Chapter 71.24 RCW

COMMUNITY MENTAL HEALTH SERVICES ACT

Sections

71.24.011Short title.
71.24.015Legislative intent and policy.
71.24.016IntentManagement of services for people with mental disorders.
71.24.025Definitions.
71.24.030Grants, purchasing of services, for community mental health programs.
71.24.035Director's powers and duties as state behavioral health authority.
71.24.037Licensed or certified service providers, residential services, community support servicesMinimum standardsViolation reportingTransfer or sale of behavioral health service to family member.
71.24.045Behavioral health organization powers and duties.
71.24.049Identification by behavioral health organizationChildren's mental health services.
71.24.061Children's mental health providersChildren's mental health evidence-based practice institutePilot programPartnership access line for moms and kidsReport to legislature.
71.24.100Joint agreements of county authoritiesRequired provisions.
71.24.110Joint agreements of county authoritiesPermissive provisions.
71.24.155Grants to behavioral health organizationsAccounting.
71.24.160Proof as to uses made of state fundsUse of maintenance of effort funds.
71.24.200Expenditures of county funds subject to county fiscal laws.
71.24.215Clients to be charged for services.
71.24.220Reimbursement may be withheld for noncompliance with chapter or related rules.
71.24.240County program plans to be approved by director prior to submittal to federal agency.
71.24.250Behavioral health organizationsGifts and grants.
71.24.260Waiver of postgraduate educational requirements.
71.24.300Behavioral health organizationsInclusion of tribal authoritiesRoles and responsibilities.
71.24.310Administration of chapters 71.05 and 71.24 RCW through behavioral health organizationsImplementation of chapter 71.05 RCW.
71.24.320Behavioral health organizationsProcurement processPenalty for voluntary termination or refusal to renew contract.
71.24.330Behavioral health organizationsContracts with authorityRequirements.
71.24.335Behavioral health organizationsProvider reimbursementRequirementsProcedureDefinitions.
71.24.340Behavioral health organizationsAgreements with city and county jails.
71.24.350Behavioral health ombuds office.
71.24.360Establishment of new behavioral health organizations.
71.24.370Behavioral health organizations contractsLimitation on state liability.
71.24.380Purchase of mental health and chemical dependency treatment servicesManaged care contractingDetailed plan.
71.24.382Mental health and chemical dependency treatment providers and programsVendor rate increases.
71.24.385Behavioral health organizationsMental disorder program development.
71.24.400Streamlining delivery systemFinding.
71.24.405Streamlining delivery system.
71.24.415Streamlining delivery systemAuthority duties to achieve outcomes.
71.24.420Expenditure of federal funds.
71.24.430Collaborative service delivery.
71.24.450Offenders with mental illnessesFindings and intent.
71.24.455Offenders with mental illnessesContracts for specialized access and services.
71.24.460Offenders with mental illnessesReport to legislatureContingent termination of program.
71.24.470Offenders with mental illness who are believed to be dangerousContract for case managementUse of appropriated funds.
71.24.480Offenders with mental illness who are believed to be dangerousLimitation on liability due to treatmentReporting requirements.
71.24.490Evaluation and treatment servicesCapacity needsRegional support network or behavioral health organization.
71.24.500Written guidance and trainingsManaged careIncarcerated and involuntarily hospitalized persons.
71.24.510Integrated comprehensive screening and assessment processImplementation.
71.24.515Chemical dependency specialist servicesTo be available at children and family services officesTraining in uniform screening.
71.24.520Chemical dependency program authority.
71.24.525Agreements authorized under the interlocal cooperation act.
71.24.530Local funding and donative funding requirementsFacilities, plans, programs.
71.24.535Duties of authority.
71.24.540Drug courts.
71.24.545Comprehensive program for treatmentRegional facilities.
71.24.550City, town, or county without facilityContribution of liquor taxes prerequisite to use of another's facility.
71.24.555Liquor taxes and profitsCity and county eligibility conditioned.
71.24.560Opioid treatment programsPregnant womenInformation and education.
71.24.565Acceptance for approved treatmentRules.
71.24.570Emergency service patrolEstablishmentRules.
71.24.575Criminal laws limitations.
71.24.580Criminal justice treatment account.
71.24.582Review of expenditures for drug and alcohol treatment.
71.24.585Opioid use disorder treatmentDeclaration of regulation by state.
71.24.587Opioid use disorder treatmentPossession or use of lawfully prescribed medicationDeclaration by state.
71.24.590Opioid treatmentProgram licensing or certification by department, department dutiesDefinition.
71.24.595Statewide treatment and operating standards for opioid treatment programsEvaluation and report.
71.24.600Inability to contribute to cost no bar to admissionAuthority may limit admissions.
71.24.605Fetal alcohol screening and assessment services.
71.24.610Interagency agreement on fetal alcohol exposure programs.
71.24.615Chemical dependency treatment expendituresPrioritization.
71.24.620Persons with substance use disordersIntensive case management pilot projects.
71.24.625Uniform application of chapterTraining for behavioral health organization-designated chemical dependency specialists.
71.24.630Integrated, comprehensive screening and assessment process for substance use and mental disorders.
71.24.640Standards for certification or licensure of evaluation and treatment facilities.
71.24.645Standards for certification or licensure of crisis stabilization units.
71.24.647Standards for certification or licensure of triage facilities.
71.24.650Standards for certification or licensure of a clubhouse.
71.24.805Mental health system reviewPerformance audit recommendations affirmed.
71.24.810Mental health system reviewImplementation of performance audit recommendations.
71.24.840Mental health system reviewStudy of long-term outcomes.
71.24.845Behavioral health organizationsTransfers between organizations.
71.24.850Regional service areasReportManaged care integration.
71.24.855FindingIntentState hospitals.
71.24.860Task forceIntegrated behavioral health services.
71.24.870Behavioral health servicesReview of rules, policies, and procedures by departmentAdoption of rulesAudit.
71.24.880Interlocal leadership structureTransition to fully integrated managed care within a regional service area.
71.24.902Construction.

NOTES:

Reviser's note: The department of social and health services filed an emergency order, WSR 89-20-030, effective October 1, 1989, establishing rules for the recognition and certification of regional support networks. A final order was filed on January 24, 1990, effective January 25, 1990.
Comprehensive community health centers: Chapter 70.10 RCW.
Funding: RCW 43.79.201 and 79.02.410.


Short title.

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This chapter may be known and cited as the community mental health services act.



Legislative intent and policy.

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It is the intent of the legislature to establish a community mental health program which shall help people experiencing mental illness to retain a respected and productive position in the community. This will be accomplished through programs that focus on resilience and recovery, and practices that are evidence-based, research-based, consensus-based, or, where these do not exist, promising or emerging best practices, which provide for:
(1) Access to mental health services for adults with mental illness and children with mental illness or emotional disturbances who meet access to care standards which services recognize the special needs of underserved populations, including minorities, children, older adults, individuals with disabilities, and low-income persons. Access to mental health services shall not be limited by a person's history of confinement in a state, federal, or local correctional facility. It is also the purpose of this chapter to promote the early identification of children with mental illness and to ensure that they receive the mental health care and treatment which is appropriate to their developmental level. This care should improve home, school, and community functioning, maintain children in a safe and nurturing home environment, and should enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment while also recognizing parents' rights to participate in treatment decisions for their children;
(2) The involvement of persons with mental illness, their family members, and advocates in designing and implementing mental health services that reduce unnecessary hospitalization and incarceration and promote the recovery and employment of persons with mental illness. To improve the quality of services available and promote the rehabilitation, recovery, and reintegration of persons with mental illness, consumer and advocate participation in mental health services is an integral part of the community mental health system and shall be supported;
(3) Accountability of efficient and effective services through state-of-the-art outcome and performance measures and statewide standards for monitoring client and system outcomes, performance, and reporting of client and system outcome information. These processes shall be designed so as to maximize the use of available resources for direct care of people with a mental illness and to assure uniform data collection across the state;
(4) Minimum service delivery standards;
(5) Priorities for the use of available resources for the care of individuals with mental illness consistent with the priorities defined in the statute;
(6) Coordination of services within the department of social and health services, including those divisions within the department of social and health services that provide services to children, between the authority, department of social and health services, and the office of the superintendent of public instruction, and among state mental hospitals, county authorities, behavioral health organizations, community mental health services, and other support services, which shall to the maximum extent feasible also include the families of individuals with mental illness, and other service providers; and
(7) Coordination of services aimed at reducing duplication in service delivery and promoting complementary services among all entities that provide mental health services to adults and children.
It is the policy of the state to encourage the provision of a full range of treatment and rehabilitation services in the state for mental disorders including services operated by consumers and advocates. The legislature intends to encourage the development of regional mental health services with adequate local flexibility to assure eligible people in need of care access to the least-restrictive treatment alternative appropriate to their needs, and the availability of treatment components to assure continuity of care. To this end, counties must enter into joint operating agreements with other counties to form regional systems of care that are consistent with the regional service areas established under RCW 74.09.870. Regional systems of care, whether operated by a county, group of counties, or another entity shall integrate planning, administration, and service delivery duties under chapter 71.05 RCW and this chapter to consolidate administration, reduce administrative layering, and reduce administrative costs. The legislature hereby finds and declares that sound fiscal management requires vigilance to ensure that funds appropriated by the legislature for the provision of needed community mental health programs and services are ultimately expended solely for the purpose for which they were appropriated, and not for any other purpose.
It is further the intent of the legislature to integrate the provision of services to provide continuity of care through all phases of treatment. To this end, the legislature intends to promote active engagement with persons with mental illness and collaboration between families and service providers.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Correction of references2005 c 503: "The code reviser shall replace all references to "county designated mental health professional" with "designated mental health professional" in the Revised Code of Washington." [ 2005 c 503 § 16.]
Savings2005 c 503: "This act does not affect any existing right acquired or liability or obligation incurred under the sections amended or repealed in this act or under any rule or order adopted under those sections, nor does it affect any proceeding instituted under those sections." [ 2005 c 503 § 17.]
Severability2005 c 503: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 2005 c 503 § 18.]
Effective date2001 c 334: See note following RCW 71.24.805.
IntentEffective date1999 c 214: See notes following RCW 72.09.370.
Conflict with federal requirements1991 c 306: "If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. The rules under this act shall meet federal requirements that are a necessary condition to the receipt of federal funds by the state.
However, if any part of this act conflicts with such federal requirements, the state appropriation for mental health services provided to children whose mental disorders are discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program shall be provided through the division of medical assistance and no state funds appropriated to the division of mental health shall be expended or transferred for this purpose." [ 1991 c 306 § 7.]
Effective date1986 c 274 §§ 1, 2, 3, 5, and 9: "Sections 1, 2, 3, 5, and 9 of this act shall take effect on July 1, 1987." [ 1986 c 274 § 11.]



IntentManagement of services for people with mental disorders.

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(1) The legislature intends that eastern and western state hospitals shall operate as clinical centers for handling the most complicated long-term care needs of patients with a primary diagnosis of mental disorder. It is further the intent of the legislature that the community mental health service delivery system focus on maintaining individuals with mental illness in the community. The program shall be evaluated and managed through a limited number of outcome and performance measures, as provided in RCW 43.20A.895, 70.320.020, and 71.36.025.
(2) The legislature intends to address the needs of people with mental disorders with a targeted, coordinated, and comprehensive set of evidence-based practices that are effective in serving individuals in their community and will reduce the need for placements in state mental hospitals. The legislature further intends to explicitly hold behavioral health organizations accountable for serving people with mental disorders within the boundaries of their regional service area and for not exceeding their allocation of state hospital beds.

NOTES:

Effective date2014 c 225: "Sections 7, 10, 13 through 54, 56 through 84, and 86 through 104 of this act take effect April 1, 2016." [ 2014 c 225 § 112.]
FindingPurposeIntent2006 c 333: "(1) The legislature finds that ambiguities have been identified regarding the appropriation and allocation of federal and state funds, and the responsibilities of the department of social and health services and the regional support networks with regard to the provision of inpatient mental health services under the community mental health services act, chapter 71.24 RCW, and the involuntary treatment act, chapter 71.05 RCW. The purpose of this 2006 act is to make retroactive, remedial, curative, and technical amendments in order to resolve such ambiguities.
(2) In enacting the community mental health services act, the legislature intended the relationship between the state and the regional support networks to be governed solely by the terms of the regional support network contracts and did not intend these relationships to create statutory causes of action not expressly provided for in the contracts. Therefore, the legislature's intent is that, except to the extent expressly provided in contracts entered after March 29, 2006, the department of social and health services and regional support networks shall resolve existing and future disagreements regarding the subject matter identified in sections 103 and 301 of this act through nonjudicial means." [ 2006 c 333 § 101.]
Severability2006 c 333: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 2006 c 333 § 402.]
Part headings not law2006 c 333: "Part headings used in this act are not part of the law." [ 2006 c 333 § 403.]
Effective dates2006 c 333: "This act takes effect July 1, 2006, except that sections 101 through 103, 107, 202, and 301 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and take effect immediately [March 29, 2006]." [ 2006 c 333 § 404.]



Definitions.

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Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
(1) "Acutely mentally ill" means a condition which is limited to a short-term severe crisis episode of:
(a) A mental disorder as defined in RCW 71.05.020 or, in the case of a child, as defined in RCW 71.34.020;
(b) Being gravely disabled as defined in RCW 71.05.020 or, in the case of a child, a gravely disabled minor as defined in RCW 71.34.020; or
(c) Presenting a likelihood of serious harm as defined in RCW 71.05.020 or, in the case of a child, as defined in RCW 71.34.020.
(2) "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.
(3) "Approved substance use disorder treatment program" means a program for persons with a substance use disorder provided by a treatment program licensed or certified by the department as meeting standards adopted under this chapter.
(4) "Authority" means the Washington state health care authority.
(5) "Available resources" means funds appropriated for the purpose of providing community mental health programs, federal funds, except those provided according to Title XIX of the Social Security Act, and state funds appropriated under this chapter or chapter 71.05 RCW by the legislature during any biennium for the purpose of providing residential services, resource management services, community support services, and other mental health services. This does not include funds appropriated for the purpose of operating and administering the state psychiatric hospitals.
(6) "Behavioral health organization" means any county authority or group of county authorities or other entity recognized by the director in contract in a defined region.
(7) "Behavioral health program" means all expenditures, services, activities, or programs, including reasonable administration and overhead, designed and conducted to prevent or treat chemical dependency and mental illness.
(8) "Behavioral health services" means mental health services as described in this chapter and chapter 71.36 RCW and substance use disorder treatment services as described in this chapter.
(9) "Child" means a person under the age of eighteen years.
(10) "Chronically mentally ill adult" or "adult who is chronically mentally ill" means an adult who has a mental disorder and meets at least one of the following criteria:
(a) Has undergone two or more episodes of hospital care for a mental disorder within the preceding two years; or
(b) Has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding year; or
(c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than twelve months. "Substantial gainful activity" shall be defined by the authority by rule consistent with Public Law 92-603, as amended.
(11) "Clubhouse" means a community-based program that provides rehabilitation services and is licensed or certified by the department.
(12) "Community mental health service delivery system" means public, private, or tribal agencies that provide services specifically to persons with mental disorders as defined under RCW 71.05.020 and receive funding from public sources.
(13) "Community support services" means services authorized, planned, and coordinated through resource management services including, at a minimum, assessment, diagnosis, emergency crisis intervention available twenty-four hours, seven days a week, prescreening determinations for persons who are mentally ill being considered for placement in nursing homes as required by federal law, screening for patients being considered for admission to residential services, diagnosis and treatment for children who are acutely mentally ill or severely emotionally disturbed discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program, investigation, legal, and other nonresidential services under chapter 71.05 RCW, case management services, psychiatric treatment including medication supervision, counseling, psychotherapy, assuring transfer of relevant patient information between service providers, recovery services, and other services determined by behavioral health organizations.
(14) "Consensus-based" means a program or practice that has general support among treatment providers and experts, based on experience or professional literature, and may have anecdotal or case study support, or that is agreed but not possible to perform studies with random assignment and controlled groups.
(15) "County authority" means the board of county commissioners, county council, or county executive having authority to establish a community mental health program, or two or more of the county authorities specified in this subsection which have entered into an agreement to provide a community mental health program.
(16) "Department" means the department of health.
(17) "Designated crisis responder" means a mental health professional designated by the county or other authority authorized in rule to perform the duties specified in this chapter.
(18) "Director" means the director of the authority.
(19) "Drug addiction" means a disease characterized by a dependency on psychoactive chemicals, 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.
(20) "Early adopter" means a regional service area for which all of the county authorities have requested that the authority purchase medical and behavioral health services through a managed care health system as defined under RCW 71.24.380(6).
(21) "Emerging best practice" or "promising practice" means a program or practice that, based on statistical analyses or a well established theory of change, shows potential for meeting the evidence-based or research-based criteria, which may include the use of a program that is evidence-based for outcomes other than those listed in subsection (22) of this section.
(22) "Evidence-based" means a program or practice that has been tested in heterogeneous or intended populations with multiple randomized, or statistically controlled evaluations, or both; or one large multiple site randomized, or statistically controlled evaluation, or both, where the weight of the evidence from a systemic review demonstrates sustained improvements in at least one outcome. "Evidence-based" also means a program or practice that can be implemented with a set of procedures to allow successful replication in Washington and, when possible, is determined to be cost-beneficial.
(23) "Licensed physician" means a person licensed to practice medicine or osteopathic medicine and surgery in the state of Washington.
(24) "Licensed or certified service provider" means an entity licensed or certified according to this chapter or chapter 71.05 RCW or an entity deemed to meet state minimum standards as a result of accreditation by a recognized behavioral health accrediting body recognized and having a current agreement with the department, or tribal attestation that meets state minimum standards, or persons licensed under chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, or 18.79 RCW, as it applies to registered nurses and advanced registered nurse practitioners.
(25) "Long-term inpatient care" means inpatient services for persons committed for, or voluntarily receiving intensive treatment for, periods of ninety days or greater under chapter 71.05 RCW. "Long-term inpatient care" as used in this chapter does not include: (a) Services for individuals committed under chapter 71.05 RCW who are receiving services pursuant to a conditional release or a court-ordered less restrictive alternative to detention; or (b) services for individuals voluntarily receiving less restrictive alternative treatment on the grounds of the state hospital.
(26) "Mental health services" means all services provided by behavioral health organizations and other services provided by the state for persons who are mentally ill.
(27) Mental health "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 of social and health services or the authority, by behavioral health organizations and their staffs, or by treatment facilities. "Treatment records" do not include notes or records maintained for personal use by a person providing treatment services for the department of social and health services, behavioral health organizations, or a treatment facility if the notes or records are not available to others.
(28) "Mentally ill persons," "persons who are mentally ill," and "the mentally ill" mean persons and conditions defined in subsections (1), (10), (36), and (37) of this section.
(29) "Recovery" means the process in which people are able to live, work, learn, and participate fully in their communities.
(30) "Registration records" include all the records of the department of social and health services, the authority, behavioral health organizations, treatment facilities, and other persons providing services for the department of social and health services, the authority, county departments, or facilities which identify persons who are receiving or who at any time have received services for mental illness.
(31) "Research-based" means a program or practice that has been tested with a single randomized, or statistically controlled evaluation, or both, demonstrating sustained desirable outcomes; or where the weight of the evidence from a systemic review supports sustained outcomes as described in subsection (22) of this section but does not meet the full criteria for evidence-based.
(32) "Residential services" means a complete range of residences and supports authorized by resource management services and which may involve a facility, a distinct part thereof, or services which support community living, for persons who are acutely mentally ill, adults who are chronically mentally ill, children who are severely emotionally disturbed, or adults who are seriously disturbed and determined by the behavioral health organization to be at risk of becoming acutely or chronically mentally ill. The services shall include at least evaluation and treatment services as defined in chapter 71.05 RCW, acute crisis respite care, long-term adaptive and rehabilitative care, and supervised and supported living services, and shall also include any residential services developed to service persons who are mentally ill in nursing homes, residential treatment facilities, assisted living facilities, and adult family homes, and may include outpatient services provided as an element in a package of services in a supported housing model. Residential services for children in out-of-home placements related to their mental disorder shall not include the costs of food and shelter, except for children's long-term residential facilities existing prior to January 1, 1991.
(33) "Resilience" means the personal and community qualities that enable individuals to rebound from adversity, trauma, tragedy, threats, or other stresses, and to live productive lives.
(34) "Resource management services" mean the planning, coordination, and authorization of residential services and community support services administered pursuant to an individual service plan for: (a) Adults and children who are acutely mentally ill; (b) adults who are chronically mentally ill; (c) children who are severely emotionally disturbed; or (d) adults who are seriously disturbed and determined solely by a behavioral health organization to be at risk of becoming acutely or chronically mentally ill. Such planning, coordination, and authorization shall include mental health screening for children eligible under the federal Title XIX early and periodic screening, diagnosis, and treatment program. Resource management services include seven day a week, twenty-four hour a day availability of information regarding enrollment of adults and children who are mentally ill in services and their individual service plan to designated crisis responders, evaluation and treatment facilities, and others as determined by the behavioral health organization.
(35) "Secretary" means the secretary of the department of health.
(36) "Seriously disturbed person" means a person who:
(a) Is gravely disabled or presents a likelihood of serious harm to himself or herself or others, or to the property of others, as a result of a mental disorder as defined in chapter 71.05 RCW;
(b) Has been on conditional release status, or under a less restrictive alternative order, at some time during the preceding two years from an evaluation and treatment facility or a state mental health hospital;
(c) Has a mental disorder which causes major impairment in several areas of daily living;
(d) Exhibits suicidal preoccupation or attempts; or
(e) Is a child diagnosed by a mental health professional, as defined in chapter 71.34 RCW, as experiencing a mental disorder which is clearly interfering with the child's functioning in family or school or with peers or is clearly interfering with the child's personality development and learning.
(37) "Severely emotionally disturbed child" or "child who is severely emotionally disturbed" means a child who has been determined by the behavioral health organization to be experiencing a mental disorder as defined in chapter 71.34 RCW, including those mental disorders that result in a behavioral or conduct disorder, that is clearly interfering with the child's functioning in family or school or with peers and who meets at least one of the following criteria:
(a) Has undergone inpatient treatment or placement outside of the home related to a mental disorder within the last two years;
(b) Has undergone involuntary treatment under chapter 71.34 RCW within the last two years;
(c) Is currently served by at least one of the following child-serving systems: Juvenile justice, child-protection/welfare, special education, or developmental disabilities;
(d) Is at risk of escalating maladjustment due to:
(i) Chronic family dysfunction involving a caretaker who is mentally ill or inadequate;
(ii) Changes in custodial adult;
(iii) Going to, residing in, or returning from any placement outside of the home, for example, psychiatric hospital, short-term inpatient, residential treatment, group or foster home, or a correctional facility;
(iv) Subject to repeated physical abuse or neglect;
(v) Drug or alcohol abuse; or
(vi) Homelessness.
(38) "State minimum standards" means minimum requirements established by rules adopted and necessary to implement this chapter by:
(a) The authority for:
(i) Delivery of mental health and substance use disorder services; and
(ii) Community support services and resource management services;
(b) The department of health for:
(i) Licensed or certified service providers for the provision of mental health and substance use disorder services; and
(ii) Residential services.
(39) "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.
(40) "Tribal authority," for the purposes of this section and RCW 71.24.300 only, means: The federally recognized Indian tribes and the major Indian organizations recognized by the director insofar as these organizations do not have a financial relationship with any behavioral health organization that would present a conflict of interest.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
Application2012 c 10: See note following RCW 18.20.010.
IntentFindings2008 c 261: See note following RCW 71.24.320.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.
PurposeIntent1999 c 10: "The purpose of this act is to eliminate dates and provisions in chapter 71.24 RCW which are no longer needed. The legislature does not intend this act to make, and no provision of this act shall be construed as, a substantive change in the service delivery system or funding of the community mental health services law." [ 1999 c 10 § 1.]
Alphabetization of section1999 c 10 § 2: "The code reviser shall alphabetize the definitions in RCW 71.24.025 and correct any cross-references." [ 1999 c 10 § 14.]
Effective date1995 c 96: See note following RCW 71.24.400.
SeverabilityHeadings and captions not lawEffective date1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Conflict with federal requirements1991 c 306: See note following RCW 71.24.015.
Effective date1986 c 274 §§ 1, 2, 3, 5, and 9: See note following RCW 71.24.015.



Grants, purchasing of services, for community mental health programs.

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The director is authorized to make grants and/or purchase services from counties, combinations of counties, or other entities, to establish and operate community mental health programs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Effective date1972 ex.s. c 122: "Chapter 122, Laws of 1972 extraordinary session shall be effective January 1, 1975." [ 1973 c 92 § 1; 1972 ex.s. c 122 § 31.]



Director's powers and duties as state behavioral health authority.

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(1) The authority is designated as the state behavioral health authority which includes recognition as the single state authority for substance use disorders and state mental health authority.
(2) The director shall provide for public, client, tribal, and licensed or certified service provider participation in developing the state behavioral health program, developing contracts with behavioral health organizations, and any waiver request to the federal government under medicaid.
(3) The director shall provide for participation in developing the state behavioral health program for children and other underserved populations, by including representatives on any committee established to provide oversight to the state behavioral health program.
(4) The director shall be designated as the behavioral health organization if the behavioral health organization fails to meet state minimum standards or refuses to exercise responsibilities under its contract or RCW 71.24.045, until such time as a new behavioral health organization is designated.
(5) The director shall:
(a) Develop a biennial state behavioral health program that incorporates regional biennial needs assessments and regional mental health service plans and state services for adults and children with mental disorders or substance use disorders or both;
(b) Assure that any behavioral health organization or county community behavioral health program provides medically necessary services to medicaid recipients consistent with the state's medicaid state plan or federal waiver authorities, and nonmedicaid services consistent with priorities established by the authority;
(c) Develop and adopt rules establishing state minimum standards for the delivery of behavioral health services pursuant to RCW 71.24.037 including, but not limited to:
(i) Licensed or certified service providers. These rules shall permit a county-operated behavioral health program to be licensed as a service provider subject to compliance with applicable statutes and rules.
(ii) Inpatient services, an adequate network of evaluation and treatment services and facilities under chapter 71.05 RCW to ensure access to treatment, resource management services, and community support services;
(d) Assure that the special needs of persons who are minorities, elderly, disabled, children, low-income, and parents who are respondents in dependency cases are met within the priorities established in this section;
(e) Establish a standard contract or contracts, consistent with state minimum standards which shall be used in contracting with behavioral health organizations. The standard contract shall include a maximum fund balance, which shall be consistent with that required by federal regulations or waiver stipulations;
(f) Make contracts necessary or incidental to the performance of its duties and the execution of its powers, including managed care contracts for behavioral health services, contracts entered into under RCW 74.09.522, and contracts with public and private agencies, organizations, and individuals to pay them for behavioral health services;
(g) Establish, to the extent possible, a standardized auditing procedure which is designed to assure compliance with contractual agreements authorized by this chapter and minimizes paperwork requirements of behavioral health organizations and licensed or certified service providers. The audit procedure shall focus on the outcomes of service as provided in RCW 43.20A.895, 70.320.020, and 71.36.025;
(h) Develop and maintain an information system to be used by the state and behavioral health organizations that includes a tracking method which allows the authority and behavioral health organizations to identify behavioral health clients' participation in any behavioral health service or public program on an immediate basis. The information system shall not include individual patient's case history files. Confidentiality of client information and records shall be maintained as provided in this chapter and chapter 70.02 RCW;
(i) Periodically monitor the compliance of behavioral health organizations and their network of licensed or certified service providers for compliance with the contract between the authority, the behavioral health organization, and federal and state rules at reasonable times and in a reasonable manner;
(j) Monitor and audit behavioral health organizations as needed to assure compliance with contractual agreements authorized by this chapter;
(k) Adopt such rules as are necessary to implement the authority's responsibilities under this chapter; and
(l) Administer or supervise the administration of the provisions relating to persons with substance use disorders and intoxicated persons of any state plan submitted for federal funding pursuant to federal health, welfare, or treatment legislation.
(6) The director shall use available resources only for behavioral health organizations, except:
(a) To the extent authorized, and in accordance with any priorities or conditions specified, in the biennial appropriations act; or
(b) To incentivize improved performance with respect to the client outcomes established in RCW 43.20A.895, 70.320.020, and 71.36.025, integration of behavioral health and medical services at the clinical level, and improved care coordination for individuals with complex care needs.
(7) Each behavioral health organization and licensed or certified service provider shall file with the secretary of the department of health or the director, on request, such data, statistics, schedules, and information as the secretary of the department of health or the director reasonably requires. A behavioral health organization or licensed or certified service provider which, without good cause, fails to furnish any data, statistics, schedules, or information as requested, or files fraudulent reports thereof, may be subject to the behavioral health organization contractual remedies in RCW 74.09.871 or may have its service provider certification or license revoked or suspended.
(8) The superior court may restrain any behavioral health organization or service provider from operating without a contract, certification, or a license or any other violation of this section. The court may also review, pursuant to procedures contained in chapter 34.05 RCW, any denial, suspension, limitation, restriction, or revocation of certification or license, and grant other relief required to enforce the provisions of this chapter.
(9) Upon petition by the secretary of the department of health or the director, and after hearing held upon reasonable notice to the facility, the superior court may issue a warrant to an officer or employee of the secretary of the department of health or the director authorizing him or her to enter at reasonable times, and examine the records, books, and accounts of any behavioral health organization or service provider refusing to consent to inspection or examination by the authority.
(10) Notwithstanding the existence or pursuit of any other remedy, the secretary of the department of health or the director may file an action for an injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, or operation of a behavioral health organization or service provider without a contract, certification, or a license under this chapter.
(11) The authority shall distribute appropriated state and federal funds in accordance with any priorities, terms, or conditions specified in the appropriations act.
(12) The director shall assume all duties assigned to the nonparticipating behavioral health organizations under chapters 71.05 and 71.34 RCW and this chapter. Such responsibilities shall include those which would have been assigned to the nonparticipating counties in regions where there are not participating behavioral health organizations.
The behavioral health organizations, or the director's assumption of all responsibilities under chapters 71.05 and 71.34 RCW and this chapter, shall be included in all state and federal plans affecting the state behavioral health program including at least those required by this chapter, the medicaid program, and P.L. 99-660. Nothing in these plans shall be inconsistent with the intent and requirements of this chapter.
(13) The director shall:
(a) Disburse funds for the behavioral health organizations within sixty days of approval of the biennial contract. The authority must either approve or reject the biennial contract within sixty days of receipt.
(b) Enter into biennial contracts with behavioral health organizations. The contracts shall be consistent with available resources. No contract shall be approved that does not include progress toward meeting the goals of this chapter by taking responsibility for: (i) Short-term commitments; (ii) residential care; and (iii) emergency response systems.
(c) Notify behavioral health organizations of their allocation of available resources at least sixty days prior to the start of a new biennial contract period.
(d) Deny all or part of the funding allocations to behavioral health organizations based solely upon formal findings of noncompliance with the terms of the behavioral health organization's contract with the authority. Behavioral health organizations disputing the decision of the director to withhold funding allocations are limited to the remedies provided in the authority's contracts with the behavioral health organizations.
(14) The authority, in cooperation with the state congressional delegation, shall actively seek waivers of federal requirements and such modifications of federal regulations as are necessary to allow federal medicaid reimbursement for services provided by freestanding evaluation and treatment facilities licensed under chapter 71.12 RCW or certified under chapter 71.05 RCW. The authority shall periodically report its efforts to the appropriate committees of the senate and the house of representatives.
(15) The authority may:
(a) Plan, establish, and maintain substance use disorder prevention and substance use disorder treatment programs as necessary or desirable;
(b) Coordinate its activities and cooperate with behavioral programs in this and other states, and make contracts and other joint or cooperative arrangements with state, local, or private agencies in this and other states for behavioral health services and for the common advancement of substance use disorder programs;
(c) Solicit and accept for use any gift of money or property made by will or otherwise, and any grant of money, services, or property from the federal government, the state, or any political subdivision thereof or any private source, and do all things necessary to cooperate with the federal government or any of its agencies in making an application for any grant;
(d) Keep records and engage in research and the gathering of relevant statistics; and
(e) Acquire, hold, or dispose of real property or any interest therein, and construct, lease, or otherwise provide substance use disorder treatment programs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2015 c 269 §§ 1-9 and 11-13: See note following RCW 71.05.010.
Effective date2013 c 200: See note following RCW 70.02.010.
Certification of triage facilitiesEffective date2011 c 148: See notes following RCW 71.05.020.
IntentFindings2008 c 261: See note following RCW 71.24.320.
Short title2007 c 410: See note following RCW 13.34.138.
FindingsPurposeConstructionSeverability2007 c 375: See notes following RCW 10.31.110.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.
Effective date2001 c 334: See note following RCW 71.24.805.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Conflict with federal requirements1991 c 306: See note following RCW 71.24.015.
Effective date1987 c 105: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect July 1, 1987." [ 1987 c 105 § 2.]
Effective date1986 c 274 §§ 1, 2, 3, 5, and 9: See note following RCW 71.24.015.



Licensed or certified service providers, residential services, community support servicesMinimum standardsViolation reportingTransfer or sale of behavioral health service to family member.

*** CHANGE IN 2019 *** (SEE 1907-S2.SL) ***
*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The secretary shall by rule establish state minimum standards for licensed or certified behavioral health service providers and services, whether those service providers and services are licensed or certified to provide solely mental health services, substance use disorder treatment services, or services to persons with co-occurring disorders.
(2) Minimum standards for licensed or certified behavioral health service providers shall, at a minimum, establish: Qualifications for staff providing services directly to persons with mental disorders, substance use disorders, or both, the intended result of each service, and the rights and responsibilities of persons receiving behavioral health services pursuant to this chapter. The secretary shall provide for deeming of licensed or certified behavioral health service providers as meeting state minimum standards as a result of accreditation by a recognized behavioral health accrediting body recognized and having a current agreement with the department.
(3) Minimum standards for community support services and resource management services shall include at least qualifications for resource management services, client tracking systems, and the transfer of patient information between behavioral health service providers.
(4) The department may suspend, revoke, limit, restrict, or modify an approval, or refuse to grant approval, for failure to meet the provisions of this chapter, or the standards adopted under this chapter. RCW 43.70.115 governs notice of a license or certification denial, revocation, suspension, or modification and provides the right to an adjudicative proceeding.
(5) No licensed or certified behavioral health service provider may advertise or represent itself as a licensed or certified behavioral health service provider if approval has not been granted, has been denied, suspended, revoked, or canceled.
(6) Licensure or certification as a behavioral health service provider is effective for one calendar year from the date of issuance of the license or certification. The license or certification must specify the types of services provided by the behavioral health service provider that meet the standards adopted under this chapter. Renewal of a license or certification must be made in accordance with this section for initial approval and in accordance with the standards set forth in rules adopted by the secretary.
(7) Licensure or certification as a licensed or certified behavioral health service provider must specify the types of services provided that meet the standards adopted under this chapter. Renewal of a license or certification must be made in accordance with this section for initial approval and in accordance with the standards set forth in rules adopted by the secretary.
(8) Licensed or certified behavioral health service providers may not provide types of services for which the licensed or certified behavioral health service provider has not been certified. Licensed or certified behavioral health service providers may provide services for which approval has been sought and is pending, if approval for the services has not been previously revoked or denied.
(9) The department periodically shall inspect licensed or certified behavioral health service providers at reasonable times and in a reasonable manner.
(10) Upon petition of the department and after a hearing held upon reasonable notice to the facility, the superior court may issue a warrant to an officer or employee of the department authorizing him or her to enter and inspect at reasonable times, and examine the books and accounts of, any licensed or certified behavioral health service provider refusing to consent to inspection or examination by the department or which the department has reasonable cause to believe is operating in violation of this chapter.
(11) The department shall maintain and periodically publish a current list of licensed or certified behavioral health service providers.
(12) Each licensed or certified behavioral health service provider shall file with the department or the authority upon request, data, statistics, schedules, and information the department or the authority reasonably requires. A licensed or certified behavioral health service provider that without good cause fails to furnish any data, statistics, schedules, or information as requested, or files fraudulent returns thereof, may have its license or certification revoked or suspended.
(13) The authority shall use the data provided in subsection (12) of this section to evaluate each program that admits children to inpatient substance use disorder treatment upon application of their parents. The evaluation must be done at least once every twelve months. In addition, the authority shall randomly select and review the information on individual children who are admitted on application of the child's parent for the purpose of determining whether the child was appropriately placed into substance use disorder treatment based on an objective evaluation of the child's condition and the outcome of the child's treatment.
(14) Any settlement agreement entered into between the department and licensed or certified behavioral health service providers to resolve administrative complaints, license or certification violations, license or certification suspensions, or license or certification revocations may not reduce the number of violations reported by the department unless the department concludes, based on evidence gathered by inspectors, that the licensed or certified behavioral health service provider did not commit one or more of the violations.
(15) In cases in which a behavioral health service provider that is in violation of licensing or certification standards attempts to transfer or sell the behavioral health service provider to a family member, the transfer or sale may only be made for the purpose of remedying license or certification violations and achieving full compliance with the terms of the license or certification. Transfers or sales to family members are prohibited in cases in which the purpose of the transfer or sale is to avoid liability or reset the number of license or certification violations found before the transfer or sale. If the department finds that the owner intends to transfer or sell, or has completed the transfer or sale of, ownership of the behavioral health service provider to a family member solely for the purpose of resetting the number of violations found before the transfer or sale, the department may not renew the behavioral health service provider's license or certification or issue a new license or certification to the behavioral health service provider.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Finding2017 c 330: "The state finds that the department should not reduce the number of license violations found by field inspectors for the purpose of allowing licensed behavioral health service providers to avoid liability in a manner that permits the violating service provider to continue to provide care at the risk of public safety. The state also recognizes the need to prohibit fraudulent transfers of licenses between licensed behavioral health service providers found in violation of the terms of their license agreement and their family members." [ 2017 c 330 § 1.]
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
PurposeIntent1999 c 10: See note following RCW 71.24.025.



Behavioral health organization powers and duties.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The behavioral health organization shall:
(1) Contract as needed with licensed or certified service providers. The behavioral health organization may, in the absence of a licensed or certified service provider entity, become a licensed or certified service provider entity pursuant to minimum standards required for licensing or certification by the department for the purpose of providing services not available from licensed or certified service providers;
(2) Operate as a licensed or certified service provider if it deems that doing so is more efficient and cost effective than contracting for services. When doing so, the behavioral health organization shall comply with rules adopted by the director that shall provide measurements to determine when a behavioral health organization provided service is more efficient and cost effective;
(3) Monitor and perform biennial fiscal audits of licensed or certified service providers who have contracted with the behavioral health organization to provide services required by this chapter. The monitoring and audits shall be performed by means of a formal process which insures that the licensed or certified service providers and professionals designated in this subsection meet the terms of their contracts;
(4) Establish reasonable limitations on administrative costs for agencies that contract with the behavioral health organization;
(5) Assure that the special needs of minorities, older adults, individuals with disabilities, children, and low-income persons are met within the priorities established in this chapter;
(6) Maintain patient tracking information in a central location as required for resource management services and the authority's information system;
(7) Collaborate to ensure that policies do not result in an adverse shift of persons with mental illness into state and local correctional facilities;
(8) Work with the authority to expedite the enrollment or reenrollment of eligible persons leaving state or local correctional facilities and institutions for mental diseases;
(9) Work closely with the designated crisis responder to maximize appropriate placement of persons into community services;
(10) Coordinate services for individuals who have received services through the community mental health system and who become patients at a state psychiatric hospital to ensure they are transitioned into the community in accordance with mutually agreed upon discharge plans and upon determination by the medical director of the state psychiatric hospital that they no longer need intensive inpatient care; and
(11) Allow reimbursement for time spent supervising persons working toward satisfying supervision requirements established for the relevant practice areas pursuant to RCW 18.225.090.

NOTES:

Reviser's note: This section was amended by 2018 c 175 § 7 and by 2018 c 201 § 4006, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingsIntent2018 c 175: See note following RCW 74.09.495.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.
Effective date1992 c 230 § 5: "Section 5 of this act shall take effect July 1, 1995." [ 1992 c 230 § 8.]
Intent1992 c 230: See note following RCW 72.23.025.
PurposeCaptions not law1991 c 363: See notes following RCW 2.32.180.
Conflict with federal requirements1991 c 306: See note following RCW 71.24.015.
Effective date1986 c 274 §§ 1, 2, 3, 5, and 9: See note following RCW 71.24.015.



Identification by behavioral health organizationChildren's mental health services.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
By January 1st of each odd-numbered year, the behavioral health organization shall identify: (1) The number of children in each priority group, as defined by this chapter, who are receiving mental health services funded in part or in whole under this chapter, (2) the amount of funds under this chapter used for children's mental health services, (3) an estimate of the number of unserved children in each priority group, and (4) the estimated cost of serving these additional children and their families.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.
PurposeIntent1999 c 10: See note following RCW 71.24.025.



Children's mental health providersChildren's mental health evidence-based practice institutePilot programPartnership access line for moms and kidsReport to legislature.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The authority shall provide flexibility in provider contracting to behavioral health organizations for children's mental health services. Behavioral health organization contracts shall authorize behavioral health organizations to allow and encourage licensed or certified community mental health centers to subcontract with individual licensed mental health professionals when necessary to meet the need for an adequate, culturally competent, and qualified children's mental health provider network.
(2) To the extent that funds are specifically appropriated for this purpose or that nonstate funds are available, a children's mental health evidence-based practice institute shall be established at the University of Washington division of public behavioral health and justice policy. The institute shall closely collaborate with entities currently engaged in evaluating and promoting the use of evidence-based, research-based, promising, or consensus-based practices in children's mental health treatment, including but not limited to the University of Washington department of psychiatry and behavioral sciences, Seattle children's hospital, the University of Washington school of nursing, the University of Washington school of social work, and the Washington state institute for public policy. To ensure that funds appropriated are used to the greatest extent possible for their intended purpose, the University of Washington's indirect costs of administration shall not exceed ten percent of appropriated funding. The institute shall:
(a) Improve the implementation of evidence-based and research-based practices by providing sustained and effective training and consultation to licensed children's mental health providers and child-serving agencies who are implementing evidence-based or researched-based practices for treatment of children's emotional or behavioral disorders, or who are interested in adapting these practices to better serve ethnically or culturally diverse children. Efforts under this subsection should include a focus on appropriate oversight of implementation of evidence-based practices to ensure fidelity to these practices and thereby achieve positive outcomes;
(b) Continue the successful implementation of the "partnerships for success" model by consulting with communities so they may select, implement, and continually evaluate the success of evidence-based practices that are relevant to the needs of children, youth, and families in their community;
(c) Partner with youth, family members, family advocacy, and culturally competent provider organizations to develop a series of information sessions, literature, and online resources for families to become informed and engaged in evidence-based and research-based practices;
(d) Participate in the identification of outcome-based performance measures under RCW 71.36.025(2) and partner in a statewide effort to implement statewide outcomes monitoring and quality improvement processes; and
(e) Serve as a statewide resource to the authority and other entities on child and adolescent evidence-based, research-based, promising, or consensus-based practices for children's mental health treatment, maintaining a working knowledge through ongoing review of academic and professional literature, and knowledge of other evidence-based practice implementation efforts in Washington and other states.
(3) To the extent that funds are specifically appropriated for this purpose, the health care authority in collaboration with the University of Washington department of psychiatry and behavioral sciences and Seattle children's hospital shall:
(a) Implement a program to support primary care providers in the assessment and provision of appropriate diagnosis and treatment of children with mental and behavioral health disorders and track outcomes of this program;
(b) Beginning January 1, 2019, implement a two-year pilot program called the partnership access line for moms and kids to:
(i) Support obstetricians, pediatricians, primary care providers, mental health professionals, and other health care professionals providing care to pregnant women and new mothers through same-day telephone consultations in the assessment and provision of appropriate diagnosis and treatment of depression in pregnant women and new mothers; and
(ii) Facilitate referrals to children's mental health services and other resources for parents and guardians with concerns related to the mental health of the parent or guardian's child. Facilitation activities include assessing the level of services needed by the child; within seven days of receiving a call from a parent or guardian, identifying mental health professionals who are in-network with the child's health care coverage who are accepting new patients and taking appointments; coordinating contact between the parent or guardian and the mental health professional; and providing postreferral reviews to determine if the child has outstanding needs. In conducting its referral activities, the program shall collaborate with existing databases and resources to identify in-network mental health professionals.
(c) The program activities described in (a) and (b)(i) of this subsection shall be designed to promote more accurate diagnoses and treatment through timely case consultation between primary care providers and child psychiatric specialists, and focused educational learning collaboratives with primary care providers.
(4) The health care authority, in collaboration with the University of Washington department of psychiatry and behavioral sciences and Seattle children's hospital, shall report on the following:
(a) The number of individuals who have accessed the resources described in subsection (3) of this section;
(b) The number of providers, by type, who have accessed the resources described in subsection (3) of this section;
(c) Demographic information, as available, for the individuals described in (a) of this subsection. Demographic information may not include any personally identifiable information and must be limited to the individual's age, gender, and city and county of residence;
(d) A description of resources provided;
(e) Average time frames from receipt of call to referral for services or resources provided; and
(f) Systemic barriers to services, as determined and defined by the health care authority, the University of Washington department of psychiatry and behavioral sciences, and Seattle children's hospital.
(5) Beginning December 30, 2019, and annually thereafter, the health care authority must submit, in compliance with RCW 43.01.036, a report to the governor and appropriate committees of the legislature with findings and recommendations for improving services and service delivery from subsection (4) of this section.
(6) The health care authority shall enforce requirements in managed care contracts to ensure care coordination and network adequacy issues are addressed in order to remove barriers to access to mental health services identified in the report described in subsection (4) of this section.

NOTES:

Reviser's note: This section was amended by 2018 c 201 § 4007 and by 2018 c 288 § 2, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Captions not law2007 c 359: See note following RCW 71.36.005.



Joint agreements of county authoritiesRequired provisions.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
A county authority or a group of county authorities may enter into a joint operating agreement to respond to a request for a detailed plan and contract with the state to operate a behavioral health organization whose boundaries are consistent with the regional service areas established under RCW 74.09.870. Any agreement between two or more county authorities shall provide:
(1) That each county shall bear a share of the cost of mental health services; and
(2) That the treasurer of one participating county shall be the custodian of funds made available for the purposes of such mental health services, and that the treasurer may make payments from such funds upon audit by the appropriate auditing officer of the county for which he or she is treasurer.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.



Joint agreements of county authoritiesPermissive provisions.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
An agreement to contract with the state to operate a behavioral health organization under RCW 71.24.100 may also provide:
(1) For the joint supervision or operation of services and facilities, or for the supervision or operation of service and facilities by one participating county under contract for the other participating counties; and
(2) For such other matters as are necessary or proper to effectuate the purposes of this chapter.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.
PurposeIntent1999 c 10: See note following RCW 71.24.025.



Grants to behavioral health organizationsAccounting.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
Grants shall be made by the authority to behavioral health organizations for community mental health programs totaling not less than ninety-five percent of available resources. The authority may use up to forty percent of the remaining five percent to provide community demonstration projects, including early intervention or primary prevention programs for children, and the remainder shall be for emergency needs and technical assistance under this chapter.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Effective date1986 c 274 §§ 1, 2, 3, 5, and 9: See note following RCW 71.24.015.



Proof as to uses made of state fundsUse of maintenance of effort funds.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The behavioral health organizations shall make satisfactory showing to the director that state funds shall in no case be used to replace local funds from any source being used to finance mental health services prior to January 1, 1990. Maintenance of effort funds devoted to judicial services related to involuntary commitment reimbursed under RCW 71.05.730 must be expended for other purposes that further treatment for mental health and chemical dependency disorders.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
IntentEffective date2011 c 343: See notes following RCW 71.05.730.



Expenditures of county funds subject to county fiscal laws.

Expenditures of county funds under this chapter shall be subject to the provisions of chapter 36.40 RCW and other statutes relating to expenditures by counties.



Clients to be charged for services.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
Clients receiving mental health services funded by available resources shall be charged a fee under sliding-scale fee schedules, based on ability to pay, approved by the authority or the department of social and health services, as appropriate. Fees shall not exceed the actual cost of care.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



Reimbursement may be withheld for noncompliance with chapter or related rules.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The director may withhold state grants in whole or in part for any community mental health program in the event of a failure to comply with this chapter or the related rules adopted by the authority.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
PurposeIntent1999 c 10: See note following RCW 71.24.025.



County program plans to be approved by director prior to submittal to federal agency.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
In order to establish eligibility for funding under this chapter, any behavioral health organization seeking to obtain federal funds for the support of any aspect of a *community mental health program as defined in this chapter shall submit program plans to the director for prior review and approval before such plans are submitted to any federal agency.

NOTES:

*Reviser's note: RCW 71.24.025 was amended by 2016 sp.s. c 29 § 501, deleting the definition of "community mental health program."
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.



Behavioral health organizationsGifts and grants.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The behavioral health organization may accept and expend gifts and grants received from private, county, state, and federal sources.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.



Waiver of postgraduate educational requirements.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The department shall waive postgraduate educational requirements applicable to mental health professionals under this chapter for those persons who have a bachelor's degree and on June 11, 1986:
(1) Are employed by an agency subject to licensure under this chapter, the community mental health services act, in a capacity involving the treatment of mental illness; and
(2) Have at least ten years of full-time experience in the treatment of mental illness.



Behavioral health organizationsInclusion of tribal authoritiesRoles and responsibilities.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Upon the request of a tribal authority or authorities within a behavioral health organization the joint operating agreement or the county authority shall allow for the inclusion of the tribal authority to be represented as a party to the behavioral health organization.
(2) The roles and responsibilities of the county and tribal authorities shall be determined by the terms of that agreement including a determination of membership on the governing board and advisory committees, the number of tribal representatives to be party to the agreement, and the provisions of law and shall assure the provision of culturally competent services to the tribes served.
(3) The state behavioral health authority may not determine the roles and responsibilities of county authorities as to each other under behavioral health organizations by rule, except to assure that all duties required of behavioral health organizations are assigned and that counties and the behavioral health organization do not duplicate functions and that a single authority has final responsibility for all available resources and performance under the behavioral health organization's contract with the director.
(4) If a behavioral health organization is a private entity, the authority shall allow for the inclusion of the tribal authority to be represented as a party to the behavioral health organization.
(5) The roles and responsibilities of the private entity and the tribal authorities shall be determined by the authority, through negotiation with the tribal authority.
(6) Behavioral health organizations shall submit an overall six-year operating and capital plan, timeline, and budget and submit progress reports and an updated two-year plan biennially thereafter, to assume within available resources all of the following duties:
(a) Administer and provide for the availability of all resource management services, residential services, and community support services.
(b) Administer and provide for the availability of an adequate network of evaluation and treatment services to ensure access to treatment, all investigation, transportation, court-related, and other services provided by the state or counties pursuant to chapter 71.05 RCW.
(c) Provide within the boundaries of each behavioral health organization evaluation and treatment services for at least ninety percent of persons detained or committed for periods up to seventeen days according to chapter 71.05 RCW. Behavioral health organizations may contract to purchase evaluation and treatment services from other organizations if they are unable to provide for appropriate resources within their boundaries. Insofar as the original intent of serving persons in the community is maintained, the director is authorized to approve exceptions on a case-by-case basis to the requirement to provide evaluation and treatment services within the boundaries of each behavioral health organization. Such exceptions are limited to:
(i) Contracts with neighboring or contiguous regions; or
(ii) Individuals detained or committed for periods up to seventeen days at the state hospitals at the discretion of the director.
(d) Administer and provide for the availability of all other mental health services, which shall include patient counseling, day treatment, consultation, education services, employment services as described in RCW 71.24.035, and mental health services to children.
(e) Establish standards and procedures for reviewing individual service plans and determining when that person may be discharged from resource management services.
(7) A behavioral health organization may request that any state-owned land, building, facility, or other capital asset which was ever purchased, deeded, given, or placed in trust for the care of the persons with mental illness and which is within the boundaries of a behavioral health organization be made available to support the operations of the behavioral health organization. State agencies managing such capital assets shall give first priority to requests for their use pursuant to this chapter.
(8) Each behavioral health organization shall appoint a behavioral health advisory board which shall review and provide comments on plans and policies developed under this chapter, provide local oversight regarding the activities of the behavioral health organization, and work with the behavioral health organization to resolve significant concerns regarding service delivery and outcomes. The authority shall establish statewide procedures for the operation of regional advisory committees including mechanisms for advisory board feedback to the authority regarding behavioral health organization performance. The composition of the board shall be broadly representative of the demographic character of the region and shall include, but not be limited to, representatives of consumers of substance use disorder and mental health services and their families, law enforcement, and, where the county is not the behavioral health organization, county elected officials. Composition and length of terms of board members may differ between behavioral health organizations but shall be included in each behavioral health organization's contract and approved by the director.
(9) Behavioral health organizations shall assume all duties specified in their plans and joint operating agreements through biennial contractual agreements with the director.
(10) Behavioral health organizations may receive technical assistance from the housing trust fund and may identify and submit projects for housing and housing support services to the housing trust fund established under chapter 43.185 RCW. Projects identified or submitted under this subsection must be fully integrated with the behavioral health organization six-year operating and capital plan, timeline, and budget required by subsection (6) of this section.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2015 c 269 §§ 10 and 14: "Sections 10 and 14 of this act take effect April 1, 2016." [ 2015 c 269 § 19.]
Effective date2014 c 225: See note following RCW 71.24.016.
IntentFindings2008 c 261: See note following RCW 71.24.320.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.
IntentEffective date1999 c 214: See notes following RCW 72.09.370.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Intent1992 c 230: See note following RCW 72.23.025.
Evaluation of transition to regional systems1989 c 205: See note following RCW 71.24.015.



Administration of chapters 71.05 and 71.24 RCW through behavioral health organizationsImplementation of chapter 71.05 RCW.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The legislature finds that administration of chapter 71.05 RCW and this chapter can be most efficiently and effectively implemented as part of the behavioral health organization defined in RCW 71.24.025. For this reason, the legislature intends that the authority and the behavioral health organizations shall work together to implement chapter 71.05 RCW as follows:
(1) Behavioral health organizations shall recommend to the authority the number of state hospital beds that should be allocated for use by each behavioral health organization. The statewide total allocation shall not exceed the number of state hospital beds offering long-term inpatient care, as defined in this chapter, for which funding is provided in the biennial appropriations act.
(2) If there is consensus among the behavioral health organizations regarding the number of state hospital beds that should be allocated for use by each behavioral health organization, the authority shall contract with each behavioral health organization accordingly.
(3) If there is not consensus among the behavioral health organizations regarding the number of beds that should be allocated for use by each behavioral health organization, the authority shall establish by emergency rule the number of state hospital beds that are available for use by each behavioral health organization. The primary factor used in the allocation shall be the estimated number of adults with acute and chronic mental illness in each behavioral health organization area, based upon population-adjusted incidence and utilization.
(4) The allocation formula shall be updated at least every three years to reflect demographic changes, and new evidence regarding the incidence of acute and chronic mental illness and the need for long-term inpatient care. In the updates, the statewide total allocation shall include (a) all state hospital beds offering long-term inpatient care for which funding is provided in the biennial appropriations act; plus (b) the estimated equivalent number of beds or comparable diversion services contracted in accordance with subsection (5) of this section.
(5) The authority is encouraged to enter performance-based contracts with behavioral health organizations to provide some or all of the behavioral health organization's allocated long-term inpatient treatment capacity in the community, rather than in the state hospital. The performance contracts shall specify the number of patient days of care available for use by the behavioral health organization in the state hospital.
(6) If a behavioral health organization uses more state hospital patient days of care than it has been allocated under subsection (3) or (4) of this section, or than it has contracted to use under subsection (5) of this section, whichever is less, it shall reimburse the authority for that care. Reimbursements must be calculated using quarterly average census data to determine an average number of days used in excess of the bed allocation for the quarter. The reimbursement rate per day shall be the hospital's total annual budget for long-term inpatient care, divided by the total patient days of care assumed in development of that budget.
(7) One-half of any reimbursements received pursuant to subsection (6) of this section shall be used to support the cost of operating the state hospital. The authority shall distribute the remaining half of such reimbursements among behavioral health organizations that have used less than their allocated or contracted patient days of care at that hospital, proportional to the number of patient days of care not used.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Effective dates2013 2nd sp.s. c 4: See note following RCW 2.68.020.
Effective date2009 c 564: See note following RCW 2.68.020.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
Evaluation of transition to regional systems1989 c 205: See note following RCW 71.24.015.



Behavioral health organizationsProcurement processPenalty for voluntary termination or refusal to renew contract.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) If an existing behavioral health organization chooses not to respond to a request for a detailed plan, or is unable to substantially meet the requirements of a request for a detailed plan, or notifies the authority it will no longer serve as a behavioral health organization, the authority shall utilize a procurement process in which other entities recognized by the director may bid to serve as the behavioral health organization.
(a) The request for proposal shall include a scoring factor for proposals that include additional financial resources beyond that provided by state appropriation or allocation.
(b) The authority shall provide detailed briefings to all bidders in accordance with authority and state procurement policies.
(c) The request for proposal shall also include a scoring factor for proposals submitted by nonprofit entities that include a component to maximize the utilization of state provided resources and the leverage of other funds for the support of mental health services to persons with mental illness.
(2) A behavioral health organization that voluntarily terminates, refuses to renew, or refuses to sign a mandatory amendment to its contract to act as a behavioral health organization is prohibited from responding to a procurement under this section or serving as a behavioral health organization for five years from the date that the department of social and health services, or the authority, as applicable, signs a contract with the entity that will serve as the behavioral health organization.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
IntentFindings2008 c 261: "In the event that an existing regional support network will no longer be contracting to provide services, it is the intent of the legislature to provide flexibility to the department to facilitate a stable transition which avoids disruption of services to consumers and families, maximizes efficiency and public safety, and maintains the integrity of the public mental health system. By granting this authority and flexibility, the legislature finds that the department will be able to maximize purchasing power within allocated resources and attract high quality organizations with optimal infrastructure to perform regional support network functions through competitive procurement processes. The legislature intends for the department of social and health services to partner with political subdivisions and other entities to provide quality, coordinated, and integrated services to address the needs of individuals with behavioral health needs." [ 2008 c 261 § 1.]
Retroactive application2008 c 261 § 5: "Section 5 of this act applies retroactively to July 1, 2007." [ 2008 c 261 § 7.]
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
Effective date2005 c 503 § 4: "Section 4 of this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [May 17, 2005]." [ 2005 c 503 § 19.]
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.



Behavioral health organizationsContracts with authorityRequirements.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1)(a) Contracts between a behavioral health organization and the authority shall include mechanisms for monitoring performance under the contract and remedies for failure to substantially comply with the requirements of the contract including, but not limited to, financial penalties, termination of the contract, and reprocurement of the contract.
(b) The authority shall incorporate the criteria to measure the performance of service coordination organizations into contracts with behavioral health organizations as provided in chapter 70.320 RCW.
(2) The behavioral health organization procurement processes shall encourage the preservation of infrastructure previously purchased by the community mental health service delivery system, the maintenance of linkages between other services and delivery systems, and maximization of the use of available funds for services versus profits. However, a behavioral health organization selected through the procurement process is not required to contract for services with any county-owned or operated facility. The behavioral health organization procurement process shall provide that public funds appropriated by the legislature shall not be used to promote or deter, encourage, or discourage employees from exercising their rights under Title 29, chapter 7, subchapter II, United States Code or chapter 41.56 RCW.
(3) In addition to the requirements of RCW 71.24.035, contracts shall:
(a) Define administrative costs and ensure that the behavioral health organization does not exceed an administrative cost of ten percent of available funds;
(b) Require effective collaboration with law enforcement, criminal justice agencies, and the chemical dependency treatment system;
(c) Require substantial implementation of authority adopted integrated screening and assessment process and matrix of best practices;
(d) Maintain the decision-making independence of designated crisis responders;
(e) Except at the discretion of the secretary of the department of social and health services in consultation with the director or as specified in the biennial budget, require behavioral health organizations to pay the state for the costs associated with individuals who are being served on the grounds of the state hospitals and who are not receiving long-term inpatient care as defined in RCW 71.24.025;
(f) Include a negotiated alternative dispute resolution clause;
(g) Include a provision requiring either party to provide one hundred eighty days' notice of any issue that may cause either party to voluntarily terminate, refuse to renew, or refuse to sign a mandatory amendment to the contract to act as a behavioral health organization. If either party decides to voluntarily terminate, refuse to renew, or refuse to sign a mandatory amendment to the contract to serve as a behavioral health organization they shall provide ninety days' advance notice in writing to the other party;
(h) Require behavioral health organizations to provide services as identified in RCW 71.05.585 to individuals committed for involuntary commitment under less restrictive alternative court orders when:
(i) The individual is enrolled in the medicaid program and meets behavioral health organization access to care standards; or
(ii) The individual is not enrolled in medicaid, does not have other insurance which can pay for the services, and the behavioral health organization has adequate available resources to provide the services; and
(i) Establish caseload guidelines for care coordinators who supervise less restrictive alternative orders and guidelines for response times during and immediately following periods of hospitalization or incarceration.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2015 c 250 §§ 2, 15, and 19: See note following RCW 71.05.020.
Effective date2014 c 225: See note following RCW 71.24.016.
IntentFindings2008 c 261: See note following RCW 71.24.320.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.



Behavioral health organizationsProvider reimbursementRequirementsProcedureDefinitions.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Upon initiation or renewal of a contract with the department, a behavioral health organization shall reimburse a provider for a behavioral health service provided to a covered person who is under eighteen years old through telemedicine or store and forward technology if:
(a) The behavioral health organization in which the covered person is enrolled provides coverage of the behavioral health service when provided in person by the provider; and
(b) The behavioral health service is medically necessary.
(2)(a) If the service is provided through store and forward technology there must be an associated visit between the covered person and the referring provider. Nothing in this section prohibits the use of telemedicine for the associated office visit.
(b) For purposes of this section, reimbursement of store and forward technology is available only for those services specified in the negotiated agreement between the behavioral health organization and provider.
(3) An originating site for a telemedicine behavioral health service subject to subsection (1) of this section means an originating site as defined in rule by the department or the health care authority.
(4) Any originating site, other than a home, under subsection (3) of this section may charge a facility fee for infrastructure and preparation of the patient. Reimbursement must be subject to a negotiated agreement between the originating site and the behavioral health organization. A distant site or any other site not identified in subsection (3) of this section may not charge a facility fee.
(5) A behavioral health organization may not distinguish between originating sites that are rural and urban in providing the coverage required in subsection (1) of this section.
(6) A behavioral health organization may subject coverage of a telemedicine or store and forward technology behavioral health service under subsection (1) of this section to all terms and conditions of the behavioral health organization in which the covered person is enrolled, including, but not limited to, utilization review, prior authorization, deductible, copayment, or coinsurance requirements that are applicable to coverage of a comparable behavioral health care service provided in person.
(7) This section does not require a behavioral health organization to reimburse:
(a) An originating site for professional fees;
(b) A provider for a behavioral health service that is not a covered benefit under the behavioral health organization; or
(c) An originating site or provider when the site or provider is not a contracted provider with the behavioral health organization.
(8) For purposes of this section:
(a) "Distant site" means the site at which a physician or other licensed provider, delivering a professional service, is physically located at the time the service is provided through telemedicine;
(b) "Hospital" means a facility licensed under chapter 70.41, 71.12, or 72.23 RCW;
(c) "Originating site" means the physical location of a patient receiving behavioral health services through telemedicine;
(d) "Provider" has the same meaning as in RCW 48.43.005;
(e) "Store and forward technology" means use of an asynchronous transmission of a covered person's medical or behavioral health information from an originating site to the provider at a distant site which results in medical or behavioral health diagnosis and management of the covered person, and does not include the use of audio-only telephone, facsimile, or email; and
(f) "Telemedicine" means the delivery of health care or behavioral health services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. For purposes of this section only, "telemedicine" does not include the use of audio-only telephone, facsimile, or email.
(9) The department must, in consultation with the health care authority, adopt rules as necessary to implement the provisions of this section.

NOTES:

Contingent effective date2017 c 202 § 7: "Section 7 of this act takes effect January 1, 2018, but only if neither Substitute House Bill No. 1388 (including any later amendments or substitutes) nor Substitute Senate Bill No. 5259 (including any later amendments or substitutes) is signed into law by the governor by July 23, 2017." [ 2017 c 202 § 10.] Neither Substitute House Bill No. 1388 nor Substitute Senate Bill No. 5259 was signed into law by July 23, 2017.
FindingsIntent2017 c 202: See note following RCW 74.09.492.



Behavioral health organizationsAgreements with city and county jails.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The director shall require the behavioral health organizations to develop agreements with city and county jails to accept referrals for enrollment on behalf of a confined person, prior to the person's release.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Correction of referencesSavingsSeverability2005 c 503: See notes following RCW 71.24.015.



Behavioral health ombuds office.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall require each behavioral health organization to provide for a separately funded behavioral health ombuds office in each behavioral health organization that is independent of the behavioral health organization. The ombuds office shall maximize the use of consumer advocates.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Establishment of new behavioral health organizations.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The authority may establish new behavioral health organization boundaries in any part of the state:
(a) Where more than one organization chooses not to respond to, or is unable to substantially meet the requirements of, the request for a detailed plan under RCW 71.24.320;
(b) Where a behavioral health organization is subject to reprocurement under RCW 71.24.330; or
(c) Where two or more behavioral health organizations propose to reconfigure themselves to achieve consolidation, in which case the procurement process described in RCW 71.24.320 and 71.24.330(2) does not apply.
(2) The authority may establish no fewer than six and no more than fourteen behavioral health organizations under this chapter. No entity shall be responsible for more than three behavioral health organizations.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Behavioral health organizations contractsLimitation on state liability.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Except for monetary damage claims which have been reduced to final judgment by a superior court, this section applies to all claims against the state, state agencies, state officials, or state employees that exist on or arise after March 29, 2006.
(2) Except as expressly provided in contracts entered into between the authority and the behavioral health organizations after March 29, 2006, the entities identified in subsection (3) of this section shall have no claim for declaratory relief, injunctive relief, judicial review under chapter 34.05 RCW, or civil liability against the state or state agencies for actions or inactions performed pursuant to the administration of this chapter with regard to the following: (a) The allocation or payment of federal or state funds; (b) the use or allocation of state hospital beds; or (c) financial responsibility for the provision of inpatient mental health care.
(3) This section applies to counties, behavioral health organizations, and entities which contract to provide behavioral health organization services and their subcontractors, agents, or employees.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingPurposeIntentSeverabilityPart headings not lawEffective dates2006 c 333: See notes following RCW 71.24.016.



Purchase of mental health and chemical dependency treatment servicesManaged care contractingDetailed plan.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The director shall purchase mental health and chemical dependency treatment services primarily through managed care contracting, but may continue to purchase behavioral health services directly from tribal clinics and other tribal providers.
(2)(a) The director shall request a detailed plan from the entities identified in (b) of this subsection that demonstrates compliance with the contractual elements of RCW 74.09.871 and federal regulations related to medicaid managed care contracting including, but not limited to: Having a sufficient network of providers to provide adequate access to mental health and chemical dependency services for residents of the regional service area that meet eligibility criteria for services, ability to maintain and manage adequate reserves, and maintenance of quality assurance processes. Any responding entity that submits a detailed plan that demonstrates that it can meet the requirements of this section must be awarded the contract to serve as the behavioral health organization.
(b)(i) For purposes of responding to the request for a detailed plan under (a) of this subsection, the entities from which a plan will be requested are:
(A) A county in a single county regional service area that currently serves as the regional support network for that area;
(B) In the event that a county has made a decision prior to January 1, 2014, not to contract as a regional support network, any private entity that serves as the regional support network for that area;
(C) All counties within a regional service area that includes more than one county, which shall form a responding entity through the adoption of an interlocal agreement. The interlocal agreement must specify the terms by which the responding entity shall serve as the behavioral health organization within the regional service area.
(ii) In the event that a regional service area is comprised of multiple counties including one that has made a decision prior to January 1, 2014, not to contract as a regional support network the counties shall adopt an interlocal agreement and may respond to the request for a detailed plan under (a) of this subsection and the private entity may also respond to the request for a detailed plan. If both responding entities meet the requirements of this section, the responding entities shall follow the authority's procurement process established in subsection (3) of this section.
(3) If an entity that has received a request under this section to submit a detailed plan does not respond to the request, a responding entity under subsection (1) of this section is unable to substantially meet the requirements of the request for a detailed plan, or more than one responding entity substantially meets the requirements for the request for a detailed plan, the authority shall use a procurement process in which other entities recognized by the director may bid to serve as the behavioral health organization in that regional service area.
(4) Contracts for behavioral health organizations must begin on April 1, 2016.
(5) Upon request of all of the county authorities in a regional service area, the authority may purchase behavioral health services through an integrated medical and behavioral health services contract with a behavioral health organization or a managed health care system as defined in RCW 74.09.522, pursuant to standards to be developed by the authority. Any contract for such a purchase must comply with all federal medicaid and state law requirements related to managed health care contracting.
(6) As an incentive to county authorities to become early adopters of fully integrated purchasing of medical and behavioral health services, the standards adopted by the authority under subsection (5) of this section shall provide for an incentive payment to counties which elect to move to full integration by January 1, 2016. Subject to federal approval, the incentive payment shall be targeted at ten percent of savings realized by the state within the regional service area in which the fully integrated purchasing takes place. Savings shall be calculated in alignment with the outcome and performance measures established in RCW 43.20A.895, 70.320.020, and 71.36.025, and incentive payments for early adopter counties shall be made available for up to a six-year period, or until full integration of medical and behavioral health services is accomplished statewide, whichever comes sooner, according to rules to be developed by the authority.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



Mental health and chemical dependency treatment providers and programsVendor rate increases.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The director shall require, in the contracts the authority negotiates pursuant to chapters 71.24 and * 70.96A RCW, that any vendor rate increases provided for mental health and chemical dependency treatment providers or programs who are parties to the contract or subcontractors of any party to the contract shall be prioritized to those providers and programs that maximize the use of evidence-based and research-based practices unless otherwise designated by the legislature.

NOTES:

*Reviser's note: Chapter 70.96A RCW was repealed and/or recodified in its entirety pursuant to 2016 sp.s. c 29 §§ 301, 601, and 701.
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Behavioral health organizationsMental disorder program development.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
*** CHANGE IN 2019 *** (SEE 1528-S2.SL) ***
(1) Within funds appropriated by the legislature for this purpose, behavioral health organizations shall develop the means to serve the needs of people:
(a) With mental disorders residing within the boundaries of their regional service area. Elements of the program may include:
(i) Crisis diversion services;
(ii) Evaluation and treatment and community hospital beds;
(iii) Residential treatment;
(iv) Programs for intensive community treatment;
(v) Outpatient services, including family support;
(vi) Peer support services;
(vii) Community support services;
(viii) Resource management services; and
(ix) Supported housing and supported employment services.
(b) With substance use disorders and their families, people incapacitated by alcohol or other psychoactive chemicals, and intoxicated people.
(i) Elements of the program shall include, but not necessarily be limited to, a continuum of substance use disorder treatment services that includes:
(A) Withdrawal management;
(B) Residential treatment; and
(C) Outpatient treatment.
(ii) The program may include peer support, supported housing, supported employment, crisis diversion, or recovery support services.
(iii) The authority may contract for the use of an approved substance use disorder treatment program or other individual or organization if the director considers this to be an effective and economical course to follow.
(2)(a) The behavioral health organization shall have the flexibility, within the funds appropriated by the legislature for this purpose and the terms of their contract, to design the mix of services that will be most effective within their service area of meeting the needs of people with behavioral health disorders and avoiding placement of such individuals at the state mental hospital. Behavioral health organizations are encouraged to maximize the use of evidence-based practices and alternative resources with the goal of substantially reducing and potentially eliminating the use of institutions for mental diseases.
(b) The behavioral health organization may allow reimbursement to providers for services delivered through a partial hospitalization or intensive outpatient program. Such payment and services are distinct from the state's delivery of wraparound with intensive services under the T.R. v. Strange and McDermott, formerly the T.R. v. Dreyfus and Porter, settlement agreement.
(3)(a) Treatment provided under this chapter must be purchased primarily through managed care contracts.
(b) Consistent with RCW 71.24.580, services and funding provided through the criminal justice treatment account are intended to be exempted from managed care contracting.

NOTES:

Reviser's note: This section was amended by 2018 c 175 § 6 and by 2018 c 201 § 4023, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingsIntent2018 c 175: See note following RCW 74.09.495.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Streamlining delivery systemFinding.

The legislature finds that the current complex set of federal, state, and local rules and regulations, audited and administered at multiple levels, which affect the community mental health service delivery system, focus primarily on the process of providing mental health services and do not sufficiently address consumer and system outcomes. The legislature finds that the authority and the community mental health service delivery system must make ongoing efforts to achieve the purposes set forth in RCW 71.24.015 related to reduced administrative layering, duplication, elimination of process measures not specifically required by the federal government for the receipt of federal funds, and reduced administrative costs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Effective date1995 c 96: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately [April 18, 1995]." [ 1995 c 96 § 5.]



Streamlining delivery system.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall establish a comprehensive and collaborative effort within behavioral health organizations and with local mental health service providers aimed at creating innovative and streamlined community mental health service delivery systems, in order to carry out the purposes set forth in RCW 71.24.400 and to capture the diversity of the community mental health service delivery system.
The authority must accomplish the following:
(1) Identification, review, and cataloging of all rules, regulations, duplicative administrative and monitoring functions, and other requirements that currently lead to inefficiencies in the community mental health service delivery system and, if possible, eliminate the requirements;
(2) The systematic and incremental development of a single system of accountability for all federal, state, and local funds provided to the community mental health service delivery system. Systematic efforts should be made to include federal and local funds into the single system of accountability;
(3) The elimination of process regulations and related contract and reporting requirements. In place of the regulations and requirements, a set of outcomes for mental health adult and children clients according to this chapter must be used to measure the performance of mental health service providers and behavioral health organizations. Such outcomes shall focus on stabilizing out-of-home and hospital care, increasing stable community living, increasing age-appropriate activities, achieving family and consumer satisfaction with services, and system efficiencies;
(4) Evaluation of the feasibility of contractual agreements between the authority and behavioral health organizations and mental health service providers that link financial incentives to the success or failure of mental health service providers and behavioral health organizations to meet outcomes established for mental health service clients;
(5) The involvement of mental health consumers and their representatives. Mental health consumers and their representatives will be involved in the development of outcome standards for mental health clients under *section 5 of this act; and
(6) An independent evaluation component to measure the success of the authority in fully implementing the provisions of RCW 71.24.400 and this section.

NOTES:

*Reviser's note: Section 5 of this act (chapter 323, Laws of 2001) was vetoed by the governor.
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Effective date1995 c 96: See note following RCW 71.24.400.



Streamlining delivery systemAuthority duties to achieve outcomes.

To carry out the purposes specified in RCW 71.24.400, the authority is encouraged to utilize its authority to eliminate any unnecessary rules, regulations, standards, or contracts, to immediately eliminate duplication of audits or any other unnecessarily duplicated functions, and to seek any waivers of federal or state rules or regulations necessary to achieve the purpose of streamlining the community mental health service delivery system and infusing it with incentives that reward efficiency, positive outcomes for clients, and quality services.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Effective date1995 c 96: See note following RCW 71.24.400.



Expenditure of federal funds.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall operate the community mental health service delivery system authorized under this chapter within the following constraints:
(1) The full amount of federal funds for mental health services, plus qualifying state expenditures as appropriated in the biennial operating budget, shall be appropriated to the authority each year in the biennial appropriations act to carry out the provisions of the community mental health service delivery system authorized in this chapter.
(2) The authority may expend funds defined in subsection (1) of this section in any manner that will effectively accomplish the outcome measures established in RCW 43.20A.895 and 71.36.025 and performance measures linked to those outcomes.
(3) The authority shall implement strategies that accomplish the outcome measures established in RCW 43.20A.895, 70.320.020, and 71.36.025 and performance measures linked to those outcomes.
(4) The authority shall monitor expenditures against the appropriation levels provided for in subsection (1) of this section.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



Collaborative service delivery.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The authority shall ensure the coordination of allied services for mental health clients. The authority shall implement strategies for resolving organizational, regulatory, and funding issues at all levels of the system, including the state, the behavioral health organizations, and local service providers.
(2) The authority shall propose, in operating budget requests, transfers of funding among programs to support collaborative service delivery to persons who require services from multiple department of social and health services and authority programs. The authority shall report annually to the appropriate committees of the senate and house of representatives on actions and projects it has taken to promote collaborative service delivery.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



Offenders with mental illnessesFindings and intent.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Many acute and chronically mentally ill offenders are delayed in their release from Washington correctional facilities due to their inability to access reasonable treatment and living accommodations prior to the maximum expiration of their sentences. Often the offender reaches the end of his or her sentence and is released without any follow-up care, funds, or housing. These delays are costly to the state, often lead to psychiatric relapse, and result in unnecessary risk to the public.
These offenders rarely possess the skills or emotional stability to maintain employment or even complete applications to receive entitlement funding. Nationwide only five percent of diagnosed schizophrenics are able to maintain part-time or full-time employment. Housing and appropriate treatment are difficult to obtain.
This lack of resources, funding, treatment, and housing creates additional stress for the mentally ill offender, impairing self-control and judgment. When the mental illness is instrumental in the offender's patterns of crime, such stresses may lead to a worsening of his or her illness, reoffending, and a threat to public safety.
(2) It is the intent of the legislature to create a pilot program to provide for postrelease mental health care and housing for a select group of mentally ill offenders entering community living, in order to reduce incarceration costs, increase public safety, and enhance the offender's quality of life.

NOTES:

Severability1997 c 342: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1997 c 342 § 6.]



Offenders with mental illnessesContracts for specialized access and services.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The director shall select and contract with a behavioral health organization or private provider to provide specialized access and services to offenders with mental illness upon release from total confinement within the department of corrections who have been identified by the department of corrections and selected by the behavioral health organization or private provider as high-priority clients for services and who meet service program entrance criteria. The program shall enroll no more than twenty-five offenders at any one time, or a number of offenders that can be accommodated within the appropriated funding level, and shall seek to fill any vacancies that occur.
(2) Criteria shall include a determination by department of corrections staff that:
(a) The offender suffers from a major mental illness and needs continued mental health treatment;
(b) The offender's previous crime or crimes have been determined by either the court or department of corrections staff to have been substantially influenced by the offender's mental illness;
(c) It is believed the offender will be less likely to commit further criminal acts if provided ongoing mental health care;
(d) The offender is unable or unlikely to obtain housing and/or treatment from other sources for any reason; and
(e) The offender has at least one year remaining before his or her sentence expires but is within six months of release to community housing and is currently housed within a work release facility or any department of corrections' division of prisons facility.
(3) The behavioral health organization or private provider shall provide specialized access and services to the selected offenders. The services shall be aimed at lowering the risk of recidivism. An oversight committee composed of a representative of the authority, a representative of the selected behavioral health organization or private provider, and a representative of the department of corrections shall develop policies to guide the pilot program, provide dispute resolution including making determinations as to when entrance criteria or required services may be waived in individual cases, advise the department of corrections and the behavioral health organization or private provider on the selection of eligible offenders, and set minimum requirements for service contracts. The selected behavioral health organization or private provider shall implement the policies and service contracts. The following services shall be provided:
(a) Intensive case management to include a full range of intensive community support and treatment in client-to-staff ratios of not more than ten offenders per case manager including: (i) A minimum of weekly group and weekly individual counseling; (ii) home visits by the program manager at least two times per month; and (iii) counseling focusing on relapse prevention and past, current, or future behavior of the offender.
(b) The case manager shall attempt to locate and procure housing appropriate to the living and clinical needs of the offender and as needed to maintain the psychiatric stability of the offender. The entire range of emergency, transitional, and permanent housing and involuntary hospitalization must be considered as available housing options. A housing subsidy may be provided to offenders to defray housing costs up to a maximum of six thousand six hundred dollars per offender per year and be administered by the case manager. Additional funding sources may be used to offset these costs when available.
(c) The case manager shall collaborate with the assigned prison, work release, or community corrections staff during release planning, prior to discharge, and in ongoing supervision of the offender while under the authority of the department of corrections.
(d) Medications including the full range of psychotropic medications including atypical antipsychotic medications may be required as a condition of the program. Medication prescription, medication monitoring, and counseling to support offender understanding, acceptance, and compliance with prescribed medication regimens must be included.
(e) A systematic effort to engage offenders to continuously involve themselves in current and long-term treatment and appropriate habilitative activities shall be made.
(f) Classes appropriate to the clinical and living needs of the offender and appropriate to his or her level of understanding.
(g) The case manager shall assist the offender in the application and qualification for entitlement funding, including medicaid, state assistance, and other available government and private assistance at any point that the offender is qualified and resources are available.
(h) The offender shall be provided access to daily activities such as drop-in centers, prevocational and vocational training and jobs, and volunteer activities.
(4) Once an offender has been selected into the pilot program, the offender shall remain in the program until the end of his or her sentence or unless the offender is released from the pilot program earlier by the department of corrections.
(5) Specialized training in the management and supervision of high-crime risk offenders with mental illness shall be provided to all participating mental health providers by the authority and the department of corrections prior to their participation in the program and as requested thereafter.
(6) The pilot program provided for in this section must be providing services by July 1, 1998.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
Severability1997 c 342: See note following RCW 71.24.450.



Offenders with mental illnessesReport to legislatureContingent termination of program.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority, in collaboration with the department of corrections and the oversight committee created in RCW 71.24.455, shall track outcomes and submit to the legislature annual reports regarding services and outcomes. The reports shall include the following: (1) A statistical analysis regarding the reoffense and reinstitutionalization rate by the enrollees in the program set forth in RCW 71.24.455; (2) a quantitative description of the services provided in the program set forth in RCW 71.24.455; and (3) recommendations for any needed modifications in the services and funding levels to increase the effectiveness of the program set forth in RCW 71.24.455. By December 1, 2003, the department shall certify the reoffense rate for enrollees in the program authorized by RCW 71.24.455 to the office of financial management and the appropriate legislative committees. If the reoffense rate exceeds fifteen percent, the authorization for the department to conduct the program under RCW 71.24.455 is terminated on January 1, 2004.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
PurposeIntent1999 c 10: See note following RCW 71.24.025.
Severability1997 c 342: See note following RCW 71.24.450.



Offenders with mental illness who are believed to be dangerousContract for case managementUse of appropriated funds.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The director shall contract, to the extent that funds are appropriated for this purpose, for case management services and such other services as the director deems necessary to assist offenders identified under RCW 72.09.370 for participation in the offender reentry community safety program. The contracts may be with behavioral health organizations or any other qualified and appropriate entities.
(2) The case manager has the authority to assist these offenders in obtaining the services, as set forth in the plan created under RCW 72.09.370(2), for up to five years. The services may include coordination of mental health services, assistance with unfunded medical expenses, obtaining chemical dependency treatment, housing, employment services, educational or vocational training, independent living skills, parenting education, anger management services, and such other services as the case manager deems necessary.
(3) The legislature intends that funds appropriated for the purposes of RCW 72.09.370, 71.05.145, and 71.05.212, and this section and distributed to the behavioral health organizations are to supplement and not to supplant general funding. Funds appropriated to implement RCW 72.09.370, 71.05.145, and 71.05.212, and this section are not to be considered available resources as defined in RCW 71.24.025 and are not subject to the priorities, terms, or conditions in the appropriations act established pursuant to RCW 71.24.035.
(4) The offender reentry community safety program was formerly known as the community integration assistance program.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.
IntentEffective date1999 c 214: See notes following RCW 72.09.370.



Offenders with mental illness who are believed to be dangerousLimitation on liability due to treatmentReporting requirements.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) A licensed or certified service provider or behavioral health organization, acting in the course of the provider's or organization's duties under this chapter, is not liable for civil damages resulting from the injury or death of another caused by a participant in the offender reentry community safety program who is a client of the provider or organization, unless the act or omission of the provider or organization constitutes:
(a) Gross negligence;
(b) Willful or wanton misconduct; or
(c) A breach of the duty to warn of and protect from a client's threatened violent behavior if the client has communicated a serious threat of physical violence against a reasonably ascertainable victim or victims.
(2) In addition to any other requirements to report violations, the licensed or certified service provider and behavioral health organization shall report an offender's expressions of intent to harm or other predatory behavior, regardless of whether there is an ascertainable victim, in progress reports and other established processes that enable courts and supervising entities to assess and address the progress and appropriateness of treatment.
(3) A licensed or certified service provider's or behavioral health organization's mere act of treating a participant in the offender reentry community safety program is not negligence. Nothing in this subsection alters the licensed or certified service provider's or behavioral health organization's normal duty of care with regard to the client.
(4) The limited liability provided by this section applies only to the conduct of licensed or certified service providers and behavioral health organizations and does not apply to conduct of the state.
(5) For purposes of this section, "participant in the offender reentry community safety program" means a person who has been identified under RCW 72.09.370 as an offender who: (a) Is reasonably believed to be dangerous to himself or herself or others; and (b) has a mental disorder.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



Evaluation and treatment servicesCapacity needsRegional support network or behavioral health organization.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority must collaborate with regional support networks or behavioral health organizations and the Washington state institute for public policy to estimate the capacity needs for evaluation and treatment services within each regional service area. Estimated capacity needs shall include consideration of the average occupancy rates needed to provide an adequate network of evaluation and treatment services to ensure access to treatment. A regional service network or behavioral health organization must develop and maintain an adequate plan to provide for evaluation and treatment needs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2015 c 269 §§ 1-9 and 11-13: See note following RCW 71.05.010.



Written guidance and trainingsManaged careIncarcerated and involuntarily hospitalized persons.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The department of social and health services and the authority shall publish written guidance and provide trainings to behavioral health organizations, managed care organizations, and behavioral health providers related to how these organizations may provide outreach, assistance, transition planning, and rehabilitation case management reimbursable under federal law to persons who are incarcerated, involuntarily hospitalized, or in the process of transitioning out of one of these services. The guidance and trainings may also highlight preventive activities not reimbursable under federal law which may be cost-effective in a managed care environment. The purpose of this written guidance and trainings is to champion best clinical practices including, where appropriate, use of care coordination and long-acting injectable psychotropic medication, and to assist the health community to leverage federal funds and standardize payment and reporting procedures. The authority and the department of social and health services shall construe governing laws liberally to effectuate the broad remedial purposes of chapter 154, Laws of 2016, and provide a status update to the legislature by December 31, 2016.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Intent2016 c 154: See note following RCW 74.09.670.



Integrated comprehensive screening and assessment processImplementation.

(1) All persons providing treatment under this chapter shall also implement the integrated comprehensive screening and assessment process for substance use and mental disorders adopted pursuant to RCW 71.24.630 and shall document the numbers of clients with co-occurring mental and substance use disorders based on a quadrant system of low and high needs.
(2) Treatment providers contracted to provide treatment under this chapter who fail to implement the integrated comprehensive screening and assessment process for substance use and mental disorders are subject to contractual penalties established under RCW 71.24.630.

NOTES:

Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Chemical dependency specialist servicesTo be available at children and family services officesTraining in uniform screening.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The department of social and health services shall contract for chemical dependency specialist services at division of children and family services offices to enhance the timeliness and quality of child protective services assessments and to better connect families to needed treatment services.
(2) The chemical dependency specialist's duties may include, but are not limited to: Conducting on-site substance use disorder screening and assessment, facilitating progress reports to department of social and health services employees, in-service training of department of social and health services employees and staff on substance use disorder issues, referring clients from the department of social and health services to treatment providers, and providing consultation on cases to department of social and health services employees.
(3) The department of social and health services shall provide training in and ensure that each case-carrying employee is trained in uniform screening for mental health and substance use disorder.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2011 c 89: See note following RCW 18.320.005.
Findings2011 c 89: See RCW 18.320.005.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Chemical dependency program authority.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority, in the operation of the chemical dependency program[,] may:
(1) Plan, establish, and maintain prevention and treatment programs as necessary or desirable;
(2) Make contracts necessary or incidental to the performance of its duties and the execution of its powers, including managed care contracts for behavioral health services, contracts entered into under RCW 74.09.522, and contracts with public and private agencies, organizations, and individuals to pay them for services rendered or furnished to persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, or intoxicated persons;
(3) Enter into agreements for monitoring of verification of qualifications of counselors employed by approved treatment programs;
(4) Adopt rules under chapter 34.05 RCW to carry out the provisions and purposes of this chapter and contract, cooperate, and coordinate with other public or private agencies or individuals for those purposes;
(5) Solicit and accept for use any gift of money or property made by will or otherwise, and any grant of money, services, or property from the federal government, the state, or any political subdivision thereof or any private source, and do all things necessary to cooperate with the federal government or any of its agencies in making an application for any grant;
(6) Administer or supervise the administration of the provisions relating to persons with substance use disorders and intoxicated persons of any state plan submitted for federal funding pursuant to federal health, welfare, or treatment legislation;
(7) Coordinate its activities and cooperate with chemical dependency programs in this and other states, and make contracts and other joint or cooperative arrangements with state, local, or private agencies in this and other states for the treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons and for the common advancement of chemical dependency programs;
(8) Keep records and engage in research and the gathering of relevant statistics;
(9) Do other acts and things necessary or convenient to execute the authority expressly granted to it;
(10) Acquire, hold, or dispose of real property or any interest therein, and construct, lease, or otherwise provide treatment programs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



Agreements authorized under the interlocal cooperation act.

Pursuant to the interlocal cooperation act, chapter 39.34 RCW, the authority may enter into agreements to accomplish the purposes of this chapter.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



Local funding and donative funding requirementsFacilities, plans, programs.

Except as provided in this chapter, the director shall not approve any substance use disorder facility, plan, or program for financial assistance under RCW 71.24.520 unless at least ten percent of the amount spent for the facility, plan, or program is provided from local public or private sources. When deemed necessary to maintain public standards of care in the substance use disorder facility, plan, or program, the director may require the substance use disorder facility, plan, or program to provide up to fifty percent of the total spent for the program through fees, gifts, contributions, or volunteer services. The director shall determine the value of the gifts, contributions, and volunteer services.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Duties of authority.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall:
(1) Develop, encourage, and foster statewide, regional, and local plans and programs for the prevention of alcoholism and other drug addiction, treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons in cooperation with public and private agencies, organizations, and individuals and provide technical assistance and consultation services for these purposes;
(2) Assure that any behavioral health organization managed care contract, or managed care contract under RCW 74.09.522 for behavioral health services or programs for the treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons provides medically necessary services to medicaid recipients. This must include a continuum of mental health and substance use disorder services consistent with the state's medicaid plan or federal waiver authorities, and nonmedicaid services consistent with priorities established by the authority;
(3) Coordinate the efforts and enlist the assistance of all public and private agencies, organizations, and individuals interested in prevention of alcoholism and drug addiction, and treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons;
(4) Cooperate with public and private agencies in establishing and conducting programs to provide treatment for persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons who are clients of the correctional system;
(5) Cooperate with the superintendent of public instruction, state board of education, schools, police departments, courts, and other public and private agencies, organizations and individuals in establishing programs for the prevention of substance use disorders, treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons, and preparing curriculum materials thereon for use at all levels of school education;
(6) Prepare, publish, evaluate, and disseminate educational material dealing with the nature and effects of alcohol and other psychoactive chemicals and the consequences of their use;
(7) Develop and implement, as an integral part of substance use disorder treatment programs, an educational program for use in the treatment of persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons, which program shall include the dissemination of information concerning the nature and effects of alcohol and other psychoactive chemicals, the consequences of their use, the principles of recovery, and HIV and AIDS;
(8) Organize and foster training programs for persons engaged in treatment of persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons;
(9) Sponsor and encourage research into the causes and nature of substance use disorders, treatment of persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons, and serve as a clearinghouse for information relating to substance use disorders;
(10) Specify uniform methods for keeping statistical information by public and private agencies, organizations, and individuals, and collect and make available relevant statistical information, including number of persons treated, frequency of admission and readmission, and frequency and duration of treatment;
(11) Advise the governor in the preparation of a comprehensive plan for treatment of persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons for inclusion in the state's comprehensive health plan;
(12) Review all state health, welfare, and treatment plans to be submitted for federal funding under federal legislation, and advise the governor on provisions to be included relating to substance use disorders;
(13) Assist in the development of, and cooperate with, programs for alcohol and other psychoactive chemical education and treatment for employees of state and local governments and businesses and industries in the state;
(14) Use the support and assistance of interested persons in the community to encourage persons with substance use disorders voluntarily to undergo treatment;
(15) Cooperate with public and private agencies in establishing and conducting programs designed to deal with the problem of persons operating motor vehicles while intoxicated;
(16) Encourage general hospitals and other appropriate health facilities to admit without discrimination persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons and to provide them with adequate and appropriate treatment;
(17) Encourage all health and disability insurance programs to include substance use disorders as a covered illness; and
(18) Organize and sponsor a statewide program to help court personnel, including judges, better understand substance use disorders and the uses of substance use disorder treatment programs.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
Severability1979 ex.s. c 176: See note following RCW 46.61.502.



Drug courts.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall contract with counties operating drug courts and counties in the process of implementing new drug courts for the provision of substance use disorder treatment services.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Legislative recognition1999 c 197: "The legislature recognizes the utility of drug court programs in reducing recidivism and assisting the courts by diverting potential offenders from the normal course of criminal trial proceedings." [ 1999 c 197 § 7.]
Severability1999 c 197: See note following RCW 9.94A.030.



Comprehensive program for treatmentRegional facilities.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The authority shall establish by appropriate means a comprehensive and coordinated program for the treatment of persons with substance use disorders and their families, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons.
(2)(a) The program shall include, but not necessarily be limited to, a continuum of chemical dependency treatment services that includes:
(i) Withdrawal management;
(ii) Residential treatment; and
(iii) Outpatient treatment.
(b) The program may include peer support, supported housing, supported employment, crisis diversion, or recovery support services.
(3) All appropriate public and private resources shall be coordinated with and used in the program when possible.
(4) The authority may contract for the use of an approved treatment program or other individual or organization if the director considers this to be an effective and economical course to follow.
(5) By April 1, 2016, treatment provided under this chapter must be purchased primarily through managed care contracts. Consistent with RCW 71.24.580, services and funding provided through the criminal justice treatment account are intended to be exempted from managed care contracting.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



City, town, or county without facilityContribution of liquor taxes prerequisite to use of another's facility.

A city, town, or county that does not have its own facility or program for the treatment and rehabilitation of persons with substance use disorders may share in the use of a facility or program maintained by another city or county so long as it contributes no less than two percent of its share of liquor taxes and profits to the support of the facility or program.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.



Liquor taxes and profitsCity and county eligibility conditioned.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
To be eligible to receive its share of liquor taxes and profits, each city and county shall devote no less than two percent of its share of liquor taxes and profits to the support of a substance use disorder program approved by the behavioral health organization and the director, and licensed or certified by the department of health.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Opioid treatment programsPregnant womenInformation and education.

*** CHANGE IN 2019 *** (SEE 5380-S.SL) ***
(1) All approved opioid treatment programs that provide services to women who are pregnant are required to disseminate up-to-date and accurate health education information to all their pregnant clients concerning the possible addiction and health risks that their treatment may have on their baby. All pregnant clients must also be advised of the risks to both them and their baby associated with not remaining on the opioid treatment program. The information must be provided to these clients both verbally and in writing. The health education information provided to the pregnant clients must include referral options for the substance-exposed baby.
(2) The department shall adopt rules that require all opioid treatment programs to educate all pregnant women in their program on the benefits and risks of medication-assisted treatment to their fetus before they are provided these medications, as part of their treatment. The department shall meet the requirements under this subsection within the appropriations provided for opioid treatment programs. The department, working with treatment providers and medical experts, shall develop and disseminate the educational materials to all certified opioid treatment programs.

NOTES:

FindingsIntent2017 c 297: See note following RCW 18.22.800.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
FindingsIntent2005 c 70: "The legislature finds that drug use among pregnant women is a significant and growing concern statewide. The legislature further finds that methadone, although an effective alternative to other substance use treatments, can result in babies who are exposed to methadone while in uteri being born addicted and facing the painful effects of withdrawal.
It is the intent of the legislature to notify all pregnant mothers who are receiving methadone treatment of the risks and benefits methadone could have on their baby during pregnancy through birth and to inform them of the potential need for the newborn baby to be taken care of in a hospital setting or in a specialized supportive environment designed specifically to address newborn addiction problems." [ 2005 c 70 § 1.]
Short title1995 c 312: See note following RCW 13.32A.010.
Effective date1989 c 175: See note following RCW 34.05.010.



Acceptance for approved treatmentRules.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The director shall adopt and may amend and repeal rules for acceptance of persons into the approved treatment program, considering available treatment resources and facilities, for the purpose of early and effective treatment of persons with substance use disorders, persons incapacitated by alcohol or other psychoactive chemicals, and intoxicated persons. In establishing the rules, the *secretary shall be guided by the following standards:
(1) If possible a patient shall be treated on a voluntary rather than an involuntary basis.
(2) A patient shall be initially assigned or transferred to outpatient treatment, unless he or she is found to require residential treatment.
(3) A person shall not be denied treatment solely because he or she has withdrawn from treatment against medical advice on a prior occasion or because he or she has relapsed after earlier treatment.
(4) An individualized treatment plan shall be prepared and maintained on a current basis for each patient.
(5) Provision shall be made for a continuum of coordinated treatment services, so that a person who leaves a facility or a form of treatment will have available and use other appropriate treatment.

NOTES:

*Reviser's note: The powers, duties, and functions of the secretary of the department of social and health services pertaining to the behavioral health system and purchasing function of the behavioral health administration, except for oversight and management of state-run mental health institutions and licensing and certification activities, were transfered to the director of the health care authority by chapter 201, Laws of 2018.
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2014 c 225: See note following RCW 71.24.016.



Emergency service patrolEstablishmentRules.

(1) The state and counties, cities, and other municipalities may establish or contract for emergency service patrols which are to be under the administration of the appropriate jurisdiction. A patrol consists of persons trained to give assistance in the streets and in other public places to persons who are intoxicated. Members of an emergency service patrol shall be capable of providing first aid in emergency situations and may transport intoxicated persons to their homes and to and from substance use disorder treatment programs.
(2) The secretary shall adopt rules pursuant to chapter 34.05 RCW for the establishment, training, and conduct of emergency service patrols.

NOTES:

Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Criminal laws limitations.

(1) No county, municipality, or other political subdivision may adopt or enforce a local law, ordinance, resolution, or rule having the force of law that includes drinking, being an individual with a substance use disorder, or being found in an intoxicated condition as one of the elements of the offense giving rise to a criminal or civil penalty or sanction.
(2) No county, municipality, or other political subdivision may interpret or apply any law of general application to circumvent the provision of subsection (1) of this section.
(3) Nothing in this chapter affects any law, ordinance, resolution, or rule against drunken driving, driving under the influence of alcohol or other psychoactive chemicals, or other similar offense involving the operation of a vehicle, aircraft, boat, machinery, or other equipment, or regarding the sale, purchase, dispensing, possessing, or use of alcoholic beverages or other psychoactive chemicals at stated times and places or by a particular class of persons; nor shall evidence of intoxication affect, other than as a defense, the application of any law, ordinance, resolution, or rule to conduct otherwise establishing the elements of an offense.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.



Criminal justice treatment account.

*** CHANGE IN 2019 *** (SEE 1109-S.SL) ***
*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
*** CHANGE IN 2019 *** (SEE 5380-S.SL) ***
(1) The criminal justice treatment account is created in the state treasury. Moneys in the account may be expended solely for: (a) Substance use disorder treatment and treatment support services for offenders with a substance use disorder that, if not treated, would result in addiction, against whom charges are filed by a prosecuting attorney in Washington state; (b) the provision of substance use disorder treatment services and treatment support services for nonviolent offenders within a drug court program; and (c) the administrative and overhead costs associated with the operation of a drug court. Amounts provided in this subsection must be used for treatment and recovery support services for criminally involved offenders and authorization of these services shall not be subject to determinations of medical necessity. During the 2017-2019 fiscal biennium, the legislature may direct the state treasurer to make transfers of moneys in the criminal justice treatment account to the state general fund. It is the intent of the legislature to continue in the 2019-2021 biennium the policy of transferring to the state general fund such amounts as reflect the excess fund balance of the account. Moneys in the account may be spent only after appropriation.
(2) For purposes of this section:
(a) "Treatment" means services that are critical to a participant's successful completion of his or her substance use disorder treatment program, including but not limited to the recovery support and other programmatic elements outlined in RCW 2.30.030 authorizing therapeutic courts; and
(b) "Treatment support" includes transportation to or from inpatient or outpatient treatment services when no viable alternative exists, and child care services that are necessary to ensure a participant's ability to attend outpatient treatment sessions.
(3) Revenues to the criminal justice treatment account consist of: (a) Funds transferred to the account pursuant to this section; and (b) any other revenues appropriated to or deposited in the account.
(4)(a) For the fiscal year beginning July 1, 2005, and each subsequent fiscal year, the state treasurer shall transfer eight million two hundred fifty thousand dollars from the general fund to the criminal justice treatment account, divided into four equal quarterly payments. For the fiscal year beginning July 1, 2006, and each subsequent fiscal year, the amount transferred shall be increased on an annual basis by the implicit price deflator as published by the federal bureau of labor statistics.
(b) In each odd-numbered year, the legislature shall appropriate the amount transferred to the criminal justice treatment account in (a) of this subsection to the department for the purposes of subsection (5) of this section.
(5) Moneys appropriated to the authority from the criminal justice treatment account shall be distributed as specified in this subsection. The authority may retain up to three percent of the amount appropriated under subsection (4)(b) of this section for its administrative costs.
(a) Seventy percent of amounts appropriated to the authority from the account shall be distributed to counties pursuant to the distribution formula adopted under this section. The authority, in consultation with the department of corrections, the Washington state association of counties, the Washington state association of drug court professionals, the superior court judges' association, the Washington association of prosecuting attorneys, representatives of the criminal defense bar, representatives of substance use disorder treatment providers, and any other person deemed by the authority to be necessary, shall establish a fair and reasonable methodology for distribution to counties of moneys in the criminal justice treatment account. County or regional plans submitted for the expenditure of formula funds must be approved by the panel established in (b) of this subsection.
(b) Thirty percent of the amounts appropriated to the authority from the account shall be distributed as grants for purposes of treating offenders against whom charges are filed by a county prosecuting attorney. The authority shall appoint a panel of representatives from the Washington association of prosecuting attorneys, the Washington association of sheriffs and police chiefs, the superior court judges' association, the Washington state association of counties, the Washington defender's association or the Washington association of criminal defense lawyers, the department of corrections, the Washington state association of drug court professionals, and substance use disorder treatment providers. The panel shall review county or regional plans for funding under (a) of this subsection and grants approved under this subsection. The panel shall attempt to ensure that treatment as funded by the grants is available to offenders statewide.
(6) The county alcohol and drug coordinator, county prosecutor, county sheriff, county superior court, a substance abuse treatment provider appointed by the county legislative authority, a member of the criminal defense bar appointed by the county legislative authority, and, in counties with a drug court, a representative of the drug court shall jointly submit a plan, approved by the county legislative authority or authorities, to the panel established in subsection (5)(b) of this section, for disposition of all the funds provided from the criminal justice treatment account within that county. The funds shall be used solely to provide approved alcohol and substance abuse treatment pursuant to RCW 71.24.560 and treatment support services. No more than ten percent of the total moneys received under subsections (4) and (5) of this section by a county or group of counties participating in a regional agreement shall be spent for treatment support services.
(7) Counties are encouraged to consider regional agreements and submit regional plans for the efficient delivery of treatment under this section.
(8) Moneys allocated under this section shall be used to supplement, not supplant, other federal, state, and local funds used for substance abuse treatment.
(9) Counties must meet the criteria established in RCW 2.30.030(3).

NOTES:

Reviser's note: This section was amended by 2018 c 201 § 4044 and by 2018 c 205 § 2, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
FindingIntent2018 c 205: "Drug courts remove a defendant's or respondent's case from the criminal and civil court traditional trial track and allow those defendants or respondents the opportunity to obtain treatment services to address particular issues that may have contributed to the conduct that led to their arrest or other issues before the court. Such courts, by focusing on specific individuals' needs, provide treatment for the issues presented and ensure rapid and appropriate accountability for program violations, which decreases recidivism, improves the safety of the community, and improves the life of the program participant and the lives of the participant's family members by decreasing the severity and frequency of the specific behavior addressed by the therapeutic court. Therefore, the legislature finds compelling the research conducted by the Washington state institute for public policy and the research and data analysis division of the department of social and health services showing that providing recovery support services to clients in drug courts creates a benefit to the state of approximately seven dollars and sixty cents in reduced public expenditures and reduced costs of victimization for each dollar spent. Therefore, it is the intent of the legislature to allow the use of a portion of the criminal justice treatment account to provide such services to foster increased success in drug courts." [ 2018 c 205 § 1.]
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2017 3rd sp.s. c 1: See note following RCW 43.41.455.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective dates2015 3rd sp.s. c 4: See note following RCW 28B.15.069.
Conflict with federal requirements2015 c 291: See note following RCW 2.30.010.
Effective dates2013 2nd sp.s. c 4: See note following RCW 2.68.020.
Effective dates2011 2nd sp.s. c 9: See note following RCW 28B.50.837.
ApplicationRecalculation of community custody terms2011 1st sp.s. c 40: See note following RCW 9.94A.501.
Effective date2009 c 479: See note following RCW 2.56.030.
SeverabilityEffective date2008 c 329: See notes following RCW 28B.105.110.
SeverabilityEffective dates2003 c 379: See notes following RCW 9.94A.728.
Effective date2002 c 290 §§ 1, 4-6, 12, 13, 26, and 27: "Sections 1, 4 through 6, 12, 13, 26, and 27 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and take effect immediately [April 1, 2002]." [ 2002 c 290 § 32.]
Intent2002 c 290: See note following RCW 9.94A.517.



Review of expenditures for drug and alcohol treatment.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall annually review and monitor the expenditures made by any county or group of counties which is funded, in whole or in part, with funds provided by chapter 290, Laws of 2002. Counties shall repay any funds that are not spent in accordance with the requirements of chapter 290, Laws of 2002.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2002 c 290 §§ 1, 4-6, 12, 13, 26, and 27: See note following RCW 71.24.580.
Intent2002 c 290: See note following RCW 9.94A.517.



Opioid use disorder treatmentDeclaration of regulation by state.

*** CHANGE IN 2019 *** (SEE 5380-S.SL) ***
The state of Washington declares that there is no fundamental right to medication-assisted treatment for opioid use disorder. The state of Washington further declares that while medications used in the treatment of opioid use disorder are addictive substances, that they nevertheless have several legal, important, and justified uses and that one of their appropriate and legal uses is, in conjunction with other required therapeutic procedures, in the treatment of persons with opioid use disorder. The state of Washington recognizes as evidence-based for the management of opioid use disorder the medications approved by the federal food and drug administration for the treatment of opioid use disorder. Medication-assisted treatment should only be used for participants who are deemed appropriate to need this level of intervention. Providers must inform patients of all treatment options available. The provider and the patient shall consider alternative treatment options, like abstinence, when developing the treatment plan. If medications are prescribed, follow up must be included in the treatment plan in order to work towards the goal of abstinence.
Because some such medications are controlled substances in chapter 69.50 RCW, the state of Washington maintains the legal obligation and right to regulate the clinical uses of these medications in the treatment of opioid use disorder.
Further, the state declares that the main goal of opiate substitution treatment is total abstinence from substance use for the individuals who participate in the treatment program, but recognizes the additional goals of reduced morbidity, and restoration of the ability to lead a productive and fulfilling life. The state recognizes that a small percentage of persons who participate in opioid treatment programs require treatment for an extended period of time. Opioid treatment programs shall provide a comprehensive transition program to eliminate substance use, including opioid use of program participants.

NOTES:

FindingsIntent2017 c 297: See note following RCW 18.22.800.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Opioid use disorder treatmentPossession or use of lawfully prescribed medicationDeclaration by state.

The state declares that a person lawfully possessing or using lawfully prescribed medication for the treatment of opioid use disorder must be treated the same in judicial and administrative proceedings as a person lawfully possessing or using other lawfully prescribed medications.

NOTES:

FindingsIntent2017 c 297: See note following RCW 18.22.800.



Opioid treatmentProgram licensing or certification by department, department dutiesDefinition.

*** CHANGE IN 2019 *** (SEE 5380-S.SL) ***
(1) When making a decision on an application for licensing or certification of a program, the department shall:
(a) Consult with the county legislative authorities in the area in which an applicant proposes to locate a program and the city legislative authority in any city in which an applicant proposes to locate a program;
(b) License or certify only programs that will be sited in accordance with the appropriate county or city land use ordinances. Counties and cities may require conditional use permits with reasonable conditions for the siting of programs. Pursuant to RCW 36.70A.200, no local comprehensive plan or development regulation may preclude the siting of essential public facilities;
(c) Not discriminate in its licensing or certification decision on the basis of the corporate structure of the applicant;
(d) Consider the size of the population in need of treatment in the area in which the program would be located and license or certify only applicants whose programs meet the necessary treatment needs of that population;
(e) Consider the availability of other certified opioid treatment programs near the area in which the applicant proposes to locate the program;
(f) Consider the transportation systems that would provide service to the program and whether the systems will provide reasonable opportunities to access the program for persons in need of treatment;
(g) Consider whether the applicant has, or has demonstrated in the past, the capability to provide the appropriate services to assist the persons who utilize the program in meeting goals established by the legislature in RCW 71.24.585. The department shall prioritize licensing or certification to applicants who have demonstrated such capability and are able to measure their success in meeting such outcomes;
(h) Hold one public hearing in the community in which the facility is proposed to be located. The hearing shall be held at a time and location that are most likely to permit the largest number of interested persons to attend and present testimony. The department shall notify all appropriate media outlets of the time, date, and location of the hearing at least three weeks in advance of the hearing.
(2) A county may impose a maximum capacity for a program of not less than three hundred fifty participants if necessary to address specific local conditions cited by the county.
(3) A program applying for licensing or certification from the department and a program applying for a contract from a state agency that has been denied the licensing or certification or contract shall be provided with a written notice specifying the rationale and reasons for the denial.
(4) For the purpose of this chapter, opioid treatment program means:
(a) Dispensing a medication approved by the federal drug administration for the treatment of opioid use disorder and dispensing medication for the reversal of opioid overdose; and
(b) Providing a comprehensive range of medical and rehabilitative services.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Contingent effective date2017 c 297 §§ 14 and 16: "Sections 14 and 16 of this act take effect only if neither Substitute House Bill No. 1388 (including any later amendments or substitutes) nor Substitute Senate Bill No. 5259 (including any later amendments or substitutes) is signed into law by the governor by July 23, 2017." [ 2017 c 297 § 18.] Neither Substitute House Bill No. 1388 nor Substitute Senate Bill No. 5259 was signed into law by July 23, 2017.
FindingsIntent2017 c 297: See note following RCW 18.22.800.



Statewide treatment and operating standards for opioid treatment programsEvaluation and report.

*** CHANGE IN 2019 *** (SEE 5380-S.SL) ***
(1) The department, in consultation with opioid treatment program service providers and counties and cities, shall establish statewide treatment standards for licensed or certified opioid treatment programs. The department shall enforce these treatment standards. The treatment standards shall include, but not be limited to, reasonable provisions for all appropriate and necessary medical procedures, counseling requirements, urinalysis, and other suitable tests as needed to ensure compliance with this chapter.
(2) The department, in consultation with opioid treatment programs and counties, shall establish statewide operating standards for certified opioid treatment programs. The department shall enforce these operating standards. The operating standards shall include, but not be limited to, reasonable provisions necessary to enable the department and counties to monitor certified or licensed opioid treatment programs for compliance with this chapter and the treatment standards authorized by this chapter and to minimize the impact of the opioid treatment programs upon the business and residential neighborhoods in which the program is located.
(3) The department shall analyze and evaluate the data submitted by each treatment program and take corrective action where necessary to ensure compliance with the goals and standards enumerated under this chapter. Opioid treatment programs are subject to the oversight required for other substance use disorder treatment programs, as described in this chapter.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Contingent effective date2017 c 297 §§ 14 and 16: See note following RCW 71.24.590.
FindingsIntent2017 c 297: See note following RCW 18.22.800.



Inability to contribute to cost no bar to admissionAuthority may limit admissions.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall not refuse admission for diagnosis, evaluation, guidance or treatment to any applicant because it is determined that the applicant is financially unable to contribute fully or in part to the cost of any services or facilities available under the program on alcoholism.
The authority may limit admissions of such applicants or modify its programs in order to ensure that expenditures for services or programs do not exceed amounts appropriated by the legislature and are allocated by the authority for such services or programs. The authority may establish admission priorities in the event that the number of eligible applicants exceeds the limits set by the authority.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Severability1989 c 271: See note following RCW 9.94A.510.



Fetal alcohol screening and assessment services.

The authority shall contract with the University of Washington fetal alcohol syndrome clinic to provide fetal alcohol exposure screening and assessment services. The University indirect charges shall not exceed ten percent of the total contract amount. The contract shall require the University of Washington fetal alcohol syndrome clinic to provide the following services:
(1) Training for health care staff in community-based fetal alcohol exposure clinics to ensure the accurate diagnosis of individuals with fetal alcohol exposure and the development and implementation of appropriate service referral plans;
(2) Development of written or visual educational materials for the individuals diagnosed with fetal alcohol exposure and their families or caregivers;
(3) Systematic information retrieval from each community clinic to (a) maintain diagnostic accuracy and reliability across all community clinics, (b) facilitate the development of effective and efficient screening tools for population-based identification of individuals with fetal alcohol exposure, (c) facilitate identification of the most clinically efficacious and cost-effective educational, social, vocational, and health service interventions for individuals with fetal alcohol exposure;
(4) Based on available funds, establishment of a network of community-based fetal alcohol exposure clinics across the state to meet the demand for fetal alcohol exposure diagnostic and referral services; and
(5) Preparation of an annual report for submission to the authority, the department of health, the department of social and health services, the department of corrections, and the office of the superintendent of public instruction which includes the information retrieved under subsection (3) of this section.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingsPurpose1995 c 54: "The legislature finds that fetal alcohol exposure is among the leading known causes of mental retardation in the children of our state. The legislature further finds that individuals with undiagnosed fetal alcohol exposure suffer substantially from secondary disabilities such as child abuse and neglect, separation from families, multiple foster placements, depression, aggression, school failure, juvenile detention, and job instability. These secondary disabilities come at a high cost to the individuals, their family, and society. The legislature finds that these problems can be reduced substantially by early diagnosis and receipt of appropriate, effective intervention.
The purpose of this act is to support current public and private efforts directed at the early identification of and intervention into the problems associated with fetal alcohol exposure through the creation of a fetal alcohol exposure clinical network." [ 1995 c 54 § 1.]



Interagency agreement on fetal alcohol exposure programs.

The authority, the department of social and health services, the department of health, the department of corrections, and the office of the superintendent of public instruction shall execute an interagency agreement to ensure the coordination of identification, prevention, and intervention programs for children who have fetal alcohol exposure, and for women who are at high risk of having children with fetal alcohol exposure.
The interagency agreement shall provide a process for community advocacy groups to participate in the review and development of identification, prevention, and intervention programs administered or contracted for by the agencies executing this agreement.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingsPurpose1995 c 54: See note following RCW 71.24.605.



Chemical dependency treatment expendituresPrioritization.

The authority shall prioritize expenditures for treatment provided under RCW 13.40.165. The authority shall provide funds for inpatient and outpatient treatment providers that are the most successful, using the standards developed by the University of Washington under section 27, chapter 338, Laws of 1997. The authority may consider variations between the nature of the programs provided and clients served but must provide funds first for those programs that demonstrate the greatest success in treatment within categories of treatment and the nature of the persons receiving treatment.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
FindingEvaluationReport1997 c 338: See note following RCW 13.40.0357.
SeverabilityEffective dates1997 c 338: See notes following RCW 5.60.060.



Persons with substance use disordersIntensive case management pilot projects.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Subject to funds appropriated for this specific purpose, the director shall select and contract with behavioral health organizations to provide intensive case management for persons with substance use disorders and histories of high utilization of crisis services at two sites. In selecting the two sites, the director shall endeavor to site one in an urban county, and one in a rural county; and to site them in counties other than those selected pursuant to *RCW 70.96B.020, to the extent necessary to facilitate evaluation of pilot project results. Subject to funds appropriated for this specific purpose, the secretary may contract with additional counties to provide intensive case management.
(2) The contracted sites shall implement the pilot programs by providing intensive case management to persons with a primary substance use disorder diagnosis or dual primary substance use disorder and mental health diagnoses, through the employment of substance use disorder case managers. The substance use disorder case managers shall:
(a) Be trained in and use the integrated, comprehensive screening and assessment process adopted under RCW 71.24.630;
(b) Reduce the use of crisis medical, substance use disorder treatment and mental health services, including but not limited to emergency room admissions, hospitalizations, withdrawal management programs, inpatient psychiatric admissions, involuntary treatment petitions, emergency medical services, and ambulance services;
(c) Reduce the use of emergency first responder services including police, fire, emergency medical, and ambulance services;
(d) Reduce the number of criminal justice interventions including arrests, violations of conditions of supervision, bookings, jail days, prison sanction day for violations, court appearances, and prosecutor and defense costs;
(e) Where appropriate and available, work with therapeutic courts including drug courts and mental health courts to maximize the outcomes for the individual and reduce the likelihood of reoffense;
(f) Coordinate with local offices of the economic services administration to assist the person in accessing and remaining enrolled in those programs to which the person may be entitled;
(g) Where appropriate and available, coordinate with primary care and other programs operated through the federal government including federally qualified health centers, Indian health programs, and veterans' health programs for which the person is eligible to reduce duplication of services and conflicts in case approach;
(h) Where appropriate, advocate for the client's needs to assist the person in achieving and maintaining stability and progress toward recovery;
(i) Document the numbers of persons with co-occurring mental and substance use disorders and the point of determination of the co-occurring disorder by quadrant of intensity of need; and
(j) Where a program participant is under supervision by the department of corrections, collaborate with the department of corrections to maximize treatment outcomes and reduce the likelihood of reoffense.
(3) The pilot programs established by this section shall begin providing services by March 1, 2006.

NOTES:

*Reviser's note: RCW 70.96B.020 was repealed by 2016 sp.s. c 29 § 301.
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Uniform application of chapterTraining for behavioral health organization-designated chemical dependency specialists.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The authority shall ensure that the provisions of this chapter are applied by the behavioral health organizations in a consistent and uniform manner. The authority shall also ensure that, to the extent possible within available funds, the behavioral health organization-designated chemical dependency specialists are specifically trained in adolescent chemical dependency issues, the chemical dependency commitment laws, and the criteria for commitment, as specified in this chapter and *chapter 70.96A RCW.

NOTES:

*Reviser's note: Chapter 70.96A RCW was repealed and/or recodified in its entirety pursuant to 2016 sp.s. c 29 §§ 301, 601, and 701.
FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Part headings not lawSeverability1992 c 205: See notes following RCW 13.40.010.



Integrated, comprehensive screening and assessment process for substance use and mental disorders.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The authority shall maintain an integrated and comprehensive screening and assessment process for substance use and mental disorders and co-occurring substance use and mental disorders.
(a) The process adopted shall include, at a minimum:
(i) An initial screening tool that can be used by intake personnel system-wide and which will identify the most common types of co-occurring disorders;
(ii) An assessment process for those cases in which assessment is indicated that provides an appropriate degree of assessment for most situations, which can be expanded for complex situations;
(iii) Identification of triggers in the screening that indicate the need to begin an assessment;
(iv) Identification of triggers after or outside the screening that indicate a need to begin or resume an assessment;
(v) The components of an assessment process and a protocol for determining whether part or all of the assessment is necessary, and at what point; and
(vi) Emphasis that the process adopted under this section is to replace and not to duplicate existing intake, screening, and assessment tools and processes.
(b) The authority shall consider existing models, including those already adopted by other states, and to the extent possible, adopt an established, proven model.
(c) The integrated, comprehensive screening and assessment process shall be implemented statewide by all substance use disorder and mental health treatment providers as well as all designated mental health professionals, designated chemical dependency specialists, and designated crisis responders.
(2) The authority shall provide adequate training to effect statewide implementation by the dates designated in this section and shall report the rates of co-occurring disorders and the stage of screening or assessment at which the co-occurring disorder was identified to the appropriate committees of the legislature.
(3) The authority shall establish contractual penalties to contracted treatment providers, the behavioral health organizations, and their contracted providers for failure to implement the integrated screening and assessment process.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.
Effective date2014 c 225: See note following RCW 71.24.016.
FindingsIntentSeverabilityApplicationConstructionCaptions, part headings, subheadings not lawAdoption of rulesEffective dates2005 c 504: See notes following RCW 71.05.027.
AlphabetizationCorrection of references2005 c 504: See note following RCW 71.05.020.



Standards for certification or licensure of evaluation and treatment facilities.

The secretary shall license or certify evaluation and treatment facilities that meet state minimum standards. The standards for certification or licensure of evaluation and treatment facilities by the department must include standards relating to maintenance of good physical and mental health and other services to be afforded persons pursuant to this chapter and chapters 71.05 and 71.34 RCW, and must otherwise assure the effectuation of the purposes of these chapters.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Standards for certification or licensure of crisis stabilization units.

The secretary shall license or certify crisis stabilization units that meet state minimum standards. The standards for certification or licensure of crisis stabilization units by the department must include standards that:
(1) Permit location of the units at a jail facility if the unit is physically separate from the general population of the jail;
(2) Require administration of the unit by mental health professionals who direct the stabilization and rehabilitation efforts; and
(3) Provide an environment affording security appropriate with the alleged criminal behavior and necessary to protect the public safety.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Standards for certification or licensure of triage facilities.

The secretary shall license or certify triage facilities that meet state minimum standards. The standards for certification or licensure of triage facilities by the department must include standards related to the ability to assess and stabilize an individual or determine the need for involuntary commitment of an individual.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



Standards for certification or licensure of a clubhouse.

The secretary shall license or certify clubhouses that meet state minimum standards. The standards for certification or licensure of a clubhouse by the department must at a minimum include:
(1) The facilities may be peer-operated and must be recovery-focused;
(2) Members and employees must work together;
(3) Members must have the opportunity to participate in all the work of the clubhouse, including administration, research, intake and orientation, outreach, hiring, training and evaluation of staff, public relations, advocacy, and evaluation of clubhouse effectiveness;
(4) Members and staff and ultimately the clubhouse director must be responsible for the operation of the clubhouse, central to this responsibility is the engagement of members and staff in all aspects of clubhouse operations;
(5) Clubhouse programs must be comprised of structured activities including but not limited to social skills training, vocational rehabilitation, employment training and job placement, and community resource development;
(6) Clubhouse programs must provide in-house educational programs that significantly utilize the teaching and tutoring skills of members and assist members by helping them to take advantage of adult education opportunities in the community;
(7) Clubhouse programs must focus on strengths, talents, and abilities of its members;
(8) The work-ordered day may not include medication clinics, day treatment, or other therapy programs within the clubhouse.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective dates2016 sp.s. c 29: See note following RCW 71.05.760.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Mental health system reviewPerformance audit recommendations affirmed.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The legislature affirms its support for those recommendations of the performance audit of the public mental health system conducted by the joint legislative audit and review committee relating to: Improving the coordination of services for clients with multiple needs; improving the consistency of client, service, and fiscal data collected by the authority; replacing process-oriented accountability activities with a uniform statewide outcome measurement system; and using outcome information to identify and provide incentives for best practices in the provision of public mental health services.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2001 c 334: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [May 15, 2001]." [ 2001 c 334 § 10.]



Mental health system reviewImplementation of performance audit recommendations.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The legislature supports recommendations 1 through 10 and 12 through 14 of the mental health system performance audit conducted by the joint legislative audit and review committee. The legislature expects the authority to work diligently within available funds to implement these recommendations.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Effective date2001 c 334: See note following RCW 71.24.805.



Mental health system reviewStudy of long-term outcomes.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The Washington institute for public policy shall conduct a longitudinal study of long-term client outcomes to assess any changes in client status at two, five, and ten years. The measures tracked shall include client change as a result of services, employment and/or education, housing stability, criminal justice involvement, and level of services needed. The institute shall report these long-term outcomes to the appropriate policy and fiscal committee of the legislature annually beginning not later than December 31, 2005.

NOTES:

Effective date2001 c 334: See note following RCW 71.24.805.



Behavioral health organizationsTransfers between organizations.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
The behavioral health organizations shall jointly develop a uniform transfer agreement to govern the transfer of clients between behavioral health organizations. By September 1, 2013, the behavioral health organizations shall submit the uniform transfer agreement to the department. By December 1, 2013, the department shall establish guidelines to implement the uniform transfer agreement and may modify the uniform transfer agreement as necessary to avoid impacts on state administrative systems.

NOTES:

Effective date2014 c 225: See note following RCW 71.24.016.



Regional service areasReportManaged care integration.

(1) By December 1, 2018, the department of social and health services and the authority shall report to the governor and the legislature regarding the preparedness of each regional service area to provide mental health services, chemical dependency services, and medical care services to medicaid clients under a fully integrated managed care health system.
(2) By January 1, 2020, the community behavioral health program must be fully integrated in a managed care health system that provides mental health services, chemical dependency services, and medical care services to medicaid clients.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



FindingIntentState hospitals.

The legislature finds that the growing demand for state hospital beds has strained the state's capacity to meet the demand while providing for a sufficient workforce to operate the state hospitals safely. It is the intent of the legislature that the executive and legislative branches work collaboratively to maximize access to, safety of, and the therapeutic role of the state hospitals to best serve patients while ensuring the safety of patients and employees.



Task forceIntegrated behavioral health services.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) The department of social and health services and the authority shall convene a task force including participation by a representative cross-section of behavioral health organizations and behavioral health providers to align regulations between behavioral health and primary health care settings and simplify regulations for behavioral health providers. The alignment must support clinical integration from the standpoint of standardizing practices and culture in a manner that to the extent practicable reduces barriers to access, including reducing the paperwork burden for patients and providers. Brief integrated behavioral health services must not, in general, take longer to document than to provide. Regulations should emphasize the desired outcome rather than how they should be achieved. The task force may also make recommendations to the department of social and health services concerning subsections (2) and (3) of this section.
(2) The department of social and health services shall collaborate with the department of health, the Washington state health care authority, and other appropriate government partners to reduce unneeded costs and burdens to health plans and providers associated with excessive audits, the licensing process, and contracting. In pursuit of this goal, the department of social and health services shall consider steps such as cooperating across divisions and agencies to combine audit functions when multiple audits of an agency or site are scheduled, sharing audit information across divisions and agencies to reduce redundancy of audits, and treating organizations with multiple sites and programs as single entities instead of as multiple agencies.
(3) The department of social and health services shall review its practices under RCW 71.24.035(5)(c)(i) to determine whether its practices comply with the statutory mandate to deem accreditation by recognized behavioral health accrediting bodies as equivalent to meeting licensure requirements, comport with standard practices used by other state divisions or agencies, and properly incentivize voluntary accreditation to the highest industry standards.
(4) The task force described in subsection (1) of this section must consider means to provide notice to parents when a minor requests chemical dependency treatment, which are consistent with federal privacy laws and consistent with the best interests of the minor and the minor's family. The department of social and health services must provide a report to the relevant committees of the legislature by December 1, 2016.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.
Short titleRight of action2016 sp.s. c 29: See notes following RCW 71.05.010.



Behavioral health servicesReview of rules, policies, and procedures by departmentAdoption of rulesAudit.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
(1) Subject to the availability of amounts appropriated for this specific purpose, the department must immediately perform a review of its rules, policies, and procedures related to the documentation requirements for behavioral health services. Rules adopted by the department relating to the provision of behavioral health services must:
(a) Identify areas in which duplicative or inefficient documentation requirements can be eliminated or streamlined for providers;
(b) Limit prescriptive requirements for individual initial assessments to allow clinicians to exercise professional judgment to conduct age-appropriate, strength-based psychosocial assessments, including current needs and relevant history according to current best practices;
(c) By April 1, 2018, provide a single set of regulations for agencies to follow that provide mental health, substance use disorder, and co-occurring treatment services;
(d) Exempt providers from duplicative state documentation requirements when the provider is following documentation requirements of an evidence-based, research-based, or state-mandated program that provides adequate protection for patient safety; and
(e) Be clear and not unduly burdensome in order to maximize the time available for the provision of care.
(2) Subject to the availability of amounts appropriated for this specific purpose, audits conducted by the department relating to provision of behavioral health services must:
(a) Rely on a sampling methodology to conduct reviews of personnel files and clinical records based on written guidelines established by the department that are consistent with the standards of other licensing and accrediting bodies;
(b) Treat organizations with multiple locations as a single entity. The department must not require annual visits at all locations operated by a single entity when a sample of records may be reviewed from a centralized location;
(c) Share audit results with behavioral health organizations to assist with their review process and, when appropriate, take steps to coordinate and combine audit activities;
(d) Coordinate audit functions between the department and the department of health to combine audit activities into a single site visit and eliminate redundancies;
(e) Not require information to be provided in particular documents or locations when the same information is included or demonstrated elsewhere in the clinical file, except where required by federal law; and
(f) Ensure that audits involving manualized programs such as wraparound with intensive services or other evidence or research-based programs are conducted to the extent practicable by personnel familiar with the program model and in a manner consistent with the documentation requirements of the program.

NOTES:

Contingent effective date2017 c 207 § 2: "Section 2 of this act takes effect only if neither Substitute House Bill No. 1388 (including any later amendments or substitutes) nor Substitute Senate Bill No. 5259 (including any later amendments or substitutes) is signed into law by the governor by July 23, 2017." [ 2017 c 207 § 5.] Neither Substitute House Bill No. 1388 nor Substitute Senate Bill No. 5259 was signed into law by July 23, 2017.
FindingsIntent2017 c 207: "The legislature finds that a prioritized recommendation of the children's mental health work group, as reported in December 2016, is to reduce burdensome and duplicative paperwork requirements for providers of children's mental health services. This recommendation is consistent with the recommendations of the behavioral health workforce assessment of the workforce training and education coordinating board to reduce time-consuming documentation requirements and the behavioral and primary health regulatory alignment task force to streamline regulations and reduce the time spent responding to inefficient and excessive audits.
The legislature further finds that duplicative and overly prescriptive documentation and audit requirements negatively impact the adequacy of the provider network by reducing workforce morale and limiting the time available for patient care. Such requirements create costly barriers to the efficient provision of services for children and their families. The legislature also finds that current state regulations are often duplicative or conflicting with research-based models and other state-mandated treatment models intended to improve the quality of services and ensure positive outcomes. These barriers can be reduced while creating a greater emphasis on quality, outcomes, and safety.
The legislature further finds that social workers serving children are encumbered by burdensome paperwork requirements which can interfere with the effective delivery of services.
Therefore, the legislature intends to require the department of social and health services to take steps to reduce paperwork, documentation, and audit requirements that are inefficient or duplicative for social workers who serve children and for providers of mental health services to children and families, and to encourage the use of effective treatment models to improve the quality of services." [ 2017 c 207 § 1.]



Interlocal leadership structureTransition to fully integrated managed care within a regional service area.

(1) The authority shall, upon the request of a county authority or authorities within a regional service area, collaborate with counties to create an interlocal leadership structure that includes participation from counties and the managed health care systems serving that regional service area. The interlocal leadership structure must include representation from physical and behavioral health care providers, tribes, and other entities serving the regional service area as necessary.
(2) The interlocal leadership structure regional organization must be chaired by the counties and jointly administered by the authority, managed health care systems, and counties. It must design and implement the fully integrated managed care model for that regional service area to assure clients are at the center of care delivery and support integrated delivery of physical and behavioral health care at the provider level.
(3) The interlocal leadership structure may address, but is not limited to addressing, the following topics:
(a) Alignment of contracting, administrative functions, and other processes to minimize administrative burden at the provider level to achieve outcomes;
(b) Monitoring implementation of fully integrated managed care in the regional service area, including design of an early warning system to monitor ongoing success to achieve better outcomes and to make adjustments to the system as necessary;
(c) Developing regional coordination processes for capital infrastructure requests, local capacity building, and other community investments;
(d) Identifying, using, and building on measures and data consistent with, but not limited to, RCW 70.320.030 and 41.05.690, for tracking and maintaining regional accountability for delivery system performance; and
(e) Discussing whether the managed health care systems awarded the contract by the authority for a regional service area should subcontract with a county-based administrative service organization or other local organization, which may include and determine, in partnership with that organization, which value-add services will best support a bidirectional system of care.
(4) To ensure an optimal transition, regional service areas that enter as mid-adopters must be allowed a transition period of up to one year during which the interlocal leadership structure develops and implements a local plan, including measurable milestones, to transition to fully integrated managed care. The transition plan may include provisions for the counties' organization to maintain existing contracts during some or all of the transition period if the managed care design begins during 2017 to 2018, with the mid-adopter transition year occurring in 2019.
(5) Nothing in this section may be used to compel contracts between a provider, integrated managed health care system, or administrative service organization.
(6) The interlocal leadership group expires December 1, 2021, unless the interlocal leadership group decides locally to extend it.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.



Construction.

*** CHANGE IN 2019 *** (SEE 5432-S2.SL) ***
Nothing in this chapter shall be construed as prohibiting the secretary of the department of social and health services from consolidating children's mental health services with other services related to children.

NOTES:

FindingsIntentEffective date2018 c 201: See notes following RCW 41.05.018.