HomeMy WebLinkAboutR-2013-140 Behavioral Health Diversion Program Agreement with Central Washington Comprehensive Mental Health (CWCMH)RESOLUTION NO. R-2013-140
A RESOLUTION authorizing and directing the City Manager of the City of Yakima to
execute an Agreement with Central Washington Comprehensive Mental
Health (CWCMH) allowing the City of Yakima to utilize the CWCMH
Behavioral Health Diversion Program at no cost to the City.
WHEREAS, the Yakima Unit of CWCMH has developed a behavioral health diversion
program to provide crisis intervention to persons with mental illness as authorized by SSB 5533,
Chapter 375, Laws of 2007, Criminal Behavior—Individuals with Mental Illness; and
WHEREAS, the CWCMH Behavioral Health Diversion Program provides crisis
stabilization and clinical staff to triage, assess and treat individuals referred for mental illness
and co-occurring substance abuse CWCMH staff will additionally complete substance abuse
assessments and, as applicable, refer these individuals for services. These services may
include, but are not limited to, outpatient mental health services, crisis residential services, dual -
diagnosis treatment, chemical dependency services, and inpatient dual diagnosis treatment;
and
WHEREAS, inmates with a history of mental health illness tend to be housed longer in
jail than inmates similarly situated without mental health illness, lose entitlements while in jail,
and receive no treatment for mental health issues while housed in City and County jail facilities;
and
WHEREAS, the Behavioral Health Diversion Program allows an officer to take an
individual to the Crisis Stabilization Unit, in lieu of jail, for assessment and treatment when an
officer has reasonable cause to believe that an individual has committed acts constituting a non-
felony crime that is not a serious offense and that the individual has a history of mental illness;
and
WHEREAS, CWCMH has agreed to allow City of Yakima Police Department to utilize
the Behavioral Health Diversion Program at no cost in exchange for Yakima Police
Department's support and utilization of the program; and
WHEREAS, the City Council deems it to be in the best interest of the City of Yakima to
execute an Agreement with CWCMH to utilize the Behavioral Health Diversion Program, now,
therefore,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA:
The Yakima City Council authorizes and directs the City Manager of the City of Yakima
to execute an Agreement with Central Washington Comprehensive Mental Health whereby the
City of Yakima will have access and utilize the Central Washington Comprehensive Mental
Health Behavioral Health Diversion Program.
This Resolution shall be effective after its adoption.
ADOPTED BY THE CITY COUNCIL this 5th day of November, 2013
EST:
Sonya Cla- -e, City Clerk
4)la
Micah Cawle Mayo/
CIT AGREEMENT BETWEEN
THE CITY OF YAKIMA AND CENTRAL WASHINGTON
COMPREHENSIVE MENTAL HEALTH
This AGREEMENT, entered into this 3rd day of November, by the City of Yakima (the City)
whose address is 129 North Second Street, Yakima, Washington 98901-2613, and Central
Washington Comprehensive Mental Health (the Contractor) whose address is P.O. Box 959,
Yakima, Washington, 98907-0959, whose signatures are reflected on this Agreement.
PURPOSE
The purpose of this Agreement is to provide crisis intervention to persons with mental illness as
authorized by SSB 5533, Chapter 375, Laws of 2007, Criminal Behavior — Individuals with
Mental Illness.
TERM OF AGREEMENT
The term of this Agreement shall be November 6, 2013 through December 31, 2014. This
Agreement may be extended, by mutual written consent of the parties.
CONSIDERATION
In consideration of the Contractors' performance of the responsibilities as defined in the
Statement of Work, the City agrees to participate and refer defendants to the Behavioral Health
Diversion Program.
GENERAL TERMS AND CONDITIONS
1. Definitions. The words and phrases listed below, as used in the Agreement, shall each
have the following definitions:
a. "Agreement" means this Agreement and any exhibits and other documents
attached or incorporated by reference, between the Contractor and the City.
b. "CFR" means Code of Federal Regulations. All references in this Agreement and
any Program Agreement to CFR chapters or sections shall include any
successor, amended, or replacement regulation. The CFR may be accessed at
http://www.gpoaccess.gov/cfr/index.html.
c. "Debarment" means an action taken by a Federal official to exclude a person or
business entity from participating in transactions involving certain federal funds.
d. "Personal Information" means information identifiable to any person, including,
but not limited to, information that relates to a person's name, health, finances,
education, business, use or receipt of governmental services or other activities,
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addresses, telephone numbers, social security numbers, drivers license
numbers, other identifying numbers, and any financial identifiers.
e. "RCW" means the Revised Code of Washington. All references in this Agreement
to RCW Chapters or sections shall include any successor, amended, or
replacement statute. The RCW can be accessed at http://slc leg.wa.gov.
f. "Subcontract" means a separate agreement between the Contractor and an
individual or entity ("Subcontractor") to perform all or a portion of the duties and
obligations, which the Contractor is obligated to perform pursuant to this
Agreement.
g.
"USCA" means United States Code Annotated. All references to USCA chapters
or sections in this Agreement, or any Program Agreement, shall include any
successor, amended, or replacement regulation. The USCA is accessible at
http://www.gpoaccess.gov/uscode/.
h. "WAC" means the Washington Administrative Code All references in this
Agreement to WAC chapters or sections shall include any successor, amended,
or replacement regulation. The WAC is accessible at http://slc.leg wa gov.
2. Amendment. This Agreement, or any term or condition, may be modified only by a
written amendment signed by both parties. Only personnel authorized to bind each of
the parties hall sign an amendment.
3. Assignment. The Contractor shall not assign rights or obligations derived from this
Agreement to a third party without the prior written consent of the Contracts
Administrator and the other parties to this Agreement. Any authorized assignment will
include a written assumption of the Contractor's obligations by the third party.
4. Compliance with Applicable Law. At all times during the term of this Agreement, and
any Program Agreement, the Contractor and DSHS shall comply with all applicable
federal, state, and local laws, regulations, and rules, including but not limited to non-
discrimination laws and regulations.
5. Confidentiality.
a. The parties shall use Personal Information and other information gained because
of this Agreement only for the purpose of this Agreement. The City and the
Contractor shall not disclose, transfer, or sell any such information to any other
party, except as provided by law or, in the case of Personal Information, without
the prior written consent of the person to whom the Personal Information
pertains. The parties shall maintain the confidentiality of all Personal Information
and other information gained because of this Agreement and shall return or
certify the destruction of such information, as authorized by law, if requested in
writing by the party to this Agreement that provided the information.
b. The Contractor shall comply with all confidentiality requirements of the Health
Insurance Portability and Accountability Act (42 CFR Sections 160-164).
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6. Debarment Certification. The Contractor, by signature to this Agreement, certifies the
Contractor is not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency from participating
in transactions (debarred). The Contractor also agrees to include the above requirement
in any and all subcontracts into which it enters. The Contractor shall immediately notify
the City if, during the term of this Agreement, the Contractor becomes debarred. The
City may immediately terminate this Agreement by providing the Contractor written
notice if the Contractor becomes debarred during the term of this Agreement.
7. Disputes. A Dispute Board shall determine disputes between the parties in the
following manner: Each party in the dispute shall appoint one member to the Dispute
Board. If additional members are needed on the Dispute Board, the members appointed
shall jointly appoint an additional member to the Dispute Board. The Dispute board shall
review the facts, agreement terms, and applicable statues and rules and make a
determination. This process shall constitute the final administrative remedy available to
the parties. Each party reserves the right to litigate issues and matters in court de novo.
A Program Agreement may supplement, but not contravene, this section.
8. Nondiscrimination. The Contractor agrees that it shall not discriminate in violation of
any applicable federal, state and/or local law or regulation on the basis of race, creed,
color, religion, national origin, sex, sexual orientation, age, marital status, disability,
political affiliation or belief, honorably discharged veteran or military status, pregnancy,
or the presence of any sensory, mental or physical handicap, and any other
classification protected under federal, state and local law. This provision shall include
but not be limited to the following. employment, upgrading, demotion, transfer,
recruitment, advertising, layoff or termination, rates of pay or other forms of
compensation, selection for training, and the provision of services under this Agreement.
In the event the Contractor violates this provision, the City may terminate this Agreement
immediately and bar the Contractor from performing any services for the City in the
future.
9. Entire Agreement. This Agreement, including all documents attached to or incorporated
by reference, contains all the terms and conditions agreed upon by the parties. No other
understandings or representations, oral or otherwise, regarding the subject matter of this
Agreement shall be deemed to exist or bind the parties.
10. Governing Law and Venue. The laws of the State of Washington govern this
Agreement. In the event of a lawsuit by the Contractor against the City involving this
Agreement or a Program Agreement, venue shall be proper only in Yakima County,
Washington. In the event of a lawsuit by the City against the Contractor involving this
Agreement or a Program Agreement, venue shall be proper only as provided in
RCW 36 01.050.
11. Independent Contractor. The parties agree that, for the purposes of this Agreement,
the Contractor is an independent contractor and neither the Contractor nor any
employee of the Contractor is an employee of the City. Neither the Contractor nor any
employee of the Contractor is entitled to any benefits that the City provides its
employees. The Contractor is solely responsible for payment of any statutory workers
compensation or employer's liability insurance as required by state law. The Contractor
shall assume full responsibility for payments of federal, state, and local taxes or
contributions imposed or required under the Social Security, Workmen's Compensation,
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and Income Tax laws for persons other than City employees performing services
pursuant to this Agreement
12. Inspection. The parties may request reasonable access to other party's records and
place of business for the limited purpose of monitoring, auditing, and evaluating the
other party's compliance with this Agreement, any Program Agreement, and applicable
laws and regulations. During the term of any Program Agreement and for one year
following termination or expiration of the Program Agreement, the parties shall, upon
receiving written notice, provide the other party with access to its place of business and
to its records, which are relevant to its compliance with this Agreement, any Program
Agreement, and applicable laws and regulations. This provision shall not be construed
to give either party access to the other party's records and place of business for any
other purpose. Nothing herein shall be construed to authorize the parties to possess or
copy records of the other parties.
13. Maintenance of Records.
a. During the term of this Agreement and for seven years following termination or
expiration of this Agreement, or in any audit, claim, litigation, or other legal action
involving the records is started before expiration of the seven year period, the
records shall be maintained until completion and resolution of all issues arising
there from or until the end of the six year period, whichever is later. The
Contractor shall maintain records sufficient to
(1) Document performance of all acts required by law, regulation, or this
Agreement;
(2) For the same period, the Contractor shall maintain records sufficient to
substantiate the Contractor's statement of its organization's structure, tax
status, capabilities, and performance.
14. Indemnification and Hold Harmless.
(1) The Contractor agrees to protect, defend, indemnify, and hold harmless
the City, its elected officials, officers, employees, agents, and volunteers
from any and all claims, demands, losses, liens, liabilities, penalties,
fines, lawsuits, and other proceedings and all judgments, awards, costs
and expenses (including reasonable attorneys' fees and disbursements)
resulting from death or bodily injury to any person or damage or
destruction to a third party or third parties to the extent caused by any
negligent act and/or omission of Contractor, its officers, employees,
agents, volunteers and/or subcontractors, arising out of the performance
of this Agreement.
(2) The City agrees to protect, defend, indemnity, and hold harmless the
Contractor, its officers, employees, agents, and volunteers from any and
all claims, demands, losses, liens, liabilities, penalties, fines, lawsuits, and
other proceedings and all judgments, awards, costs and expenses
(including reasonable attorneys' fees and disbursements) resulting from
death or bodily injury to any person or damage or destruction to a third
party or third parties to the extent caused by any negligent act/or
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(3)
omission of Contractor, its officers, employees, agents, volunteers and/or
subcontractors, arising out of the performance of this Agreement.
If the City and the Contractor are found to be joint and severally liable for
damages as a result of an act or omission arising from the performance of
this Agreement, each party shall be responsible for its proportionate
share of damages.
(4) The City and the Contractor agree to notify the attorneys of records in any
tort lawsuit involving the performance under this Agreement, if either the
City or the Contractor enters into settlement negotiations. It is understood
that the notice shall occur prior to any negotiations, or as soon as
possible, and the notice may be either written or oral.
(5)
15. Insurance.
Nothing contained in this Section or this Contract shall be construed to
create a liability or a right of indemnification in any third party.
a. The City certifies that it is part of a risk pool and shall pay for losses if they are
found liable.
b. At all times during performance of the services, the Contractor shall secure and
maintain in effect insurance to protect the City from and against all claims,
damages, losses, and expenses arising out of or resulting from the performance
of this Contract. The Contractor shall provide and maintain in force insurance in
limits no less than that stated below, as applicable. The City reserves the right to
require higher limits should it deem it necessary in the best interest of the public.
(1) Commercial Liability Insurance. Before this Agreement is fully executed
by the parties, the Contractor shall provide the City with a certificate of
insurance as proof of commercial liability insurance and commercial
umbrella liability insurance with a total minimum liability limit of Three
Million Dollars ($3,000,000.00) per occurrence combined single limit
bodily injury and property damage, and Three Million Dollars
($3,000,000 00) general aggregate. The certificate shall clearly state who
the provider is, the coverage amount, the policy number, and when the
policy and provisions provided are in effect. Said policy shall be in effect
for the duration of this Agreement. The policy shall name the City, their
elected officials, officers, agents, employees and volunteers as additional
insureds. The insurance shall be with an insurance company or
companies rated B+ or higher in Best's Guide and admitted in the State of
Washington
(2) Commercial Automobile Insurance.
If the Contractor owns any vehicles, before this Agreement is fully
executed by the parties, the Contractor shall provide the City with a
certificate of insurance as proof of commercial automobile liability
insurance and commercial umbrella liability insurance with a total
minimum liability limit of Three Million Dollars ($3,000,000.00) per
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(3)
occurrence combined single limit bodily injury and property damage.
Automobile liability will apply to "any auto" and be shown on the
certificate.
ii. If the Contractor does not own any vehicles, only "non -owned and
Hired Automobile Liability" will be required and may be added to the
commercial liability coverage at the same limits as required in that
section of this Agreement, which is Section 15.1 entitled "Commercial
Liability Insurance".
iii. Under either situation described above, the required certificate of
insurance shall clearly state who the provider is, the coverage
amount, the policy number, and when the policy and provisions
provided are in effect. Said policy shall be in effect for the duration of
this Agreement. The policy shall name the City, their elected officials,
officers, agents, employees, and volunteers as additional insureds,
and shall contain a clause that the insurer will not cancel or change
the insurance without first giving the City 30 calendar days prior
written notice. The insurance shall be with an insurance company or
companies rated A -VII or higher in Best's Guide and admitted in the
State of Washington.
Directors and Officers. Before this Agreement is fully executed by the
parties, the Contractor shall provide the City with a certificate of insurance
as evidence of Directors and Officers Liability Insurance with coverage of
at least One Million Dollars ($1,000,000.00) per occurrence and an
annual aggregate limit of at least One Million Dollars ($1,000,000.00).
The certificate shall clearly state who the provider is, the amount of
coverage, the policy number, • and when the policy and provisions
provided are in effect. The insurance shall be with an insurance company
rated A -VII or higher in Best's Guide. If the policy is on a claims made
basis, the retroactive date of the insurance policy shall be on or before
the inception date of the Agreement, or shall provide full prior acts The
insurance coverage shall remain in effect during the term of this
Agreement and for a minimum of three years following the termination of
this Contract.
16. Order of Precedence. In the event of an inconsistency in this Agreement, or between
its terms and any applicable statute or rule, the inconsistency shall be resolved by giving
precedence in the following order:
a. State statutes and regulations;
b. Other applicable federal, state, or local law.
17. Ownership of Material. Material created by the Contractor as part of this Agreement
shall be equally owned by the city and shall be "work made for hire" as defined by Title
17 USCA, Section 101. This matter includes, but is not limited to: books, computer
programs; documents; films; pamphlets, reports; sound reproductions; studies; surveys;
tapes; and/or training materials. Material which the Contract uses to perform the
Program Agreement but is not created for or paid for by the City is owned by the
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Contractor and is not "work made for hire"; however, the City shall have a perpetual
license to use this material for City internal purposes at no charge to the City, provided
that such license shall be limited to the extent which the Contractor has a right to grant
such a license.
No report, device, thing, or document of whatever kind or nature, produced in whole or in
part in connection with the project shall be the subject of an application for copyright or
patent by or on behalf of the Contractor without prior written approval of the City.
Supplies and equipment (such as computer equipment, office supplies, etc.) provided by
the City for use during the course of this Agreement remain the property of the loaning
entity and may be utilized by the loaning entity in any manner, which is deemed
appropriate.
18. Severability. The provisions of this Agreement are severable If any court holds any
provision of this Agreement, including any provision of any document incorporated by
reference, invalid, that invalidity shall not affect the other provisions of this Agreement.
19. Subcontracting. The Contractor may subcontract services provided under this
Agreement, unless otherwise specified in a Program Agreement. Any subcontractor
shall be required to indemnify and hold harmless the Contractor and maintain adequate
liability insurance, comparable to the insurance maintained by the Contractor pursuant to
this Agreement.
The Contractor shall not subcontract with an individual provider or an entity with an
individual who is an officer, director, agent, or manager, or who owns or has a controlling
interest in the entity, and who has been convicted of crimes as specified in 42 USC
1320a.
20. Subrecipients.
a. General. If the Contractor is a subrecipient of federal awards as defined by the
Office of Management and Budget (OMB) Circular A-133 and this Agreement,
the Contractor shall, unless otherwise indicated in the Special Terms and
Conditions:
(1) Maintain records that identify, in its accounts, all federal awards received
and expended and the federal programs under which they are were
received, by Catalog of Federal Domestic Assistance (CFDA) title and
number, award number and year, name of the federal agency, and name
of the pass-through entity;
(2) Maintain internal controls that provide reasonable assurance that the
Contractor is managing federal awards in compliance with laws,
regulations, and provisions of contracts or grant agreements that could
have a material effect on each of its federal programs;
(3) Prepare appropriate financial statements, including a schedule of
expenditures of federal awards;
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(4) Incorporate OMB Circular A-133 audit requirements into all agreements
between the Contractor and its Subcontractors who are subrecipients.
(5)
Comply with any future amendments to OMB Circular A-133 and any
successor or replacement Circular or regulation;
(6) Comply with the applicable requirements of OMB Circular A-87 and any
future amendments to OMB Circular A-87, and any successor or
replacement Circular or regulation; and
(7)
Comply with the Omnibus Crime Control and Safe Streets Act of 1968,
Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation
Act of 1973, Title II of the Americans with Disabilities Act of 1990, Title IX
of the Education Amendments of 1972, the Age Discrimination Act of
1975, and the Department of Justice Non -Discrimination Regulations, 28
CFR Part 42, Subparts C, D, E and G, and 28 CFR Part 35 and 39. (See
www.ojp.usdoj/gov/ocr for additional information and access to the
aforementioned Federal laws and regulations.)
b. Single Audit Act Compliance. If the Contractor is a subrecipient and expends
$500,000 or more in Federal awards from any and/or all sources in any fiscal
year, the Contractor shall procure and pay for a single audit or a program -specific
audit for that fiscal year. Upon completion of each audit, the Contractor shall.
(1) Submit to the City contact person, listed on the first page of this
Agreement, the data collection form and reporting package specified in
OMB Circular A-133, reports required by the program -specific audit guide
(if applicable), and a copy of any management letters issued by the
auditor;
(2) Follow-up and develop corrective action for all audit findings; in
accordance with OMB Circular A-133, prepare a "Summary Schedule of
Prior Audit Findings."
c. Overpayments. If it is determined by the City, or during the course of a required
audit, that the Contractor has been paid unallowable costs under this Agreement,
the City may require the Contractor to reimburse the City in accordance with
OMB Circular A-87.
21. Survivability. The terms and conditions contained in this Agreement, which by their
sense and context, are intended to survive the expiration of this Agreement, shall so
survive. Surviving terms include, but are not limited to Confidentiality, Disputes,
Inspection, Maintenance of Records, Mutual Indemnification and Hold Harmless,
Ownership of Material, Termination for Default, Termination Procedure, and Treatment
of Assets Purchased by the RSN, and Treatment of Property.
22. Termination for Convenience. Except otherwise as provided in this Agreement, the
City of Yakima representative may terminate this Agreement, in whole or in part, when it
is in the best interest of either of the parties by giving the Contractor at least 90 calendar
days' written notification by certified mail The Contractor may terminate this Agreement
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for convenience by giving the City at least 90 calendar days' written notification receipt
by certified mail addressed to:
City Manager
City of Yakima
129 North Second Street
Yakima, WA 98901
The effective date of the termination shall be the last day of the calendar month in which
the ninetieth day occurs.
This Agreement may also be terminated in whole or in part by either party, upon thirty
days advance written request to terminate, with the written consent of the other party, in
which case the two parties shall devise by mutual Agreement the conditions of
termination including effective date and in the case of termination in part, the portion to
be terminated.
23. Termination for Default.
a. The City of Yakima representative may terminate this Agreement for default, in
whole or in part, by written notice to the Contractor, if the City has a reasonable
basis to believe that the Contractor has:
(1) Failed to perform under any provision of this Agreement;
(2) Performed any of the Contractor's obligations under this Agreement in a
manner that comprised the health or safety of any individual with whom
the Contractor had contact;
(3)
Violated any law, regulation, rule, or ordinance applicable to the services
provided under this Agreement, including those pertaining to health and
safety; or
(4) Otherwise breached any provision or condition of this Agreement.
b. Before the City may terminate this Agreement for default, the City shall provide
the Contractor with written notice of the Contractor's noncompliance with this
Agreement and provide the Contractor a reasonable opportunity to correct the
Contractor's noncompliance. The complaining party shall provide a copy of the
written notice to the other party of this Agreement. If the Contractor does not
correct the Contractor's noncompliance within the period of time specified in the
written notice of noncompliance, the complaining party may then terminate this
Agreement. The City of Yakima representative, however, may terminate this
Agreement for default without such written notice and without opportunity for
correction if the City has a reasonable basis to believe that an individual's health
or safety is in jeopardy or if the Contractor has violated any law, regulation, rule,
or ordinance applicable to the services provided under this Agreement.
c. The Contractor may terminate this Agreement with the City for default, in whole
or in part, by written notice to the City, if the Contractor has a reasonable basis to
believe that the City has:
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(1) Failed to meet or maintain any requirement for contracting with the
Contractor;
(2) Failed to perform under any provision of this Agreement;
(3) Violated any law, regulation, rule or ordinance applicable to work
performed under this Agreement; and/or
(4) Otherwise breached any provision or condition of this Agreement.
d. Before the Contractor may terminate this Agreement for default, the Contractor
shall provide the City with written notice of either parties' noncompliance with this
Agreement and provide the noncomplying party a reasonable opportunity to
correct the noncompliance. If the noncomplying party has not corrected the
noncompliance within the period specified in the written notice of noncompliance,
the Contractor may then terminate this Agreement.
24. Termination Procedure. The following provisions shall survive and be binding on the
parties in the event this Agreement is terminated.
a. The Contractor shall cease to perform any services required by this Agreement
as of the effective date of termination and shall comply with all reasonable
instructions contained in the notice of termination which are related to the
transfer of individuals, distribution of property, and termination of services Each
party shall be responsible only for its performance in accordance with the terms
of this Agreement, rendered prior to the effective date of termination. The
Contractor shall assist in the orderly transfer/transition of the individuals served
under this Agreement. The Contractor shall promptly supply all information
necessary for the reimbursement of any outstanding Medicaid claims.
b. The Contractor shall immediately deliver to the City contact person (or to his or
her successor) listed on the first page of this Agreement, all loaned City assets
(property) to the owner agency in the Contractor's possession. The Contractor
grants the City the right to enter upon the Contractor's premises for the sole
purpose of recovering any of their respective property that the Contractor fails to
return within 10 working days of termination of this Agreement. Upon failure to
return City property within 10 working days of termination of this Agreement, the
Contractor shall be charged with all reasonable costs of recovery, including
transportation and attorney's fees. The Contractor shall protect and preserve
any property of the City that is in the possession of the Contractor pending return
to the respective party.
c. The City representative may direct assignment of the Contractor's rights to any
interest in any subcontract or orders placed to the City. The City may terminate
any subcontract or orders and settle or pay any or all claims arising out of the
termination of such orders and subcontracts.
25. Waiver. Waiver of any breach or default of any provision of this Agreement shall not be
deemed a waiver of any subsequent breach or default. Any waiver shall not be
construed to be a modification of the terms and conditions of this Agreement. Only the
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City representative or designee has the authority to waive any term or condition of this
Agreement, on behalf of its agency.
STATEMENT OF WORK
The Contractor shall:
1. Administer and staff a Crisis Triage Center (CTC) where client assessment, referral to
community services, and crisis treatment services will occur over a period of up to 12
hours as contemplated in SSB 5533 — an act relating to procedures for individuals who
are mentally ill and engaged in acts constituting criminal behavior, attached as Exhibit A.
A. This program shall be known as the Behavioral Health Diversion Program.
The Crisis Triage Center shall provide a means for law enforcement officers of
the City of Yakima to deliver individuals believed to meet the criteria for the
Behavioral Health Diversion Program to the facility and to, as quickly as is
feasible, accept the individual for evaluation.
B. The Contractor warrants that it is certified by the DSHS/Department of Behavioral
Health and Recovery as the Emergency Evaluation and Treatment provider for
Yakima County, that it is a Washington State Licensed Community Mental Health
Center authorized to provide the contemplated services, and that it is a
Washington State certified chemical dependency treatment provider.
C. The Contractor shall be accredited by the Joint Commission on the Accreditation
of Health Care Organization (JCAHO). The proposed facility is licensed by the
Washington State Department of Health as a Residential Treatment Facility
(RTF).
2. Provide initial screening and assessment for admission to the diversion program.
3. For individuals accepted into the program, coordinate crisis, involuntary, outpatient, and
residential treatment services based on the individuals needs; develop initial
service/treatment plans and coordinate placement and other community services
including, but not limited to, housing placement, income supports, and medical services.
a. Monitor participants for treatment compliance.
(1) Individuals who fail to follow treatment plans or recommendations at any
time within the first two weeks of referral will be referred back to the
referring law enforcement agency and the appropriate prosecuting
authority for further disposition.
4. For individuals not accepted into the program, refer the individual back to the referring
law enforcement agency and the appropriate prosecuting authority within 12 hours of the
individual's arrival at the Crisis Triage Center for further disposition.
5 Utilize the Referral for Treatment Standards (attached as Exhibit A) developed by the
City of Yakima prosecutors as criteria for admission to the program.
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a Should modifications to this document be necessary, assist the City of Yakima
prosecutors to develop client offense level criteria standards to determine
appropriate referral of clients to CDC.
6. The Contractor will provide regular orientation training to law enforcement personnel at
mutually agreed upon times and locations (e.g., musters, Department training events).
The Contractor will make law enforcement aware of CIT training events it sponsors and
provide registration materials. Because these training events are funded by other
sources admission to any particular class cannot be guaranteed.
7. Based on a mutually agreed upon data dictionary, Contractor will collect and report data
using approved intake and assessment tools, and documentation of client services and
referrals, including law enforcement contact reports and service data. Currently
collected data is attached as Exhibit A. The Contractor will staff and participate in a
Data Collection and Monitoring Committee, which incorporates representation from all
parties to this Agreement. This committee will coordinate evaluation of this outcomes
and effectiveness of the program.
8. Develop, staff, and participate in the Program Oversight Committee, comprised of
stakeholders, who meet regularly to discuss program development, implementation,
systemic integration of services, staffing, training, and public education regarding the
program.
THEREFORE, the City of Yakima and Central Washington Comprehensive Mental Health
agreed to the terms and conditions of the Agreement and its exhibits as listed above by signing
below:
CITY a F YAKIMA
Date
'Rourk City Manager
'DO L3
CITY CONTRAC r NO:a241�/
RESOLUTION NO: /6141/34
CENTRAL WASHINGTON
COMPR E MENTAL HEALTH
Rick eaver, President and CEO
Date
CONTRA AUTHORIZATIO
Attest:
Christina S St&
Date
Page 12 of 12
the Board
CERTIFICATION OF ENROLLMENT
SUBSTITUTE SENATE BILL 5533
Chapter 375, Laws of 2007
60th Legislature
2007 Regular Session
CRIMINAL BEHAVIOR --INDIVIDUALS WITH MENTAL ILLNESS
EFFECTIVE DATE: 07/22/07
Passed by the Senate April 16, 2007 CERTIFICATE
YEAS 47 NAYS 0
BRAD OWEN
President of the Senate
Passed by the House April 9, 2007
YEAS 98 NAYS 0
FRANK CHOPP
Speaker of the House of Representatives
I, Thomas Hoemann, Secretary of
the Senate of the State of
Washington, do hereby certify that
the attached is SUBSTITUTE SENATE
BILL 5533 as passed by the Senate
and the House of Representatives
on the dates hereon set forth.
THOMAS HOEMANN
Secretary
Approved May 8, 2007, 4:15 p.m. FILED
May 10, 2007
CHRISTINE GREGOIRE Secretary of State
State of Washington
Governor of the State of Washington
Page 1 of 36
CMH CIT 09
Exhibit A
SUBSTITUTE SENATE BILL 5533
AS AMENDED BY THE HOUSE
Passed Legislature - 2007 Regular Session
State of Washington
60th Legislature 2007 Regular Session
By Senate Committee on Human Services & Corrections (originally
sponsored by Senators Pflug, Hargrove, Kline, Swecker, Delvin,
Stevens, Holmquist, Parlette and Hewitt)
READ FIRST TIME 02/22/07.
1 AN ACT Relating to procedures for individuals who are mentally ill
2 and engaged in acts constituting criminal behavior; amending RCW
3 71.05.020, 71.05.150, 71.05.157, 49.19.010, 71.34.600, 71.24.035,
4 71.05.160, and 71.05.360; reenacting and amending RCW 71.05.390; adding
5 a new section to chapter 10.31 RCW; adding new sections to chapter
6 10.77 RCW; adding a new section to chapter 71.05 RCW; creating new
7 sections; and repealing RCW 10.77.090.
8 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
9 NEW SECTION. Sec. 1. The legislature finds that RCW 10.77.090
10 contains laws relating to three discrete subjects. Therefore, one
11 purpose of this act is to reorganize some of those laws by creating new
12 sections in the Revised Code of Washington that clarify and identify
13 these discrete subjects.
14 The legislature further finds that there are disproportionate
15 numbers of individuals with mental illness in jail. The needs of
16 individuals with mental illness and the public safety needs of society
17 at large are better served when individuals with mental illness are
18 provided an opportunity to obtain treatment and support.
Page 2 of 36
p. 1
CMH CIT 09
Exhibit A
SSB 5533.SL
1 NEW SECTION. Sec. 2. A new section is added to chapter 10.31 RCW
2 to read as follows:
3 (1) When a police officer has reasonable cause to believe that the
4 individual has committed acts constituting a nonfelony crime that is
5 not a serious offense as identified in RCW 10.77.092 and the individual
6 is known by history or consultation with the regional support network
7 to suffer from a mental disorder, the arresting officer may:
8 (a) Take the individual to a crisis stabilization unit as defined
9 in RCW 71.05.020(6). Individuals delivered to a crisis stabilization
10 unit pursuant to this section may be held by the facility for a period
11 of up to twelve hours: PROVIDED, that they are examined by a mental
12 health professional within three hours of their arrival;
13 (L) RefeL iadividudi Lu a milLal ha1Li professional for
14 evaluation for initial detention and proceeding under chapter 71.05
15 RCW; or
16 (c) Release the individual upon agreement to voluntary
17 participation in outpatient treatment.
18 (2) In deciding whether to refer the individual to treatment under
19 this section, the police officer shall be guided by standards mutually
20 agreed upon with the prosecuting authority, which address, at a
21 minimum, the length, seriousness, and recency of the known criminal
22 history of the individual, the mental health history of the individual,
23 where available, and the circumstances surrounding the commission of
24 the alleged offense.
25 (3) Any agreement to participate in treatment shall not require
26 individuals to stipulate to any of the alleged facts regarding the
27 criminal activity as a prerequisite to participation in a mental health
28 treatment alternative. The agreement is inadmissible in any criminal
29 or civil proceeding. The agreement does not create immunity from
30 prosecution for the alleged criminal activity.
31 (4) If an individual violates such agreement and the mental health
32 treatment alternative is no longer appropriate:
33 (a) The mental health provider shall inform the referring law
34 enforcement agency of the violation; and
35 (b) The original charges may be filed or referred to the
36 prosecutor, as appropriate, and the matter may proceed accordingly.
37 (5) The police officer is immune from liability for any good faith
38 conduct under this section.
Page 3 of 36
SSB 5533.SL p.. 2
CMII CIT 09
Exhibit A
1 NEW SECTION. Sec. 3. A new section is added to chapter 10.77 RCW
2 to read as follows:
3 GENERAL STAY PROVISIONS. (1) (a) If at any time during the pendency
4 of an action and prior to judgment the court finds, following a report
5 as provided in RCW 10.77.060, a defendant is incompetent, the court
6 shall order the proceedings against the defendant be stayed except as
7 provided in subsection (4) of this section.
8 (b) A defendant found incompetent shall be evaluated at the
9 direction of the secretary and a determination made whether the
10 defendant is an individual with a developmental disability. Such
11 evaluation and determination shall be accomplished as soon as possible
12 following the court's placement of the defendant in the custody of the
13 secretary.
14 (i) When appropriate, and subject to available funds, if the
15 defendant is determined to be an individual with a developmental
16 disability, he or she may be placed in a program specifically reserved
17 for the treatment and training of persons with developmental
18 disabilities where the defendant shall have the right to habilitation
19 according to an individualized service plan specifically developed for
20 the particular needs of the defendant. A copy of the evaluation shall
21 be sent to the program.
22 (A) The program shall be separate from programs serving persons
23 involved in any other treatment or habilitation program.
24 (B) The program shall be appropriately secure under the
25 circumstances and shall be administered by developmental disabilities
26 professionals who shall direct the habilitation efforts.
27 (C) The program shall provide an environment affording security
28 appropriate with the charged criminal behavior and necessary to protect
29 the public safety.
30 (ii) The department may limit admissions of such persons to this
31 specialized program in order to ensure that expenditures for services
32 do not exceed amounts appropriated by the legislature and allocated by
33 the department for such services.
34 (iii) The department may establish admission priorities in the
35 event that the number of eligible persons exceeds the limits set by the
36 department.
37 (c) At the end of the mental health treatment and restoration
38 period, or at any time a professional person determines competency has
Page 4 of 36
p. 3
CMH CIT 09
Exhibit A
SSB 5533.SL
1 been, or is unlikely to be, restored, the defendant shall be returned
2 to court for a hearing. If, after notice and hearing, competency has
3 been restored, the stay entered under (a) of this subsection shall be
4 lifted. If competency has not been restored, the proceedings shall be
5 dismissed. If the court concludes that competency has not been
6 restored, but that further treatment within the time limits established
7 by section 4 or 5 of this act is likely to restore competency, the
8 court may order that treatment for purposes of competency restoration
9 be continued. Such treatment may not extend beyond the combination of
10 time provided for in section 4 or 5 of this act.
11 (d) If at any time during the proceeding the court finds, following
12 notice and hearing, a defendant is not likely to regain competency, the
13 proceedings shall be dismissed and the detendant shall be evaluated for
14 civil commitment proceedings.
15 (2) If the defendant is referred to the designated mental health
16 professional for consideration of initial detention proceedings under
17 chapter 71.05 RCW pursuant to this chapter, the designated mental
18 health professional shall provide prompt written notification of the
19 results of the determination whether to commence initial detention
20 proceedings under chapter 71.05 RCW and whether the person was
21 detained. The notification shall be provided to the court in which the
22 criminal action was pending, the prosecutor, the defense attorney in
23 the criminal action, and the facility that evaluated the defendant for
24 competency.
25 (3) The fact that the defendant is unfit to proceed does not
26 preclude any pretrial proceedings which do not require the personal
27 participation of the defendant.
28 (4) A defendant receiving medication for either physical or mental
29 problems shall not be prohibited from standing trial, if the medication
30 either enables the defendant to understand the proceedings against him
31 or her and to assist in his or her own defense, or does not disable him
32 or her from so understanding and assisting in his or her own defense.
33 (5) At or before the conclusion of any commitment period provided
34 for by this section, the facility providing evaluation and treatment
35 shall provide to the court a written report of examination which meets
36 the requirements of RCW 10.77.060(3).
Page 5 of 36
SSB 5533.SL p. 4
CMH CIT 09
Exhibit A
1 NEW SECTION. Sec. 4. A new section is added to chapter 10.77 RCW
2 to read as follows:
3 FELONY PROCEDURE, (1) If the defendant is charged with a felony
4 and determined to be incompetent, until he or she has regained the
5 competency necessary to understand the proceedings against him or her
6 and assist in his or her own defense, or has been determined unlikely
7 to regain competency pursuant to section 3 (1) (c) of this act, but in
8 any event for a period of no longer than ninety days, the court:
9 (a) Shall commit the defendant to the custody of the secretary who
10 shall place such defendant in an appropriate facility of the department
11 for evaluation and treatment; or
12 (b) May alternatively order the defendant to undergo evaluation and
13 treatment at some other facility as determined by the department, or
14 under the guidance and control of a professional person.
15 (2) On or before expiration of the initial ninety -day period of
16 commitment under subsection (1) of this section the court shall conduct
17 a hearing, at which it shall determine whether or not the defendant is
18 incompetent.
19 (3) If the court finds by a preponderance of the evidence that a
20 defendant charged with a felony is incompetent, the court shall have
21 the option of extending the order of commitment or alternative
22 treatment for an additional ninety -day period, but the court must at
23 the time of extension set a date for a prompt hearing to determine the
24 defendant's competency before the expiration of the second ninety -day
25 period. The defendant, the defendant's attorney, or the prosecutor has
26 the right to demand that the hearing be before a jury. No extension
27 shall be ordered for a second ninety -day period, nor for any subsequent
28 period as provided in subsection (4) of this section, if the
29 defendant's incompetence has been determined by the secretary to be
30 solely the result of a developmental disability which is such that
31 competence is not reasonably likely to be regained during an extension.
32 (4) For persons charged with a felony, at the hearing upon the
33 expiration of the second ninety -day period or at the end of the first
34 ninety -day period, in the case of a defendant with a developmental
35 disability, if the jury or court finds that the defendant is
36 incompetent, the charges shall be dismissed without prejudice, and
37 either civil commitment proceedings shall be instituted or the court
38 shall order the release of the defendant. The criminal charges shall
Page 6 of 36
p. 5
CMH CIT 09
Exhibit A
SSB 5533.SL
1 not be dismissed if the court or jury finds that: (a) The defendant
2 (i) is a substantial danger to other persons; or (ii) presents a
3 substantial likelihood of committing criminal acts jeopardizing public
4 safety or security; and (b) there is a substantial probability that the
5 defendant will regain competency within a reasonable period of time.
6 In the event that the court or jury makes such a finding, the court may
7 extend the period of commitment for up to an additional six months.
8 NEW SECTION. Sec. 5. A new section is added to chapter 10.77 RCW
9 to read as follows:
10 MISDEMEANOR PROCEDURE. (1)(a) If the defendant is charged with a
11 nonfelony crime which is a serious offense as identified in RCW
12 10.77.092 and found by the court to be not competent, then the court
13 shall order the secretary to place the defendant:
14 (i) At a secure mental health facility in the custody of the
15 department or an agency designated by the department for mental health
16 treatment and restoration of competency. The placement shall not
17 exceed fourteen days in addition to any unused time of the evaluation
18 under RCW 10.77.060. The court shall compute this total period and
19 include its computation in the order. The fourteen -day period plus any
20 unused time of the evaluation under RCW 10.77.060 shall be considered
21 to include only the time the defendant is actually at the facility and
22 shall be in addition to reasonable time for transport to or from the
23 facility;
24 (ii) On conditional release for up to ninety days for mental health
25 treatment and restoration of competency; or
26 (iii) Any combination of this subsection.
27 (b)(i) If the proceedings are dismissed under section 3 of this act
28 and the defendant was on conditional release at the time of dismissal,
29 the court shall order the designated mental health professional within
30 that county to evaluate the defendant pursuant to chapter 71.05 RCW.
31 The evaluation may be conducted in any location chosen by the
32 professional.
33 (ii) If the defendant was in custody and not on conditional release
34 at the time of dismissal, the defendant shall be detained and sent to
35 an evaluation and treatment facility for up to seventy-two hours,
36 excluding Saturdays, Sundays, and holidays, for evaluation for purposes
37 of filing a petition under chapter 71.05 RCW. The seventy -two-hour
Page 7 of 36 CMH CIT 09
Exhibit A
SSB 5533.SL p. 6
1 period shall commence upon the next nonholiday weekday following the
2 court order and shall run to the end of the last nonholiday weekday
3 within the seventy -two-hour period.
4 (2) If the defendant is charged with a nonfelony crime that is not
5 a serious offense as defined in RCW 10.77.092:
6 The court may stay or dismiss proceedings and detain the defendant
7 for sufficient time to allow the designated mental health professional
8 to evaluate the defendant and consider initial detention proceedings
9 under chapter 71.05 RCW. The court must give notice to all parties at
10 least twenty-four hours before the dismissal of any proceeding under
11 this subsection, and provide an opportunity for a hearing on whether to
12 dismiss the proceedings.
13 Sec. 6. RCW 71.05.020 and 2005 c 504 s 104 are each amended to
14 read as follows:
15 The definitions in this section apply throughout this chapter
16 unless the context clearly requires otherwise.
17 (1) "Admission" or "admit" means a decision by a physician that a
18 person should be examined or treated as a patient in a hospital;
19 (2) "Antipsychotic medications" means that class of drugs primarily
20 used to treat serious manifestations of mental illness associated with
21 thought disorders, which includes, but is not limited to atypical
22 antipsychotic medications;
23 (3) "Attending staff" means any person on the staff of a public or
24 private agency having responsibility for the care and treatment of a
25 patient;
26 (4) "Commitment" means the determination by a court that a person
27 should be detained for a period of either evaluation or treatment, or
28 both, in an inpatient or a less restrictive setting;
29 (5) "Conditional release" means a revocable modification of a
30 commitment, which may be revoked upon violation of any of its terms;
31 (6) "Crisis stabilization unit" means a short-term facility or a
32 portion of a facility licensed by the department of health and
33 certified by the department of social and health services under RCW
34 71.24.035, such as an evaluation and treatment facility or a hospital,
35 which has been designed to assess, diagnose, and treat individuals
36 experiencing an acute crisis without the use of long-term
37 hospitalization;
Page 8 of 36
p. 7
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (7) "Custody" means involuntary detention under the provisions of
2 this chapter or chapter 10.77 RCW, uninterrupted by any period of
3 unconditional release from commitment from a facility providing
4 involuntary care and treatment;
5 (((7))) (8) "Department" means the department of social and health
6 services;
7 ((*44-)) (9) "Designated chemical dependency specialist" means a
8 person designated by the county alcoholism and other drug addiction
9 program coordinator designated under RCW 70.96A.310 to perform the
10 commitment duties described in chapters 70.96A and 70.96B RCW;
11 ((+4*)) (10) "Designated crisis responder" means a mental health
12 professional appointed by the county or the regional support network to
13 perform the duties specified in this chapter;
14 (((10))) (11) "Designated mental health professional" means a
15 mental health professional designated by the county or other authority
16 authorized in rule to perform the duties specified in this chapter;
17 (((11))) (12) "Detention" or "detain" means the lawful confinement
18 of a person, under the provisions of this chapter;
19 (((12))) (13) "Developmental disabilities professional" means a
20 person who has specialized training and three years of experience in
21 directly treating or working with persons with developmental
22 disabilities and is a psychiatrist, psychologist, or social worker, and
23 such other developmental disabilities professionals as may be defined
24 by rules adopted by the secretary;
25 (((13))) (14) "Developmental disability" means that condition
26 defined in RCW 71A.10.020(3);
27 (((14))) (15) "Discharge" means the termination of hospital medical
28 authority. The commitment may remain in place, be terminated, or be
29 amended by court order;
30 (((15))) (16) "Evaluation and treatment facility" means any
31 facility which can provide directly, or by direct arrangement with
32 other public or private agencies, emergency evaluation and treatment,
33 outpatient care, and timely and appropriate inpatient care to persons
34 suffering from a mental disorder, and which is certified as such by the
35 department. A physically separate and separately operated portion of
36 a state hospital may be designated as an evaluation and treatment
37 facility. A facility which is part of, or operated by, the department
SSB 5533.SL
Page 9 of 36
p. 8
CMH CIT 09
Exhibit A
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
or any federal agency will not require certification. No correctional
institution or facility, or jail, shall be an evaluation and treatment
facility within the meaning of this chapter;
(HIGH) (17) "Gravely disabled" means a condition in which a
person, as a result of a mental disorder: (a) Is in danger of serious
physical harm resulting from a failure to provide for his or her
essential human needs of health or safety; or (b) manifests severe
deterioration in routine functioning evidenced by repeated and
escalating loss of cognitive or volitional control over his or her
actions and is not receiving such care as is essential for his or her
health or safety;
(((17))) (18) "Habilitative services" means those services provided
by program personnel to assist persons in acquiring and maintaining
life skills and in raising their levels of physical, mental, social,
and vocational functioning. Habilitative services include education,
training for employment, and therapy. The habilitative process shall
be undertaken with recognition of the risk to the public safety
presented by the person being assisted as manifested by prior charged
criminal conduct;
(((10))) (19) "History of one or more violent acts" refers to the
period of time ten years prior to the filing of a petition under this
chapter, excluding any time spent, but not any violent acts committed,
in a mental health facility or in confinement as a result of a criminal
conviction;
(((19))) (20) "Imminent" means the state or condition of being
likely to occur at any moment or near at hand, rather than distant or
remote;
(21) "Individualized service plan" means a plan prepared by a
developmental disabilities professional with other professionals as a
team, for a person with developmental disabilities, which shall state:
(a) The nature of the person's specific problems,
criminal behavior, and habilitation needs;
(b) The conditions and strategies necessary to achieve the purposes
of habilitation;
(c) The intermediate and long-range goals of the habilitation
program, with a projected timetable for the attainment;
(d) The rationale for using this plan of habilitation to achieve
those intermediate and long-range goals;
prior charged
Page 10 of 36
p. 9
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (e) The staff responsible for carrying out the plan;
2 (f) Where relevant in light of past criminal behavior and due
3 consideration for public safety, the criteria for proposed movement to
4 less -restrictive settings, criteria for proposed eventual discharge or
5 release, and a projected possible date for discharge or release; and
6 (g) The type of residence immediately anticipated for the person
7 and possible future types of residences;
8 (((20))) (22) "Judicial commitment" means a commitment by a court
9 pursuant to the provisions of this chapter;
10 (((21))) (23) "Likelihood of serious harm" means:
11 (a) A substantial risk that: (i) Physical harm will be inflicted
12 by a person upon his or her own person, as evidenced by threats or
13 attempts Cu commit suicide or inflict physical harm on oneself, (ii)
14 physical harm will be inflicted by a person upon another, as evidenced
15 by behavior which has caused such harm or which places another person
16 or persons in reasonable fear of sustaining such harm; or (iii)
17 physical harm will be inflicted by a person upon the property of
18 others, as evidenced by behavior which has caused substantial loss or
19 damage to the property of others; or
20 (b) The person has threatened the physical safety of another and
21 has a history of one or more violent acts;
22 (((22))) (24) "Mental disorder" means any organic, mental, or
23 emotional impairment which has substantial adverse effects on a
24 person's cognitive or volitional functions;
25 (((23))) (25) "Mental health professional" means a psychiatrist,
26 psychologist, psychiatric nurse, or social worker, and such other
27 mental health professionals as may be defined by rules adopted by the
28 secretary pursuant to the provisions of this chapter;
29 (((...4))) (26) "Peace officer" means a law enforcement official of
30 a public agency or governmental unit, and includes persons specifically
31 given peace officer powers by any state law, local ordinance, or
32 judicial order of appointment;
33 (((25))) (27) "Private agency" means any person, partnership,
34 corporation, or association that is not a public agency, whether or not
35 financed in whole or in part by public funds, which constitutes an
36 evaluation and treatment facility or private institution, or hospital,
37 which is conducted for, or includes a department or ward conducted for,
38 the care and treatment of persons who are mentally ill;
Page 11 of 36
SSB 5533.SL p. 10
CMH CIT 09
Exhibit A
1 (((2G))) (28) "Professional person" means a mental health
2 professional and shall also mean a physician, registered nurse, and
3 such others as may be defined by rules adopted by the secretary
4 pursuant to the provisions of this chapter;
5 (((27))) (29) "Psychiatrist" means a person having a license as a
6 physician and surgeon in this state who has in addition completed three
7 years of graduate training in psychiatry in a program approved by the
8 American medical association or the American osteopathic association
9 and is certified or eligible to be certified by the American board of
10 psychiatry and neurology;
11 (((28))) (30) "Psychologist" means a person who has been licensed
12 as a psychologist pursuant to chapter 18.83 RCW;
13 (((29))) (31) "Public agency" means any evaluation and treatment
14 facility or institution, or hospital which is conducted for, or
15 includes a department or ward conducted for, the care and treatment of
16 persons ((who arc mentally ill)) with mental illness, if the agency is
17 operated directly by, federal, state, county, or municipal government,
18 or a combination of such governments;
19 (((30))) (32) "Registration records" include all the records of the
20 department, regional support networks, treatment facilities, and other
21 persons providing services to the department, county departments, or
22 facilities which identify persons who are receiving or who at any time
23 have received services for mental illness;
24 (((31))) (33) "Release" means legal termination of the commitment
25 under the provisions of this chapter;
26 (((32))) (34) "Resource management services" has the meaning given
27 in chapter 71.24 RCW;
28 (((33))) (35) "Secretary" means the secretary of the department of
29 social and health services, or his or her designee;
30 (((34))) (36) "Social worker" means a person with a master's or
31 further advanced degree from an accredited school of social work or a
32 degree deemed equivalent under rules adopted by the secretary;
33 (((35))) (37) "Treatment records" include registration and all
34 other records concerning persons who are receiving or who at any time
35 have received services for mental illness, which are maintained by the
36 department, by regional support networks and their staffs, and by
37 treatment facilities. Treatment records do not include notes or
Page 12 of 36
p. 11
CMH CIT 09
Exhibit A
SSB 5533.SL
1 records maintained for personal use by a person providing treatment
2 services for the department, regional support networks, or a treatment
3 facility if the notes or records are not available to others;
4 (((36))) (38) "Violent act" means behavior that resulted in
5 homicide, attempted suicide, nonfatal injuries, or substantial damage
6 to property.
7 Sec. 7. RCW 71.05.150 and 1998 c 297 s 8 are each amended to read
8 as follows:
9 NONEMERGENT DETENTION. (1) ((-(-a-)-)) When a ((county)) designated
10 mental health professional receives information alleging that a person,
11 as a result of a mental disorder: (i) Presents a likelihood of serious
12 harm; or (ii) is gravely disabled; the ((county)) designated mental
13 health professional may, after investigation and evaluation of the
14 specific facts alleged and of the reliability and credibility of any
15 person providing information to initiate detention, if satisfied that
16 the allegations are true and that the person will not voluntarily seek
17 appropriate treatment, file a petition for initial detention. Before
18 filing the petition, the ((county)) designated mental health
19 professional must personally interview the person, unless the person
20 refuses an interview, and determine whether the person will voluntarily
21 receive appropriate evaluation and treatment at an evaluation and
22 treatment facility or in a crisis stabilization unit.
23 (((b) Whenever it appears, by petition for initial detention, to
24
25 presents, as a result of a mental disorder, a likelihood of serious
26 harm, or is gravely disabled, and that the person has refused or failed
27 to accept appropriate evaluation and treatment voluntarily, the judge
28 may issue an order requiring the person to appear within twenty four
29 hours after service of the order at a designated evaluation and
30 treatment f,cility for not more than a seventy two hour evaluation and
31
32 and treatment facility to which the person is to report and whether the
33 required seventy two hour evaluation and treatment services may be
34 delivered on an outpatient or inpatient basis and that if the person
35 named in the order fails to ,ppcar at the evaluation and treatment
36 facility at or before the date and time stated in the order, such
37 person may be involuntarily t,kcn into custody for evaluation and
Page 13 of 36 CMH CIT 09
Exhibit A
SSB 5533.SL p. 12
1 treatment. Thc order ahall also designate retained counsel or, if
2 counsel is appointed from a list provided by thc court, the name,
3 business address, and telephone number of the attorney appointed to
4 represent the person.
5 4e*)) (2)(a) An order to detain to a designated evaluation and
6 treatment facility for not more than a seventy -two-hour evaluation and
7 treatment period may be issued by a judge of the superior court upon
8 request of a designated mental health professional, whenever it appears
9 to the satisfaction of a judge of the superior court:
10 (i) That there is probable cause to support the petition; and
11 (ii) That the person has refused or failed to accept appropriate
12 evaluation and treatment voluntarily.
13 (b) The petition for initial detention, 6icilled uudul ptilidiLy or
14 penury, or sworn telephonic testimony may be considered by the court
15 in determining whether there are sufficient grounds for issuing the
16 order.
17 (c) The order shall designate retained counsel or, if counsel is
18 appointed from a list provided by the court, the name, business
19 address, and telephone number of the attorney appointed to represent
20 the person.
21 (3) The ((county)) designated mental health professional shall then
22 serve or cause to be served on such person, his or her guardian, and
23 conservator, if any, a copy of the order ((to appear)) together with a
24 notice of rights,_ and a petition for initial detention. After service
25 on such person the ((county)) designated mental health professional
26 shall file the return of service in court and provide copies of all
27 papers in the court file to the evaluation and treatment facility and
28 the designated attorney. The ((county)) designated mental health
29 professional shall notify the court and the prosecuting attorney that
30 a probable cause hearing will be held within seventy-two hours of the
31 date and time of outpatient evaluation or admission to the evaluation
32 and treatment facility. The person shall be permitted ((to remain in
33 his or her home or othcr place of his or her choosing prior to thc timc
34 of evaluation and shall bc permitted)) to be accompanied by one or more
35 of his or her relatives, friends, an attorney, a personal physician, or
36 other professional or religious advisor to the place of evaluation. An
37 attorney accompanying the person to the place of evaluation shall be
38 permitted to be present during the admission evaluation. Any other
Page 14 of 36
p. 13
CMH CIT 09
Exhibit A
SSB 5533.SL
1 individual accompanying the person may be present during the admission
2 evaluation. The facility may exclude the individual if his or her
3 presence would present a safety risk, delay the proceedings, or
4 otherwise interfere with the evaluation.
5 ((
6 date and time specified, thc evaluation and trcatmcnt facility may
7 admit such person as required by RCW 71.0=.170 or may providc trcatmcnt
8 n an outpatient basis. If the person ordered t app ar fails to
9 date and time specified, the evaluation and
10 trcatmcnt facility shall immcdiatcly notify))
11 (4) The ((county)) designated mental health professional ((who))
12 may notify a peace officer to take such person or cause such person to
13 be taken into custody and placed in an evaluation and treatment
14 facility. ((Should the county designated mental health professional
15 notify a peace officcr authorizing him or her to take a person into
16 . sic= of this subsection, he or she shall file
17 with the court a copy of such authorization and a notice of
18 detention.)) At the time such person is taken into custody there shall
19 commence to be served on such person, his or her guardian, and
20 conservator, if any, a copy of the original order together with a
21 ((notice of detention, a)) notice of rights(M) and a petition for
22 initial detention.
23 (((2) When a county designated mental health professional receives
24 information alleging that a person, as the result of a mental disorder,
25 presents an imminent likelihood of serious harm, or is in imminent
26 danger bcc-usc of being gravely dis-bled, after investigation and
27 evaluation of the specific facts alleged and of the reliability and
28 credibility of the person r persons providing the information if any,
29 the county designated mental health professional may take such person,
30 r cause by oral or written order such person to be taken into
31 emergency custody in an evaluation and trcatmcnt facility for not more
32 than seventy two hours as described in RCW 71.05.180.
33 (3) A pc,cc officer may t -kc such peroon or cause such person to be
34 taken into custody and placed in -an evaluation and treatment facility
35 pursuant to subsection (1)(d) of this section.
36 (4) A peace officer may, without prior notice of the proceedings
37 provided for in subsection (1) of this section, take or cause such
Page 15 of 36
SSB 5533.SL p. 14
CMH CIT 09
Exhibit A
1 person t bc taken int cust dy ,nd immediately delivered t an
2 evaluation and treatment facility or the emergency department of a
3 lo al hospital:
4 (a) Only pursuant to subsections (1)(d) and (2) of this section; or
5
6
7 of serious harm or is in imminent danger bec,use of being gravely
8 disabled.
9 (5) Persons delivered to evaluation and treatment facilities by
10 peace officers pursuant to subsection (4)(b) f this section may be
11 held by the facility for a period of up to twelve hours: PROVIDED,
12 That they arc examined by a mental health professional within three
13
14 county designated mental health profe3 '
15 petition for detention, and commence service on the designated attorney
16 for the detained person.))
ausc to believe that such person
'
o
17 NEW SECTION. Sec. 8. A new section is added to chapter 71.05 RCW
18 to read as follows:
19 EMERGENT DETENTION. (1) When a designated mental health
20 professional receives information alleging that a person, as the result
21 of a mental disorder, presents an imminent likelihood of serious harm,
22 or is in imminent danger because of being gravely disabled, after
23 investigation and evaluation of the specific facts alleged and of the
24 reliability and credibility of the person or persons providing the
25 information if any, the designated mental health professional may take
26 such person, or cause by oral or written order such person to be taken
27 into emergency custody in an evaluation and treatment facility for not
28 more than seventy-two hours as described in RCW 71.05.180.
29 (2) A peace officer may take or cause such person to be taken into
30 custody and immediately delivered to a crisis stabilization unit, an
31 evaluation and treatment facility, or the emergency department of a
32 local hospital under the following circumstances:
33 (a) Pursuant to subsection (1) of this section; or
34 (b) When he or she has reasonable cause to believe that such person
35 is suffering from a mental disorder and presents an imminent likelihood
36 of serious harm or is in imminent danger because of being gravely
37 disabled.
Page 16 of 36
p. 15
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (3) Persons delivered to a crisis stabilization unit, evaluation
2 and treatment facility, or the emergency department of a local hospital
3 by peace officers pursuant to subsection (2) of this section may be
4 held by the facility for a period of up to twelve hours: PROVIDED,
5 That they are examined by a mental health professional within three
6 hours of their arrival. Within twelve hours of their arrival, the
7 designated mental health professional must determine whether the
8 individual meets detention criteria. If the individual is detained,
9 the designated mental health professional shall file a petition for
10 detention or a supplemental petition as appropriate and commence
11 service on the designated attorney for the detained person.
12 Sec. 9. RCW 71.05.157 and 2005 c 504 s 507 are each amended to
13 read as follows:
14 (1) When a designated mental health professional is notified by a
15 jail that a defendant or offender who was subject to a discharge review
16 under RCW 71.05.232 is to be released to the community, the designated
17 mental health professional shall evaluate the person within seventy-two
18 hours of release.
19 (2) When an offender is under court-ordered treatment in the
20 community and the supervision of the department of corrections, and the
21 treatment provider becomes aware that the person is in violation of the
22 terms of the court order, the treatment provider shall notify the
23 designated mental health professional and the department of corrections
24 of the violation and request an evaluation for purposes of revocation
25 of the less restrictive alternative.
26 (3) When a designated mental health professional becomes aware that
27 an offender who is under court-ordered treatment in the community and
28 the supervision of the department of corrections is in violation of a
29 treatment order or a condition of supervision that relates to public
30 safety, or the designated mental health professional detains a person
31 under this chapter, the designated mental health professional shall
32 notify the person's treatment provider and the department of
33 corrections.
34 (4) When an offender who is confined in a state correctional
35 facility or is under supervision of the department of corrections in
36 the community is subject to a petition for involuntary treatment under
37 this chapter, the petitioner shall notify the department of corrections
Page 17 of 36
SSB 5533.SL p. 16
CMH CIT 09
Exhibit A
1 and the department of corrections shall provide documentation of its
2 risk assessment or other concerns to the petitioner and the court if
3 the department of corrections classified the offender as a high risk or
4 high needs offender.
5 (5) Nothing in this section creates a duty on any treatment
6 provider or designated mental health professional to provide offender
7 supervision.
8 (6) No jail or state correctional facility may be considered a less
9 restrictive alternative to an evaluation and treatment facility.
10 Sec. 10, RCW 49.19.010 and 2000 c 94 s 18 are each amended to read
11 as follows:
12 For purposes of this chapter:
13 (1) "Health care setting" means:
14 (a) Hospitals as defined in RCW 70.41.020;
15 (b) Home health, hospice, and home care agencies under chapter
16 70.127 RCW, subject to RCW 49.19.070;
17 (c) Evaluation and treatment facilities as defined in RCW
18 71.05.020(((12))); and
19 (d) Community mental health programs as defined in RCW
20 71.24.025(5).
21 (2) "Department" means the department of labor and industries.
22 (3) "Employee" means an employee as defined in RCW 49.17.020.
23 (4) "Violence" or "violent act" means any physical assault or
24 verbal threat of physical assault against an employee of a health care
25 setting.
26 Sec. 11. RCW 71.34.600 and 2005 c 371 s 4 are each amended to read
27 as follows:
28 (1) A parent may bring, or authorize the bringing of, his or her
29 minor child to an evaluation and treatment facility or an inpatient
30 facility licensed under chapter 70.41, 71.12, or 72.23 RCW and request
31 that the professional person ((as dcfincd in RCW 71.05.020(24)))
32 examine the minor to determine whether the minor has a mental disorder
33 and is in need of inpatient treatment.
34 (2) The consent of the minor is not required for admission,
35 evaluation, and treatment if the parent brings the minor to the
36 facility.
Page 18 of 36
p. 17
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (3) An appropriately trained professional person may evaluate
2 whether the minor has a mental disorder. The evaluation shall be
3 completed within twenty-four hours of the time the minor was brought to
4 the facility, unless the professional person determines that the
5 condition of the minor necessitates additional time for evaluation. In
6 no event shall a minor be held longer than seventy-two hours for
7 evaluation. If, in the judgment of the professional person, it is
8 determined it is a medical necessity for the minor to receive inpatient
9 treatment, the minor may be held for treatment. The facility shall
10 limit treatment to that which the professional person determines is
11 medically necessary to stabilize the minor's condition until the
12 evaluation has been completed. Within twenty-four hours of completion
13 of the evaluation, the professional person shall notify the department
14 if the child is held for treatment and of the date of admission.
15 (4) No provider is obligated to provide treatment to a minor under
16 the provisions of this section except that no provider may refuse to
17 treat a minor under the provisions of this section solely on the basis
18 that the minor has not consented to the treatment. No provider may
19 admit a minor to treatment under this section unless it is medically
20 necessary.
21 (5) No minor receiving inpatient treatment under this section may
22 be discharged from the facility based solely on his or her request.
23 (6) Prior to the review conducted under RCW 71.34.610, the
24 professional person shall notify the minor of his or her right to
25 petition superior court for release from the facility.
26 (7) For the purposes of this section "professional person" means
27 "professional person" as defined in RCW 71.05.020.
28 Sec. 12. RCW 71.24.035 and 2006 c 333 s 201 are each amended to
29 read as follows:
30 (1) The department is designated as the state mental health
31 authority.
32 (2) The secretary shall provide for public, client, and licensed
33 service provider participation in developing the state mental health
34 program, developing contracts with regional support networks, and any
35 waiver request to the federal government under medicaid.
36 (3) The secretary shall provide for participation in developing the
Page 19 of 36
SSB 5533.SL p. 18
CMH CIT 09
Exhibit A
1 state mental health program for children and other underserved
2 populations, by including representatives on any committee established
3 to provide oversight to the state mental health program.
4 (4) The secretary shall be designated as the regional support
5 network if the regional support network fails to meet state minimum
6 standards or refuses to exercise responsibilities under RCW 71 24.045.
7 (5) The secretary shall:
8 (a) Develop a biennial state mental health program that
9 incorporates regional biennial needs assessments and regional mental
10 health service plans and state services for ((mentally ill)) adults and
11 children with mental illness. The secretary shall also develop a six -
12 year state mental health plan;
13 (b) Assure that any regional or county community mental health
14 program provides access to treatment for the region's residents in the
15 following order of priority: (i) ((Thc acutely mentally ill)) Persons
16 with acute mental illness; (ii) ((chroni ally mentally ill)) adults
17 with chronic mental illness and children who are severely emotionally
18 disturbed ((children)); and (iii) ((the)) persons who are seriously
19 disturbed. Such programs shall provide:
20 (A) Outpatient services;
21 (B) Emergency care services for twenty-four hours per day;
22 (C) Day treatment for ((mentally ill)) persons with mental illness
23 which includes training in basic living and social skills, supported
24 work, vocational rehabilitation, and day activities. Such services may
25 include therapeutic treatment. In the case of a child, day treatment
26 includes age-appropriate basic living and social skills, educational
27 and prevocational services, day activities, and therapeutic treatment;
28 (D) Screening for patients being considered for admission to state
29 mental health facilities to determine the appropriateness of admission;
30 (E) Employment services, which may include supported employment,
31 transitional work, placement in competitive employment, and other work -
32 related services, that result in ((mentally ill)) persons with mental
33 illness becoming engaged in meaningful and gainful full or part-time
34 work. Other sources of funding such as the division of vocational
35 rehabilitation may be utilized by the secretary to maximize federal
36 funding and provide for integration of services;
37 (F) Consultation and education services; and
38 (G) Community support services;
Page 20 of 36 CMH CIT 09
Exhibit A
p. 19 SSB 5533.SL
1 (c) Develop and adopt rules establishing state minimum standards
2 for the delivery of mental health services pursuant to RCW 71.24.037
3 including, but not limited to:
4 (i) Licensed service providers. These rules shall permit a county-
5 operated mental health program to be licensed as a service provider
subject to compliance with applicable statutes and rules. The
secretary shall provide for deeming of compliance with state minimum
standards for those entities accredited by recognized behavioral health
accrediting bodies recognized and having a current agreement with the
department;
(ii) Regional support networks; and
(iii) Inpatient services, evaluation and treatment services and
facilities under chapter /±.05 RCW, resource management_ eLVIL dJIU
community support services;
(d) Assure that the special needs of persons who are minorities,
((t4.1e)) elderly, disabled, children, and low-income ((persons)) are met
within the priorities established in this section;
(e) Establish a standard contract or contracts, consistent with
state minimum standards and RCW 71.24.320, 71.24.330, and 71.24.3201,
which shall be used in contracting with regional support networks. The
standard contract shall include a maximum fund balance, which shall be
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
consistent with that
stipulations;
(f) Establish, to
required by federal regulations or waiver
the extent possible, a standardized auditing
procedure which minimizes paperwork requirements of regional support
networks and licensed service providers. The audit procedure shall
focus on the outcomes of service and not the processes for
accomplishing them;
(g) Develop and maintain an information system to be used by the
state and regional support networks that includes a tracking method
which allows the department and regional support networks to identify
mental health clients' participation in any mental 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 in RCW 71.05.390, 71.05.420, and 71.05.440;
(h) License service providers who meet state minimum standards;
Page 21 of 36
SSB 5533.SL p. 20
CMH CIT 09
Exhibit A
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
(i) Certify regional support networks that meet state minimum
standards;
(j) Periodically monitor the compliance of certified regional
support networks and their network of licensed service providers for
compliance with the contract between the department, the regional
support network, and federal and state rules at reasonable times and in
a reasonable manner;
(k) Fix fees to be paid by evaluation and treatment centers to the
secretary for the required inspections;
(1) Monitor and audit regional support networks and licensed
service providers as needed to assure compliance with contractual
agreements authorized by this chapter;
(m) Adopt such rules as are necessary to implement the department's
responsibilities under this chapter; (())
(n) Assure the availability of an appropriate amount, as determined
by the legislature in the operating budget by amounts appropriated for
this specific purpose, of community-based, geographically distributed
residential services; and
(o) Certify crisis stabilization units that meet state minimum
standards.
(6) The secretary shall use available resources only for regional
support networks, except to the extent authorized, and in accordance
with any priorities or conditions specified, in the biennial
appropriations act.
(7) Each certified regional support network and licensed service
provider shall file with the secretary, on request, such data,
statistics, schedules, and information as the secretary reasonably
requires. A certified regional support network or licensed service
provider which, without good cause, fails to furnish any data,
statistics, schedules, or information as requested,
or files fraudulent
reports thereof, may have its certification or license
suspended.
(8) The secretary may suspend, revoke, limit, or
certification or license, or refuse to grant a certification
for failure to conform to: (a) The law; (b) applicable
regulations; (c) applicable standards; or (d) state minimum
(9) The superior court may restrain any regional support
service provider from operating without certification or a
Page 22 of 36
p. 21
revoked or
restrict a
or license
rules and
standards.
network or
license or
CMH CIT 09
Exhibit A
SSB 5533.SL
1 any other violation of this section. The court may also review,
2 pursuant to procedures contained in chapter 34.05 RCW, any denial,
3 suspension, limitation, restriction, or revocation of certification or
4 license, and grant other relief required to enforce the provisions of
5 this chapter.
6 (10) Upon petition by the secretary, and after hearing held upon
7 reasonable notice to the facility, the superior court may issue a
8 warrant to an officer or employee of the secretary authorizing him or
9 her to enter at reasonable times, and examine the records, books, and
10 accounts of any regional support network or service provider refusing
11 to consent to inspection or examination by the authority.
12 (11) Notwithstanding the existence or pursuit of any other remedy,
13 the secretary may file an action for an injunction or other process
14 against any person or governmental unit to restrain or prevent the
15 establishment, conduct, or operation of a regional support network or
16 service provider without certification or a license under this chapter.
17 (12) The standards for certification of evaluation and treatment
18 facilities shall include standards relating to maintenance of good
19 physical and mental health and other services to be afforded persons
20 pursuant to this chapter and chapters 71.05 and 71.34 RCW, and shall
21 otherwise assure the effectuation of the purposes of these chapters.
22 (13) The standards for certification of crisis stabilization units
23 shall include standards that:
24 (a) Permit location of the units at a jail facility if the unit is
25 physically separate from the general population of the jail;
26 (b) Require administration of the unit by mental health
27 professionals who direct the stabilization and rehabilitation efforts;
28 and
29 (c) Provide an environment affording security appropriate with the
30 alleged criminal behavior and necessary to protect the public safety.
31 (14) The department shall distribute appropriated state and federal
32 funds in accordance with any priorities, terms, or conditions specified
33 in the appropriations act.
34 (((14))) (15) The secretary shall assume all duties assigned to the
35 nonparticipating regional support networks under chapters 71.05, 71.34,
36 and 71.24 RCW. Such responsibilities shall include those which would
37 have been assigned to the nonparticipating counties in regions where
38 there are not participating regional support networks.
Page 23 of 36
SSB 5533.SL p. 22
CMH CIT 09
Exhibit A
1 The regional support networks, or the secretary's assumption of all
2 responsibilities under chapters 71.05, 71.34, and 71.24 RCW, shall be
3 included in all state and federal plans affecting the state mental
4 health program including at least those required by this chapter, the
5 medicaid program, and P.L. 99-660. Nothing in these plans shall be
6 inconsistent with the intent and requirements of this chapter.
7 (((15))) (16) The secretary shall:
8 (a) Disburse funds for the regional support networks within sixty
9 days of approval of the biennial contract. The department must either
10 approve or reject the biennial contract within sixty days of receipt.
11 (b) Enter into biennial contracts with regional support networks.
12 The contracts shall be consistent with available resources. No
13 contract shall be approved that does not include progress toward
14 meeting the goals of this chapter by taking responsibility for: (i)
15 Short-term commitments; (ii) residential care; and (iii) emergency
16 response systems.
17 (c) Notify regional support networks of their allocation of
18 available resources at least sixty days prior to the start of a new
19 biennial contract period.
20 (d) Deny all or part of the funding allocations to regional support
21 networks based solely upon formal findings of noncompliance with the
22 terms of the regional support network's contract with the department.
23 Regional support networks disputing the decision of the secretary to
24 withhold funding allocations are limited to the remedies provided in
25 the department's contracts with the regional support networks.
26 (((1G))) (17) The department, in cooperation with the state
27 congressional delegation, shall actively seek waivers of federal
28 requirements and such modifications of federal regulations as are
29 necessary to allow federal medicaid reimbursement for services provided
30 by free-standing evaluation and treatment facilities certified under
31 chapter 71.05 RCW. The department shall periodically report its
32 efforts to the appropriate committees of the senate and the house of
33 representatives.
34 Sec. 13. RCW 71.05.160 and 1998 c 297 s 9 are each amended to read
35 as follows:
36 Any facility receiving a person pursuant to RCW 71.05.150 or
37 section 8 of this act shall require the designated mental health
Page 24 of 36
p. 23
CMH CIT 09
Exhibit A
SSB 5533.SL
1 professional to prepare a petition for initial detention stating the
2 circumstances under which the person's condition was made known and
3 stating that ((such officcr or person ha3)) there is evidence, as a
4 result of his or her personal observation or investigation, that the
5 actions of the person for which application is made constitute a
6 likelihood of serious harm, or that he or she is gravely disabled, and
7 stating the specific facts known to him or her as a result of his or
8 her personal observation or investigation, upon which he or she bases
9 the belief that such person should be detained for the purposes and
10 under the authority of this chapter.
11 If a person is involuntarily placed in an evaluation and treatment
12 facility pursuant to RCW 71.05.150 or section 8 of this act, on the
13 next judicial day tollowing the initial detention, the ((county))
14 designated mental health professional shall file with the court and
15 serve the designated attorney of the detained person the petition or
16 supplemental petition for initial detention, proof of service of
17 notice, and a copy of a notice of emergency detention.
18 Sec. 14. RCW 71.05.360 and 2005 c 504 s 107 are each amended to
19 read as follows:
20 (1)(a) Every person involuntarily detained or committed under the
21 provisions of this chapter shall be entitled to all the rights set
22 forth in this chapter, which shall be prominently posted in the
23 facility, and shall retain all rights not denied him or her under this
24 chapter except as chapter 9.41 RCW may limit the right of a person to
25 purchase or possess a firearm or to qualify for a concealed pistol
26 license.
27 (b) No person shall be presumed incompetent as a consequence of
28 receiving an evaluation or voluntary or involuntary treatment for a
29 mental disorder, under this chapter or any prior laws of this state
30 dealing with mental illness. Competency shall not be determined or
31 withdrawn except under the provisions of chapter ((10.97)) 10.77 or
32 11.88 RCW.
33 (c) Any person who leaves a public or private agency following
34 evaluation or treatment for mental disorder shall be given a written
35 statement setting forth the substance of this section.
36 (2) Each person involuntarily detained or committed pursuant to
Page 25 of 36
SSB 5533.SL p. 24
CMH CIT 09
Exhibit A
1 this chapter shall have the right to adequate care and individualized
2 treatment.
3 (3) The provisions of this chapter shall not be construed to deny
4 to any person treatment by spiritual means through prayer in accordance
5 with the tenets and practices of a church or religious denomination.
6 (4) Persons receiving evaluation or treatment under this chapter
7 shall be given a reasonable choice of an available physician or other
8 professional person qualified to provide such services.
9 (5) Whenever any person is detained for evaluation and treatment
10 pursuant to this chapter, both the person and, if possible, a
11 responsible member of his or her immediate family, personal
12 representative, guardian, or conservator, if any, shall be advised as
ii soon as possible in writing or orally, by Lh oiriceL ui pw_son taking
14 him or her into custody or by personnel of the evaluation and treatment
15 facility where the person is detained that unless the person is
16 released or voluntarily admits himself or herself for treatment within
17 seventy-two hours of the initial detention:
18 (a) A judicial hearing in a superior court, either by a judge or
19 court commissioner thereof, shall be held not more than seventy-two
20 hours after the initial detention to determine whether there is
21 probable cause to detain the person after the seventy-two hours have
22 expired for up to an additional fourteen days without further automatic
23 hearing for the reason that the person is a person whose mental
24 disorder presents a likelihood of serious harm or that the person is
25 gravely disabled;
26 (b) The person has a right to communicate immediately with an
27 attorney; has a right to have an attorney appointed to represent him or
28 her before and at the probable cause hearing if he or she is indigent;
29 and has the right to be told the name and address of the attorney that
30 the mental health professional has designated pursuant to this chapter;
31 (c) The person has the right to remain silent and that any
32 statement he or she makes may be used against him or her;
33 (d) The person has the right to present evidence and to cross -
34 examine witnesses who testify against him or her at the probable cause
35 hearing; and
36 (e) The person has the right to refuse psychiatric medications,
37 including antipsychotic medication beginning twenty-four hours prior to
38 the probable cause hearing.
Page 26 of 36
p. 25
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (6) When proceedings are initiated under ((RCW 71.05.150 (2), (3),
2 or (4)(b))) section 8 of this act, no later than twelve hours after
3 such person is admitted to the evaluation and treatment facility the
4 personnel of the evaluation and treatment facility or the designated
5 mental health professional shall serve on such person a copy of the
6 petition for initial detention and the name, business address, and
7 phone number of the designated attorney and shall forthwith commence
8 service of a copy of the petition for initial detention on the
9 designated attorney.
10 (7) The judicial hearing described in subsection (5) of this
11 section is hereby authorized, and shall be held according to the
12 provisions of subsection (5) of this section and rules promulgated by
13 the supreme court.
14 (8) At the probable cause hearing the detained person shall have
15 the following rights in addition to the rights previously specified:
16 (a) To present evidence on his or her behalf;
17 (b) To cross-examine witnesses who testify against him or her;
18 (c) To be proceeded against by the rules of evidence;
19 (d) To remain silent;
20 (e) To view and copy all petitions and reports in the court file.
21 (9) The physician -patient privilege or the psychologist -client
22 privilege shall be deemed waived in proceedings under this chapter
23 relating to the administration of antipsychotic medications. As to
24 other proceedings under this chapter, the privileges shall be waived
25 when a court of competent jurisdiction in its discretion determines
26 that such waiver is necessary to protect either the detained person or
27 the public.
28 The waiver of a privilege under this section is limited to records
29 or testimony relevant to evaluation of the detained person for purposes
30 of a proceeding under this chapter. Upon motion by the detained person
31 or on its own motion, the court shall examine a record or testimony
32 sought by a petitioner to determine whether it is within the scope of
33 the waiver.
34 The record maker shall not be required to testify in order to
35 introduce medical or psychological records of the detained person so
36 long as the requirements of RCW 5.45.020 are met except that portions
37 of the record which contain opinions as to the detained person's mental
Page 27 of 36
SSB 5533.SL p. 26
CMH CIT 09
Exhibit A
1 state must be deleted from such records unless the person making such
2 conclusions is available for cross-examination.
3 (10) Insofar as danger to the person or others is not created, each
4 person involuntarily detained, treated in a less restrictive
5 alternative course of treatment, or committed for treatment and
6 evaluation pursuant to this chapter shall have, in addition to other
7 rights not specifically withheld by law, the following rights:
8 (a) To wear his or her own clothes and to keep and use his or her
9 own personal possessions, except when deprivation of same is essential
10 to protect the safety of the resident or other persons;
11 (b) To keep and be allowed to spend a reasonable sum of his or her
12 own money for canteen expenses and small purchases;
13 (c) To have access to individual storage space for his or her
14 private use;
15 (d) To have visitors at reasonable times;
16 (e) To have reasonable access to a telephone, both to make and
17 receive confidential calls, consistent with an effective treatment
18 program;
19 (f) To have ready access to letter writing materials, including
20 stamps, and to send and receive uncensored correspondence through the
21 mails;
22 (g) To discuss treatment plans and decisions with professional
23 persons;
24 (h) Not to consent to the administration of antipsychotic
25 medications and not to thereafter be administered antipsychotic
26 medications unless ordered by a court under RCW 71.05.217 or pursuant
27 to an administrative hearing under RCW 71.05.215;
28 (i) Not to consent to the performance of electroconvulsant therapy
29 or surgery, except emergency life-saving surgery, unless ordered by a
30 court under RCW 71.05.217;
31 (j) Not to have psychosurgery performed on him or her under any
32 circumstances;
33 (k) To dispose of property and sign contracts unless such person
34 has been adjudicated an incompetent in a court proceeding directed to
35 that particular issue.
36 (11) Every person involuntarily detained shall immediately be
37 informed of his or her right to a hearing to review the legality of his
38 or her detention and of his or her right to counsel, by the
Page 28 of 36
p. 27
CMH CIT 09
Exhibit A
SSB 5533.SL
1 professional person in charge of the facility providing evaluation and
2 treatment, or his or her designee, and, when appropriate, by the court.
3 If the person so elects, the court shall immediately appoint an
4 attorney to assist him or her.
5 (12) A person challenging his or her detention or his or her
6 attorney((--)) shall have the right to designate and have the court
7 appoint a reasonably available independent physician or licensed mental
8 health professional to examine the person detained, the results of
9 which examination may be used in the proceeding. The person shall, if
10 he or she is financially able, bear the cost of such expert
11 )) examination, otherwise such expert
12 examination shall be at public expense.
13 (i_s) Nothing contained in this chapter shall prohibiL Lhe pai..iaL
14 from petitioning by writ of habeas corpus for release.
15 (14) Nothing in this chapter shall prohibit a person committed on
16 or prior to January 1, 1974, from exercising a right available to him
17 or her at or prior to January 1, 1974, for obtaining release from
18 confinement.
19 (15) Nothing in this section permits any person to knowingly
20 violate a no -contact order or a condition of an active judgment and
21 sentence or an active condition of supervision by the department of
22 corrections.
23 Sec. 15. RCW 71.05.390 and 2005 c 504 s 109, 2005 c 453 s 5, and
24 2005 c 274 s 346 are each reenacted and amended to read as follows:
25 Except as provided in this section, RCW 71.05.445, 71.05.630,
26 70.96A.150, or pursuant to a valid release under RCW 70.02.030, the
27 fact of admission and all information and records compiled, obtained,
28 or maintained in the course of providing services to either voluntary
29 or involuntary recipients of services at public or private agencies
30 shall be confidential.
31 Information and records may be disclosed only:
32 (1) In communications between qualified professional persons to
33 meet the requirements of this chapter, in the provision of services or
34 appropriate referrals, or in the course of guardianship proceedings.
35 The consent of the person, or his or her personal representative or
36 guardian, shall be obtained before information or records may be
Page 29 of 36
SSB 5533.SL p. 28
CMH CIT 09
Exhibit A
1 disclosed by a professional person employed by a facility unless
2 provided to a professional person:
3 (a) Employed by the facility;
4 (b) Who has medical responsibility for the patient's care;
5 (c) Who is a designated mental health professional;
6 (d) Who is providing services under chapter 71.24 RCW;
7 (e) Who is employed by a state or local correctional facility where
8 the person is confined or supervised; or
9 (f) Who is providing evaluation, treatment, or follow-up services
10 under chapter 10.77 RCW.
11 (2) When the communications regard the special needs of a patient
12 and the necessary circumstances giving rise to such needs and the
13 disclosure is made by a facility providing services to the operator of
14 a facility in which the patient resides or will reside.
15 (3)(a) When the person receiving services, or his or her guardian,
16 designates persons to whom information or records may be released, or
17 if the person is a minor, when his or her parents make such
18 designation.
19 (b) A public or private agency shall release to a person's next of
20 kin, attorney, personal representative, guardian, or conservator, if
21 any:
22 (i) The information that the person is presently a patient in the
23 facility or that the person is seriously physically ill;
24 (ii) A statement evaluating the mental and physical condition of
25 the patient, and a statement of the probable duration of the patient's
26 confinement, if such information is requested by the next of kin,
27 attorney, personal representative, guardian, or conservator; and
28 (iii) Such other information requested by the next of kin or
29 attorney as may be necessary to decide whether or not proceedings
30 should be instituted to appoint a guardian or conservator.
31 (4) To the extent necessary for a recipient to make a claim, or for
32 a claim to be made on behalf of a recipient for aid, insurance, or
33 medical assistance to which he or she may be entitled.
34 (5)(a) For either program evaluation or research, or both:
35 PROVIDED, That the secretary adopts rules for the conduct of the
36 evaluation or research, or both. Such rules shall include, but need
37 not be limited to, the requirement that all evaluators and researchers
38 must sign an oath of confidentiality substantially as follows:
Page 30 of 36
p. 29
CMH CIT 09
Exhibit A
SSB 5533.SL
1 "As a condition of conducting evaluation or research concerning
2 persons who have received services from (fill in the facility, agency,
3 or person) I, , agree not to divulge, publish, or
4 otherwise make known to unauthorized persons or the public any
5 information obtained in the course of such evaluation or research
6 regarding persons who have received services such that the person who
7 received such services is identifiable.
8 I recognize that unauthorized release of confidential information
9 may subject me to civil liability under the provisions of state law.
10 /s/
11 (b) Nothing in this chapter shall be construed to prohibit the
12 compilation and publication of statistical data for use by government
13 or researchers under standards, including standards to assure
14 maintenance of confidentiality, set forth by the secretary.
15 (6)(a) To the courts as necessary to the administration of this
16 chapter or to a court ordering an evaluation or treatment under chapter
17 10.77 RCW solely for the purpose of preventing the entry of any
18 evaluation or treatment order that is inconsistent with any order
19 entered under this chapter.
20 (b) To a court or its designee in which a motion under chapter
21 10.77 RCW has been made for involuntary medication of a defendant for
22 the purpose of competency restoration.
23 (c) Disclosure under this subsection is mandatory for the purpose
24 of the health insurance portability and accountability act.
25 (7)(a) When a mental health professional is requested by a
26 representative of a law enforcement or corrections agency, including a
27 police officer, sheriff, community corrections officer, a municipal
28 attorney, or prosecuting attorney to undertake an investigation or
29 provide treatment under RCW 71.05.150 or section 2 or 8 of this act,
30 the mental health professional shall, if requested to do so, advise the
31 representative in writing of the results of the investigation including
32 a statement of reasons for the decision to detain or release the person
33 investigated. Such written report shall be submitted within seventy -
34 two hours of the completion of the investigation or the request from
Page 31 of 36
SSB 5533.SL p. 30
CMH CIT 09
Exhibit A
1 the law enforcement or corrections representative, whichever occurs
2 later.
3 (b) To law enforcement officers, public health officers, or
4 personnel of the department of corrections or the indeterminate
5 sentence review board for persons who are the subject of the records
6 and who are committed to the custody or supervision of the department
7 of corrections or indeterminate sentence review board which information
8 or records are necessary to carry out the responsibilities of their
9 office. Except for dissemination of information released pursuant to
10 RCW 71.05.425 and 4.24.550, regarding persons committed under this
11 chapter under RCW 71.05.280(3) and 71.05.320(()) (3) (c) after
12 dismissal of a sex offense as defined in RCW 9.94A.030, the extent of
13 111fuLLLLLiuI1 LliaL may b _Lleasd is limited Ew follows:
14 (i) Only the fact, place, and date of involuntary commitment, the
15 fact and date of discharge or release, and the last known address shall
16 be disclosed upon request;
17 (ii) The law enforcement and public health officers or personnel of
18 the department of corrections or indeterminate sentence review board
19 shall be obligated to keep such information confidential in accordance
20 with this chapter;
21 (iii) Additional information shall be disclosed only after giving
22 notice to said person and his or her counsel and upon a showing of
23 clear, cogent, and convincing evidence that such information is
24 necessary and that appropriate safeguards for strict confidentiality
25 are and will be maintained. However, in the event the said person has
26 escaped from custody, said notice prior to disclosure is not necessary
27 and that the facility from which the person escaped shall include an
28 evaluation as to whether the person is of danger to persons or property
29 and has a propensity toward violence;
30 (iv) Information and records shall be disclosed to the department
31 of corrections pursuant to and in compliance with the provisions of RCW
32 71.05.445 for the purposes of completing presentence investigations or
33 risk assessment reports, supervision of an incarcerated offender or
34 offender under supervision in the community, planning for and provision
35 of supervision of an offender, or assessment of an offender's risk to
36 the community; and
37 (v) Disclosure under this subsection is mandatory for the purposes
38 of the health insurance portability and accountability act.
Page 32 of 36
p. 31
CMH CIT 09
Exhibit A
SSB 5533.SL
1 (8) To the attorney of the detained person.
2 (9) To the prosecuting attorney as necessary to carry out the
3 responsibilities of the office under RCW 71.05.330(2) and
4 71.05.340(1)(b) and 71.05.335. The prosecutor shall be provided access
5 to records regarding the committed person's treatment and prognosis,
6 medication, behavior problems, and other records relevant to the issue
7 of whether treatment less restrictive than inpatient treatment is in
8 the best interest of the committed person or others. Information shall
9 be disclosed only after giving notice to the committed person and the
10 person's counsel.
11 (10) To appropriate law enforcement agencies and to a person, when
12 the identity of the person is known to the public or private agency,
13 whose health and safety has been threatened, or who is known to have
14 been repeatedly harassed, by the patient. The person may designate a
15 representative to receive the disclosure. The disclosure shall be made
16 by the professional person in charge of the public or private agency or
17 his or her designee and shall include the dates of commitment,
18 admission, discharge, or release, authorized or unauthorized absence
19 from the agency's facility, and only such other information that is
20 pertinent to the threat or harassment. The decision to disclose or not
21 shall not result in civil liability for the agency or its employees so
22 long as the decision was reached in good faith and without gross
23 negligence.
24 (11) To appropriate corrections and law enforcement agencies all
25 necessary and relevant information in the event of a crisis or emergent
26 situation that poses a significant and imminent risk to the public.
27 The decision to disclose or not shall not result in civil liability for
28 the mental health service provider or its employees so long as the
29 decision was reached in good faith and without gross negligence.
30 (12) To the persons designated in RCW 71.05.425 for the purposes
31 described in that section.
32 (13) Civil liability and immunity for the release of information
33 about a particular person who is committed to the department under RCW
34 71.05.280(3) and 71.05.320(((2))) (3)(c) after dismissal of a sex
35 offense as defined in RCW 9.94A.030, is governed by RCW 4.24.550.
36 (14) Upon the death of a person, his or her next of kin, personal
37 representative, guardian, or conservator, if any, shall be notified.
Page 33 of 36
SSB 5533.SL p. 32
CMH CIT 09
Exhibit A
1 Next of kin who are of legal age and competent shall be notified
2 under this section in the following order: Spouse, parents, children,
3 brothers and sisters, and other relatives according to the degree of
4 relation. Access to all records and information compiled, obtained, or
5 maintained in the course of providing services to a deceased patient
6 shall be governed by RCW 70.02.140.
7 (15) To the department of health for the purposes of determining
8 compliance with state or federal licensure, certification, or
9 registration rules or laws. However, the information and records
10 obtained under this subsection are exempt from public inspection and
11 copying pursuant to chapter 42.56 RCW.
12 (16) To mark headstones or otherwise memorialize patients interred
13 at state hospital cemeteries. The department of social and health
14 services shall make available the name, date of birth, and date of
15 death of patients buried in state hospital cemeteries fifty years after
16 the death of a patient.
17 (17) To law enforcement officers and to prosecuting attorneys as
18 are necessary to enforce RCW 9.41.040(2)(a)(ii). The extent of
19 information that may be released is limited as follows:
20 (a) Only the fact, place, and date of involuntary commitment, an
21 official copy of any order or orders of commitment, and an official
22 copy of any written or oral notice of ineligibility to possess a
23 firearm that was provided to the person pursuant to RCW 9.41.047(1),
24 shall be disclosed upon request;
25 (b) The law enforcement and prosecuting attorneys may only release
26 the information obtained to the person's attorney as required by court
27 rule and to a jury or judge, if a jury is waived, that presides over
28 any trial at which the person is charged with violating RCW
29 9.41.040(2)(a)(ii);
30 (c) Disclosure under this subsection is mandatory for the purposes
31 of the health insurance portability and accountability act.
32 (18) When a patient would otherwise be subject to the provisions of
33 RCW 71.05.390 and disclosure is necessary for the protection of the
34 patient or others due to his or her unauthorized disappearance from the
35 facility, and his or her whereabouts is unknown, notice of such
36 disappearance, along with relevant information, may be made to
37 relatives, the department of corrections when the person is under the
38 supervision of the department, and governmental law enforcement
Page 34 of 36
p. 33
CMH CIT 09
Exhibit A
SSB 5533.SL
1 agencies designated by the physician in charge of the patient or the
2 professional person in charge of the facility, or his or her
3 professional designee.
4 Except as otherwise provided in this chapter, the uniform health
5 care information act, chapter 70.02 RCW, applies to all records and
6 information compiled, obtained, or maintained in the course of
7 providing services.
8 (19) The fact of admission, as well as all records, files,
9 evidence, findings, or orders made, prepared, collected, or maintained
10 pursuant to this chapter shall not be admissible as evidence in any
11 legal proceeding outside this chapter without the written consent of
12 the person who was the subject of the proceeding except in a subsequent
13 criminal prosecution of a person committed pursuant to RCW 71.05.280(3)
14 or 71.05.320(((2))) (3)(c) on charges that were dismissed pursuant to
15 chapter 10.77 RCW due to incompetency to stand trial, in a civil
16 commitment proceeding pursuant to chapter 71.09 RCW, or, in the case of
17 a minor, a guardianship or dependency proceeding. The records and
18 files maintained in any court proceeding pursuant to this chapter shall
19 be confidential and available subsequent to such proceedings only to
20 the person who was the subject of the proceeding or his or her
21 attorney. In addition, the court may order the subsequent release or
22 use of such records or files only upon good cause shown if the court
23 finds that appropriate safeguards for strict confidentiality are and
24 will be maintained.
25 NEW SECTION. Sec. 16. Nothing in this act shall be construed to
26 alter or diminish a prosecutor's inherent authority to divert or pursue
27 the prosecution of criminal offenders.
28 NEW SECTION. Sec. 17. RCW 10.77.090 (Stay of proceedings --
29 Commitment--Findings--Evaluation, treatment --Extensions of commitment --
30 Alternative procedures --Procedure in nonfelony charge) and 2000 c 74 s
31 3, 1998 c 297 s 38, 1989 c 420 s 5, 1979 ex.s. c 215 s 3, 1974 ex.s. c
32 198 s 8, & 1973 1st ex.s. c 117 s 9 are each repealed.
33 NEW SECTION. Sec. 18. If any provision of this act or its
34 application to any person or circumstance is held invalid, the
Page 35 of 36
SSB 5533.SL p. 34
CMH CIT 09
Exhibit A
1 remainder of the act or the application of the provision to other
2 persons or circumstances is not affected.
3 NEW SECTION. Sec. 19. Captions used in this act are not any part
4 of the law.
Passed by the Senate April 16, 2007.
Passed by the House April 9, 2007.
Approved by the Governor May 8, 2007.
Filed in Office of Secretary of State May 10, 2007.
Page 36 of 36 CMH CIT 09
Exhibit A
p. 35 SSB 5533.SL
MENTAL HEALTH CRISIS STABILIZATION UNIT
(Crisis Triage Unit)
REIT
L FOR TREATMENT STANDARDS
Authority: Chapter 375, Laws of 2007 (SSB 5533).
Statement of Authority: Section 2 of Chapter 375, Laws of 2007 adds a new section to RCW
10.31, which, in subpart (2) provides that police officers are to be guided by standards mutually
agreed upon with the prosecuting attorney. These are the standards mutually agreed upon:
Statement of law: When a police officer has reasonable cause to believe that the individual has
committed acts constituting a non -felony crime that is not a serious offense as identified in RCW
10.77.092 and the individual is known by history or consultation with the regional support
network to suffer from a mental disorder, the arresting officer MAY take the individual to a
crisis stabilization unit and be held up to 12 hours.
In deciding whether to refer the individual to treatment, the officer shall be guided by these
standards.
Types of crimes covered: Any non -felony crime EXCEPT the following:
1. Any DV crime;
2. DUI, Physical control, Flit and Run (attended), Reckless driving;
3 Non felony violations of RCW 9.41 (firearms issues) or an equivalent city ordinance;
4. Assault with injuries, stalking, harassment or intimidation that involves threats of harm to
person and/or property; and
5. Any sex offense.
Criminal history: The individual may not be referred if they have the following criminal history:
1. There should be no recent history of serious assaultive behavior.
Mental health history: The statute requires consideration of the mental health history of the
individual (if known). Due to state and federal privacy laws, this will typically not be known. It
will be up to the knowledge and discretion of the officer handling the case. If the officer believes
or knows that the individual has a history of mental health issues and the officer believes that the
individual would benefit from referral to treatment and otherwise would qualify for this option, it
is within the discretion of the officer to so do.
Page 1 of 2
CMH CIT 09
Exhibit C
Circumstances surrounding commission of alleged offense: The statute requires consideration of
the circumstances surrounding the commission of the alleged offense. Some offenses will appear
to be strongly related to instances of mental illness. Such offenses and their relationship to any
issues of mental illness will be up to the knowledge and discretion of the officer handling the
case.
Yakima County Prosecuting Attorney City of Yakima Legal Department
Date Date
Yakima County Sheriff City of Yakima Chief of Police
Date Date
Central Washington Comprehensive Mental Health, CEO
Date
Page 2 of 2
CMH CIT 09
Exhibit C
SUMMARY REPORT OF CONTRACTED BEHAVIORAL HEALTH (JAIL) DIVERSION SERVICES
FOR THE PERIOD OF OCTOBER 1, 2009 THROUGH MARCH 31, 2010
central
washington
Date: 3/29/2010
omprehensive
mental health
Behavioral Health Diversion is a community partnership between Yakima
County/City of Yakima law enforcement agencies (i.e., Yakima Police
Department, Yakima County Sheriff Department and Yakima County
Probation) and Central Washington Comprehensive Mental Health
(Comprehensive). The program is modeled after the CIT (Crisis Intervention
Team) national movement within law enforcement that focuses on sheriff,
police and probation officers as the first point of contact with individuals in a
behavioral crisis.
Comprehensive's Behavioral Health Diversion program maintains the
following goals:
1. Divert individuals with a mental illness or co-occurring mental illness
and substance abuse disorder, who commit a non-violent
misdemeanor, out of the mainstream legal system (jail) and into
needed treatment, thus allocating legal resources.
2. Educated and assist law enforcement in handling crises involving
people with mental illness and co-occurring disorders.
3. Make the mental health system of care more understandable and
accessible to law enforcement officers
The State of Washington enacted SB 5533, which provides law enforcement
with access to behavioral health diversion. This legislation has been used
collaboratively by Yakima County, the City of Yakima and Comprehensive to
create access to care standards that address the legal principles guiding this
program. Yakima County residents who present with mental illness or a co-
occurring mental illness and substance abuse disorder, and come to the
attention of law enforcement with a non-violent misdemeanor crime, can be
referred to the program. In doing so, individuals with a mental illness
and/or a co-occurring disorder can be diverted from jail and placed in
treatment services. (See attached Flow Chart showing BHD service referral process)
A Brief History of Behavioral Health Diversion in Yakima County:
Yakima County and Comprehensive first began exploring the possibility of
post -booking diversion in 2002 and submitted a grant proposal to SAMHSA.
In 2004 Yakima County received the SAMHSA grant. The initial three-year
grant period held many challenges, but much was learned about what
worked and did not work. Effective partnerships and working relationships
were developed. A no -cost fourth year extension was granted under the
grant. During the first part of the fourth year law enforcement, elected
officials and Comprehensive staff began learning about pre -booking
diversion models and observed them in action.
Yakima County Commissioners provided partial funding to continue the
program through the end of 2008 based on the success of the pilot. One-
time funds provided the remaining funding in 2008. Additional one-time
funding (a penalty paid by Spokane County) funded the program through
June 2009. Comprehensive continued to operate the program until the end
of September 2009. In October 2009 Yakima County and the City of Yakima
approved a six-month contract for Comprehensive to continue providing this
service.
Crisis Intervention Team (CIT):
A significant part of implementing and providing Behavioral Health Diversion
is training law enforcement officers in crisis intervention techniques. CIT
provides law enforcement with the needed tools for dealing with individuals
with acute mental illness, and provides them with assessment skills for
making a diversion.
Crisis Intervention Training is a collaborative process between
Comprehensive's clinical staff and officers from the Yakima Police
Department and deputies from the Yakima County Sheriff's Office.
® 130 law enforcements officers have received advanced training in
assessment and detention of individuals with mental health, post
traumatic stress and defensive tactics, and practical intervention skills
with individuals diagnosed with mental illness. Of the 130 officers
trained approximately 80% were from Yakima Police Department and
Yakima County Sheriff's Office.
® 40 YPD reserve officers have received an abbreviated training course
on working with individuals with mental health and co-occurring
illnesses.
In an effort to further educate officers to engage and utilize the BHD
program staff from Comprehensive attended morning musters with Yakima
Police Department and even went on patrol car ride along with officers.
Additionally Comprehensive provided officers with small adhesive post -its for
their vehicles. The post -its contained a brief description of BHD and the
program's phone number. These post -its were intended to serve as a
reminder to officer to consider utilization of BHD.
Behavioral Health Diversion Data/Outcomes:
Data reflects use during the past five months (Oct 1, 2009 -Feb 28, 2010).
Percentages are consistent with those experienced for the complete duration
of the Behavioral Health Diversion program.
Total Number of Individual Served: N=78
• 16.6 average referrals into behavioral diversion per month
• 94% from Yakima Probation, 2% Yakima County Sheriff, 2% from
Yakima City Police
• 64% male, 36% female
• 57% Caucasian, 35% Hispanic, 8% other ethnic origin
It is important to realize that individuals entering BHD have typically been
heavy users of treatment services:
• 66% have prior chemical dependency outpatient treatment
• 28% have prior chemical dependency inpatient treatment
• 40% have prior mental health outpatient services
• 10% have been in prior mental health inpatient services
Of those referred by probation:
• 56% charges originated from the City of Yakima
• 36% charges originated from Yakima County
• 8% other
• 70% are residents of the City of Yakima, 5% Union Gap,
5% Selah, 20% other
(See attached monthly tracking data sheet. Note data is only available up through February
28, 2010 because of time of submission of this report. Date for March 2010 will be
available upon request after March 31, 2010.)
Community Impact:
Direct Impact
In the absence of behavioral health diversion, Yakima Probation officials
have indicated they would likely prosecute many of these non-violent
probation violators. Typical costs would include re -arrest, incarceration
typically 4 to 14 days (5 days used for illustration), and court costs. This
equates to roughly $12,200 per month at the current referral rate.
($100 re -arrest + $68 per day jail cost x 5 days + $300 court cost, x 16.6
potential prosecutions per month.)
Indirect
When diversion is successful and an individual can get treatment for
chemical dependency and mental illness, then the cycle of re -arrest can be
broken. The reduction on recidivism was a major motivation for prior
Yakima County Prosecutor, Ron Zirkle.
During the duration of summary data period (October 1, 2009 to February
28, 2010), of the 78 individuals referred into Behavioral Health Diversion
there has only been one re -arrest to date. This is remarkable considering
that this population of 78 offenders has been responsible for 1,096 arrests
prior to diversion.*
* Source: Yakima Probation
Summary
The Behavioral Health Diversion program has been a successful partnership
since the Fall of 2007. There is additional work to be done: further
refinement of diversion criteria for law enforcement officers, additional CIT
training for public officials that may become in contact with individuals
suffering from acute mental illness, and extending CIT/Diversion capacity
with youth offenders.
Behavioral Health Diversion: Monthly Report
October 1, 2009 through March 31, 2010
October
November
December
January
February
March
Total Admissions
14
15
16
13
19
Total Referred
15
16
16
13
19
REFERRAL SOURCE
Yakima Police Department
0
2
0
0
1
Yakima Sheriff's Office
0
0
0
1
1
Yakima City/County Probation
15
14
16
12
17
Originating Charges
City of Yakima
7
10
9
7
1
County
6
2
6
4
1
Other
1
1
1
2
0
GENDER
Male
7
7
13
6
6
Female
7
8
3
7
3
Age Range
21 - 65
20 - 50
20
- 52
18
- 60
21
- 53
Average Age
33.6
29.6
31.1
28.7
36.2
ETHNICITY
Caucasian
11
8
6
9
11
Hispanic
2
5
9
3
7
Other
1
2
1
1
1
HOUSING
Own home or Rent
12
13
13
13
14
Homeless
2
2
3
0
5
Other
0
0
0
0
0
CLIENT PRIORITY
Acute
14
15
16
13
19
Chronic Adult
0
0
0
0
0
Seriously Disturbed Person
0
0
0
0
0
Other
0
0
0
0
0
IMPAIRMENT
Physical/Hearing/Vision
0
0
0
0
0
Developmental/Intelligence
0
0
0
0
0
Alcohol/Drug Dependence
9
9
14
11
15
PRIOR TREATMENT SERVICES
Chemical Dependency
10
6
13
6
17
Inpatient Chem. Dep.
6
4
8
4
0
Mental Health
6
6
8
5
7
Inpatient Mental Health
2
2
I 2
1
1
PROBATIONS SERVICES
Originating Charges
City of Yakima
7
10
9
7
8
County
6
2
6
3
7
Other
1
1
1
2
2
Prior Probation
Yes
9
9
16
8
14
No
5
4
0
4
3
Known History of Violence
Yes
7
7
10
8
11
No
Imminent Risk of Violation
Yes
14
13
16
12
17
No
0
0
0
0
0
LAW ENFORCEMENT
Prior Contact
Yes
0
2
0
0
2
No
0
0
0
1
0
Drug/Alcohol Involvement
Yes
0
1
0
1
1
No
0
1
0
0
1
Central Washington Comprehensive Mental Health
Behavioral Health Diversion
Referral Process Flow Chart
YPD, YSD or DOG
Refers to
Diversion
After -routine work hours ACS
provides initial assessment
for Fun Individuals need
Inpatient MH TX should be
referred to at this time
Needs MH Assessmen
BHD Staff
Complete initial
Assessment
Yes
DHS YC
Co-occurring Services
For individuals
Needing both
MH & CD
Not ready or currently
Appropriate for
CD &/or MH OP
Services
MRT
Permits referral from MRT
To MH or CD outpt or visa versa based •
Upon individuals need to maintain services
Following discharge •
From Inpatient CD TX client
may be referred back for MH
and/or CD outpatient TX
BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. 7
For Meeting of: 11/5/2013
ITEM TITLE: Resolution authorizing an Agreement with Central
Washington Comprehensive Mental Health (CWCMH)
allowing the City of Yakima to utilize the CWCMH Behavioral
Health Diversion Program at no cost to the City.
SUBMITTED BY: Cynthia I. Martinez, Senior Assistant City Attorney, 575-6030
SUMMARY EXPLANATION:
Prosecutors are prohibited from prosecuting individuals who lack the capacity to understand the
nature of the proceedings against him or her, or to assist in his or her own defense, as a result
of mental disease or defect.[1] Once a person is recognized to be suffering from a mental
disease or defect is charged with a crime, prosecutors are mandated to follow the procedure
found in RCW 10.77. Due to a constant shortage of available beds at Eastern State Hospital,
this Court process can. be lengthy. In the meantime, these defendants are typically being held
at the County Jail until a bed at Eastern Washington State Hospital becomes available. A wait
of at least 30 days is common and costly for the City and the defendant. Mentally ill defendants,
unlike inmates similarly situated without mental health illness, lose entitlements while in jail, and
receive no treatment for mental health. In most cases, when a defendant is found to be suffering
from a mental disease or defect, the end result, by law, is dismissal of the charge(s). Central
Washington Comprehensive Mental Health (CWCMH) Behavioral Health Diversion Program will
provide an option to incarceration of mentally ill defendants in crisis. Instead of jail, officers may
transport defendants that fit the program criteria to the Crisis Intervention Unit so that
stabilization can take place. Once stabilized, the Unit works on obtaining services for the
defendant to prevent further incidents of crisis and crime. Yakima County Probation Officers
may also refer convicted City defendants in crisis to the program, reducing the chance of
reoffending. The initial study of this program did show reduced recidivism among program
participants. In 2009, facing severe budget reductions, the City discontinued funding of the
program. The documented jail reduction savings were too few to justify the cost at a time when
the budget was tight. However, due to the probation referral increases were many and Yakima
County Probation urged the City to continue the funding. Unfortunately, the probation savings
were hard to document and the program was cut. Those involved in making the decision
lamented that the program was the right thing to do but the City just could not afford it at the
time. Comprehensive Mental Health is now proposing to provide access to the CWCMH
Behavioral Health Diversion Program at no cost to the City. Yakima Police Chief Dominic Rizzi
supports the reimplementation of the program and will encourage officers to utilize the program
when appropriate so that the potential jail savings are realized.
[1] RCW 10.77.010(14)
Resolution: X Ordinance:
Other (Specify):
Contract: X Contract Term: 11/6/2013-12/31/2014
Start Date: 11/6/2013 End Date: 12/31/2014
Item Budgeted: NA Amount:
Funding Source/Fiscal
Impact:
Strategic Priority: Public Safety
Insurance Required? No
Mail to: City of Yakima Legal Department, Attn: Cynthia I. Martinez,
200 South Third Street, 2nd Fl., Yakima, WA 98901
Phone: 509-575-6030
APPROVED FOR
SUBMITTAL:
RECOMMENDATION:
Adopt Resolution.
City Manager
ATTACHMENTS:
Description
Resolution-CWCMH Diversion Program
Agreement
CIT Agreement between City & CWCMH
Upload Date
10/18/2013
10/18/2013
Type
Resolution
Contract
Important Effective Dates for Employers and Health Plans
Fik
Plan years beginning on
or after Sept 23, 2010
(continued)
Dependent Coverage for Children Under Age 26
Ifa group health plan or insurer provides dependent coverage of children, the plan
must make that coverage available until a child turns age 26. A limited exception
applies for grandfathered health plans prior to Jan 1, 2014.
Eliminating Pre-existing Condition Exclusions for Children
Group health plans and health insurance issuers may not impose pre-existing condition
exclusions on coverage for children under age 19. This provision applies to all
employer plans and new plans in the individual market.
Coverage of Preventive Care Services
Group health plans and health insurance issuers offering group or individual health
insurance coverage must provide coverage for certain preventive care services without
cost-sharing (for example, deductibles, copayments or coinsurance) Grandfathered
plans are exempt from this requirement.
Rescissions Prohibition
ACA prohibits rescissions, or retroactive cancellations, of coverage, except in cases of
fraud or intentional misrepresentation Also, plans and issuers must provide at least 30
days' advance notice to the enrollee before coverage may be rescinded This provision
applies to all grandfathered and non -grandfathered plans.
1= EitrIltDATIEZ
yj�h �114'w'M4�r,P6e r D. ^ki,5.�..�nixt:
Distributions after Dec.
31, 2010
OU.S11
Increased Tax on Withdrawals from HSAs and Archer MSAs
ACA increased the additional tax on HSA withdrawals prior to age 65 that are not used
for qualified medical expenses from 10 to 20 percent. The additional tax for Archer
MSA withdrawals not used for qualified medical expenses also increased from 15 to 20
percent.
Beginning on Jan. 1,
2011
Medical Loss Ratio (MLR) Requirements
Health insurance issuers offering coverage in the group or individual markets (including
grandfathered health plans) must comply with medical loss ratio standards Issuers
must annually report on the share of premium dollars spent on health care and provide
consumer rebates for excessive medical loss ratios.
Simple Cafeteria Plans
ACA created a simple cafeteria plan to provide a vehicle through which small
businesses can provide tax-free benefits to their employees This plan is designed to
ease the small employer's administrative burden of sponsoring a cafeteria plan The
provision also exempts employers who make contributions for employees under a
simple cafeteria plan from certain nondiscrimination requirements applicable to highly
compensated and key employees.
This Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers
should contact legal counsel for legal advice.
2
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important Effective Dates for Employers and Health Plans
On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into law ACA
makes sweeping changes to the U S health care system. ACA's health care reforms, which are primarily focused on
reducing the uninsured population and decreasing health care costs, will be implemented over the next several years.
This Legislative Brief provides effective dates for key ACA reforms that affect employers and individuals Please read
below for more information
EFFEC7IU
isioN
2010 Taxable Year
Small Business Health Care Tax Credit
Eligible small employers can receive a credit for contributions to purchase health
insurance for employees The credit is up to 35 percent of the employer's contribution
to provide health insurance for employees. There is also up to a 25 percent credit for
small tax-exempt organizations. When the Exchanges are operational,the tax credits
will increase, up to 50 percent of premiums
March 30, 2010
Tax-free Coverage to Children Under Age 27
Employer-provided accident or health plan coverage for an eligible adult child can
generally be excluded from taxable income.
Plan ears beginning on
Y g 9
or after Sept. 23, 2010
Prohibition on Lifetime and Annual Dollar Limits
Group health plans and health insurance issuers offering group or individual health
insurance coverage may not impose lifetime limits or unreasonable annual limits on the
dollar value of essential health benefits This requirement applies to all plans, although
plans were allowed to request a waiver of the annual limit requirement through HHS
untilSept. 22, 2011 All annual limits will also be prohibited beginning in 2014
Appeals Process and External Review Requirements
Enhanced internal claims and appeals requirements and external review procedures
apply for group health plans and health insurance issuers, and insurers offering
individual coverage (except for grandfathered health plans)
Patient Protections
ACA imposes three new requirements on group health plans and group or individual
health insurance coverage that are referred to as "patient protections "These patient
protections relate to the choice of a health care professional, access to obstetrical and
gynecological care, and coverage for emergency services.
E
.MSPRI G
1
mportant Effective Dates for Employers and Health Plans
Plan years beginning on
or after Jan. 1, 2014
(continued)
Nondiscrimination Based on Health Status
Group health plans and health insurance issuers offering group or individual health
insurance coverage (except grandfathered plans) may not establish rules for eligibility
or continued eligibility based on health status -related factors
Nondiscrimination in Health Care
Group health plans and health insurance issuers offering group or individual insurance
coverage may not discriminate against any provider operating within their scope of
practice However, this provision does not require a plan to contract with any willing
provider or prevent tiered networks. It also does not apply to grandfathered plans
Plans and issuers also may not discriminate against individuals based on whether they
receive subsidies or cooperate in a Fair Labor Standards Act investigation
Insurance Premium Restrictions
Health insurance issuers in the individual and small group markets will not be permitted
to charge higher rates due to health status, gender or other factors. Premiums will be
able to vary based only on age, geography, family size and tobacco use. The rating
limitations will not apply to health insurance issuers that offer coverage in the large
group market unless the state elects to offer large group coverage through the state
exchange Also, these restrictions do not apply to grandfathered coverage
Excessive Waiting Periods Prohibited
Group health plans and health insurance issuers offering group or individual health
insurance coverage will not be able to require a waiting period of more than 90 days
Coverage for Clinical Trial Participants
Non -grandfathered group health plans and insurance policies will not be able to
terminate coverage because an individual chooses to participate in a clinical trial for
cancer or other life-threatening diseases or deny coverage for routine care that they
would otherwise provide just because an individual is enrolled in such a clinical trial
Comprehensive Benefits Coverage
Health insurance issuers that offer health insurance coverage in the individual or small
group market will be required to provide the essential benefits package required of
plans sold in the health insurance exchanges. This requirement does not apply to
grandfathered plans
Limits on Cost-sharing
Non -grandfathered group health plans will be subject to limits on cost-sharing or out-
of-pocket costs. ACA's annual deductible limit applies only to insured health plans
offered in the small group market,whereas ACA's out-of-pocket maximum limit applies
to all non -grandfathered health plans
Delayed for one year,
until 2015
Reporting of Health Insurance Coverage
See 2015 section below The employer mandate penalties and related reporting
requirements have been delayed for one year, until 2015
This Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers
should contact legal counsel for legal advice.
6
mportant Effective Dates for Employers and Health Plans
Delayed for one year,
until 2015
Employer Coverage Requirements
See 2015 section below The employer mandate penalties and related reporting
requirements have been delayed for one year, until 2015
Jan. 1, 2014
Individual Coverage Mandates
ACA requires most individuals to obtain acceptable health insurance coverage or pay a
penalty Individuals may be eligible for an exemption from the penalty if they cannot
obtain affordable coverage
Individual Health Insurance Subsidies
ACA makes federal subsidies available through the Exchanges, in the form of premium
tax credits and cost-sharing reductions, for low-income individuals who are not eligible
for or offered other acceptable coverage.
Health Insurance Exchanges
ACA calls for the creation of state -based competitive marketplaces, known as
Affordable Health Insurance Exchanges (Exchanges), for individuals and small
businesses to purchase private health insurance
Reinsurance Payments
Health insurance issuers and third -party administrators (TPAs) will be required to make
contributions based on a federal contribution rate established by HHS States may
collect additional contributions on top of the federal contribution rate
Plan years beginning on
or after Jan. 1, 2014
Employer Wellness Programs
Under health care reform, the potential incentive for employer wellness programs
increases to 30 percent of. the premium for employee participation in the program or
meeting certain health standards Employers must offer an alternative standard for
those employees whom it is unreasonably difficult or inadvisable to meet the standard
Following a governmental study on wellness programs,the incentive may be increased
to as much as 50 percent.
Annual Limits Prohibited
Plans and issuers may not impose annual limits on the coverage of essential health
benefits
Guaranteed Issue and Renewability
Health insurance issuers offering health insurance coverage in the individual or group
market in a state must accept every employer and individual in the state that applies
for coverage and must renew or continue to enforce the coverage at the option of the
plan sponsor or the individual. Grandfathered plans are exempt from this requirement.
Pre-existing Condition Prohibition
Group health plans and health insurance issuers may not impose pre-existing condition
exclusions on coverage for anyone
This Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers
hould contact legal counsel for legal advice.
5