provider with a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene as soon as possible, but before the hearing, and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The court clerk shall provide copies of any court orders necessary for the designated crisis responder to provide notice to the tribe or Indian health care provider under this section. Notification under this section is subject to any federal and state laws and regulations including the requirements in RCW 70.02.230 (2)(ff) and (3) and shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan.
When a designated crisis responder receives information alleging that a person, as the result of a behavioral health disorder, presents an imminent likelihood of serious harm, or is in imminent danger because of being gravely disabled, after investigation and evaluation of the specific facts alleged and of the reliability and credibility of the person or persons providing the information if any, the designated crisis responder may take such person, or cause by oral or written order such person to be taken into emergency custody in an emergency department, evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program, for not more than 120 hours as described in RCW 71.05.180. If the person is located in a 23-hour crisis relief center when a designated crisis responder takes the person into emergency custody, the person may remain at the 23-hour crisis relief center or an adjacent crisis stabilization facility in accordance with rules promulgated by the department.
A peace officer may take or cause such person to be taken into custody and immediately delivered to a crisis stabilization unit, 23-hour crisis relief center, evaluation and treatment facility, secure withdrawal management and stabilization facility, approved substance use disorder treatment program, or the emergency department of a local hospital under subsection (1) of this section or when he or she has reasonable cause to believe that such person is suffering from a behavioral health disorder and presents an imminent likelihood of serious harm or is in imminent danger because of being gravely disabled. Upon request of a designated crisis responder, a peace officer shall provide assistance in taking a person into custody under subsection (1) of this section. A peace officer may decline to provide assistance if, in the judgment of the officer based on the totality of the circumstances known at the time, the officer believes there is a reasonable likelihood that the amount of force required to take the person into custody could cause greater harm than the risk of harm to the person and the community posed by the person's behavioral health condition.
Persons delivered to a crisis stabilization unit, 23-hour crisis relief center, evaluation and treatment facility, emergency department of a local hospital, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program by peace officers pursuant to subsection (2) of this section may be held by the facility for a period of up to 12 hours, not counting time periods prior to medical clearance.
Within three hours after arrival at an emergency department, not counting time periods prior to medical clearance, the person must be examined by a mental health professional or substance use disorder professional. Within 12 hours of notice of the need for evaluation, not counting time periods prior to medical clearance, the designated crisis responder must determine whether the individual meets detention criteria. In conjunction with this evaluation, the facility where the patient is located must inquire as to a person's veteran status or eligibility for veterans benefits and, if the person appears to be potentially eligible for these benefits, inquire whether the person would be amenable to treatment by the veterans health administration compared to other relevant treatment options. This information must be shared with the designated crisis responder. If the person has been identified as being potentially eligible for veterans health administration services and as being amenable for those services, and if appropriate in light of all reasonably available information about the person's circumstances, the designated crisis responder must first refer the person to the veterans health administration for mental health or substance use disorder treatment at a facility capable of meeting the needs of the person including, but not limited to, the involuntary treatment options available at the Seattle division of the VA Puget Sound health care system. If the person is accepted for treatment by the veterans health administration, and is willing to accept treatment by the veterans health administration as an alternative to other available treatment options, the designated crisis responder, the veterans health administration, and the facility where the patient is located will work to make arrangements to have the person transported to a veterans health administration facility. As part of the assessment, the designated crisis responder must attempt to ascertain if the person has executed a mental health advance directive under chapter 71.32 RCW. The interview performed by the designated crisis responder 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 interview. If the individual is detained, the designated crisis responder shall file a petition for detention or a supplemental petition as appropriate and commence service on the designated attorney for the detained person. If the individual is released to the community, the behavioral health service provider shall inform the peace officer of the release within a reasonable period of time after the release if the peace officer has specifically requested notification and provided contact information to the provider.
Dismissal of a commitment petition is not the appropriate remedy for a violation of the timeliness requirements of this section based on the intent of this chapter under RCW 71.05.010 except in the few cases where the facility staff or designated crisis responder has totally disregarded the requirements of this section.
If a designated crisis responder decides not to detain a person for evaluation and treatment under RCW 71.05.150 or 71.05.153 or 48 hours have elapsed since a designated crisis responder received a request for investigation and the designated crisis responder has not taken action to have the person detained, the following individuals may petition the superior court for the person's initial detention: An intimate partner or family or household member of the person; a guardian or conservator of the person; a representative of a federally recognized Indian tribe if the person is a member of such a tribe; a representative of a human services provider that has provided services to the person; or any person authorized to file a petition under RCW 71.05.148.
A petition under this section must be filed within 10 calendar days following the designated crisis responder investigation or the request for a designated crisis responder investigation. If more than 10 days have elapsed, a person authorized to file a petition under this section may request a new designated crisis responder investigation.
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The petition must be filed in the county in which the designated crisis responder investigation occurred or was requested to occur and must be submitted on forms developed by the administrative office of the courts for this purpose. The petition must be accompanied by a sworn declaration from the petitioner, and other witnesses if desired, describing why the person should be detained for evaluation and treatment. The description of why the person should be detained may contain, but is not limited to, the information identified in RCW 71.05.212.
The petition must contain:
A description of the relationship between the petitioner and the person; and
The date on which an investigation was requested from the designated crisis responder.
The court shall, within one judicial day, review the petition to determine whether the petition raises sufficient evidence to support the allegation. If the court so finds, it shall provide a copy of the petition to the designated crisis responder agency with an order for the agency to provide the court, within one judicial day, with a written sworn statement describing the basis for the decision not to seek initial detention and a copy of all information material to the designated crisis responder's current decision.
Following the filing of the petition and before the court reaches a decision, any person, including a mental health professional, may submit a sworn declaration to the court in support of or in opposition to initial detention.
The court shall dismiss the petition at any time if it finds that a designated crisis responder has filed a petition for the person's initial detention under RCW 71.05.150 or 71.05.153 or that the person has voluntarily accepted appropriate treatment.
The court must issue a final ruling on the petition within five judicial days after it is filed. After reviewing all of the information provided to the court, the court may enter an order for initial detention if the court finds that: (a) There is probable cause to support a petition for detention; and (b) the person has refused or failed to accept appropriate evaluation and treatment voluntarily. The court shall transmit its final decision to the petitioner.
If the court enters an order for initial detention, it shall provide the order to the designated crisis responder agency and issue a warrant. The designated crisis responder agency serving the jurisdiction of the court must collaborate and coordinate with law enforcement, including tribal law enforcement, regarding apprehensions and detentions under this subsection, including sharing of information relating to risk and which would assist in locating the person. The law enforcement agency shall provide assistance in locating the person, taking the person into custody, and ensuring the person is transported to a designated evaluation and treatment facility, a secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program. A law enforcement officer may decline to provide assistance if, in the judgment of the officer based on the totality of the circumstances known at the time, the officer believes there is a reasonable likelihood that the amount of force required to take the person into custody could cause greater harm than the risk of harm to the person and the community posed by the person's behavioral health condition. A person may not be detained to jail pursuant to a warrant issued under this subsection. An order for detention under this section should contain the advisement of rights which the person would receive if the person were detained by a designated crisis responder. An order for initial detention under this section expires 180 days from issuance.
Except as otherwise expressly stated in this chapter, all procedures must be followed as if the order had been entered under RCW 71.05.150. RCW 71.05.160 does not apply if detention was initiated under the process set forth in this section.
For purposes of this section:
"Family or household member" includes: Persons related by blood, marriage, domestic partnership, or adoption; persons who currently reside together or formerly resided together; and persons who have a biological or legal parent-child relationship, including stepparents and stepchildren and grandparents and grandchildren.
"Human services provider" means an organization that provides behavioral health services, case management, housing and homelessness services, food or economic assistance, or other similar programs.
"Intimate partner" includes: Spouses or domestic partners; former spouses or former domestic partners; persons who have a child in common regardless of whether they have been married or have lived together at any time, unless the child is conceived through sexual assault; or persons who have or have had a dating relationship where both persons are at least 18 years of age or older.
The authority and each behavioral health administrative services organization or agency employing designated crisis responders shall publish information in an easily accessible format describing the process for a petition for court review of a detention decision under RCW 71.05.201.
A designated crisis responder or designated crisis responder agency that receives a request for investigation for possible detention under this chapter must inquire whether the request comes from a person who is eligible to petition under RCW 71.05.201. If the designated crisis responder decides not to detain the person for evaluation and treatment under RCW 71.05.150 or 71.05.153 or 48 hours have elapsed since the request for investigation was received and the designated crisis responder has not taken action to have the person detained, the designated crisis responder or designated crisis responder agency must inform the eligible petitioner who made the request for investigation about the process to petition for court review under RCW 71.05.201 and, to the extent feasible, provide the eligible petitioner with written or electronic information about the petition process. Information provided to a federally recognized Indian tribe shall be sent to the tribal contact listed in the authority's tribal crisis coordination plan. If provision of written or electronic information is not feasible, the designated crisis responder or designated crisis responder agency must refer the eligible petitioner to a website where published information on the petition process may be accessed. The designated crisis responder or designated crisis responder agency must document the manner and date on which the information required under this subsection was provided .
A designated crisis responder or designated crisis responder agency must, upon request, disclose the date of a designated crisis responder investigation under this chapter to an eligible petitioner to assist in the preparation of a petition under RCW 71.05.201.
If a petition is filed for up to 14 days of involuntary treatment, 90 days of less restrictive alternative treatment, or 18 months of less restrictive alternative treatment under RCW 71.05.148, the court shall hold a probable cause hearing within 120 hours of the initial detention under RCW 71.05.180, or at a time scheduled under RCW 71.05.148.
If the petition is for mental health treatment, the court or the prosecutor at the time of the probable cause hearing and before an order of commitment is entered shall inform the person both orally and in writing that the failure to make a good faith effort to seek voluntary treatment as provided in RCW 71.05.230 will result in the loss of his or her firearm rights if the person is subsequently detained for involuntary treatment under this section. The respondent or the respondent's counsel may waive in writing the notice required under this subsection if the respondent waives the respondent's presence at or before the time of the probable cause hearing.
If the person or his or her attorney alleges, prior to the commencement of the hearing, that the person has in good faith volunteered for treatment, the petitioner must show, by preponderance of the evidence, that the person has not in good faith volunteered for appropriate treatment. In order to qualify as a good faith volunteer, the person must abide by procedures and a treatment plan as prescribed by a treatment facility and professional staff.
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At the conclusion of the probable cause hearing, if the court finds by a preponderance of the evidence that a person detained for behavioral health treatment, as the result of a behavioral health disorder, presents a likelihood of serious harm, or is gravely disabled, and, after considering less restrictive alternatives to involuntary detention and treatment, finds that no such alternatives are in the best interests of such person or others, the court shall order that such person be detained for involuntary treatment not to exceed 14 days in a facility licensed or certified to provide treatment by the department or under RCW 71.05.745.
At the conclusion of the probable cause hearing, if the court finds by a preponderance of the evidence that a person detained for behavioral health treatment, as the result of a behavioral health disorder, presents a likelihood of serious harm or is gravely disabled, but that treatment in a less restrictive setting than detention is in the best interest of such person or others, the court shall order an appropriate less restrictive alternative course of treatment for up to 90 days.
If the court finds by a preponderance of the evidence that a person subject to a petition under RCW 71.05.148, as the result of a behavioral health disorder, is in need of assisted outpatient treatment, the court shall order an appropriate less restrictive alternative course of treatment for up to 18 months.
An order for less restrictive alternative treatment must name the behavioral health service provider responsible for identifying the services the person will receive in accordance with RCW 71.05.585, and must include a requirement that the person cooperate with the treatment recommendations of the behavioral health service provider.
The court shall notify the person orally and in writing that if involuntary treatment is sought beyond the 14-day inpatient or 90-day less restrictive treatment period, such person has the right to a full hearing or jury trial under RCW 71.05.310. If the commitment is for mental health treatment, the court shall also notify the person orally and in writing that the person is barred from the possession of firearms and that the prohibition remains in effect until a court restores his or her right to possess a firearm under RCW 9.41.047.
If the court does not issue an order to detain or commit a person under this section, the court shall issue an order to dismiss the petition. If the court dismisses the petition for a person who was detained on the grounds that the person presents a likelihood of serious harm, the court shall enter an order requiring the person to immediately surrender any firearms in the person's possession, custody, or control and any concealed pistol license issued under RCW 9.41.070. Proof of compliance must be provided to the court in the form of a proof of surrender and receipt form, a declaration that the person has no firearms, or other evidence sufficient to establish full and timely compliance. Proof of compliance must be submitted to the court within 24 hours of the person's release from detention following dismissal of the petition. The court shall set a compliance review hearing under section 13 of this act as soon as possible but not later than five days after the dismissal of the petition.
Nothing in this section precludes the court from subsequently modifying the terms of an order for less restrictive alternative treatment under RCW 71.05.590(3).
(1) When a designated crisis responder files a petition for initial detention under RCW 71.05.150 or 71.05.153 on the grounds that the person presents a likelihood of serious harm, the petition shall include a copy of the person's driver's license or identicard or comparable information such as their name, address, and date of birth. If the person is not subsequently committed for involuntary treatment under RCW 71.05.240, the court shall forward within three business days of the probable cause hearing a copy of the person's driver's license or identicard, or comparable information, along with the date of release from the facility, to the department of licensing, the criminal division of the county prosecutor in the county in which the petition was filed, and the Washington state patrol firearms background check program, which shall. The Washington state patrol shall enter the information into the Washington state crime information center or other secure database readily accessible to law enforcement officers noting the person is prohibited from possessing a firearm for a period of six months. The Washington state patrol shall also forward the information to the national instant criminal background check system index, denied persons file, created by the federal Brady handgun violence prevention act (P.L. 103-159). Upon expiration of the six-month period during which the person's right to possess a firearm is suspended as provided in RCW 71.05.182, the Washington state patrol firearms background check program must remove the person from the national instant criminal background check system and update the Washington state crime information center or other secure database readily accessible to law enforcement officers.
In making a determination of whether a person is gravely disabled, presents a likelihood of serious harm, or is in need of assisted outpatient treatment in a hearing conducted under RCW 71.05.240 or 71.05.320, the court must consider the symptoms and behavior of the respondent in light of all available evidence concerning the respondent's historical behavior.
Symptoms or behavior which standing alone would not justify civil commitment may support a finding of grave disability or likelihood of serious harm, or a finding that the person is in need of assisted outpatient treatment, when: (a) Such symptoms or behavior are closely associated with symptoms or behavior which preceded and led to a past incident of involuntary hospitalization, severe deterioration, or one or more violent acts; (b) these symptoms or behavior represent a marked and concerning change in the baseline behavior of the respondent; and (c) without treatment, the continued deterioration of the respondent is probable.
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In making a determination of whether there is a likelihood of serious harm in a hearing conducted under RCW 71.05.240 or 71.05.320, the court shall give great weight to any evidence before the court regarding whether the person has: (i) A recent history of one or more violent acts; or (ii) a recent history of one or more commitments under this chapter or its equivalent provisions under the laws of another state which were based on a likelihood of serious harm. The existence of prior violent acts or commitments under this chapter or its equivalent shall not be the sole basis for determining whether a person presents a likelihood of serious harm.
For the purposes of this subsection "recent" refers to the period of time not exceeding three years prior to the current hearing.
Before making a determination under subsection (2) or (3) of this section, the court shall consult the judicial information system or any related databases, if available, to determine the respondent's criminal history, prior civil commitments under this chapter, and the respondent's firearms history, including purchase history and any concealed pistol license history.
Before release, conditional release, or discharge of a person involuntarily committed for treatment of a mental disorder, the professional person in charge of the facility providing involuntary treatment services shall notify the court of the person's release, conditional release, or discharge at the earliest possible date but no later than five days prior to the person's release, conditional release, or discharge. The professional person in charge of the facility shall also provide the person being released, conditionally released, or discharged with a notice informing the person that the person is required pursuant to the court order issued under section 13 of this act to surrender all firearms in the person's possession, custody, or control, and any concealed pistol license, to a law enforcement agency and provide proof of compliance with the order to surrender firearms to the clerk of the court as required under section 13 of this act.
When a court enters an order for involuntary commitment for treatment of a mental disorder under RCW 71.05.240 or 71.05.320, the court shall enter an order requiring the person to surrender all firearms in the person's possession, custody, or control, and any concealed pistol license issued under RCW 9.41.070, to a law enforcement agency.
To prove compliance with the court's order to surrender firearms, the person subject to the order shall file with the clerk of the court: (a) A completed proof of surrender and receipt form; (b) a declaration that the person has no firearms; or (c) other evidence sufficient to establish full and timely compliance with the order.
If the person subject to the order to surrender firearms is committed to inpatient treatment, proof of compliance must be provided to the court within 24 hours of the person's release, conditional release, or discharge from inpatient detention. If the person subject to the order to surrender firearms is committed to less restrictive alternative treatment, proof of compliance must be provided to the court within 24 hours of the person's release from detention to less restrictive alternative treatment.
Courts shall develop procedures to verify timely and complete compliance with orders to surrender firearms, including compliance review hearings to be held as soon as possible and not later than five days following the person's release or conditional release from inpatient treatment or following release of the person to less restrictive alternative treatment.
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A compliance review hearing may be waived by the court or held at a later date if the information attested to by the person subject to the order, along with verification from law enforcement and any other relevant evidence, makes a sufficient showing that the person has surrendered all firearms in the person's possession, custody, or control, and any concealed pistol license, to a law enforcement agency, and the court is able to make a finding of compliance. In making its findings regarding compliance, the court should consider any available department of licensing and Washington state patrol firearm records, any affidavits from law enforcement in response to a respondent's declaration regarding firearm surrender, or other relevant evidence regarding firearms or a concealed pistol license in the person's possession, custody, or control.
If the court does not have a sufficient record before it on which to make such a finding of compliance, the court shall set a review hearing to occur as soon as possible and not later than five days following the person's release, conditional release, or discharge from inpatient treatment or release to less restrictive alternative treatment. The clerk of the court shall electronically transmit a copy of the notice of hearing to the law enforcement agency where the person subject to the order resides for personal service or service in the manner provided in the civil rules of superior court or applicable statute.
The person subject to the order must be present at the hearing and provide proof of compliance with the court's order to surrender firearms.
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If a court finds at the compliance review hearing, or any other hearing where compliance with the order to surrender firearms is addressed, that there is probable cause to believe the respondent was aware of and failed to fully comply with the order, failed to appear at the compliance review hearing, or violated the order after the court entered findings of compliance, pursuant to its authority under chapter 7.21 RCW, the court may issue an arrest warrant and initiate a contempt proceeding to impose remedial sanctions on its own motion, or upon the motion of the prosecuting attorney, and issue an order requiring the respondent to appear, provide proof of compliance with the order, and show cause why the respondent should not be held in contempt of court.
If the respondent is not present in court at the compliance review hearing or if the court issues an order to appear and show cause after a compliance review hearing, the clerk of the court shall electronically transmit a copy of the order to show cause to the law enforcement agency where the respondent resides for personal service or service in the manner provided in the civil rules of superior court or applicable statute.
The order to show cause served upon the respondent shall state the date, time, and location of the hearing and shall include a warning that the respondent may be held in contempt of court if the respondent fails to promptly comply with the terms of the order to surrender firearms and a warning that an arrest warrant could be issued if the respondent fails to appear on the date and time provided in the order.
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At the show cause hearing, the respondent must be present and provide proof of compliance with the underlying court order to surrender firearms and demonstrate why the relief requested should not be granted.
The court shall take judicial notice of the receipt filed with the court by the law enforcement agency pursuant to subsection (8) of this section. The court shall also provide sufficient notice to the law enforcement agency of the hearing. Upon receiving notice pursuant to this subsection, a law enforcement agency shall:
(A) Provide the court with a complete list of firearms surrendered by the respondent or otherwise belonging to the respondent that are in the possession of the law enforcement agency; and
(B) Provide the court with verification that any concealed pistol license issued to the respondent has been surrendered and an agency with authority to revoke the license has been notified.
iii. If the law enforcement agency has a reasonable suspicion that the respondent is not in full compliance with the terms of the order, the law enforcement agency shall submit the basis for its belief to the court, and may do so through the filing of a declaration.
e. If the court finds the respondent in contempt, the court may impose remedial sanctions designed to ensure swift compliance with the order to surrender firearms.
To help ensure that accurate and comprehensive information about firearms compliance is provided to judicial officers, a representative from the prosecuting attorney's office from the relevant jurisdiction may appear and be heard or submit written information at any hearing that concerns compliance with an order to surrender firearms. The prosecuting attorney's office from the relevant jurisdiction may designate an advocate or a staff person from their office who is not an attorney to appear on behalf of their office. Such appearance does not constitute the unauthorized practice of law.
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Surrender of firearms to local law enforcement must occur in a safe manner. At the time of surrender, a law enforcement officer taking possession of firearms and any concealed pistol license shall issue a receipt identifying all firearms and any concealed pistol license that have been surrendered and provide a copy of the receipt to the respondent. The law enforcement agency shall file the original receipt with the court and retain a copy of the receipt, electronically whenever electronic filing is available.
All law enforcement agencies shall have policies and procedures to provide for the acceptance, storage, and return of firearms and concealed pistol licenses that a court requires be surrendered under this section. A law enforcement agency holding any firearm or concealed pistol license that has been surrendered shall comply with the provisions of RCW 9.41.340 and 9.41.345 before the return of the firearm or concealed pistol license to the owner or individual from whom it was obtained.
A person who voluntarily surrenders firearms, provides testimony relating to the surrender of firearms, or complies with a court's order to surrender firearms is entitled to the statutory immunity against prosecution and substantive and procedural rights provided under RCW 9.41.801(9).
The administrative office of the courts shall create a pattern form to assist the courts in ensuring timely and complete compliance with orders to surrender firearms issued under this chapter and shall develop and distribute any new or updated forms necessary to implement this section.
Involuntary intensive treatment ordered at the time of the probable cause hearing shall be for no more than 14 days, and shall terminate sooner when, in the opinion of the professional person in charge of the facility or his or her professional designee, (a) the person no longer constitutes a likelihood of serious harm, or (b) no longer is gravely disabled, or (c) is prepared to accept voluntary treatment upon referral, or (d) is to remain in the facility providing intensive treatment on a voluntary basis.
A person who has been detained for 14 days of intensive treatment shall be released at the end of the 14 days unless one of the following applies: (a) Such person agrees to receive further treatment on a voluntary basis; or (b) such person is a patient to whom RCW 71.05.280 is applicable.
Before release of a person involuntarily committed for treatment of a mental disorder, the professional person in charge of the facility shall provide the notifications required under section 12 of this act.
Before a person committed under grounds set forth in RCW 71.05.280following dismissal of criminal charges under RCW 10.77.645(7) is released because a new petition for involuntary treatment has not been filed under RCW 71.05.320(4), the superintendent, professional person, or designated crisis responder responsible for the decision whether to file a new petition shall in writing notify the prosecuting attorney of the county in which the criminal charges against the committed person were dismissed, of the decision not to file a new petition for involuntary treatment. Notice shall be provided at least 45 days before the period of commitment expires.
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Before a person committed under grounds set forth in RCW 71.05.280following dismissal of criminal charges under RCW 10.77.645(7) is permitted temporarily to leave a treatment facility pursuant to RCW 71.05.270 for any period of time without constant accompaniment by facility staff, the superintendent, professional person in charge of a treatment facility, or his or her professional designee shall in writing notify the prosecuting attorney of any county of the person's destination and the prosecuting attorney of the county in which the criminal charges against the committed person were dismissed. The notice shall be provided at least 45 days before the anticipated leave and shall describe the conditions under which the leave is to occur.
The provisions of RCW 71.05.330(2) apply to proposed leaves, and either or both prosecuting attorneys receiving notice under this subsection may petition the court under RCW 71.05.330(2).
Nothing in this section shall be construed to authorize detention of a person unless a valid order of commitment is in effect.
The existence of the notice requirements in this section will not require any extension of the leave date in the event the leave plan changes after notification.
The notice requirements contained in this section shall not apply to emergency medical transfers.
The notice provisions of this section are in addition to those provided in RCW 71.05.425.
Whenever the superintendent or professional person in charge of a hospital or facility providing involuntary treatment pursuant to this chapter releases a person prior to the expiration of the period of commitment, the superintendent or professional person in charge shall in writing notify the court which committed the person for treatment. Before release of a person involuntarily committed for treatment of a mental disorder, the professional person in charge of the facility shall provide the notifications required under section 12 of this act.
In any proceeding under this chapter to modify a commitment order of a person committed to inpatient treatment under grounds set forth in RCW 71.05.280 or 71.05.320(4)following dismissal of criminal charges under RCW 10.77.645(7) in which the requested relief includes treatment less restrictive than detention, the prosecuting attorney shall be entitled to intervene. The party initiating the motion to modify the commitment order shall serve the prosecuting attorney of the county in which the criminal charges against the committed person were dismissed with written notice and copies of the initiating papers.
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When, in the opinion of the superintendent or the professional person in charge of the hospital or facility providing involuntary treatment, the committed person can be appropriately served by outpatient treatment prior to or at the expiration of the period of commitment, then such outpatient care may be required as a term of conditional release for a period which, when combined with the number of days the person has spent in inpatient treatment, shall not exceed 90 days if the underlying commitment was for a period of 14 or 90 days, or 180 days if the underlying commitment was for a period of 180 days. If the facility or agency designated to provide outpatient treatment is other than the facility providing involuntary treatment, the outpatient facility so designated must agree in writing to assume such responsibility. A copy of the terms of conditional release shall be given to the patient, the designated crisis responder in the county in which the patient is to receive outpatient treatment, and to the court of original commitment.
Before conditional release of a person involuntarily committed for treatment of a mental disorder, the professional person in charge of the facility shall provide the notifications required under section 12 of this act.
Before a person committed under grounds set forth in RCW 71.05.280 or 71.05.320(4)following dismissal of criminal charges under RCW 10.77.645(7) is conditionally released under (a) of this subsection, the superintendent or professional person in charge of the hospital or facility providing involuntary treatment shall in writing notify the prosecuting attorney of the county in which the criminal charges against the committed person were dismissed, of the decision to conditionally release the person. Notice and a copy of the terms of conditional release shall be provided at least 30 days before the person is released from inpatient care. Within 20 days after receiving notice, the prosecuting attorney may petition the court in the county that issued the commitment order to hold a hearing to determine whether the person may be conditionally released and the terms of the conditional release. The prosecuting attorney shall provide a copy of the petition to the superintendent or professional person in charge of the hospital or facility providing involuntary treatment, the attorney, if any, and guardian or conservator of the committed person, and the court of original commitment. If the county in which the committed person is to receive outpatient treatment is the same county in which the criminal charges against the committed person were dismissed, then the court shall, upon the motion of the prosecuting attorney, transfer the proceeding to the court in that county. The court shall conduct a hearing on the petition within 10 days of the filing of the petition. The committed person shall have the same rights with respect to notice, hearing, and counsel as for an involuntary treatment proceeding, except as set forth in this subsection and except that there shall be no right to jury trial. The issue to be determined at the hearing is whether or not the person may be conditionally released without substantial danger to other persons, or substantial likelihood of committing criminal acts jeopardizing public safety or security. If the court disapproves of the conditional release, it may do so only on the basis of substantial evidence. Pursuant to the determination of the court upon the hearing, the conditional release of the person shall be approved by the court on the same or modified conditions or the person shall be returned for involuntary treatment on an inpatient basis subject to release at the end of the period for which he or she was committed, or otherwise in accordance with the provisions of this chapter.
The facility or agency designated to provide outpatient care or the secretary of the department of social and health services may modify the conditions for continued release when such modification is in the best interest of the person. Notification of such changes shall be sent to all persons receiving a copy of the original conditions. Enforcement or revocation proceedings related to a conditional release may occur as provided under RCW 71.05.590.
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Except as provided in subsection (2) of this section, at the earliest possible date, and in no event later than 30 days before conditional release, final release, authorized leave under RCW 71.05.325(2), or transfer to a facility other than a state mental hospital, the superintendent shall send written notice of conditional release, release, authorized leave, or transfer of a person committed under RCW 71.05.280 or 71.05.320(4) following dismissal of a sex, violent, or felony harassment offense pursuant to RCW 10.77.645(7) to the following:
The chief of police of the city, if any, in which the person will reside;
The sheriff of the county in which the person will reside; and
The prosecuting attorney of the county in which the criminal charges against the committed person were dismissed.
The same notice as required by (a) of this subsection shall be sent to the following, if such notice has been requested in writing about a specific person committed under RCW 71.05.280 or 71.05.320(4) following dismissal of a sex, violent, or felony harassment offense pursuant to RCW 10.77.645(7):
The victim of the sex, violent, or felony harassment offense that was dismissed pursuant to RCW 10.77.645(7) preceding commitment under RCW 71.05.280 or 71.05.320(4) or the victim's next of kin if the crime was a homicide;
Any witnesses who testified against the person in any court proceedings;
Any person specified in writing by the prosecuting attorney. Information regarding victims, next of kin, or witnesses requesting the notice, information regarding any other person specified in writing by the prosecuting attorney to receive the notice, and the notice are confidential and shall not be available to the person committed under this chapter; and
The chief of police of the city, if any, and the sheriff of the county, if any, which had jurisdiction of the person on the date of the applicable offense.
The 30-day notice requirements contained in this subsection shall not apply to emergency medical transfers.
The existence of the notice requirements in this subsection will not require any extension of the release date in the event the release plan changes after notification.
If a person committed under RCW 71.05.280 or 71.05.320(4) following dismissal of a sex, violent, or felony harassment offense pursuant to RCW 10.77.645(7) escapes, the superintendent shall immediately notify, by the most reasonable and expedient means available, the chief of police of the city and the sheriff of the county in which the person escaped and in which the person resided immediately before the person's arrest and the prosecuting attorney of the county in which the criminal charges against the committed person were dismissed. If previously requested, the superintendent shall also notify the witnesses and the victim of the sex, violent, or felony harassment offense that was dismissed pursuant to RCW 10.77.645(7) preceding commitment under RCW 71.05.280 or 71.05.320(4) or the victim's next of kin if the crime was a homicide. In addition, the secretary shall also notify appropriate parties pursuant to RCW 70.02.230(2)(p). If the person is recaptured, the superintendent shall send notice to the persons designated in this subsection as soon as possible but in no event later than two working days after the department of social and health services learns of such recapture.
If the victim, the victim's next of kin, or any witness is under the age of 16, the notice required by this section shall be sent to the parent or legal guardian of the child.
The superintendent shall send the notices required by this chapter to the last address provided to the department of social and health services by the requesting party. The requesting party shall furnish the department of social and health services with a current address.
For purposes of this section the following terms have the following meanings:
"Violent offense" means a violent offense under RCW 9.94A.030;
"Sex offense" means a sex offense under RCW 9.94A.030;
"Next of kin" means a person's spouse, state registered domestic partner, parents, siblings, and children;
"Felony harassment offense" means a crime of harassment as defined in RCW 9A.46.060 that is a felony.
Less restrictive alternative treatment, at a minimum, includes the following services:
Assignment of a care coordinator;
An intake evaluation with the provider of the less restrictive alternative treatment;
A psychiatric evaluation, a substance use disorder evaluation, or both;
A schedule of regular contacts with the provider of the treatment services for the duration of the order;
A transition plan addressing access to continued services at the expiration of the order;
An individual crisis plan;
Consultation about the formation of a mental health advance directive under chapter 71.32 RCW; and
Notification to the care coordinator assigned in (a) of this subsection if reasonable efforts to engage the client fail to produce substantial compliance with court-ordered treatment conditions.
Less restrictive alternative treatment may additionally include requirements to participate in the following services:
Medication management;
Psychotherapy;
Nursing;
Substance use disorder counseling;
Residential treatment;
Partial hospitalization;
Intensive outpatient treatment;
Substance use monitoring through urinalysis, an alcohol detection breathalyzer device, a transdermal sensor device, or other technology designed to detect drugs or alcohol in a person's system;
Periodic court review.
If the person was provided with involuntary medication under RCW 71.05.215 or pursuant to a judicial order during the involuntary commitment period, the less restrictive alternative treatment order may authorize the less restrictive alternative treatment provider or its designee to administer involuntary antipsychotic medication to the person if the provider has attempted and failed to obtain the informed consent of the person and there is a concurring medical opinion approving the medication by a psychiatrist, physician assistant working with a psychiatrist who is acting as a participating physician as defined in RCW 18.71A.010, psychiatric advanced registered nurse practitioner, or physician or physician assistant in consultation with an independent mental health professional with prescribing authority.
Less restrictive alternative treatment must be administered by a provider that is certified or licensed to provide or coordinate the full scope of services required under the less restrictive alternative order and that has agreed to assume this responsibility.
The care coordinator assigned to a person ordered to less restrictive alternative treatment must submit an individualized plan for the person's treatment services to the court that entered the order. An initial plan must be submitted as soon as possible following the intake evaluation and a revised plan must be submitted upon any subsequent modification in which a type of service is removed from or added to the treatment plan.
A care coordinator may disclose information and records related to mental health services pursuant to RCW 70.02.230(2)(l) for purposes of implementing less restrictive alternative treatment.
For the purpose of this section, "care coordinator" means a clinical practitioner who coordinates the activities of less restrictive alternative treatment. The care coordinator coordinates activities with the designated crisis responders that are necessary for enforcement and continuation of less restrictive alternative orders and is responsible for coordinating service activities with other agencies and establishing and maintaining a therapeutic relationship with the individual on a continuing basis.
Less restrictive alternative treatment, at a minimum, includes the following services:
Assignment of a care coordinator;
An intake evaluation with the provider of the less restrictive alternative treatment;
A psychiatric evaluation, a substance use disorder evaluation, or both;
A schedule of regular contacts with the provider of the treatment services for the duration of the order;
A transition plan addressing access to continued services at the expiration of the order;
An individual crisis plan;
Consultation about the formation of a mental health advance directive under chapter 71.32 RCW; and
Notification to the care coordinator assigned in (a) of this subsection if reasonable efforts to engage the client fail to produce substantial compliance with court-ordered treatment conditions.
Less restrictive alternative treatment may additionally include requirements to participate in the following services:
Medication management;
Psychotherapy;
Nursing;
Substance use disorder counseling;
Residential treatment;
Partial hospitalization;
Intensive outpatient treatment;
Substance use monitoring through urinalysis, an alcohol detection breathalyzer device, a transdermal sensor device, or other technology designed to detect drugs or alcohol in a person's system;
Periodic court review.
If the person was provided with involuntary medication under RCW 71.05.215 or pursuant to a judicial order during the involuntary commitment period, the less restrictive alternative treatment order may authorize the less restrictive alternative treatment provider or its designee to administer involuntary antipsychotic medication to the person if the provider has attempted and failed to obtain the informed consent of the person and there is a concurring medical opinion approving the medication by a psychiatrist, physician assistant working with a psychiatrist who is acting as a participating physician as defined in RCW 18.71A.010, psychiatric advanced practice registered nurse, or physician or physician assistant in consultation with an independent mental health professional with prescribing authority.
Less restrictive alternative treatment must be administered by a provider that is certified or licensed to provide or coordinate the full scope of services required under the less restrictive alternative order and that has agreed to assume this responsibility.
The care coordinator assigned to a person ordered to less restrictive alternative treatment must submit an individualized plan for the person's treatment services to the court that entered the order. An initial plan must be submitted as soon as possible following the intake evaluation and a revised plan must be submitted upon any subsequent modification in which a type of service is removed from or added to the treatment plan.
A care coordinator may disclose information and records related to mental health services pursuant to RCW 70.02.230(2)(l) for purposes of implementing less restrictive alternative treatment.
For the purpose of this section, "care coordinator" means a clinical practitioner who coordinates the activities of less restrictive alternative treatment. The care coordinator coordinates activities with the designated crisis responders that are necessary for enforcement and continuation of less restrictive alternative orders and is responsible for coordinating service activities with other agencies and establishing and maintaining a therapeutic relationship with the individual on a continuing basis.
An agency or facility designated to monitor or provide less restrictive alternative treatment services under a court order or conditional release, or a designated crisis responder, may take action to enforce, modify, or revoke the less restrictive alternative treatment order or conditional release if the agency, facility, or designated crisis responder determines that:
The person is failing to adhere to the terms and conditions of the order;
Substantial deterioration in the person's functioning has occurred;
There is evidence of substantial decompensation with a reasonable probability that the decompensation can be reversed by further evaluation, intervention, or treatment; or
The person poses a likelihood of serious harm.
Actions taken under this section must include a flexible range of responses of varying levels of intensity appropriate to the circumstances and consistent with the interests of the individual and the public in personal autonomy, safety, recovery, and compliance. Available actions may include, but are not limited to, any of the following:
To counsel or advise the person as to their rights and responsibilities under the court order, and to offer incentives to motivate compliance;
To increase the intensity of outpatient services provided to the person by increasing the frequency of contacts with the provider, referring the person for an assessment for assertive community services, or by other means;
To request a court hearing for review and modification of the court order. The request must be directed to the court with jurisdiction over the order and specify the circumstances that give rise to the request and what modification is being sought. The county prosecutor shall assist the entity requesting the hearing and issue an appropriate summons to the person. This subsection does not limit the inherent authority of a treatment provider to alter conditions of treatment for clinical reasons, and is intended to be used only when court intervention is necessary or advisable to secure the person's compliance and prevent decompensation or deterioration;
To detain the person for up to 12 hours for evaluation at an agency, facility providing services under the court order, crisis stabilization unit, 23-hour crisis relief center, emergency department, evaluation and treatment facility, secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program. The purpose of the evaluation is to determine whether modification, revocation, or commitment proceedings are necessary and appropriate to stabilize the person and prevent decompensation, deterioration, or physical harm. Temporary detention for evaluation under this subsection is intended to occur only following a pattern of noncompliance or the failure of reasonable attempts at outreach and engagement, and may occur only when, based on clinical judgment, temporary detention is appropriate. The agency, facility, or designated crisis responder may request assistance from a peace officer for the purposes of temporary detention under this subsection (2)(d). This subsection does not limit the ability or obligation of the agency, facility, or designated crisis responder to pursue revocation procedures under subsection (5) of this section in appropriate circumstances; and
To initiate revocation procedures under subsection (5) of this section.
A court may supervise a person on an order for less restrictive alternative treatment or a conditional release. While the person is under the order, the court may:
Require appearance in court for periodic reviews; and
Modify the order after considering input from the agency or facility designated to provide or facilitate services. The court may not remand the person into inpatient treatment except as provided under subsection (5) of this section, but may take actions under subsection (2)(a) through (d) of this section.
The facility or agency designated to provide outpatient treatment shall notify the secretary of the department of social and health services or designated crisis responder when a person fails to adhere to terms and conditions of court ordered treatment or experiences substantial deterioration in his or her condition and, as a result, presents an increased likelihood of serious harm.
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A designated crisis responder or the secretary of the department of social and health services may, upon their own motion or upon request of the facility or agency designated to provide outpatient care, cause a person to be detained in an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program in or near the county in which he or she is receiving outpatient treatment for the purpose of a hearing for revocation of a less restrictive alternative treatment order or conditional release order under this chapter. If the person is located in a 23-hour crisis relief center when a designated crisis responder detains the person for revocation of a less restrictive alternative treatment order or conditional release order under this chapter, the person may remain at the 23-hour crisis relief center or adjacent crisis stabilization facility in accordance with rules promulgated by the department. The designated crisis responder or secretary of the department of social and health services shall file a petition for revocation within 24 hours and serve the person, their guardian, if any, and their attorney. A hearing for revocation of a less restrictive alternative treatment order or conditional release order may be scheduled without detention of the person.
A person detained under this subsection (5) must be held until such time, not exceeding five days, as a hearing can be scheduled to determine whether or not the order for less restrictive alternative treatment or conditional release should be revoked, modified, or retained. If the person is not detained, the hearing must be scheduled within five days of service on the person. The designated crisis responder or the secretary of the department of social and health services may withdraw its petition for revocation at any time before the court hearing.
A person detained under this subsection (5) has the same rights with respect to notice, hearing, and counsel as in any involuntary treatment proceeding, except as specifically set forth in this section. There is no right to jury trial. The venue for proceedings is the county where the petition is filed. Notice of the filing must be provided to the court that originally ordered commitment, if different from the court where the petition for revocation is filed, within two judicial days of the person's detention.
The issues for the court to determine are whether: (i) The person adhered to the terms and conditions of the order or conditional release; (ii) substantial deterioration in the person's functioning has occurred; (iii) there is evidence of substantial decompensation with a reasonable probability that the decompensation can be reversed by further inpatient treatment; or (iv) there is a likelihood of serious harm; and, if any of the above conditions apply, whether it is appropriate for the court to reinstate or modify the person's less restrictive alternative treatment order or conditional release or order the person's detention for inpatient treatment. The person may waive the court hearing and allow the court to enter a stipulated order upon the agreement of all parties. If the court orders detention for inpatient treatment, the treatment period must be for 14 days from the revocation hearing if the less restrictive alternative treatment order or conditional release was based on a petition under RCW 71.05.148, 71.05.160, or 71.05.230. The person must return to less restrictive alternative treatment under the order at the end of the 14-day period unless a petition for further treatment is filed under RCW 71.05.320. If the court orders detention for inpatient treatment and the less restrictive alternative treatment order or conditional release order was based on a petition under RCW 71.05.290 or 71.05.320, the number of days remaining on the order must be converted to days of inpatient treatment.
In determining whether or not to take action under this section the designated crisis responder, agency, or facility must consider the factors specified under RCW 71.05.212 and the court must consider the factors specified under RCW 71.05.245 as they apply to the question of whether to enforce, modify, or revoke a court order for involuntary treatment.
Upon request of an agency, facility, or designated crisis responder, a peace officer shall provide assistance in detaining a person as authorized under this section. A peace officer may decline to provide assistance if, in the judgment of the officer based on the totality of the circumstances known at the time, the officer believes there is a reasonable likelihood that the amount of force required to take the person into custody could cause greater harm than the risk of harm to the person and the community posed by the person's behavioral health condition.
Prior to taking any action to enforce, modify, or revoke a less restrictive alternative treatment order or conditional release order in which the agency, facility, or designated crisis responder knows, or has reason to know, that the individual is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the agency, facility, or designated crisis responder shall notify the tribe and Indian health care provider regarding any action that will be taken under this section as soon as possible, but no later than three hours from the time the decision to take action is made. The agency, facility, or designated crisis responder must provide the tribe and Indian health care provider with a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene as soon as possible, but before any hearing under this section, and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The court clerk shall provide copies of any court orders necessary for the agency, facility, or designated crisis responder to provide notice to the tribe or Indian health care provider under this section. Notification under this section is subject to any federal and state laws and regulations including the requirements in RCW 70.02.230 (2)(ff) and (3) and shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan.
A warrant for the detention of a person issued by a court under the provisions of this chapter constitutes authority of law for a peace officer to enter the person's residence for the sole purpose of effectuating the detention and transportation of the person to an evaluation and treatment facility, a secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program.
The files and records of court proceedings under this chapter and chapter 71.34 RCW shall be closed but shall be accessible to:
The department;
The department of social and health services;
The authority;
The state hospitals as defined in RCW 72.23.010;
Any person who is the subject of a petition;
The attorney or guardian of the person;
Resource management services for that person;
Service providers authorized to receive such information by resource management services;
The prosecuting attorney of a county or tribe located in this state;
The tribe or Indian health care provider who has the right to intervene or receive notice and copies of any orders issued by a court in any court proceeding under this chapter and chapter 71.34 RCW; and
The office of public defense when designated under RCW 71.05.110 or 10.73.150 to provide counsel for the person.
The authority shall adopt rules to implement this section.
An ambulance service licensed under chapter 18.73 RCW may transport a patient detained or committed for evaluation or treatment under the provisions of this chapter pursuant to a judicial warrant or a custody order or pickup order authorized by a designated crisis responder or peace officer under this chapter.
An ambulance service licensed under chapter 18.73 RCW may not use restraints while transporting a patient detained or committed for evaluation or treatment under the provisions of this chapter unless the patient is combative or is interfering with the provision of medical care, there is reasonable cause to believe the patient will elope, or there is reasonable cause to believe that restraints are necessary for the safety of the patient or staff. If an ambulance service determines that use of restraints while transporting a patient is necessary, the ambulance service shall use the least restrictive form of restraint possible under the circumstances in order to maintain safety of the patient and staff.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
"23-hour crisis relief center" has the same meaning as provided in RCW 71.24.025.
"Admission" or "admit" means a decision by a physician, physician assistant, or psychiatric advanced registered nurse practitioner that a minor should be examined or treated as a patient in a hospital.
"Adolescent" means a minor 13 years of age or older.
"Alcoholism" means a disease, characterized by a dependency on alcoholic beverages, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued, and impairment of health or disruption of social or economic functioning.
"Antipsychotic medications" means that class of drugs primarily used to treat serious manifestations of mental illness associated with thought disorders, which includes, but is not limited to, atypical antipsychotic medications.
"Approved substance use disorder treatment program" means a program for minors with substance use disorders provided by a treatment program licensed or certified by the department of health as meeting standards adopted under chapter 71.24 RCW.
"Attending staff" means any person on the staff of a public or private agency having responsibility for the care and treatment of a minor patient.
"Authority" means the Washington state health care authority.
"Behavioral health administrative services organization" has the same meaning as provided in RCW 71.24.025.
"Behavioral health disorder" means either a mental disorder as defined in this section, a substance use disorder as defined in this section, or a co-occurring mental disorder and substance use disorder.
"Child psychiatrist" means a person having a license as a physician and surgeon in this state, who has had graduate training in child psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and who is board eligible or board certified in child psychiatry.
"Children's mental health specialist" means:
A mental health professional who has completed a minimum of 100 actual hours, not quarter or semester hours, of specialized training devoted to the study of child development and the treatment of children; and
A mental health professional who has the equivalent of one year of full-time experience in the treatment of children under the supervision of a children's mental health specialist.
"Commitment" means a determination by a judge or court commissioner, made after a commitment hearing, that the minor is in need of inpatient diagnosis, evaluation, or treatment or that the minor is in need of less restrictive alternative treatment.
"Conditional release" means a revocable modification of a commitment, which may be revoked upon violation of any of its terms.
"Co-occurring disorder specialist" means an individual possessing an enhancement granted by the department of health under chapter 18.205 RCW that certifies the individual to provide substance use disorder counseling subject to the practice limitations under RCW 18.205.105.
"Crisis stabilization unit" means a short-term facility or a portion of a facility licensed or certified by the department of health under RCW 71.24.035, such as a residential treatment facility or a hospital, which has been designed to assess, diagnose, and treat individuals experiencing an acute crisis without the use of long-term hospitalization, or to determine the need for involuntary commitment of an individual.
"Custody" means involuntary detention under the provisions of this chapter or chapter 10.77 RCW, uninterrupted by any period of unconditional release from commitment from a facility providing involuntary care and treatment.
"Department" means the department of social and health services.
"Designated crisis responder" has the same meaning as provided in RCW 71.05.020.
"Detention" or "detain" means the lawful confinement of a person, under the provisions of this chapter.
"Developmental disabilities professional" means a person who has specialized training and three years of experience in directly treating or working with persons with developmental disabilities and is a psychiatrist, physician assistant working with a supervising psychiatrist, psychologist, psychiatric advanced registered nurse practitioner, or social worker, and such other developmental disabilities professionals as may be defined by rules adopted by the secretary of the department.
"Developmental disability" has the same meaning as defined in RCW 71A.10.020.
"Director" means the director of the authority.
"Discharge" means the termination of hospital medical authority. The commitment may remain in place, be terminated, or be amended by court order.
"Evaluation and treatment facility" means a public or private facility or unit that is licensed or certified by the department of health to provide emergency, inpatient, residential, or outpatient mental health evaluation and treatment services for minors. A physically separate and separately operated portion of a state hospital may be designated as an evaluation and treatment facility for minors. A facility which is part of or operated by the state or federal agency does not require licensure or certification. No correctional institution or facility, juvenile court detention facility, or jail may be an evaluation and treatment facility within the meaning of this chapter.
"Evaluation and treatment program" means the total system of services and facilities coordinated and approved by a county or combination of counties for the evaluation and treatment of minors under this chapter.
"Gravely disabled minor" means a minor who, as a result of a behavioral health disorder, (a) is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or (b) manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.
"Habilitative services" means those services provided by program personnel to assist minors in acquiring and maintaining life skills and in raising their levels of physical, behavioral, social, and vocational functioning. Habilitative services include education, training for employment, and therapy.
"Hearing" means any proceeding conducted in open court that conforms to the requirements of RCW 71.34.910.
"History of one or more violent acts" refers to the period of time five years prior to the filing of a petition under this chapter, excluding any time spent, but not any violent acts committed, in a mental health facility, a long-term substance use disorder treatment facility, or in confinement as a result of a criminal conviction.
"Individualized service plan" means a plan prepared by a developmental disabilities professional with other professionals as a team, for a person with developmental disabilities, which states:
The nature of the person's specific problems, prior charged criminal behavior, and habilitation needs;
The conditions and strategies necessary to achieve the purposes of habilitation;
The intermediate and long-range goals of the habilitation program, with a projected timetable for the attainment;
The rationale for using this plan of habilitation to achieve those intermediate and long-range goals;
The staff responsible for carrying out the plan;
Where relevant in light of past criminal behavior and due consideration for public safety, the criteria for proposed movement to less-restrictive settings, criteria for proposed eventual discharge or release, and a projected possible date for discharge or release; and
The type of residence immediately anticipated for the person and possible future types of residences.
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"Inpatient treatment" means 24-hour-per-day mental health care provided within a general hospital, psychiatric hospital, residential treatment facility licensed or certified by the department of health as an evaluation and treatment facility for minors, secure withdrawal management and stabilization facility for minors, or approved substance use disorder treatment program for minors.
For purposes of family-initiated treatment under RCW 71.34.600 through 71.34.670, "inpatient treatment" has the meaning included in (a) of this subsection and any other residential treatment facility licensed under chapter 71.12 RCW.
"Intoxicated minor" means a minor whose mental or physical functioning is substantially impaired as a result of the use of alcohol or other psychoactive chemicals.
"Judicial commitment" means a commitment by a court pursuant to the provisions of this chapter.
"Kinship caregiver" has the same meaning as in RCW 74.13.031.
"Legal counsel" means attorneys and staff employed by county prosecutor offices or the state attorney general acting in their capacity as legal representatives of public behavioral health service providers under RCW 71.05.130.
"Less restrictive alternative" or "less restrictive setting" means outpatient treatment provided to a minor as a program of individualized treatment in a less restrictive setting than inpatient treatment . "Less restrictive alternative" or "less restrictive setting" includes the services described in RCW 71.34.755, including residential treatment and treatment pursuant to an assisted outpatient treatment order under RCW 71.34.815.
"Licensed physician" means a person licensed to practice medicine or osteopathic medicine and surgery in the state of Washington.
"Likelihood of serious harm" means:
A substantial risk that: (i) Physical harm will be inflicted by a minor upon his or her own person, as evidenced by threats or attempts to commit suicide or inflict physical harm on oneself; (ii) physical harm will be inflicted by a minor upon another individual, as evidenced by behavior which has caused such harm or which places another person or persons in reasonable fear of sustaining such harm; or (iii) physical harm will be inflicted by a minor upon the property of others, as evidenced by behavior which has caused substantial loss or damage to the property of others; or
The minor has threatened the physical safety of another and has a history of one or more violent acts.
"Managed care organization" has the same meaning as provided in RCW 71.24.025.
"Medical clearance" means a physician or other health care provider, including an Indian health care provider, has determined that a person is medically stable and ready for referral to the designated crisis responder or facility. For a person presenting in the community, no medical clearance is required prior to investigation by a designated crisis responder.
"Medical necessity" for inpatient care means a requested service which is reasonably calculated to: (a) Diagnose, correct, cure, or alleviate a mental disorder or substance use disorder; or (b) prevent the progression of a mental disorder or substance use disorder that endangers life or causes suffering and pain, or results in illness or infirmity or threatens to cause or aggravate a disability, or causes physical deformity or malfunction, and there is no adequate less restrictive alternative available.
"Mental disorder" means any organic, mental, or emotional impairment that has substantial adverse effects on an individual's cognitive or volitional functions. The presence of alcohol abuse, drug abuse, juvenile criminal history, antisocial behavior, or intellectual disabilities alone is insufficient to justify a finding of "mental disorder" within the meaning of this section.
"Mental health professional" has the same meaning as provided in RCW 71.05.020.
"Minor" means any person under the age of 18 years.
"Outpatient treatment" means any of the nonresidential services mandated under chapter 71.24 RCW and provided by licensed or certified behavioral health agencies as identified by RCW 71.24.025.
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"Parent" has the same meaning as defined in RCW 26.26A.010, including either parent if custody is shared under a joint custody agreement, or a person or agency judicially appointed as legal guardian or custodian of the child.
For purposes of family-initiated treatment under RCW 71.34.600 through 71.34.670, "parent" also includes a person to whom a parent defined in (a) of this subsection has given a signed authorization to make health care decisions for the adolescent, a stepparent who is involved in caring for the adolescent, a kinship caregiver who is involved in caring for the adolescent, or another relative who is responsible for the health care of the adolescent, who may be required to provide a declaration under penalty of perjury stating that he or she is a relative responsible for the health care of the adolescent pursuant to chapter 5.50 RCW. If a dispute arises between individuals authorized to act as a parent for the purpose of RCW 71.34.600 through 71.34.670, the disagreement must be resolved according to the priority established under RCW 7.70.065(2)(a).
"Peace officer" means a law enforcement official of a public agency or governmental unit, and includes persons specifically given peace officer powers by any state law, local ordinance, or judicial order of appointment.
"Physician assistant" means a person licensed as a physician assistant under chapter 18.71A RCW.
"Private agency" means any person, partnership, corporation, or association that is not a public agency, whether or not financed in whole or in part by public funds, that constitutes an evaluation and treatment facility or private institution, or hospital, or approved substance use disorder treatment program, that is conducted for, or includes a distinct unit, floor, or ward conducted for, the care and treatment of persons with mental illness, substance use disorders, or both mental illness and substance use disorders.
"Professional person in charge" or "professional person" means a physician, other mental health professional, or other person empowered by an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program with authority to make admission and discharge decisions on behalf of that facility.
"Psychiatric nurse" means a registered nurse who has experience in the direct treatment of persons who have a mental illness or who are emotionally disturbed, such experience gained under the supervision of a mental health professional.
"Psychiatrist" means a person having a license as a physician in this state who has completed residency training in psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and is board eligible or board certified in psychiatry.
"Psychologist" means a person licensed as a psychologist under chapter 18.83 RCW.
"Public agency" means any evaluation and treatment facility or institution, or hospital, or approved substance use disorder treatment program that is conducted for, or includes a distinct unit, floor, or ward conducted for, the care and treatment of persons with mental illness, substance use disorders, or both mental illness and substance use disorders if the agency is operated directly by federal, state, county, or municipal government, or a combination of such governments.
"Release" means legal termination of the commitment under the provisions of this chapter.
"Resource management services" has the meaning given in chapter 71.24 RCW.
"Responsible other" means the minor, the minor's parent or estate, or any other person legally responsible for support of the minor.
"Secretary" means the secretary of the department or secretary's designee.
"Secure withdrawal management and stabilization facility" means a facility operated by either a public or private agency or by the program of an agency which provides care to voluntary individuals and individuals involuntarily detained and committed under this chapter for whom there is a likelihood of serious harm or who are gravely disabled due to the presence of a substance use disorder. Secure withdrawal management and stabilization facilities must:
Provide the following services:
Assessment and treatment, provided by certified substance use disorder professionals or co-occurring disorder specialists;
Clinical stabilization services;
Acute or subacute detoxification services for intoxicated individuals; and
Discharge assistance provided by certified substance use disorder professionals or co-occurring disorder specialists, including facilitating transitions to appropriate voluntary or involuntary inpatient services or to less restrictive alternatives as appropriate for the individual;
Include security measures sufficient to protect the patients, staff, and community; and
Be licensed or certified as such by the department of health.
"Social worker" means a person with a master's or further advanced degree from a social work educational program accredited and approved as provided in RCW 18.320.010.
"Start of initial detention" means the time of arrival of the minor at the first evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program offering inpatient treatment if the minor is being involuntarily detained at the time. With regard to voluntary patients, "start of initial detention" means the time at which the minor gives notice of intent to leave under the provisions of this chapter.
"State hospital" means a hospital designated under RCW 72.23.020.
"Store and forward technology" means use of an asynchronous transmission of a person's medical information from a mental health service provider to the designated crisis responder which results in medical diagnosis, consultation, or treatment.
"Substance use disorder" means a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using the substance despite significant substance-related problems. The diagnosis of a substance use disorder is based on a pathological pattern of behaviors related to the use of the substances.
"Substance use disorder professional" means a person certified as a substance use disorder professional by the department of health under chapter 18.205 RCW.
"Therapeutic court personnel" means the staff of a mental health court or other therapeutic court which has jurisdiction over defendants who are dually diagnosed with mental disorders, including court personnel, probation officers, a court monitor, prosecuting attorney, or defense counsel acting within the scope of therapeutic court duties.
"Treatment records" include registration and all other records concerning persons who are receiving or who at any time have received services for mental illness, which are maintained by the department, the department of health, the authority, behavioral health organizations and their staffs, and by treatment facilities. Treatment records include mental health information contained in a medical bill including but not limited to mental health drugs, a mental health diagnosis, provider name, and dates of service stemming from a medical service. Treatment records do not include notes or records maintained for personal use by a person providing treatment services for the department, the department of health, the authority, behavioral health organizations, or a treatment facility if the notes or records are not available to others.
"Tribe" has the same meaning as in RCW 71.24.025.
"Video" means the delivery of behavioral health services through the use of interactive audio and video technology, permitting real-time communication between a person and a designated crisis responder, for the purpose of evaluation. "Video" does not include the use of audio-only telephone, facsimile, email, or store and forward technology.
"Violent act" means behavior that resulted in homicide, attempted suicide, injury, or substantial loss or damage to property.
"In need of assisted outpatient treatment" refers to a minor who meets the criteria for assisted outpatient treatment under RCW 71.34.815.
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
"23-hour crisis relief center" has the same meaning as provided in RCW 71.24.025.
"Admission" or "admit" means a decision by a physician, physician assistant, or psychiatric advanced registered nurse practitioner that a minor should be examined or treated as a patient in a hospital.
"Adolescent" means a minor 13 years of age or older.
"Alcoholism" means a disease, characterized by a dependency on alcoholic beverages, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued, and impairment of health or disruption of social or economic functioning.
"Antipsychotic medications" means that class of drugs primarily used to treat serious manifestations of mental illness associated with thought disorders, which includes, but is not limited to, atypical antipsychotic medications.
"Approved substance use disorder treatment program" means a program for minors with substance use disorders provided by a treatment program licensed or certified by the department of health as meeting standards adopted under chapter 71.24 RCW.
"Attending staff" means any person on the staff of a public or private agency having responsibility for the care and treatment of a minor patient.
"Authority" means the Washington state health care authority.
"Behavioral health administrative services organization" has the same meaning as provided in RCW 71.24.025.
"Behavioral health disorder" means either a mental disorder as defined in this section, a substance use disorder as defined in this section, or a co-occurring mental disorder and substance use disorder.
"Child psychiatrist" means a person having a license as a physician and surgeon in this state, who has had graduate training in child psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and who is board eligible or board certified in child psychiatry.
"Children's mental health specialist" means:
A mental health professional who has completed a minimum of 100 actual hours, not quarter or semester hours, of specialized training devoted to the study of child development and the treatment of children; and
A mental health professional who has the equivalent of one year of full-time experience in the treatment of children under the supervision of a children's mental health specialist.
"Commitment" means a determination by a judge or court commissioner, made after a commitment hearing, that the minor is in need of inpatient diagnosis, evaluation, or treatment or that the minor is in need of less restrictive alternative treatment.
"Conditional release" means a revocable modification of a commitment, which may be revoked upon violation of any of its terms.
"Co-occurring disorder specialist" means an individual possessing an enhancement granted by the department of health under chapter 18.205 RCW that certifies the individual to provide substance use disorder counseling subject to the practice limitations under RCW 18.205.105.
"Crisis stabilization unit" means a short-term facility or a portion of a facility licensed or certified by the department of health under RCW 71.24.035, such as a residential treatment facility or a hospital, which has been designed to assess, diagnose, and treat individuals experiencing an acute crisis without the use of long-term hospitalization, or to determine the need for involuntary commitment of an individual.
"Custody" means involuntary detention under the provisions of this chapter or chapter 10.77 RCW, uninterrupted by any period of unconditional release from commitment from a facility providing involuntary care and treatment.
"Department" means the department of social and health services.
"Designated crisis responder" has the same meaning as provided in RCW 71.05.020.
"Detention" or "detain" means the lawful confinement of a person, under the provisions of this chapter.
"Developmental disabilities professional" means a person who has specialized training and three years of experience in directly treating or working with persons with developmental disabilities and is a psychiatrist, physician assistant working with a supervising psychiatrist, psychologist, psychiatric advanced registered nurse practitioner, or social worker, and such other developmental disabilities professionals as may be defined by rules adopted by the secretary of the department.
"Developmental disability" has the same meaning as defined in RCW 71A.10.020.
"Director" means the director of the authority.
"Discharge" means the termination of hospital medical authority. The commitment may remain in place, be terminated, or be amended by court order.
"Evaluation and treatment facility" means a public or private facility or unit that is licensed or certified by the department of health to provide emergency, inpatient, residential, or outpatient mental health evaluation and treatment services for minors. A physically separate and separately operated portion of a state hospital may be designated as an evaluation and treatment facility for minors. A facility which is part of or operated by the state or federal agency does not require licensure or certification. No correctional institution or facility, juvenile court detention facility, or jail may be an evaluation and treatment facility within the meaning of this chapter.
"Evaluation and treatment program" means the total system of services and facilities coordinated and approved by a county or combination of counties for the evaluation and treatment of minors under this chapter.
"Gravely disabled minor" means a minor who, as a result of a behavioral health disorder, (a) is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or (b) manifests severe deterioration from safe behavior evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.
"Habilitative services" means those services provided by program personnel to assist minors in acquiring and maintaining life skills and in raising their levels of physical, behavioral, social, and vocational functioning. Habilitative services include education, training for employment, and therapy.
"Hearing" means any proceeding conducted in open court that conforms to the requirements of RCW 71.34.910.
"History of one or more violent acts" refers to the period of time five years prior to the filing of a petition under this chapter, excluding any time spent, but not any violent acts committed, in a mental health facility, a long-term substance use disorder treatment facility, or in confinement as a result of a criminal conviction.
"Individualized service plan" means a plan prepared by a developmental disabilities professional with other professionals as a team, for a person with developmental disabilities, which states:
The nature of the person's specific problems, prior charged criminal behavior, and habilitation needs;
The conditions and strategies necessary to achieve the purposes of habilitation;
The intermediate and long-range goals of the habilitation program, with a projected timetable for the attainment;
The rationale for using this plan of habilitation to achieve those intermediate and long-range goals;
The staff responsible for carrying out the plan;
Where relevant in light of past criminal behavior and due consideration for public safety, the criteria for proposed movement to less-restrictive settings, criteria for proposed eventual discharge or release, and a projected possible date for discharge or release; and
The type of residence immediately anticipated for the person and possible future types of residences.
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"Inpatient treatment" means 24-hour-per-day mental health care provided within a general hospital, psychiatric hospital, residential treatment facility licensed or certified by the department of health as an evaluation and treatment facility for minors, secure withdrawal management and stabilization facility for minors, or approved substance use disorder treatment program for minors.
For purposes of family-initiated treatment under RCW 71.34.600 through 71.34.670, "inpatient treatment" has the meaning included in (a) of this subsection and any other residential treatment facility licensed under chapter 71.12 RCW.
"Intoxicated minor" means a minor whose mental or physical functioning is substantially impaired as a result of the use of alcohol or other psychoactive chemicals.
"Judicial commitment" means a commitment by a court pursuant to the provisions of this chapter.
"Kinship caregiver" has the same meaning as in RCW 74.13.031.
"Legal counsel" means attorneys and staff employed by county prosecutor offices or the state attorney general acting in their capacity as legal representatives of public behavioral health service providers under RCW 71.05.130.
"Less restrictive alternative" or "less restrictive setting" means outpatient treatment provided to a minor as a program of individualized treatment in a less restrictive setting than inpatient treatment . "Less restrictive alternative" or "less restrictive setting" includes the services described in RCW 71.34.755, including residential treatment and treatment pursuant to an assisted outpatient treatment order under RCW 71.34.815.
"Licensed physician" means a person licensed to practice medicine or osteopathic medicine and surgery in the state of Washington.
"Likelihood of serious harm" means:
A substantial risk that: (i) Physical harm will be inflicted by a minor upon his or her own person, as evidenced by threats or attempts to commit suicide or inflict physical harm on oneself; (ii) physical harm will be inflicted by a minor upon another individual, as evidenced by behavior which has caused harm, substantial pain, or which places another person or persons in reasonable fear of harm to themselves or others; or (iii) physical harm will be inflicted by a minor upon the property of others, as evidenced by behavior which has caused substantial loss or damage to the property of others; or
The minor has threatened the physical safety of another and has a history of one or more violent acts.
"Managed care organization" has the same meaning as provided in RCW 71.24.025.
"Medical clearance" means a physician or other health care provider, including an Indian health care provider, has determined that a person is medically stable and ready for referral to the designated crisis responder or facility. For a person presenting in the community, no medical clearance is required prior to investigation by a designated crisis responder.
"Medical necessity" for inpatient care means a requested service which is reasonably calculated to: (a) Diagnose, correct, cure, or alleviate a mental disorder or substance use disorder; or (b) prevent the progression of a mental disorder or substance use disorder that endangers life or causes suffering and pain, or results in illness or infirmity or threatens to cause or aggravate a disability, or causes physical deformity or malfunction, and there is no adequate less restrictive alternative available.
"Mental disorder" means any organic, mental, or emotional impairment that has substantial adverse effects on an individual's cognitive or volitional functions. The presence of alcohol abuse, drug abuse, juvenile criminal history, antisocial behavior, or intellectual disabilities alone is insufficient to justify a finding of "mental disorder" within the meaning of this section.
"Mental health professional" has the same meaning as provided in RCW 71.05.020.
"Minor" means any person under the age of 18 years.
"Outpatient treatment" means any of the nonresidential services mandated under chapter 71.24 RCW and provided by licensed or certified behavioral health agencies as identified by RCW 71.24.025.
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"Parent" has the same meaning as defined in RCW 26.26A.010, including either parent if custody is shared under a joint custody agreement, or a person or agency judicially appointed as legal guardian or custodian of the child.
For purposes of family-initiated treatment under RCW 71.34.600 through 71.34.670, "parent" also includes a person to whom a parent defined in (a) of this subsection has given a signed authorization to make health care decisions for the adolescent, a stepparent who is involved in caring for the adolescent, a kinship caregiver who is involved in caring for the adolescent, or another relative who is responsible for the health care of the adolescent, who may be required to provide a declaration under penalty of perjury stating that he or she is a relative responsible for the health care of the adolescent pursuant to chapter 5.50 RCW. If a dispute arises between individuals authorized to act as a parent for the purpose of RCW 71.34.600 through 71.34.670, the disagreement must be resolved according to the priority established under RCW 7.70.065(2)(a).
"Peace officer" means a law enforcement official of a public agency or governmental unit, and includes persons specifically given peace officer powers by any state law, local ordinance, or judicial order of appointment.
"Physician assistant" means a person licensed as a physician assistant under chapter 18.71A RCW.
"Private agency" means any person, partnership, corporation, or association that is not a public agency, whether or not financed in whole or in part by public funds, that constitutes an evaluation and treatment facility or private institution, or hospital, or approved substance use disorder treatment program, that is conducted for, or includes a distinct unit, floor, or ward conducted for, the care and treatment of persons with mental illness, substance use disorders, or both mental illness and substance use disorders.
"Professional person in charge" or "professional person" means a physician, other mental health professional, or other person empowered by an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program with authority to make admission and discharge decisions on behalf of that facility.
"Psychiatric nurse" means a registered nurse who has experience in the direct treatment of persons who have a mental illness or who are emotionally disturbed, such experience gained under the supervision of a mental health professional.
"Psychiatrist" means a person having a license as a physician in this state who has completed residency training in psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and is board eligible or board certified in psychiatry.
"Psychologist" means a person licensed as a psychologist under chapter 18.83 RCW.
"Public agency" means any evaluation and treatment facility or institution, or hospital, or approved substance use disorder treatment program that is conducted for, or includes a distinct unit, floor, or ward conducted for, the care and treatment of persons with mental illness, substance use disorders, or both mental illness and substance use disorders if the agency is operated directly by federal, state, county, or municipal government, or a combination of such governments.
"Release" means legal termination of the commitment under the provisions of this chapter.
"Resource management services" has the meaning given in chapter 71.24 RCW.
"Responsible other" means the minor, the minor's parent or estate, or any other person legally responsible for support of the minor.
"Secretary" means the secretary of the department or secretary's designee.
"Secure withdrawal management and stabilization facility" means a facility operated by either a public or private agency or by the program of an agency which provides care to voluntary individuals and individuals involuntarily detained and committed under this chapter for whom there is a likelihood of serious harm or who are gravely disabled due to the presence of a substance use disorder. Secure withdrawal management and stabilization facilities must:
Provide the following services:
Assessment and treatment, provided by certified substance use disorder professionals or co-occurring disorder specialists;
Clinical stabilization services;
Acute or subacute detoxification services for intoxicated individuals; and
Discharge assistance provided by certified substance use disorder professionals or co-occurring disorder specialists, including facilitating transitions to appropriate voluntary or involuntary inpatient services or to less restrictive alternatives as appropriate for the individual;
Include security measures sufficient to protect the patients, staff, and community; and
Be licensed or certified as such by the department of health.
"Severe deterioration from safe behavior" means that a person will, if not treated, suffer or continue to suffer severe and abnormal mental, emotional, or physical distress, and this distress is associated with significant impairment of judgment, reason, or behavior.
"Social worker" means a person with a master's or further advanced degree from a social work educational program accredited and approved as provided in RCW 18.320.010.
"Start of initial detention" means the time of arrival of the minor at the first evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program offering inpatient treatment if the minor is being involuntarily detained at the time. With regard to voluntary patients, "start of initial detention" means the time at which the minor gives notice of intent to leave under the provisions of this chapter.
"State hospital" means a hospital designated under RCW 72.23.020.
"Store and forward technology" means use of an asynchronous transmission of a person's medical information from a mental health service provider to the designated crisis responder which results in medical diagnosis, consultation, or treatment.
"Substance use disorder" means a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using the substance despite significant substance-related problems. The diagnosis of a substance use disorder is based on a pathological pattern of behaviors related to the use of the substances.
"Substance use disorder professional" means a person certified as a substance use disorder professional by the department of health under chapter 18.205 RCW.
"Therapeutic court personnel" means the staff of a mental health court or other therapeutic court which has jurisdiction over defendants who are dually diagnosed with mental disorders, including court personnel, probation officers, a court monitor, prosecuting attorney, or defense counsel acting within the scope of therapeutic court duties.
"Treatment records" include registration and all other records concerning persons who are receiving or who at any time have received services for mental illness, which are maintained by the department, the department of health, the authority, behavioral health organizations and their staffs, and by treatment facilities. Treatment records include mental health information contained in a medical bill including but not limited to mental health drugs, a mental health diagnosis, provider name, and dates of service stemming from a medical service. Treatment records do not include notes or records maintained for personal use by a person providing treatment services for the department, the department of health, the authority, behavioral health organizations, or a treatment facility if the notes or records are not available to others.
"Tribe" has the same meaning as in RCW 71.24.025.
"Video" means the delivery of behavioral health services through the use of interactive audio and video technology, permitting real-time communication between a person and a designated crisis responder, for the purpose of evaluation. "Video" does not include the use of audio-only telephone, facsimile, email, or store and forward technology.
"Violent act" means behavior that resulted in homicide, attempted suicide, injury, or substantial loss or damage to property.
"In need of assisted outpatient treatment" refers to a minor who meets the criteria for assisted outpatient treatment under RCW 71.34.815.
If an adolescent is brought to an evaluation and treatment facility, secure withdrawal management and stabilization facility, approved substance use disorder treatment program, or hospital emergency room for immediate behavioral health services, the professional person in charge of the facility shall evaluate the adolescent's condition, determine whether the adolescent suffers from a behavioral health disorder, and whether the adolescent is in need of immediate inpatient treatment. If the adolescent is located in a 23-hour crisis relief center for minors when a designated crisis responder takes the adolescent into emergency custody, the adolescent may remain at the 23-hour crisis relief center for minors or adjacent crisis stabilization facility in accordance with rules promulgated by the department of health.
If it is determined under subsection (1) of this section that the adolescent suffers from a behavioral health disorder, inpatient treatment is required, the adolescent is unwilling to consent to voluntary admission, and the professional person believes that the adolescent meets the criteria for initial detention, the facility may detain or arrange for the detention of the adolescent for up to 12 hours, not including time periods prior to medical clearance, in order to enable a designated crisis responder to evaluate the adolescent and commence initial detention proceedings under the provisions of this chapter.
Dismissal of a commitment petition is not the appropriate remedy for a violation of the timeliness requirements of this section, based on the purpose of this chapter under RCW 71.34.010, except in the few cases where the facility staff or the designated crisis responder have totally disregarded the requirements of this section.
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When a designated crisis responder receives information that an adolescent as a result of a behavioral health disorder presents a likelihood of serious harm or is gravely disabled, has investigated the specific facts alleged and of the credibility of the person or persons providing the information, and has determined that voluntary admission for inpatient treatment is not possible, the designated crisis responder may take the adolescent, or cause the adolescent to be taken, into custody and transported to an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program providing inpatient treatment. If the adolescent is located in a 23-hour crisis relief center for minors when a designated crisis responder takes the adolescent into emergency custody, the adolescent may remain at the 23-hour crisis relief center for minors or adjacent crisis stabilization facility in accordance with rules promulgated by the department of health.
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If a designated crisis responder decides not to detain an adolescent for evaluation and treatment under RCW 71.34.700(2), or 48 hours have elapsed since a designated crisis responder received a request for investigation and the designated crisis responder has not taken action to have the adolescent detained, the following persons may petition the superior court for the adolescent's detention using the procedures under RCW 71.05.201 and 71.05.203: A family or household member of the adolescent; a guardian or conservator of the adolescent; a representative of a federally recognized Indian tribe if the adolescent is a member of such a tribe; a human services provider that has provided services to the adolescent; and any person authorized to file a petition under RCW 71.34.815. However, when the court enters an order of initial detention, except as otherwise expressly stated in this chapter, all procedures must be followed as if the order has been entered under (a) of this subsection.
For the purposes of this subsection (1)(b), "family or household member" and "human services provider" have the same meanings as defined in RCW 71.05.201.
The interview performed by the designated crisis responder 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 interview.
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Within 12 hours of the adolescent's arrival at the evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program, the designated crisis responder shall serve or cause to be served on the adolescent a copy of the petition for initial detention, notice of initial detention, and statement of rights. The designated crisis responder shall file with the court on the next judicial day following the initial detention the original petition for initial detention, notice of initial detention, and statement of rights along with an affidavit of service. The designated crisis responder shall commence service of the petition for initial detention and notice of the initial detention on the adolescent's parent and the adolescent's attorney as soon as possible following the initial detention.
The facility or program may serve the adolescent, notify the adolescent's parents and the adolescent's attorney, and file with the court on the next judicial day following the initial detention the original petition for initial detention, notice of initial detention, and statement of rights along with an affidavit of service when filing with the court at the request of the designated crisis responder.
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At the time of initial detention, the designated crisis responder shall advise the adolescent both orally and in writing that if admitted to the evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program for inpatient treatment, a commitment hearing shall be held within 120 hours of the adolescent's provisional acceptance to determine whether probable cause exists to commit the adolescent for further treatment.
The adolescent shall be advised that he or she has a right to communicate immediately with an attorney and that he or she has a right to have an attorney appointed to represent him or her before and at the hearing if the adolescent is indigent.
Whenever the designated crisis responder petitions for detention of an adolescent under this chapter, an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program providing 120-hour evaluation and treatment must immediately accept on a provisional basis the petition and the person. Within 24 hours of the adolescent's arrival, the facility must evaluate the adolescent's condition and either admit or release the adolescent in accordance with this chapter.
If an adolescent is not approved for admission by the inpatient evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program, the facility shall make such recommendations and referrals for further care and treatment of the adolescent as necessary.
Dismissal of a commitment petition is not the appropriate remedy for a violation of the timeliness requirements of this section, based on the purpose of this chapter under RCW 71.34.010, except in the few cases where the facility staff or the designated crisis responder have totally disregarded the requirements of this section.
In any investigation and evaluation of an adolescent under this section in which the designated crisis responder knows, or has reason to know, that the adolescent is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the designated crisis responder shall notify the tribe and the Indian health care provider whether or not a petition for initial detention or involuntary outpatient treatment will be filed as soon as possible, but no later than three hours from the time the decision is made. If a petition for initial detention or involuntary outpatient treatment is filed, the designated crisis responder must provide the tribe with a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene as soon as possible, but before the hearing, and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The court clerk shall provide copies of any court orders necessary for the designated crisis responder to provide notice to the tribe or Indian health care provider under this section. Notification under this section is subject to any federal and state laws and regulations including the requirements in RCW 70.02.240 and shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan.
A commitment hearing shall be held within 120 hours of the minor's admission, excluding Saturday, Sunday, and holidays, or if the hearing is held on a petition filed under RCW 71.34.815, the hearing shall be held at a time scheduled under that section, unless a continuance is ordered under RCW 71.34.735.
The commitment hearing shall be conducted at the superior court or an appropriate place at the facility in which the minor is being detained.
At the commitment hearing, the evidence in support of the petition shall be presented by the county prosecutor.
The minor shall be present at the commitment hearing unless the minor, with the assistance of the minor's attorney, waives the right to be present at the hearing.
If the parents are opposed to the petition, they may be represented at the hearing and shall be entitled to court-appointed counsel if they are indigent.
At the commitment hearing, the minor shall have the following rights:
To be represented by an attorney;
To present evidence on his or her own behalf;
To question persons testifying in support of the petition.
If the petition is for commitment for mental health treatment, the court at the time of the commitment hearing and before an order of commitment is entered shall inform the minor both orally and in writing that the failure to make a good faith effort to seek voluntary treatment as provided in RCW 71.34.730 will result in the loss of his or her firearm rights if the minor is subsequently ordered to receive involuntary treatment under this section.
If the minor has received medication within 24 hours of the hearing, the court shall be informed of that fact and of the probable effects of the medication.
For a 14-day commitment, the court must find by a preponderance of the evidence that:
The minor has a behavioral health disorder and presents a likelihood of serious harm or is gravely disabled;
The minor is in need of evaluation and treatment of the type provided by the inpatient evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program to which continued inpatient care is sought or is in need of less restrictive alternative treatment found to be in the best interests of the minor or others; and
The minor is unwilling or unable in good faith to consent to voluntary treatment.
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If the court finds that the minor meets the criteria for a 14-day commitment, the court shall either authorize commitment of the minor for inpatient treatment or for less restrictive alternative treatment upon such conditions as are necessary. If the court determines that the minor does not meet the criteria for a 14-day commitment, the minor shall be released.
If the court finds by a preponderance of the evidence that the minor is in need of assisted outpatient treatment pursuant to a petition filed under RCW 71.34.815, the court shall order an appropriate less restrictive course of treatment for up to 18 months.
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Nothing in this section prohibits the professional person in charge of the facility from releasing the minor at any time, when, in the opinion of the professional person in charge of the facility, further inpatient treatment is no longer necessary. The release may be subject to reasonable conditions if appropriate.
Whenever a minor is released under this section, the professional person in charge shall within three days, notify the court in writing of the release.
A minor who has been committed for 14 days shall be released at the end of that period unless a petition for 180-day commitment is pending before the court.
Less restrictive alternative treatment, at a minimum, must include the following services:
Assignment of a care coordinator;
An intake evaluation with the provider of the less restrictive alternative treatment;
A psychiatric evaluation, a substance use disorder evaluation, or both;
A schedule of regular contacts with the provider of the less restrictive alternative treatment services for the duration of the order;
A transition plan addressing access to continued services at the expiration of the order;
An individual crisis plan;
Consultation about the formation of a mental health advance directive under chapter 71.32 RCW; and
Notification to the care coordinator assigned in (a) of this subsection if reasonable efforts to engage the client fail to produce substantial compliance with court-ordered treatment conditions.
Less restrictive alternative treatment may include the following additional services:
Medication management;
Psychotherapy;
Nursing;
Substance use disorder counseling;
Residential treatment;
Partial hospitalization;
Intensive outpatient treatment;
Substance use monitoring through urinalysis, an alcohol detection breathalyzer device, a transdermal sensor device, or other technology designed to detect drugs or alcohol in a person's system;
Periodic court review.
If the minor was provided with involuntary medication during the involuntary commitment period, the less restrictive alternative treatment order may authorize the less restrictive alternative treatment provider or its designee to administer involuntary antipsychotic medication to the person if the provider has attempted and failed to obtain the informed consent of the person and there is a concurring medical opinion approving the medication by a psychiatrist, physician assistant working with a psychiatrist who is acting as a participating physician as defined in RCW 18.71A.010, psychiatric advanced registered nurse practitioner, or physician or physician assistant in consultation with an independent mental health professional with prescribing authority.
Less restrictive alternative treatment must be administered by a provider that is certified or licensed to provide or coordinate the full scope of services required under the less restrictive alternative order and that has agreed to assume this responsibility.
The care coordinator assigned to a minor ordered to less restrictive alternative treatment must submit an individualized plan for the minor's treatment services to the court that entered the order. An initial plan must be submitted as soon as possible following the intake evaluation and a revised plan must be submitted upon any subsequent modification in which a type of service is removed from or added to the treatment plan.
A care coordinator may disclose information and records related to mental health services pursuant to RCW 70.02.230(2)(l) for purposes of implementing less restrictive alternative treatment.
For the purpose of this section, "care coordinator" means a clinical practitioner who coordinates the activities of less restrictive alternative treatment. The care coordinator coordinates activities with the designated crisis responders that are necessary for enforcement and continuation of less restrictive alternative treatment orders and is responsible for coordinating service activities with other agencies and establishing and maintaining a therapeutic relationship with the individual on a continuing basis.
Less restrictive alternative treatment, at a minimum, must include the following services:
Assignment of a care coordinator;
An intake evaluation with the provider of the less restrictive alternative treatment;
A psychiatric evaluation, a substance use disorder evaluation, or both;
A schedule of regular contacts with the provider of the less restrictive alternative treatment services for the duration of the order;
A transition plan addressing access to continued services at the expiration of the order;
An individual crisis plan;
Consultation about the formation of a mental health advance directive under chapter 71.32 RCW; and
Notification to the care coordinator assigned in (a) of this subsection if reasonable efforts to engage the client fail to produce substantial compliance with court-ordered treatment conditions.
Less restrictive alternative treatment may include the following additional services:
Medication management;
Psychotherapy;
Nursing;
Substance use disorder counseling;
Residential treatment;
Partial hospitalization;
Intensive outpatient treatment;
Substance use monitoring through urinalysis, an alcohol detection breathalyzer device, a transdermal sensor device, or other technology designed to detect drugs or alcohol in a person's system;
Periodic court review.
If the minor was provided with involuntary medication during the involuntary commitment period, the less restrictive alternative treatment order may authorize the less restrictive alternative treatment provider or its designee to administer involuntary antipsychotic medication to the person if the provider has attempted and failed to obtain the informed consent of the person and there is a concurring medical opinion approving the medication by a psychiatrist, physician assistant working with a psychiatrist who is acting as a participating physician as defined in RCW 18.71A.010, psychiatric advanced practice registered nurse, or physician or physician assistant in consultation with an independent mental health professional with prescribing authority.
Less restrictive alternative treatment must be administered by a provider that is certified or licensed to provide or coordinate the full scope of services required under the less restrictive alternative order and that has agreed to assume this responsibility.
The care coordinator assigned to a minor ordered to less restrictive alternative treatment must submit an individualized plan for the minor's treatment services to the court that entered the order. An initial plan must be submitted as soon as possible following the intake evaluation and a revised plan must be submitted upon any subsequent modification in which a type of service is removed from or added to the treatment plan.
A care coordinator may disclose information and records related to mental health services pursuant to RCW 70.02.230(2)(l) for purposes of implementing less restrictive alternative treatment.
For the purpose of this section, "care coordinator" means a clinical practitioner who coordinates the activities of less restrictive alternative treatment. The care coordinator coordinates activities with the designated crisis responders that are necessary for enforcement and continuation of less restrictive alternative treatment orders and is responsible for coordinating service activities with other agencies and establishing and maintaining a therapeutic relationship with the individual on a continuing basis.
An agency or facility designated to monitor or provide less restrictive alternative treatment services to a minor under a court order or conditional release may take a range of actions to enforce the terms of the order or conditional release in the event the minor is not adhering to the terms or is experiencing substantial deterioration, decompensation, or a likelihood of serious harm. Such actions may include:
Counseling the minor and offering incentives for compliance;
Increasing the intensity of services;
Petitioning the court to review the minor's compliance and optionally modify the terms of the order or conditional release while the minor remains in outpatient treatment;
Requesting assistance from a peace officer for temporarily detaining the minor for up to 12 hours for evaluation at a crisis stabilization unit, evaluation and treatment facility, secure withdrawal management and stabilization facility, facility providing services under a court order, or emergency department to determine if revocation or enforcement proceedings under this section are necessary and appropriate to stabilize the minor, if there has been a pattern of noncompliance or failure of reasonable attempts at outreach and engagement; or
Initiating revocation proceedings under subsection (3) of this section.
If the professional person in charge of an outpatient treatment program, a designated crisis responder, or the director or secretary, as appropriate, determines that a minor is failing to adhere to the conditions of a court order for less restrictive alternative treatment or the conditions of conditional release, or that substantial deterioration in the minor's functioning has occurred, the designated crisis responder, or the director or secretary, as appropriate, may order that the minor be taken into custody and transported to an inpatient evaluation and treatment facility, a secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program. If the minor is located in a 23-hour crisis relief center for minors when a designated crisis responder takes the minor into custody, the minor may remain at the 23-hour crisis relief center for minors or adjacent crisis stabilization facility in accordance with rules promulgated by the department of health.
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The designated crisis responder, director, or secretary, as appropriate, shall file the order of apprehension and detention and serve it upon the minor and notify the minor's parent and the minor's attorney, if any, of the detention within two days of return. At the time of service the minor shall be informed of the right to a hearing and to representation by an attorney. The designated crisis responder or the director or secretary, as appropriate, may modify or rescind the order of apprehension and detention at any time prior to the hearing.
If the minor is involuntarily detained for revocation at an evaluation and treatment facility, secure withdrawal management and stabilization facility, or approved substance use disorder treatment program in a different county from where the minor was initially detained, the facility or program may file the order of apprehension, serve it on the minor and notify the minor's parents and the minor's attorney at the request of the designated crisis responder.
A petition for revocation of less restrictive alternative treatment shall be filed by the designated crisis responder or the director, secretary, or facility, as appropriate, with the court in the county where the minor is detained. The court shall conduct the hearing in that county. A petition for revocation of conditional release must be filed in the county where the minor is detained. A petition shall describe the behavior of the minor indicating violation of the conditions or deterioration of routine functioning and a dispositional recommendation. The hearing shall be held within seven days of the minor's return. The issues to be determined are whether the minor did or did not adhere to the conditions of the less restrictive alternative treatment or conditional release, or whether the minor's routine functioning has substantially deteriorated, and, if so, whether the conditions of less restrictive alternative treatment or conditional release should be modified or whether the court should order the minor's detention for inpatient treatment. Pursuant to the determination of the court, the minor shall be returned to less restrictive alternative treatment or conditional release on the same or modified conditions or shall be detained for inpatient treatment. If the minor is detained for inpatient treatment, RCW 71.34.760 regarding the director's placement responsibility shall apply. The hearing may be waived by the minor and the minor detained for inpatient treatment or returned to less restrictive alternative treatment or conditional release on the same or modified conditions. If the court orders detention for inpatient treatment, the treatment period must be for 14 days from the revocation hearing if the less restrictive alternative treatment order was based on a petition under RCW 71.34.740 or 71.34.815. The minor must return to less restrictive alternative treatment under the order at the end of the 14-day period unless a petition for further treatment is filed under RCW 71.34.750. If the court orders detention for inpatient treatment and the less restrictive alternative treatment order or conditional release was based on a petition under RCW 71.34.750, the number of days remaining on the less restrictive alternative treatment order or conditional release must be converted to days of inpatient treatment.
Upon request of an agency, facility, or designated crisis responder, a peace officer shall provide assistance in detaining a minor as authorized under this section. If, in the judgment of the officer based on the totality of the circumstances known at the time, the officer believes there is a reasonable likelihood that the amount of force required to take the person into custody could cause greater harm than the risk of harm to the person and the community posed by the person's untreated behavioral health condition, the officer may decline to provide assistance.
Prior to taking any action to enforce, modify, or revoke a less restrictive alternative treatment order or conditional release order in which the agency, facility, or designated crisis responder knows, or has reason to know, that the minor is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the agency, facility, or designated crisis responder shall notify the tribe and Indian health care provider regarding any action that will be taken under this section as soon as possible, but no later than three hours from the time the decision to take action is made. The agency, facility, or designated crisis responder must provide the tribe and Indian health care provider with a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene as soon as possible, but before any hearing under this section, and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The court clerk shall provide copies of any court orders necessary for the agency, facility, or designated crisis responder to provide notice to the tribe or Indian health care provider under this section. Notification under this section is subject to any federal and state laws and regulations including the requirements in RCW 70.02.240 and shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan.
An adolescent is in need of assisted outpatient treatment if the court finds by a preponderance of the evidence in response to a petition filed under this section that:
The adolescent has a behavioral health disorder;
Based on a clinical determination and in view of the adolescent's treatment history and current behavior, at least one of the following is true:
The adolescent is unlikely to survive safely in the community without supervision and the adolescent's condition is substantially deteriorating; or
The adolescent is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would be likely to result in grave disability or a likelihood of serious harm to the adolescent or to others;
The adolescent has a history of lack of compliance with treatment for his or her behavioral health disorder that has:
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating hospitalization of the adolescent, or the adolescent's receipt of services in a forensic or other mental health unit of a state, local, or tribal correctional facility, provided that the 36-month period shall be extended by the length of any hospitalization or incarceration of the adolescent that occurred within the 36-month period;
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating emergency medical care or hospitalization for behavioral health-related medical conditions including overdose, infected abscesses, sepsis, endocarditis, or other maladies, or a significant factor in behavior which resulted in the adolescent's incarceration in a state, local, or tribal correctional facility; or
Resulted in one or more violent acts, threats, or attempts to cause serious physical harm to the adolescent or another within the 48 months prior to the filing of the petition, provided that the 48-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred during the 48-month period;
Participation in an assisted outpatient treatment program would be the least restrictive alternative necessary to ensure the adolescent's recovery and stability; and
The adolescent will benefit from assisted outpatient treatment.
The following individuals may directly file a petition for less restrictive alternative treatment on the basis that an adolescent is in need of assisted outpatient treatment:
The director of a hospital where the adolescent is hospitalized or the director's designee;
The director of a behavioral health service provider providing behavioral health care or residential services to the adolescent or the director's designee;
The adolescent's treating mental health professional or substance use disorder professional or one who has evaluated the person;
A designated crisis responder;
A release planner from a juvenile detention or rehabilitation facility; or
An emergency room physician.
A court order for less restrictive alternative treatment on the basis that the adolescent is in need of assisted outpatient treatment may be effective for up to 18 months. The petitioner must personally interview the adolescent, unless the adolescent refuses an interview, to determine whether the adolescent will voluntarily receive appropriate treatment.
The petitioner must allege specific facts based on personal observation, evaluation, or investigation, and must consider the reliability or credibility of any person providing information material to the petition.
The petition must include:
b.
The declarations of witnesses, if any, supporting the petition for assisted outpatient treatment;
c. The name of an agency, provider, or facility that agrees to provide less restrictive alternative treatment if the petition is granted by the court; and
d. If the adolescent is detained in a state hospital, inpatient treatment facility, or juvenile detention or rehabilitation facility at the time the petition is filed, the anticipated release date of the adolescent and any other details needed to facilitate successful reentry and transition into the community.
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Upon receipt of a petition meeting all requirements of this section, the court shall fix a date for a hearing:
No sooner than three days or later than seven days after the date of service or as stipulated by the parties or, upon a showing of good cause, no later than 30 days after the date of service; or
If the adolescent is hospitalized at the time of filing of the petition, before discharge of the adolescent and in sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.
A copy of the petition and notice of hearing shall be served, in the same manner as a summons, on the petitioner, the adolescent, a current provider, if any, and a surrogate decision maker or agent under chapter 71.32 RCW, if any.
If the adolescent has a surrogate decision maker or agent under chapter 71.32 RCW who wishes to provide testimony at the hearing, the court shall afford the surrogate decision maker or agent an opportunity to testify.
The adolescent shall be represented by counsel at all stages of the proceedings.
If the adolescent fails to appear at the hearing after notice, the court may conduct the hearing in the adolescent's absence; provided that the adolescent's counsel is present.
If the petition does not include a declaration from a qualified professional person who has examined the adolescent no more than 10 days prior to submission of the petition, the court may order a mental examination of the adolescentby a qualified professional .
If the adolescent has refused to be examined by a qualified professional and the court finds reasonable grounds to believe that the allegations of the petition are true, the court may issue a written order directing a peace officer who has completed crisis intervention training to detain and transport the adolescent to a provider for examination by a qualified professional. An adolescent detained pursuant to this subsection shall be detained no longer than necessary to complete the examination and in no event longer than 24 hours. All papers in the court file must be provided to the adolescent's designated attorney.
If the petition involves an adolescent whom the petitioner or behavioral health administrative services organization knows, or has reason to know, is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the petitioner or behavioral health administrative services organization shall notify the tribe and Indian health care provider. Notification shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan as soon as possible, but before the hearing and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The notice to the tribe or Indian health care provider must include a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene. The court clerk shall provide copies of any court orders necessary for the petitioner or the behavioral health administrative services organization to provide notice to the tribe or Indian health care provider under this section.
A petition for assisted outpatient treatment filed under this section shall be adjudicated under RCW 71.34.740.
A petition for assisted outpatient treatment must be filed on forms developed by the administrative office of the courts.
An adolescent is in need of assisted outpatient treatment if the court finds by a preponderance of the evidence in response to a petition filed under this section that:
The adolescent has a behavioral health disorder;
Based on a clinical determination and in view of the adolescent's treatment history and current behavior, at least one of the following is true:
The adolescent is unlikely to survive safely in the community without supervision and the adolescent's condition is substantially deteriorating; or
The adolescent is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would be likely to result in grave disability or a likelihood of serious harm to the adolescent or to others;
The adolescent has a history of lack of compliance with treatment for his or her behavioral health disorder that has:
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating hospitalization of the adolescent, or the adolescent's receipt of services in a forensic or other mental health unit of a state, local, or tribal correctional facility, provided that the 36-month period shall be extended by the length of any hospitalization or incarceration of the adolescent that occurred within the 36-month period;
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating emergency medical care or hospitalization for behavioral health-related medical conditions including overdose, infected abscesses, sepsis, endocarditis, or other maladies, or a significant factor in behavior which resulted in the adolescent's incarceration in a state, local, or tribal correctional facility; or
Resulted in one or more violent acts, threats, or attempts to cause serious physical harm to the adolescent or another within the 48 months prior to the filing of the petition, provided that the 48-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred during the 48-month period;
Participation in an assisted outpatient treatment program would be the least restrictive alternative necessary to ensure the adolescent's recovery and stability; and
The adolescent will benefit from assisted outpatient treatment.
The following individuals may directly file a petition for less restrictive alternative treatment on the basis that an adolescent is in need of assisted outpatient treatment:
The director of a hospital where the adolescent is hospitalized or the director's designee;
The director of a behavioral health service provider providing behavioral health care or residential services to the adolescent or the director's designee;
The adolescent's treating mental health professional or substance use disorder professional or one who has evaluated the person;
A designated crisis responder;
A release planner from a juvenile detention or rehabilitation facility; or
An emergency room physician.
A court order for less restrictive alternative treatment on the basis that the adolescent is in need of assisted outpatient treatment may be effective for up to 18 months. The petitioner must personally interview the adolescent, unless the adolescent refuses an interview, to determine whether the adolescent will voluntarily receive appropriate treatment.
The petitioner must allege specific facts based on personal observation, evaluation, or investigation, and must consider the reliability or credibility of any person providing information material to the petition.
The petition must include:
b.
The declarations of witnesses, if any, supporting the petition for assisted outpatient treatment;
c. The name of an agency, provider, or facility that agrees to provide less restrictive alternative treatment if the petition is granted by the court; and
d. If the adolescent is detained in a state hospital, inpatient treatment facility, or juvenile detention or rehabilitation facility at the time the petition is filed, the anticipated release date of the adolescent and any other details needed to facilitate successful reentry and transition into the community.
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Upon receipt of a petition meeting all requirements of this section, the court shall fix a date for a hearing:
No sooner than three days or later than seven days after the date of service or as stipulated by the parties or, upon a showing of good cause, no later than 30 days after the date of service; or
If the adolescent is hospitalized at the time of filing of the petition, before discharge of the adolescent and in sufficient time to arrange for a continuous transition from inpatient treatment to assisted outpatient treatment.
A copy of the petition and notice of hearing shall be served, in the same manner as a summons, on the petitioner, the adolescent, a current provider, if any, and a surrogate decision maker or agent under chapter 71.32 RCW, if any.
If the adolescent has a surrogate decision maker or agent under chapter 71.32 RCW who wishes to provide testimony at the hearing, the court shall afford the surrogate decision maker or agent an opportunity to testify.
The adolescent shall be represented by counsel at all stages of the proceedings.
If the adolescent fails to appear at the hearing after notice, the court may conduct the hearing in the adolescent's absence; provided that the adolescent's counsel is present.
If the petition does not include a declaration from a qualified professional person who has examined the adolescent no more than 10 days prior to submission of the petition, the court may order a behavioral health examination of the adolescentby a qualified professional .
If the adolescent has refused to be examined by a qualified professional and the court finds reasonable grounds to believe that the allegations of the petition are true, the court may issue a written order directing a peace officer who has completed crisis intervention training to detain and transport the adolescent to a provider for examination by a qualified professional. An adolescent detained pursuant to this subsection shall be detained no longer than necessary to complete the examination and in no event longer than 24 hours. All papers in the court file must be provided to the adolescent's designated attorney.
If the petition involves an adolescent whom the petitioner or behavioral health administrative services organization knows, or has reason to know, is an American Indian or Alaska Native who receives medical or behavioral health services from a tribe within this state, the petitioner or behavioral health administrative services organization shall notify the tribe and Indian health care provider. Notification shall be made in person or by telephonic or electronic communication to the tribal contact listed in the authority's tribal crisis coordination plan as soon as possible, but before the hearing and no later than 24 hours from the time the petition is served upon the person and the person's guardian. The notice to the tribe or Indian health care provider must include a copy of the petition, together with any orders issued by the court and a notice of the tribe's right to intervene. The court clerk shall provide copies of any court orders necessary for the petitioner or the behavioral health administrative services organization to provide notice to the tribe or Indian health care provider under this section.
A petition for assisted outpatient treatment filed under this section shall be adjudicated under RCW 71.34.740.
A petition for assisted outpatient treatment must be filed on forms developed by the administrative office of the courts.
The fact of admission to a provider for mental health services and all information and records compiled, obtained, or maintained in the course of providing mental health services to either voluntary or involuntary recipients of services at public or private agencies may not be disclosed except as provided in this section, RCW 70.02.050, 71.05.445, 74.09.295, 70.02.210, 70.02.240, 70.02.250, 70.02.260, and 70.02.265, or pursuant to a valid authorization under RCW 70.02.030.
Information and records related to mental health services, other than those obtained through treatment under chapter 71.34 RCW, may be disclosed:
In communications between qualified professional persons to meet the requirements of chapter 71.05 RCW, including Indian health care providers, in the provision of services or appropriate referrals, or in the course of guardianship proceedings if provided to a professional person:
Employed by the facility;
Who has medical responsibility for the patient's care;
Who is a designated crisis responder;
Who is providing services under chapter 71.24 RCW;
Who is employed by a state or local correctional facility where the person is confined or supervised; or
When the communications regard the special needs of a patient and the necessary circumstances giving rise to such needs and the disclosure is made by a facility providing services to the operator of a facility in which the patient resides or will reside;
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When the person receiving services, or his or her guardian, designates persons to whom information or records may be released, or if the person is a minor, when his or her parents make such a designation;
A public or private agency shall release to a person's next of kin, attorney, personal representative, guardian, or conservator, if any:
(A) The information that the person is presently a patient in the facility or that the person is seriously physically ill;
(B) A statement evaluating the mental and physical condition of the patient, and a statement of the probable duration of the patient's confinement, if such information is requested by the next of kin, attorney, personal representative, guardian, or conservator; and
iii. Other information requested by the next of kin or attorney as may be necessary to decide whether or not proceedings should be instituted to appoint a guardian or conservator;
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i. To the courts, including tribal courts, as necessary to the administration of chapter 71.05 RCW, or equivalent proceedings in tribal courts, or to a court ordering an evaluation or treatment under chapter 10.77 RCW solely for the purpose of preventing the entry of any evaluation or treatment order that is inconsistent with any order entered under chapter 71.05 RCW.
ii. To a court or its designee in which a motion under chapter 10.77 RCW has been made for involuntary medication of a defendant for the purpose of competency restoration.
iii. Disclosure under this subsection is mandatory for the purpose of the federal health insurance portability and accountability act;
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i. When a mental health professional or designated crisis responder is requested by a representative of a law enforcement or corrections agency, including a police officer, sheriff, community corrections officer, a municipal attorney, or prosecuting attorney to undertake an investigation or provide treatment under RCW 71.05.150, 10.31.110, or 71.05.153, the mental health professional or designated crisis responder shall, if requested to do so, advise the representative in writing of the results of the investigation including a statement of reasons for the decision to detain or release the person investigated. The written report must be submitted within 72 hours of the completion of the investigation or the request from the law enforcement or corrections representative, whichever occurs later.
ii. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
f. To the attorney of the detained person;
g. To the prosecuting attorney, including tribal prosecuting attorney, as necessary to carry out the responsibilities of the office under RCW 71.05.330(2), 71.05.340(1)(b), and 71.05.335. The prosecutor, including tribal prosecutor, must be provided access to records regarding the committed person's treatment and prognosis, medication, behavior problems, and other records relevant to the issue of whether treatment less restrictive than inpatient treatment is in the best interest of the committed person or others. Information must be disclosed only after giving notice to the committed person and the person's counsel;
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i. To appropriate law enforcement agencies, including tribal law enforcement agencies, and to a person, when the identity of the person is known to the public or private agency, whose health and safety has been threatened, or who is known to have been repeatedly harassed, by the patient. The person may designate a representative to receive the disclosure. The disclosure must be made by the professional person in charge of the public or private agency or his or her designee and must include the dates of commitment, admission, discharge, or release, authorized or unauthorized absence from the agency's facility, and only any other information that is pertinent to the threat or harassment. The agency or its employees are not civilly liable for the decision to disclose or not, so long as the decision was reached in good faith and without gross negligence. Nothing in this section shall be interpreted as a waiver of sovereign immunity by a tribe.
ii. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
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i. To appropriate corrections and law enforcement agencies, including tribal corrections and law enforcement agencies, all necessary and relevant information in the event of a crisis or emergent situation that poses a significant and imminent risk to the public. The mental health service agency or its employees are not civilly liable for the decision to disclose or not so long as the decision was reached in good faith and without gross negligence.
ii. Disclosure under this subsection is mandatory for the purposes of the health insurance portability and accountability act;
j. To the persons designated in RCW 71.05.425 for the purposes described in those sections;
k. When the person receiving services has been committed for treatment under chapter 71.05 RCW and is subject to a pending criminal charge, in which case the following information may be disclosed to the prosecuting attorney of the jurisdiction in which the criminal charge against the person was filed and to the attorney representing the person in the criminal matter for purposes of coordination between civil and forensic mental health systems:
i. The fact, place, and date of an involuntary commitment and the date of court hearings relating to the commitment;
ii. The anticipated date of discharge or release, and the fact and date of discharge or release; and
iii. The last known address of the person who has been committed;
l. By a care coordinator, including an Indian health care provider, under RCW 71.05.585 or 10.77.575 assigned to a person ordered to receive less restrictive alternative treatment for the purpose of sharing information to parties necessary for the implementation of proceedings under chapter 71.05 or 10.77 RCW;
m. Upon the death of a person. The person's next of kin, personal representative, guardian, or conservator, if any, must be notified. Next of kin who are of legal age and competent must be notified under this section in the following order: Spouse, parents, children, brothers and sisters, and other relatives according to the degree of relation. Access to all records and information compiled, obtained, or maintained in the course of providing services to a deceased patient are governed by RCW 70.02.140;
n. To mark headstones or otherwise memorialize patients interred at state hospital cemeteries. The department of social and health services shall make available the name, date of birth, and date of death of patients buried in state hospital cemeteries 50 years after the death of a patient;
o. To law enforcement officers and to prosecuting attorneys as are necessary to enforce RCW 9.41.040(2)(a)(iii). The extent of information that may be released is limited as follows:
i. Only the fact, place, and date of involuntary commitment, an official copy of any order or orders of commitment, and an official copy of any written or oral notice of ineligibility to possess a firearm that was provided to the person pursuant to RCW 9.41.047(1), must be disclosed upon request;
ii. The law enforcement and prosecuting attorneys may only release the information obtained to the person's attorney as required by court rule and to a jury or judge, if a jury is waived, that presides over any trial at which the person is charged with violating RCW 9.41.040(2)(a)(iii);
iii. Tribal law enforcement officers and tribal prosecuting attorneys who enforce tribal laws or tribal court orders similar to RCW 9.41.040(2)(a)(v) may also receive confidential information in accordance with this subsection;
iv. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
p. When a patient would otherwise be subject to the provisions of this section and disclosure is necessary for the protection of the patient or others due to his or her unauthorized disappearance from the facility, and his or her whereabouts is unknown, notice of the disappearance, along with relevant information, may be made to relatives, the department of corrections when the person is under the supervision of the department, and governmental law enforcement agencies designated by the physician or psychiatric advanced registered nurse practitioner in charge of the patient or the professional person in charge of the facility, or his or her professional designee;
q. Pursuant to lawful order of a court, including a tribal court;
r. To qualified staff members of the department, to the authority, to behavioral health administrative services organizations, to managed care organizations, to resource management services responsible for serving a patient, or to service providers designated by resource management services as necessary to determine the progress and adequacy of treatment and to determine whether the person should be transferred to a less restrictive or more appropriate treatment modality or facility;
s. Within the mental health service agency or Indian health care provider facility where the patient is receiving treatment, confidential information may be disclosed to persons employed, serving in bona fide training programs, or participating in supervised volunteer programs, at the facility when it is necessary to perform their duties;
t. Within the department and the authority as necessary to coordinate treatment for mental illness, developmental disabilities, or substance use disorder of persons who are under the supervision of the department;
u. Between the department of social and health services, the department of children, youth, and families, and the health care authority as necessary to coordinate treatment for mental illness, developmental disabilities, or substance use disorder of persons who are under the supervision of the department of social and health services or the department of children, youth, and families;
v. To a licensed physician or psychiatric advanced registered nurse practitioner who has determined that the life or health of the person is in danger and that treatment without the information and records related to mental health services could be injurious to the patient's health. Disclosure must be limited to the portions of the records necessary to meet the medical emergency;
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i. Consistent with the requirements of the federal health insurance portability and accountability act, to:
(A) A health care provider, including an Indian health care provider, who is providing care to a patient, or to whom a patient has been referred for evaluation or treatment; or
(B) Any other person who is working in a care coordinator role for a health care facility, health care provider, or Indian health care provider, or is under an agreement pursuant to the federal health insurance portability and accountability act with a health care facility or a health care provider and requires the information and records to assure coordinated care and treatment of that patient.
ii. A person authorized to use or disclose information and records related to mental health services under this subsection (2)(w) must take appropriate steps to protect the information and records relating to mental health services.
iii. Psychotherapy notes may not be released without authorization of the patient who is the subject of the request for release of information;
x. To administrative and office support staff designated to obtain medical records for those licensed professionals listed in (w) of this subsection;
y. To a facility that is to receive a person who is involuntarily committed under chapter 71.05 RCW, or upon transfer of the person from one evaluation and treatment facility to another. The release of records under this subsection is limited to the information and records related to mental health services required by law, a record or summary of all somatic treatments, and a discharge summary. The discharge summary may include a statement of the patient's problem, the treatment goals, the type of treatment which has been provided, and recommendation for future treatment, but may not include the patient's complete treatment record;
z. To the person's counsel or guardian ad litem, without modification, at any time in order to prepare for involuntary commitment or recommitment proceedings, reexaminations, appeals, or other actions relating to detention, admission, commitment, or patient's rights under chapter 71.05 RCW;
aa. To staff members of the protection and advocacy agency or to staff members of a private, nonprofit corporation for the purpose of protecting and advocating the rights of persons with mental disorders or developmental disabilities. Resource management services may limit the release of information to the name, birthdate, and county of residence of the patient, information regarding whether the patient was voluntarily admitted, or involuntarily committed, the date and place of admission, placement, or commitment, the name and address of a guardian of the patient, and the date and place of the guardian's appointment. Any staff member who wishes to obtain additional information must notify the patient's resource management services in writing of the request and of the resource management services' right to object. The staff member shall send the notice by mail to the guardian's address. If the guardian does not object in writing within 15 days after the notice is mailed, the staff member may obtain the additional information. If the guardian objects in writing within 15 days after the notice is mailed, the staff member may not obtain the additional information;
bb. To all current treating providers, including Indian health care providers, of the patient with prescriptive authority who have written a prescription for the patient within the last 12 months. For purposes of coordinating health care, the department or the authority may release without written authorization of the patient, information acquired for billing and collection purposes as described in RCW 70.02.050(1)(d). The department, or the authority, if applicable, shall notify the patient that billing and collection information has been released to named providers, and provide the substance of the information released and the dates of such release. Neither the department nor the authority may release counseling, inpatient psychiatric hospitalization, or drug and alcohol treatment information without a signed written release from the client;
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i. To the secretary of social and health services and the director of the health care authority for either program evaluation or research, or both so long as the secretary or director, where applicable, adopts rules for the conduct of the evaluation or research, or both. Such rules must include, but need not be limited to, the requirement that all evaluators and researchers sign an oath of confidentiality substantially as follows:
"As a condition of conducting evaluation or research concerning persons who have received services from (fill in the facility, agency, or person) I, . . . . . ., agree not to divulge, publish, or otherwise make known to unauthorized persons or the public any information obtained in the course of such evaluation or research regarding persons who have received services such that the person who received such services is identifiable.
I recognize that unauthorized release of confidential information may subject me to civil liability under the provisions of state law.
/s/ . . . . . ."
ii. Nothing in this chapter may be construed to prohibit the compilation and publication of statistical data for use by government or researchers under standards, including standards to assure maintenance of confidentiality, set forth by the secretary, or director, where applicable;
dd. To any person if the conditions in RCW 70.02.205 are met;
ee. To the secretary of health for the purposes of the maternal mortality review panel established in RCW 70.54.450; or
ff. To a tribe or Indian health care provider to carry out the requirements of RCW 71.05.150(5).
Whenever federal law or federal regulations restrict the release of information contained in the information and records related to mental health services of any patient who receives treatment for a substance use disorder, the department or the authority may restrict the release of the information as necessary to comply with federal law and regulations.
Civil liability and immunity for the release of information about a particular person who is committed to the department of social and health services or the authority under RCW 71.05.280(3) and 71.05.320(4)(c) after dismissal of a sex offense as defined in RCW 9.94A.030, is governed by RCW 4.24.550.
The fact of admission to a provider of mental health services, as well as all records, files, evidence, findings, or orders made, prepared, collected, or maintained pursuant to chapter 71.05 RCW are not admissible as evidence in any legal proceeding outside that chapter without the written authorization of the person who was the subject of the proceeding except as provided in RCW 70.02.260, in a subsequent criminal prosecution of a person committed pursuant to RCW 71.05.280(3) or 71.05.320(4)(c) on charges that were dismissed pursuant to chapter 10.77 RCW due to incompetency to stand trial, in a civil commitment proceeding pursuant to chapter 71.09 RCW, or, in the case of a minor, a guardianship or dependency proceeding. The records and files maintained in any court proceeding pursuant to chapter 71.05 RCW must be confidential and available subsequent to such proceedings in accordance with RCW 71.05.620. In addition, the court may order the subsequent release or use of such records or files only upon good cause shown if the court finds that appropriate safeguards for strict confidentiality are and will be maintained.
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Except as provided in RCW 4.24.550, any person may bring an action against an individual who has willfully released confidential information or records concerning him or her in violation of the provisions of this section, for the greater of the following amounts:
$1,000; or
Three times the amount of actual damages sustained, if any.
It is not a prerequisite to recovery under this subsection that the plaintiff suffered or was threatened with special, as contrasted with general, damages.
Any person may bring an action to enjoin the release of confidential information or records concerning him or her or his or her ward, in violation of the provisions of this section, and may in the same action seek damages as provided in this subsection.
The court may award to the plaintiff, should he or she prevail in any action authorized by this subsection, reasonable attorney fees in addition to those otherwise provided by law.
If an action is brought under this subsection, no action may be brought under RCW 70.02.170.
The fact of admission to a provider for mental health services and all information and records compiled, obtained, or maintained in the course of providing mental health services to either voluntary or involuntary recipients of services at public or private agencies may not be disclosed except as provided in this section, RCW 70.02.050, 71.05.445, 74.09.295, 70.02.210, 70.02.240, 70.02.250, 70.02.260, and 70.02.265, or pursuant to a valid authorization under RCW 70.02.030.
Information and records related to mental health services, other than those obtained through treatment under chapter 71.34 RCW, may be disclosed:
In communications between qualified professional persons to meet the requirements of chapter 71.05 RCW, including Indian health care providers, in the provision of services or appropriate referrals, or in the course of guardianship proceedings if provided to a professional person:
Employed by the facility;
Who has medical responsibility for the patient's care;
Who is a designated crisis responder;
Who is providing services under chapter 71.24 RCW;
Who is employed by a state or local correctional facility where the person is confined or supervised; or
When the communications regard the special needs of a patient and the necessary circumstances giving rise to such needs and the disclosure is made by a facility providing services to the operator of a facility in which the patient resides or will reside;
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When the person receiving services, or his or her guardian, designates persons to whom information or records may be released, or if the person is a minor, when his or her parents make such a designation;
A public or private agency shall release to a person's next of kin, attorney, personal representative, guardian, or conservator, if any:
(A) The information that the person is presently a patient in the facility or that the person is seriously physically ill;
(B) A statement evaluating the mental and physical condition of the patient, and a statement of the probable duration of the patient's confinement, if such information is requested by the next of kin, attorney, personal representative, guardian, or conservator; and
iii. Other information requested by the next of kin or attorney as may be necessary to decide whether or not proceedings should be instituted to appoint a guardian or conservator;
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i. To the courts, including tribal courts, as necessary to the administration of chapter 71.05 RCW, or equivalent proceedings in tribal courts, or to a court ordering an evaluation or treatment under chapter 10.77 RCW solely for the purpose of preventing the entry of any evaluation or treatment order that is inconsistent with any order entered under chapter 71.05 RCW.
ii. To a court or its designee in which a motion under chapter 10.77 RCW has been made for involuntary medication of a defendant for the purpose of competency restoration.
iii. Disclosure under this subsection is mandatory for the purpose of the federal health insurance portability and accountability act;
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i. When a mental health professional or designated crisis responder is requested by a representative of a law enforcement or corrections agency, including a police officer, sheriff, community corrections officer, a municipal attorney, or prosecuting attorney to undertake an investigation or provide treatment under RCW 71.05.150, 10.31.110, or 71.05.153, the mental health professional or designated crisis responder shall, if requested to do so, advise the representative in writing of the results of the investigation including a statement of reasons for the decision to detain or release the person investigated. The written report must be submitted within 72 hours of the completion of the investigation or the request from the law enforcement or corrections representative, whichever occurs later.
ii. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
f. To the attorney of the detained person;
g. To the prosecuting attorney, including tribal prosecuting attorney, as necessary to carry out the responsibilities of the office under RCW 71.05.330(2), 71.05.340(1)(b), and 71.05.335. The prosecutor, including tribal prosecutor, must be provided access to records regarding the committed person's treatment and prognosis, medication, behavior problems, and other records relevant to the issue of whether treatment less restrictive than inpatient treatment is in the best interest of the committed person or others. Information must be disclosed only after giving notice to the committed person and the person's counsel;
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i. To appropriate law enforcement agencies, including tribal law enforcement agencies, and to a person, when the identity of the person is known to the public or private agency, whose health and safety has been threatened, or who is known to have been repeatedly harassed, by the patient. The person may designate a representative to receive the disclosure. The disclosure must be made by the professional person in charge of the public or private agency or his or her designee and must include the dates of commitment, admission, discharge, or release, authorized or unauthorized absence from the agency's facility, and only any other information that is pertinent to the threat or harassment. The agency or its employees are not civilly liable for the decision to disclose or not, so long as the decision was reached in good faith and without gross negligence. Nothing in this section shall be interpreted as a waiver of sovereign immunity by a tribe.
ii. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
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i. To appropriate corrections and law enforcement agencies, including tribal corrections and law enforcement agencies, all necessary and relevant information in the event of a crisis or emergent situation that poses a significant and imminent risk to the public. The mental health service agency or its employees are not civilly liable for the decision to disclose or not so long as the decision was reached in good faith and without gross negligence.
ii. Disclosure under this subsection is mandatory for the purposes of the health insurance portability and accountability act;
j. To the persons designated in RCW 71.05.425 for the purposes described in those sections;
k. When the person receiving services has been committed for treatment under chapter 71.05 RCW and is subject to a pending criminal charge, in which case the following information may be disclosed to the prosecuting attorney of the jurisdiction in which the criminal charge against the person was filed and to the attorney representing the person in the criminal matter for purposes of coordination between civil and forensic mental health systems:
i. The fact, place, and date of an involuntary commitment and the date of court hearings relating to the commitment;
ii. The anticipated date of discharge or release, and the fact and date of discharge or release; and
iii. The last known address of the person who has been committed;
l. By a care coordinator, including an Indian health care provider, under RCW 71.05.585 or 10.77.575 assigned to a person ordered to receive less restrictive alternative treatment for the purpose of sharing information to parties necessary for the implementation of proceedings under chapter 71.05 or 10.77 RCW;
m. Upon the death of a person. The person's next of kin, personal representative, guardian, or conservator, if any, must be notified. Next of kin who are of legal age and competent must be notified under this section in the following order: Spouse, parents, children, brothers and sisters, and other relatives according to the degree of relation. Access to all records and information compiled, obtained, or maintained in the course of providing services to a deceased patient are governed by RCW 70.02.140;
n. To mark headstones or otherwise memorialize patients interred at state hospital cemeteries. The department of social and health services shall make available the name, date of birth, and date of death of patients buried in state hospital cemeteries 50 years after the death of a patient;
o. To law enforcement officers and to prosecuting attorneys as are necessary to enforce RCW 9.41.040(2)(a)(iii). The extent of information that may be released is limited as follows:
i. Only the fact, place, and date of involuntary commitment, an official copy of any order or orders of commitment, and an official copy of any written or oral notice of ineligibility to possess a firearm that was provided to the person pursuant to RCW 9.41.047(1), must be disclosed upon request;
ii. The law enforcement and prosecuting attorneys may only release the information obtained to the person's attorney as required by court rule and to a jury or judge, if a jury is waived, that presides over any trial at which the person is charged with violating RCW 9.41.040(2)(a)(iii);
iii. Tribal law enforcement officers and tribal prosecuting attorneys who enforce tribal laws or tribal court orders similar to RCW 9.41.040(2)(a)(v) may also receive confidential information in accordance with this subsection;
iv. Disclosure under this subsection is mandatory for the purposes of the federal health insurance portability and accountability act;
p. When a patient would otherwise be subject to the provisions of this section and disclosure is necessary for the protection of the patient or others due to his or her unauthorized disappearance from the facility, and his or her whereabouts is unknown, notice of the disappearance, along with relevant information, may be made to relatives, the department of corrections when the person is under the supervision of the department, and governmental law enforcement agencies designated by the physician or psychiatric advanced practice registered nurse in charge of the patient or the professional person in charge of the facility, or his or her professional designee;
q. Pursuant to lawful order of a court, including a tribal court;
r. To qualified staff members of the department, to the authority, to behavioral health administrative services organizations, to managed care organizations, to resource management services responsible for serving a patient, or to service providers designated by resource management services as necessary to determine the progress and adequacy of treatment and to determine whether the person should be transferred to a less restrictive or more appropriate treatment modality or facility;
s. Within the mental health service agency or Indian health care provider facility where the patient is receiving treatment, confidential information may be disclosed to persons employed, serving in bona fide training programs, or participating in supervised volunteer programs, at the facility when it is necessary to perform their duties;
t. Within the department and the authority as necessary to coordinate treatment for mental illness, developmental disabilities, or substance use disorder of persons who are under the supervision of the department;
u. Between the department of social and health services, the department of children, youth, and families, and the health care authority as necessary to coordinate treatment for mental illness, developmental disabilities, or substance use disorder of persons who are under the supervision of the department of social and health services or the department of children, youth, and families;
v. To a licensed physician or psychiatric advanced practice registered nurse who has determined that the life or health of the person is in danger and that treatment without the information and records related to mental health services could be injurious to the patient's health. Disclosure must be limited to the portions of the records necessary to meet the medical emergency;
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i. Consistent with the requirements of the federal health insurance portability and accountability act, to:
(A) A health care provider, including an Indian health care provider, who is providing care to a patient, or to whom a patient has been referred for evaluation or treatment; or
(B) Any other person who is working in a care coordinator role for a health care facility, health care provider, or Indian health care provider, or is under an agreement pursuant to the federal health insurance portability and accountability act with a health care facility or a health care provider and requires the information and records to assure coordinated care and treatment of that patient.
ii. A person authorized to use or disclose information and records related to mental health services under this subsection (2)(w) must take appropriate steps to protect the information and records relating to mental health services.
iii. Psychotherapy notes may not be released without authorization of the patient who is the subject of the request for release of information;
x. To administrative and office support staff designated to obtain medical records for those licensed professionals listed in (w) of this subsection;
y. To a facility that is to receive a person who is involuntarily committed under chapter 71.05 RCW, or upon transfer of the person from one evaluation and treatment facility to another. The release of records under this subsection is limited to the information and records related to mental health services required by law, a record or summary of all somatic treatments, and a discharge summary. The discharge summary may include a statement of the patient's problem, the treatment goals, the type of treatment which has been provided, and recommendation for future treatment, but may not include the patient's complete treatment record;
z. To the person's counsel or guardian ad litem, without modification, at any time in order to prepare for involuntary commitment or recommitment proceedings, reexaminations, appeals, or other actions relating to detention, admission, commitment, or patient's rights under chapter 71.05 RCW;
aa. To staff members of the protection and advocacy agency or to staff members of a private, nonprofit corporation for the purpose of protecting and advocating the rights of persons with mental disorders or developmental disabilities. Resource management services may limit the release of information to the name, birthdate, and county of residence of the patient, information regarding whether the patient was voluntarily admitted, or involuntarily committed, the date and place of admission, placement, or commitment, the name and address of a guardian of the patient, and the date and place of the guardian's appointment. Any staff member who wishes to obtain additional information must notify the patient's resource management services in writing of the request and of the resource management services' right to object. The staff member shall send the notice by mail to the guardian's address. If the guardian does not object in writing within 15 days after the notice is mailed, the staff member may obtain the additional information. If the guardian objects in writing within 15 days after the notice is mailed, the staff member may not obtain the additional information;
bb. To all current treating providers, including Indian health care providers, of the patient with prescriptive authority who have written a prescription for the patient within the last 12 months. For purposes of coordinating health care, the department or the authority may release without written authorization of the patient, information acquired for billing and collection purposes as described in RCW 70.02.050(1)(d). The department, or the authority, if applicable, shall notify the patient that billing and collection information has been released to named providers, and provide the substance of the information released and the dates of such release. Neither the department nor the authority may release counseling, inpatient psychiatric hospitalization, or drug and alcohol treatment information without a signed written release from the client;
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i. To the secretary of social and health services and the director of the health care authority for either program evaluation or research, or both so long as the secretary or director, where applicable, adopts rules for the conduct of the evaluation or research, or both. Such rules must include, but need not be limited to, the requirement that all evaluators and researchers sign an oath of confidentiality substantially as follows:
"As a condition of conducting evaluation or research concerning persons who have received services from (fill in the facility, agency, or person) I, . . . . . ., agree not to divulge, publish, or otherwise make known to unauthorized persons or the public any information obtained in the course of such evaluation or research regarding persons who have received services such that the person who received such services is identifiable.
I recognize that unauthorized release of confidential information may subject me to civil liability under the provisions of state law.
/s/ . . . . . ."
ii. Nothing in this chapter may be construed to prohibit the compilation and publication of statistical data for use by government or researchers under standards, including standards to assure maintenance of confidentiality, set forth by the secretary, or director, where applicable;
dd. To any person if the conditions in RCW 70.02.205 are met;
ee. To the secretary of health for the purposes of the maternal mortality review panel established in RCW 70.54.450; or
ff. To a tribe or Indian health care provider to carry out the requirements of RCW 71.05.150(5).
Whenever federal law or federal regulations restrict the release of information contained in the information and records related to mental health services of any patient who receives treatment for a substance use disorder, the department or the authority may restrict the release of the information as necessary to comply with federal law and regulations.
Civil liability and immunity for the release of information about a particular person who is committed to the department of social and health services or the authority under RCW 71.05.280(3) and 71.05.320(4)(c) after dismissal of a sex offense as defined in RCW 9.94A.030, is governed by RCW 4.24.550.
The fact of admission to a provider of mental health services, as well as all records, files, evidence, findings, or orders made, prepared, collected, or maintained pursuant to chapter 71.05 RCW are not admissible as evidence in any legal proceeding outside that chapter without the written authorization of the person who was the subject of the proceeding except as provided in RCW 70.02.260, in a subsequent criminal prosecution of a person committed pursuant to RCW 71.05.280(3) or 71.05.320(4)(c) on charges that were dismissed pursuant to chapter 10.77 RCW due to incompetency to stand trial, in a civil commitment proceeding pursuant to chapter 71.09 RCW, or, in the case of a minor, a guardianship or dependency proceeding. The records and files maintained in any court proceeding pursuant to chapter 71.05 RCW must be confidential and available subsequent to such proceedings in accordance with RCW 71.05.620. In addition, the court may order the subsequent release or use of such records or files only upon good cause shown if the court finds that appropriate safeguards for strict confidentiality are and will be maintained.
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Except as provided in RCW 4.24.550, any person may bring an action against an individual who has willfully released confidential information or records concerning him or her in violation of the provisions of this section, for the greater of the following amounts:
$1,000; or
Three times the amount of actual damages sustained, if any.
It is not a prerequisite to recovery under this subsection that the plaintiff suffered or was threatened with special, as contrasted with general, damages.
Any person may bring an action to enjoin the release of confidential information or records concerning him or her or his or her ward, in violation of the provisions of this section, and may in the same action seek damages as provided in this subsection.
The court may award to the plaintiff, should he or she prevail in any action authorized by this subsection, reasonable attorney fees in addition to those otherwise provided by law.
If an action is brought under this subsection, no action may be brought under RCW 70.02.170.
By January 1, 2028, the department shall develop protocols that address when a hospital should summon a designated crisis responder to conduct an evaluation under chapter 71.05 or 71.34 RCW of a patient who presents behaviors or symptoms that indicate the patient may be exhibiting signs of a behavioral health disorder and as a result may pose a danger to self or others or may be gravely disabled. In developing the protocols, the department shall consult with the health care authority, an association that represents designated crisis responders, the Washington state hospital association, and other appropriate stakeholders. The protocols shall address:
Standards for assessing patients who present with behaviors or symptoms that indicate the person may have a mental health disorder, substance use disorder, or co-occurring disorders, including timelines for conducting the assessment; and
Clinical presentations, collateral information, and other circumstances that warrant summoning a designated crisis responder to conduct an evaluation of the patient, and timelines for initiating the summons.
By July 1, 2028, hospitals shall comply with the protocols established by the department under this section. A hospital that fails to summon a designated crisis responder over the objection of a person who has knowledge of the patient's behavior must inform the person of the process for filing a complaint with the department.
The department shall promptly investigate any complaint alleging that a hospital failed to summon a designated crisis responder when warranted, and shall take enforcement action under RCW 70.41.130 if the department determines a hospital failed to summon a designated crisis responder in accordance with standards established in the protocols.
Except for sections 4, 21, 27, 32, 35, and 37 of this act, this act takes effect July 1, 2026.
Sections 3, 20, 31, 34, and 36 of this act expire June 30, 2027.
Sections 4, 21, 32, 35, and 37 of this act take effect June 30, 2027.
Section 26 of this act expires when section 27 of this act takes effect.
Section 27 of this act takes effect when the contingency in section 27, chapter 433, Laws of 2023 takes effect.