Substance use/commitment

AN ACT Relating to updating the involuntary treatment commitment 1
standards for individuals suffering from a substance use disorder to 2
ensure the safety and well-being of our communities; reenacting and 3
amending RCW 71.05.020, 71.34.020, and 71.34.020; adding a new 4
section to chapter 71.05 RCW; creating a new section; providing an 5
effective date; and providing contingent expiration dates.6
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:7
NEW SECTION. Sec. 1. The legislature recognizes the immediate 8
and present dangers of the substance use crisis in Washington state. 9
Soaring substance use rates have served as a leading contributor to 10
increases in crime and homelessness which is plaguing communities 11
throughout our state. While the legislature has taken steps to 12
address this crisis through the passage of Ricky's law and dedicating 13
increased funding for building treatment capacity, the substance use 14
problem only continues to grow. In recognition of this crisis, the 15
legislature intends to fully implement new standards for involuntary 16
treatment commitment for individuals suffering from substance use 17
disorder who are an immediate danger to the community or themselves. 18
The legislature and mental health professionals recognized the need 19
for new involuntary treatment commitment standards upon passage of 20
chapter 302, Laws of 2020, yet these commitment standards have yet to 21
H-0799.2
HOUSE BILL 1787
State of Washington 69th Legislature 2025 Regular Session
By Representatives Griffey, Couture, Jacobsen, Connors, Schmidt,
Barnard, McClintock, Eslick, Ley, and Barkis
Read first time 02/03/25. Referred to Committee on Civil Rights &
Judiciary.
p. 1 HB 1787
be implemented resulting in an inability for local governments to 1
ensure that each and every individual suffering from a substance use 2
disorder who are a severe threat to the community or themselves are 3
able to receive necessary treatment. 4
The legislature also recognizes that the substance use crisis in 5
Washington state is geographically widespread and not isolated to 6
only urban communities, and continues to permeate throughout all 7
Washington communities. Therefore, the legislature intends to 8
appropriate additional funding for secure withdrawal management and 9
stabilization facilities in order to build the capacity of treatment 10
beds necessary to ensure each community throughout Washington state 11
has the resources to address the substance use crisis. The 12
legislature finds that communities who are geographically isolated 13
from these facilities face challenges in their ability to refer those 14
suffering from substance use disorder to existing facilities, leading 15
to either limited ability to commit these individuals for treatment 16
or placement in a facility not intended for proper substance use 17
treatment. The perpetuation of this practice has wreaked havoc on 18
communities throughout Washington state. Furthermore, the legislature 19
intends to double the current secure withdrawal management and 20
stabilization facility bed count through incentivizing the creation 21
of these facilities in areas lacking capacity as identified by the 22
health care authority single bed certification and unavailable 23
detention facility reports. This increased treatment capacity is 24
intended to ensure that the increased population of those detained 25
under these new involuntary treatment commitment standards for 26
substance use disorder have access to the proper treatment 27
facilities, and ensures that all communities throughout Washington 28
state have access to these facilities. 29
Sec. 2. RCW 71.05.020 and 2024 c 371 s 17, 2024 c 209 s 5, and 30
2024 c 62 s 18 are each reenacted and amended to read as follows:31
The definitions in this section apply throughout this chapter 32
unless the context clearly requires otherwise. 33
(1) "23-hour crisis relief center" has the same meaning as under 34
RCW 71.24.025; 35
(2) "Admission" or "admit" means a decision by a physician, 36
physician assistant, or psychiatric advanced registered nurse 37
practitioner that a person should be examined or treated as a patient 38
in a hospital; 39
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(3) "Alcoholism" means a disease, characterized by a dependency 1
on alcoholic beverages, loss of control over the amount and 2
circumstances of use, symptoms of tolerance, physiological or 3
psychological withdrawal, or both, if use is reduced or discontinued, 4
and impairment of health or disruption of social or economic 5
functioning; 6
(4) "Antipsychotic medications" means that class of drugs 7
primarily used to treat serious manifestations of mental illness 8
associated with thought disorders, which includes, but is not limited 9
to atypical antipsychotic medications; 10
(5) "Approved substance use disorder treatment program" means a 11
program for persons with a substance use disorder provided by a 12
treatment program certified by the department as meeting standards 13
adopted under chapter 71.24 RCW; 14
(6) "Attending staff" means any person on the staff of a public 15
or private agency having responsibility for the care and treatment of 16
a patient; 17
(7) "Authority" means the Washington state health care authority;18
(8) "Behavioral health disorder" means either a mental disorder 19
as defined in this section, a substance use disorder as defined in 20
this section, or a co-occurring mental disorder and substance use 21
disorder; 22
(9) "Behavioral health service provider" means a public or 23
private agency that provides mental health, substance use disorder, 24
or co-occurring disorder services to persons with behavioral health 25
disorders as defined under this section and receives funding from 26
public sources. This includes, but is not limited to: Hospitals 27
licensed under chapter 70.41 RCW; evaluation and treatment facilities 28
as defined in this section; community mental health service delivery 29
systems or community behavioral health programs as defined in RCW 30
71.24.025; licensed or certified behavioral health agencies under RCW 31
71.24.037; an entity with a tribal attestation that it meets minimum 32
standards or a licensed or certified behavioral health agency as 33
defined in RCW 71.24.025; facilities conducting competency 34
evaluations and restoration under chapter 10.77 RCW; approved 35
substance use disorder treatment programs as defined in this section; 36
secure withdrawal management and stabilization facilities as defined 37
in this section; and correctional facilities operated by state, 38
local, and tribal governments; 39
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(10) "Co-occurring disorder specialist" means an individual 1
possessing an enhancement granted by the department of health under 2
chapter 18.205 RCW that certifies the individual to provide substance 3
use disorder counseling subject to the practice limitations under RCW 4
18.205.105; 5
(11) "Commitment" means the determination by a court that a 6
person should be detained for a period of either evaluation or 7
treatment, or both, in an inpatient or a less restrictive setting;8
(12) "Community behavioral health agency" has the same meaning as 9
"licensed or certified behavioral health agency" defined in RCW 10
71.24.025; 11
(13) "Conditional release" means a revocable modification of a 12
commitment, which may be revoked upon violation of any of its terms;13
(14) "Crisis stabilization unit" means a short-term facility or a 14
portion of a facility licensed or certified by the department, such 15
as an evaluation and treatment facility or a hospital, which has been 16
designed to assess, diagnose, and treat individuals experiencing an 17
acute crisis without the use of long-term hospitalization, or to 18
determine the need for involuntary commitment of an individual;19
(15) "Custody" means involuntary detention under the provisions 20
of this chapter or chapter 10.77 RCW, uninterrupted by any period of 21
unconditional release from commitment from a facility providing 22
involuntary care and treatment; 23
(16) "Department" means the department of health;24
(17) "Designated crisis responder" means a mental health 25
professional appointed by the county, by an entity appointed by the 26
county, or by the authority in consultation with a tribe or after 27
meeting and conferring with an Indian health care provider, to 28
perform the duties specified in this chapter; 29
(18) "Detention" or "detain" means the lawful confinement of a 30
person, under the provisions of this chapter; 31
(19) "Developmental disabilities professional" means a person who 32
has specialized training and three years of experience in directly 33
treating or working with persons with developmental disabilities and 34
is a psychiatrist, physician assistant working with a psychiatrist 35
who is acting as a participating physician as defined in RCW 36
18.71A.010, psychologist, psychiatric advanced registered nurse 37
practitioner, or social worker, and such other developmental 38
disabilities professionals as may be defined by rules adopted by the 39
secretary of the department of social and health services;40
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(20) "Developmental disability" means that condition defined in 1
RCW 71A.10.020(6); 2
(21) "Director" means the director of the authority;3
(22) "Discharge" means the termination of hospital medical 4
authority. The commitment may remain in place, be terminated, or be 5
amended by court order; 6
(23) "Drug addiction" means a disease, characterized by a 7
dependency on psychoactive chemicals, loss of control over the amount 8
and circumstances of use, symptoms of tolerance, physiological or 9
psychological withdrawal, or both, if use is reduced or discontinued, 10
and impairment of health or disruption of social or economic 11
functioning; 12
(24) "Evaluation and treatment facility" means any facility which 13
can provide directly, or by direct arrangement with other public or 14
private agencies, emergency evaluation and treatment, outpatient 15
care, and timely and appropriate inpatient care to persons suffering 16
from a mental disorder, and which is licensed or certified as such by 17
the department. The authority may certify single beds as temporary 18
evaluation and treatment beds under RCW 71.05.745. A physically 19
separate and separately operated portion of a state hospital may be 20
designated as an evaluation and treatment facility. A facility which 21
is part of, or operated by, the department of social and health 22
services or any federal agency will not require certification. No 23
correctional institution or facility, or jail, shall be an evaluation 24
and treatment facility within the meaning of this chapter;25
(25) "Gravely disabled" means a condition in which a person ((, 26
as)):27
(a) As a result of a ((behavioral health )) mental disorder: 28
(((a))) (i) Is in danger of serious physical harm resulting from a 29
failure to provide for his or her essential human needs of health or 30
safety; or (((b))) (ii) manifests severe deterioration in routine 31
functioning evidenced by repeated and escalating loss of cognitive or 32
volitional control over his or her actions and is not receiving such 33
care as is essential for his or her health or safety; or34
(b) As a result of a substance use disorder: (i) Is in danger of 35
serious physical harm resulting from a failure to provide for his or 36
her essential human needs of health or safety; or (ii) manifests 37
severe deterioration from safe behavior evidenced by repeated and 38
escalating loss of cognitive or volitional control over his or her 39
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actions and is not receiving such care as is essential for his or her 1
health or safety; 2
(26) "Habilitative services" means those services provided by 3
program personnel to assist persons in acquiring and maintaining life 4
skills and in raising their levels of physical, mental, social, and 5
vocational functioning. Habilitative services include education, 6
training for employment, and therapy. The habilitative process shall 7
be undertaken with recognition of the risk to the public safety 8
presented by the person being assisted as manifested by prior charged 9
criminal conduct; 10
(27) "Hearing" means any proceeding conducted in open court that 11
conforms to the requirements of RCW 71.05.820; 12
(28) "History of one or more violent acts" refers to the period 13
of time ten years prior to the filing of a petition under this 14
chapter, excluding any time spent, but not any violent acts 15
committed, in a behavioral health facility, or in confinement as a 16
result of a criminal conviction; 17
(29) "Imminent" means the state or condition of being likely to 18
occur at any moment or near at hand, rather than distant or remote;19
(30) "In need of assisted outpatient treatment" refers to a 20
person who meets the criteria for assisted outpatient treatment 21
established under RCW 71.05.148; 22
(31) "Individualized service plan" means a plan prepared by a 23
developmental disabilities professional with other professionals as a 24
team, for a person with developmental disabilities, which shall 25
state: 26
(a) The nature of the person's specific problems, prior charged 27
criminal behavior, and habilitation needs; 28
(b) The conditions and strategies necessary to achieve the 29
purposes of habilitation; 30
(c) The intermediate and long-range goals of the habilitation 31
program, with a projected timetable for the attainment;32
(d) The rationale for using this plan of habilitation to achieve 33
those intermediate and long-range goals; 34
(e) The staff responsible for carrying out the plan;35
(f) Where relevant in light of past criminal behavior and due 36
consideration for public safety, the criteria for proposed movement 37
to less-restrictive settings, criteria for proposed eventual 38
discharge or release, and a projected possible date for discharge or 39
release; and 40
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(g) The type of residence immediately anticipated for the person 1
and possible future types of residences; 2
(32) "Intoxicated person" means a person whose mental or physical 3
functioning is substantially impaired as a result of the use of 4
alcohol or other psychoactive chemicals; 5
(33) "Judicial commitment" means a commitment by a court pursuant 6
to the provisions of this chapter; 7
(34) "Legal counsel" means attorneys and staff employed by county 8
prosecutor offices or the state attorney general acting in their 9
capacity as legal representatives of public behavioral health service 10
providers under RCW 71.05.130; 11
(35) "Less restrictive alternative treatment" means a program of 12
individualized treatment in a less restrictive setting than inpatient 13
treatment that includes the services described in RCW 71.05.585. This 14
term includes: Treatment pursuant to a less restrictive alternative 15
treatment order under RCW 71.05.240 or 71.05.320; treatment pursuant 16
to a conditional release under RCW 71.05.340; and treatment pursuant 17
to an assisted outpatient treatment order under RCW 71.05.148;18
(36) "Licensed physician" means a person licensed to practice 19
medicine or osteopathic medicine and surgery in the state of 20
Washington; 21
(37) "Likelihood of serious harm" means: 22
(a) With respect to a person with a mental disorder:23
(i) A substantial risk that: (((i))) (A) Physical harm will be 24
inflicted by a person upon his or her own person, as evidenced by 25
threats or attempts to commit suicide or inflict physical harm on 26
oneself; (((ii))) (B) physical harm will be inflicted by a person 27
upon another, as evidenced by behavior which has caused such harm or 28
which places another person or persons in reasonable fear of 29
sustaining such harm; or (((iii))) (C) physical harm will be 30
inflicted by a person upon the property of others, as evidenced by 31
behavior which has caused substantial loss or damage to the property 32
of others; or 33
(((b))) (ii) The person has threatened the physical safety of 34
another and has a history of one or more violent acts; or35
(b) With respect to a person with a substance use disorder:36
(i) A substantial risk that: (A) Physical harm will be inflicted 37
by a person upon his or her own person, as evidenced by threats or 38
attempts to commit suicide or inflict physical harm on oneself; (B) 39
physical harm will be inflicted by a person upon another, as 40
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evidenced by behavior which has caused harm, substantial pain, or 1
which places another person or persons in reasonable fear of harm to 2
themselves or others; or (C) physical harm will be inflicted by a 3
person upon the property of others, as evidenced by behavior which 4
has caused substantial loss or damage to the property of others; or5
(ii) The person has threatened the physical safety of another and 6
has a history of one or more violent acts;7
(38) "Medical clearance" means a physician or other health care 8
provider, including an Indian health care provider, has determined 9
that a person is medically stable and ready for referral to the 10
designated crisis responder or facility. For a person presenting in 11
the community, no medical clearance is required prior to 12
investigation by a designated crisis responder; 13
(39) "Mental disorder" means any organic, mental, or emotional 14
impairment which has substantial adverse effects on a person's 15
cognitive or volitional functions; 16
(40) "Mental health professional" means an individual practicing 17
within the mental health professional's statutory scope of practice 18
who is: 19
(a) A psychiatrist, psychologist, physician assistant working 20
with a psychiatrist who is acting as a participating physician as 21
defined in RCW 18.71A.010, psychiatric advanced registered nurse 22
practitioner, psychiatric nurse, or social worker, as defined in this 23
chapter and chapter 71.34 RCW; 24
(b) A mental health counselor, mental health counselor associate, 25
marriage and family therapist, or marriage and family therapist 26
associate, as defined in chapter 18.225 RCW; 27
(c) A certified or licensed agency affiliated counselor, as 28
defined in chapter 18.19 RCW; or 29
(d) A licensed psychological associate as described in chapter 30
18.83 RCW; 31
(41) "Peace officer" means a law enforcement official of a public 32
agency or governmental unit, and includes persons specifically given 33
peace officer powers by any state law, local ordinance, or judicial 34
order of appointment; 35
(42) "Physician assistant" means a person licensed as a physician 36
assistant under chapter 18.71A RCW; 37
(43) "Private agency" means any person, partnership, corporation, 38
or association that is not a public agency, whether or not financed 39
in whole or in part by public funds, which constitutes an evaluation 40
p. 8 HB 1787
and treatment facility or private institution, or hospital, or 1
approved substance use disorder treatment program, which is conducted 2
for, or includes a department or ward conducted for, the care and 3
treatment of persons with behavioral health disorders;4
(44) "Professional person" means a mental health professional, 5
substance use disorder professional, or designated crisis responder 6
and shall also mean a physician, physician assistant, psychiatric 7
advanced registered nurse practitioner, registered nurse, and such 8
others as may be defined by rules adopted by the secretary pursuant 9
to the provisions of this chapter; 10
(45) "Psychiatric advanced registered nurse practitioner" means a 11
person who is licensed as an advanced practice registered nurse 12
((practitioner)) pursuant to chapter 18.79 RCW; and who is board 13
certified in advanced practice psychiatric and mental health nursing;14
(46) "Psychiatrist" means a person having a license as a 15
physician and surgeon in this state who has in addition completed 16
three years of graduate training in psychiatry in a program approved 17
by the American medical association or the American osteopathic 18
association and is certified or eligible to be certified by the 19
American board of psychiatry and neurology; 20
(47) "Psychologist" means a person who has been licensed as a 21
psychologist pursuant to chapter 18.83 RCW; 22
(48) "Public agency" means any evaluation and treatment facility 23
or institution, secure withdrawal management and stabilization 24
facility, approved substance use disorder treatment program, or 25
hospital which is conducted for, or includes a department or ward 26
conducted for, the care and treatment of persons with behavioral 27
health disorders, if the agency is operated directly by federal, 28
state, county, or municipal government, or a combination of such 29
governments; 30
(49) "Release" means legal termination of the commitment under 31
the provisions of this chapter; 32
(50) "Resource management services" has the meaning given in 33
chapter 71.24 RCW; 34
(51) "Secretary" means the secretary of the department of health, 35
or his or her designee; 36
(52) "Secure withdrawal management and stabilization facility" 37
means a facility operated by either a public or private agency or by 38
the program of an agency which provides care to voluntary individuals 39
and individuals involuntarily detained and committed under this 40
p. 9 HB 1787
chapter for whom there is a likelihood of serious harm or who are 1
gravely disabled due to the presence of a substance use disorder. 2
Secure withdrawal management and stabilization facilities must:3
(a) Provide the following services: 4
(i) Assessment and treatment, provided by certified substance use 5
disorder professionals or co-occurring disorder specialists;6
(ii) Clinical stabilization services; 7
(iii) Acute or subacute detoxification services for intoxicated 8
individuals; and 9
(iv) Discharge assistance provided by certified substance use 10
disorder professionals or co-occurring disorder specialists, 11
including facilitating transitions to appropriate voluntary or 12
involuntary inpatient services or to less restrictive alternatives as 13
appropriate for the individual; 14
(b) Include security measures sufficient to protect the patients, 15
staff, and community; and 16
(c) Be licensed or certified as such by the department of health;17
(53) "Social worker" means a person with a master's or further 18
advanced degree from a social work educational program accredited and 19
approved as provided in RCW 18.320.010; 20
(54) "Severe deterioration from safe behavior" means that a 21
person will, if not treated, suffer or continue to suffer severe and 22
abnormal mental, emotional, or physical distress, and this distress 23
is associated with significant impairment of judgment, reason, or 24
behavior;25
(55) "Substance use disorder" means a cluster of cognitive, 26
behavioral, and physiological symptoms indicating that an individual 27
continues using the substance despite significant substance-related 28
problems. The diagnosis of a substance use disorder is based on a 29
pathological pattern of behaviors related to the use of the 30
substances; 31
(((55))) (56) "Substance use disorder professional" means a 32
person certified as a substance use disorder professional by the 33
department of health under chapter 18.205 RCW; 34
(((56))) (57) "Therapeutic court personnel" means the staff of a 35
mental health court or other therapeutic court which has jurisdiction 36
over defendants who are dually diagnosed with mental disorders, 37
including court personnel, probation officers, a court monitor, 38
prosecuting attorney, or defense counsel acting within the scope of 39
therapeutic court duties; 40
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(((57))) (58) "Treatment records" include registration and all 1
other records concerning persons who are receiving or who at any time 2
have received services for behavioral health disorders, which are 3
maintained by the department of social and health services, the 4
department, the authority, behavioral health administrative services 5
organizations and their staffs, managed care organizations and their 6
staffs, and by treatment facilities. Treatment records include mental 7
health information contained in a medical bill including but not 8
limited to mental health drugs, a mental health diagnosis, provider 9
name, and dates of service stemming from a medical service. Treatment 10
records do not include notes or records maintained for personal use 11
by a person providing treatment services for the department of social 12
and health services, the department, the authority, behavioral health 13
administrative services organizations, managed care organizations, or 14
a treatment facility if the notes or records are not available to 15
others; 16
(((58))) (59) "Tribe" has the same meaning as in RCW 71.24.025;17
(((59))) (60) "Video," unless the context clearly indicates 18
otherwise, means the delivery of behavioral health services through 19
the use of interactive audio and video technology, permitting real-20
time communication between a person and a designated crisis 21
responder, for the purpose of evaluation. "Video" does not include 22
the use of audio-only telephone, facsimile, email, or store and 23
forward technology. "Store and forward technology" means use of an 24
asynchronous transmission of a person's medical information from a 25
mental health service provider to the designated crisis responder 26
which results in medical diagnosis, consultation, or treatment;27
(((60))) (61) "Violent act" means behavior that resulted in 28
homicide, attempted suicide, injury, or substantial loss or damage to 29
property. 30
Sec. 3. RCW 71.34.020 and 2024 c 367 s 3 and 2024 c 209 s 7 are 31
each reenacted and amended to read as follows: 32
Unless the context clearly requires otherwise, the definitions in 33
this section apply throughout this chapter. 34
(1) "23-hour crisis relief center" has the same meaning as 35
provided in RCW 71.24.025. 36
(2) "Admission" or "admit" means a decision by a physician, 37
physician assistant, or psychiatric advanced registered nurse 38
p. 11 HB 1787
practitioner that a minor should be examined or treated as a patient 1
in a hospital. 2
(3) "Adolescent" means a minor thirteen years of age or older.3
(4) "Alcoholism" means a disease, characterized by a dependency 4
on alcoholic beverages, loss of control over the amount and 5
circumstances of use, symptoms of tolerance, physiological or 6
psychological withdrawal, or both, if use is reduced or discontinued, 7
and impairment of health or disruption of social or economic 8
functioning. 9
(5) "Antipsychotic medications" means that class of drugs 10
primarily used to treat serious manifestations of mental illness 11
associated with thought disorders, which includes, but is not limited 12
to, atypical antipsychotic medications. 13
(6) "Approved substance use disorder treatment program" means a 14
program for minors with substance use disorders provided by a 15
treatment program licensed or certified by the department of health 16
as meeting standards adopted under chapter 71.24 RCW.17
(7) "Attending staff" means any person on the staff of a public 18
or private agency having responsibility for the care and treatment of 19
a minor patient. 20
(8) "Authority" means the Washington state health care authority.21
(9) "Behavioral health administrative services organization" has 22
the same meaning as provided in RCW 71.24.025. 23
(10) "Behavioral health disorder" means either a mental disorder 24
as defined in this section, a substance use disorder as defined in 25
this section, or a co-occurring mental disorder and substance use 26
disorder. 27
(11) "Child psychiatrist" means a person having a license as a 28
physician and surgeon in this state, who has had graduate training in 29
child psychiatry in a program approved by the American Medical 30
Association or the American Osteopathic Association, and who is board 31
eligible or board certified in child psychiatry. 32
(12) "Children's mental health specialist" means:33
(a) A mental health professional who has completed a minimum of 34
one hundred actual hours, not quarter or semester hours, of 35
specialized training devoted to the study of child development and 36
the treatment of children; and 37
(b) A mental health professional who has the equivalent of one 38
year of full-time experience in the treatment of children under the 39
supervision of a children's mental health specialist.40
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(13) "Commitment" means a determination by a judge or court 1
commissioner, made after a commitment hearing, that the minor is in 2
need of inpatient diagnosis, evaluation, or treatment or that the 3
minor is in need of less restrictive alternative treatment.4
(14) "Conditional release" means a revocable modification of a 5
commitment, which may be revoked upon violation of any of its terms.6
(15) "Co-occurring disorder specialist" means an individual 7
possessing an enhancement granted by the department of health under 8
chapter 18.205 RCW that certifies the individual to provide substance 9
use disorder counseling subject to the practice limitations under RCW 10
18.205.105. 11
(16) "Crisis stabilization unit" means a short-term facility or a 12
portion of a facility licensed or certified by the department of 13
health under RCW 71.24.035, such as a residential treatment facility 14
or a hospital, which has been designed to assess, diagnose, and treat 15
individuals experiencing an acute crisis without the use of long-term 16
hospitalization, or to determine the need for involuntary commitment 17
of an individual. 18
(17) "Custody" means involuntary detention under the provisions 19
of this chapter or chapter 10.77 RCW, uninterrupted by any period of 20
unconditional release from commitment from a facility providing 21
involuntary care and treatment. 22
(18) "Department" means the department of social and health 23
services. 24
(19) "Designated crisis responder" has the same meaning as 25
provided in RCW 71.05.020. 26
(20) "Detention" or "detain" means the lawful confinement of a 27
person, under the provisions of this chapter. 28
(21) "Developmental disabilities professional" means a person who 29
has specialized training and three years of experience in directly 30
treating or working with persons with developmental disabilities and 31
is a psychiatrist, physician assistant working with a supervising 32
psychiatrist, psychologist, psychiatric advanced registered nurse 33
practitioner, or social worker, and such other developmental 34
disabilities professionals as may be defined by rules adopted by the 35
secretary of the department. 36
(22) "Developmental disability" has the same meaning as defined 37
in RCW 71A.10.020. 38
(23) "Director" means the director of the authority.39
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(24) "Discharge" means the termination of hospital medical 1
authority. The commitment may remain in place, be terminated, or be 2
amended by court order. 3
(25) "Evaluation and treatment facility" means a public or 4
private facility or unit that is licensed or certified by the 5
department of health to provide emergency, inpatient, residential, or 6
outpatient mental health evaluation and treatment services for 7
minors. A physically separate and separately operated portion of a 8
state hospital may be designated as an evaluation and treatment 9
facility for minors. A facility which is part of or operated by the 10
state or federal agency does not require licensure or certification. 11
No correctional institution or facility, juvenile court detention 12
facility, or jail may be an evaluation and treatment facility within 13
the meaning of this chapter. 14
(26) "Evaluation and treatment program" means the total system of 15
services and facilities coordinated and approved by a county or 16
combination of counties for the evaluation and treatment of minors 17
under this chapter. 18
(27) "Gravely disabled minor" means a minor who((, as)):19
(a) As a result of a ((behavioral health )) mental disorder, 20
(((a))) (i) is in danger of serious physical harm resulting from a 21
failure to provide for his or her essential human needs of health or 22
safety, or (((b))) (ii) manifests severe deterioration in routine 23
functioning evidenced by repeated and escalating loss of cognitive or 24
volitional control over his or her actions and is not receiving such 25
care as is essential for his or her health or safety; or26
(b) As a result of a substance use disorder, (i) is in danger of 27
serious physical harm resulting from a failure to provide for his or 28
her essential human needs of health or safety, or (ii) manifests 29
severe deterioration from safe behavior evidenced by repeated and 30
escalating loss of cognitive or volitional control over his or her 31
actions and is not receiving such care as is essential for his or her 32
health or safety. 33
(28) "Habilitative services" means those services provided by 34
program personnel to assist minors in acquiring and maintaining life 35
skills and in raising their levels of physical, behavioral, social, 36
and vocational functioning. Habilitative services include education, 37
training for employment, and therapy. 38
(29) "Hearing" means any proceeding conducted in open court that 39
conforms to the requirements of RCW 71.34.910. 40
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(30) "History of one or more violent acts" refers to the period 1
of time five years prior to the filing of a petition under this 2
chapter, excluding any time spent, but not any violent acts 3
committed, in a mental health facility, a long-term substance use 4
disorder treatment facility, or in confinement as a result of a 5
criminal conviction. 6
(31) "Individualized service plan" means a plan prepared by a 7
developmental disabilities professional with other professionals as a 8
team, for a person with developmental disabilities, which states:9
(a) The nature of the person's specific problems, prior charged 10
criminal behavior, and habilitation needs; 11
(b) The conditions and strategies necessary to achieve the 12
purposes of habilitation; 13
(c) The intermediate and long-range goals of the habilitation 14
program, with a projected timetable for the attainment;15
(d) The rationale for using this plan of habilitation to achieve 16
those intermediate and long-range goals; 17
(e) The staff responsible for carrying out the plan;18
(f) Where relevant in light of past criminal behavior and due 19
consideration for public safety, the criteria for proposed movement 20
to less-restrictive settings, criteria for proposed eventual 21
discharge or release, and a projected possible date for discharge or 22
release; and 23
(g) The type of residence immediately anticipated for the person 24
and possible future types of residences. 25
(32)(a) "Inpatient treatment" means twenty-four-hour-per-day 26
mental health care provided within a general hospital, psychiatric 27
hospital, residential treatment facility licensed or certified by the 28
department of health as an evaluation and treatment facility for 29
minors, secure withdrawal management and stabilization facility for 30
minors, or approved substance use disorder treatment program for 31
minors. 32
(b) For purposes of family-initiated treatment under RCW 33
71.34.600 through 71.34.670, "inpatient treatment" has the meaning 34
included in (a) of this subsection and any other residential 35
treatment facility licensed under chapter 71.12 RCW.36
(33) "Intoxicated minor" means a minor whose mental or physical 37
functioning is substantially impaired as a result of the use of 38
alcohol or other psychoactive chemicals. 39
p. 15 HB 1787
(34) "Judicial commitment" means a commitment by a court pursuant 1
to the provisions of this chapter. 2
(35) "Kinship caregiver" has the same meaning as in RCW 3
74.13.031(((22)(a))). 4
(36) "Legal counsel" means attorneys and staff employed by county 5
prosecutor offices or the state attorney general acting in their 6
capacity as legal representatives of public behavioral health service 7
providers under RCW 71.05.130. 8
(37) "Less restrictive alternative" or "less restrictive setting" 9
means outpatient treatment provided to a minor as a program of 10
individualized treatment in a less restrictive setting than inpatient 11
treatment that includes the services described in RCW 71.34.755, 12
including residential treatment. 13
(38) "Licensed physician" means a person licensed to practice 14
medicine or osteopathic medicine and surgery in the state of 15
Washington. 16
(39) "Likelihood of serious harm" means: 17
(a) With respect to a minor with a mental disorder:18
(i) A substantial risk that: (((i))) (A) Physical harm will be 19
inflicted by a minor upon his or her own person, as evidenced by 20
threats or attempts to commit suicide or inflict physical harm on 21
oneself; (((ii))) (B) physical harm will be inflicted by a minor upon 22
another individual, as evidenced by behavior which has caused such 23
harm or which places another person or persons in reasonable fear of 24
sustaining such harm; or (((iii))) (C) physical harm will be 25
inflicted by a minor upon the property of others, as evidenced by 26
behavior which has caused substantial loss or damage to the property 27
of others; or 28
(((b))) (ii) The minor has threatened the physical safety of 29
another and has a history of one or more violent acts; or30
(b) With respect to a minor with a substance use disorder:31
(i) A substantial risk that: (A) Physical harm will be inflicted 32
by a minor upon his or her own person, as evidenced by threats or 33
attempts to commit suicide or inflict physical harm on oneself; (B) 34
physical harm will be inflicted by a minor upon another individual, 35
as evidenced by behavior which has caused harm, substantial pain, or 36
which places another person or persons in reasonable fear of harm to 37
themselves or others; or (C) physical harm will be inflicted by a 38
minor upon the property of others, as evidenced by behavior which has 39
caused substantial loss or damage to the property of others; or40
p. 16 HB 1787
(ii) The minor has threatened the physical safety of another and 1
has a history of one or more violent acts. 2
(40) "Managed care organization" has the same meaning as provided 3
in RCW 71.24.025. 4
(41) "Medical clearance" means a physician or other health care 5
provider, including an Indian health care provider, has determined 6
that a person is medically stable and ready for referral to the 7
designated crisis responder or facility. For a person presenting in 8
the community, no medical clearance is required prior to 9
investigation by a designated crisis responder. 10
(42) "Medical necessity" for inpatient care means a requested 11
service which is reasonably calculated to: (a) Diagnose, correct, 12
cure, or alleviate a mental disorder or substance use disorder; or 13
(b) prevent the progression of a mental disorder or substance use 14
disorder that endangers life or causes suffering and pain, or results 15
in illness or infirmity or threatens to cause or aggravate a 16
disability, or causes physical deformity or malfunction, and there is 17
no adequate less restrictive alternative available.18
(43) "Mental disorder" means any organic, mental, or emotional 19
impairment that has substantial adverse effects on an individual's 20
cognitive or volitional functions. The presence of alcohol abuse, 21
drug abuse, juvenile criminal history, antisocial behavior, or 22
intellectual disabilities alone is insufficient to justify a finding 23
of "mental disorder" within the meaning of this section.24
(44) "Mental health professional" has the same meaning as 25
provided in RCW 71.05.020. 26
(45) "Minor" means any person under the age of eighteen years.27
(46) "Outpatient treatment" means any of the nonresidential 28
services mandated under chapter 71.24 RCW and provided by licensed or 29
certified behavioral health agencies as identified by RCW 71.24.025.30
(47)(a) "Parent" has the same meaning as defined in RCW 31
26.26A.010, including either parent if custody is shared under a 32
joint custody agreement, or a person or agency judicially appointed 33
as legal guardian or custodian of the child. 34
(b) For purposes of family-initiated treatment under RCW 35
71.34.600 through 71.34.670, "parent" also includes a person to whom 36
a parent defined in (a) of this subsection has given a signed 37
authorization to make health care decisions for the adolescent, a 38
stepparent who is involved in caring for the adolescent, a kinship 39
caregiver who is involved in caring for the adolescent, or another 40
p. 17 HB 1787
relative who is responsible for the health care of the adolescent, 1
who may be required to provide a declaration under penalty of perjury 2
stating that he or she is a relative responsible for the health care 3
of the adolescent pursuant to chapter 5.50 RCW. If a dispute arises 4
between individuals authorized to act as a parent for the purpose of 5
RCW 71.34.600 through 71.34.670, the disagreement must be resolved 6
according to the priority established under RCW 7.70.065(2)(a).7
(48) "Peace officer" means a law enforcement official of a public 8
agency or governmental unit, and includes persons specifically given 9
peace officer powers by any state law, local ordinance, or judicial 10
order of appointment. 11
(49) "Physician assistant" means a person licensed as a physician 12
assistant under chapter 18.71A RCW. 13
(50) "Private agency" means any person, partnership, corporation, 14
or association that is not a public agency, whether or not financed 15
in whole or in part by public funds, that constitutes an evaluation 16
and treatment facility or private institution, or hospital, or 17
approved substance use disorder treatment program, that is conducted 18
for, or includes a distinct unit, floor, or ward conducted for, the 19
care and treatment of persons with mental illness, substance use 20
disorders, or both mental illness and substance use disorders.21
(51) "Professional person in charge" or "professional person" 22
means a physician, other mental health professional, or other person 23
empowered by an evaluation and treatment facility, secure withdrawal 24
management and stabilization facility, or approved substance use 25
disorder treatment program with authority to make admission and 26
discharge decisions on behalf of that facility. 27
(52) "Psychiatric nurse" means a registered nurse who has 28
experience in the direct treatment of persons who have a mental 29
illness or who are emotionally disturbed, such experience gained 30
under the supervision of a mental health professional.31
(53) "Psychiatrist" means a person having a license as a 32
physician in this state who has completed residency training in 33
psychiatry in a program approved by the American Medical Association 34
or the American Osteopathic Association, and is board eligible or 35
board certified in psychiatry. 36
(54) "Psychologist" means a person licensed as a psychologist 37
under chapter 18.83 RCW. 38
(55) "Public agency" means any evaluation and treatment facility 39
or institution, or hospital, or approved substance use disorder 40
p. 18 HB 1787
treatment program that is conducted for, or includes a distinct unit, 1
floor, or ward conducted for, the care and treatment of persons with 2
mental illness, substance use disorders, or both mental illness and 3
substance use disorders if the agency is operated directly by 4
federal, state, county, or municipal government, or a combination of 5
such governments. 6
(56) "Release" means legal termination of the commitment under 7
the provisions of this chapter. 8
(57) "Resource management services" has the meaning given in 9
chapter 71.24 RCW. 10
(58) "Responsible other" means the minor, the minor's parent or 11
estate, or any other person legally responsible for support of the 12
minor. 13
(59) "Secretary" means the secretary of the department or 14
secretary's designee. 15
(60) "Secure withdrawal management and stabilization facility" 16
means a facility operated by either a public or private agency or by 17
the program of an agency which provides care to voluntary individuals 18
and individuals involuntarily detained and committed under this 19
chapter for whom there is a likelihood of serious harm or who are 20
gravely disabled due to the presence of a substance use disorder. 21
Secure withdrawal management and stabilization facilities must:22
(a) Provide the following services: 23
(i) Assessment and treatment, provided by certified substance use 24
disorder professionals or co-occurring disorder specialists;25
(ii) Clinical stabilization services; 26
(iii) Acute or subacute detoxification services for intoxicated 27
individuals; and 28
(iv) Discharge assistance provided by certified substance use 29
disorder professionals or co-occurring disorder specialists, 30
including facilitating transitions to appropriate voluntary or 31
involuntary inpatient services or to less restrictive alternatives as 32
appropriate for the individual; 33
(b) Include security measures sufficient to protect the patients, 34
staff, and community; and 35
(c) Be licensed or certified as such by the department of health.36
(61) "Severe deterioration from safe behavior" means that a 37
person will, if not treated, suffer or continue to suffer severe and 38
abnormal mental, emotional, or physical distress, and this distress 39
p. 19 HB 1787
is associated with significant impairment of judgment, reason, or 1
behavior. 2
(62) "Social worker" means a person with a master's or further 3
advanced degree from a social work educational program accredited and 4
approved as provided in RCW 18.320.010. 5
(((62))) (63) "Start of initial detention" means the time of 6
arrival of the minor at the first evaluation and treatment facility, 7
secure withdrawal management and stabilization facility, or approved 8
substance use disorder treatment program offering inpatient treatment 9
if the minor is being involuntarily detained at the time. With regard 10
to voluntary patients, "start of initial detention" means the time at 11
which the minor gives notice of intent to leave under the provisions 12
of this chapter. 13
(((63))) (64) "Store and forward technology" means use of an 14
asynchronous transmission of a person's medical information from a 15
mental health service provider to the designated crisis responder 16
which results in medical diagnosis, consultation, or treatment.17
(((64))) (65) "Substance use disorder" means a cluster of 18
cognitive, behavioral, and physiological symptoms indicating that an 19
individual continues using the substance despite significant 20
substance-related problems. The diagnosis of a substance use disorder 21
is based on a pathological pattern of behaviors related to the use of 22
the substances. 23
(((65))) (66) "Substance use disorder professional" means a 24
person certified as a substance use disorder professional by the 25
department of health under chapter 18.205 RCW. 26
(((66))) (67) "Therapeutic court personnel" means the staff of a 27
mental health court or other therapeutic court which has jurisdiction 28
over defendants who are dually diagnosed with mental disorders, 29
including court personnel, probation officers, a court monitor, 30
prosecuting attorney, or defense counsel acting within the scope of 31
therapeutic court duties. 32
(((67))) (68) "Treatment records" include registration and all 33
other records concerning persons who are receiving or who at any time 34
have received services for mental illness, which are maintained by 35
the department, the department of health, the authority, behavioral 36
health organizations and their staffs, and by treatment facilities. 37
Treatment records include mental health information contained in a 38
medical bill including but not limited to mental health drugs, a 39
mental health diagnosis, provider name, and dates of service stemming 40
p. 20 HB 1787
from a medical service. Treatment records do not include notes or 1
records maintained for personal use by a person providing treatment 2
services for the department, the department of health, the authority, 3
behavioral health organizations, or a treatment facility if the notes 4
or records are not available to others. 5
(((68))) (69) "Tribe" has the same meaning as in RCW 71.24.025.6
(((69))) (70) "Video" means the delivery of behavioral health 7
services through the use of interactive audio and video technology, 8
permitting real-time communication between a person and a designated 9
crisis responder, for the purpose of evaluation. "Video" does not 10
include the use of audio-only telephone, facsimile, email, or store 11
and forward technology. 12
(((70))) (71) "Violent act" means behavior that resulted in 13
homicide, attempted suicide, injury, or substantial loss or damage to 14
property. 15
Sec. 4. RCW 71.34.020 and 2024 c 209 s 7 and 2024 c 62 s 26 are 16
each reenacted and amended to read as follows: 17
Unless the context clearly requires otherwise, the definitions in 18
this section apply throughout this chapter. 19
(1) "Admission" or "admit" means a decision by a physician, 20
physician assistant, or psychiatric advanced registered nurse 21
practitioner that a minor should be examined or treated as a patient 22
in a hospital. 23
(2) "Adolescent" means a minor thirteen years of age or older.24
(3) "Alcoholism" means a disease, characterized by a dependency 25
on alcoholic beverages, loss of control over the amount and 26
circumstances of use, symptoms of tolerance, physiological or 27
psychological withdrawal, or both, if use is reduced or discontinued, 28
and impairment of health or disruption of social or economic 29
functioning. 30
(4) "Antipsychotic medications" means that class of drugs 31
primarily used to treat serious manifestations of mental illness 32
associated with thought disorders, which includes, but is not limited 33
to, atypical antipsychotic medications. 34
(5) "Approved substance use disorder treatment program" means a 35
program for minors with substance use disorders provided by a 36
treatment program licensed or certified by the department of health 37
as meeting standards adopted under chapter 71.24 RCW.38
p. 21 HB 1787
(6) "Attending staff" means any person on the staff of a public 1
or private agency having responsibility for the care and treatment of 2
a minor patient. 3
(7) "Authority" means the Washington state health care authority.4
(8) "Behavioral health administrative services organization" has 5
the same meaning as provided in RCW 71.24.025. 6
(9) "Behavioral health disorder" means either a mental disorder 7
as defined in this section, a substance use disorder as defined in 8
this section, or a co-occurring mental disorder and substance use 9
disorder. 10
(10) "Child psychiatrist" means a person having a license as a 11
physician and surgeon in this state, who has had graduate training in 12
child psychiatry in a program approved by the American Medical 13
Association or the American Osteopathic Association, and who is board 14
eligible or board certified in child psychiatry. 15
(11) "Children's mental health specialist" means:16
(a) A mental health professional who has completed a minimum of 17
one hundred actual hours, not quarter or semester hours, of 18
specialized training devoted to the study of child development and 19
the treatment of children; and 20
(b) A mental health professional who has the equivalent of one 21
year of full-time experience in the treatment of children under the 22
supervision of a children's mental health specialist.23
(12) "Commitment" means a determination by a judge or court 24
commissioner, made after a commitment hearing, that the minor is in 25
need of inpatient diagnosis, evaluation, or treatment or that the 26
minor is in need of less restrictive alternative treatment.27
(13) "Conditional release" means a revocable modification of a 28
commitment, which may be revoked upon violation of any of its terms.29
(14) "Co-occurring disorder specialist" means an individual 30
possessing an enhancement granted by the department of health under 31
chapter 18.205 RCW that certifies the individual to provide substance 32
use disorder counseling subject to the practice limitations under RCW 33
18.205.105. 34
(15) "Crisis stabilization unit" means a short-term facility or a 35
portion of a facility licensed or certified by the department of 36
health under RCW 71.24.035, such as a residential treatment facility 37
or a hospital, which has been designed to assess, diagnose, and treat 38
individuals experiencing an acute crisis without the use of long-term 39
p. 22 HB 1787
hospitalization, or to determine the need for involuntary commitment 1
of an individual. 2
(16) "Custody" means involuntary detention under the provisions 3
of this chapter or chapter 10.77 RCW, uninterrupted by any period of 4
unconditional release from commitment from a facility providing 5
involuntary care and treatment. 6
(17) "Department" means the department of social and health 7
services. 8
(18) "Designated crisis responder" has the same meaning as 9
provided in RCW 71.05.020. 10
(19) "Detention" or "detain" means the lawful confinement of a 11
person, under the provisions of this chapter. 12
(20) "Developmental disabilities professional" means a person who 13
has specialized training and three years of experience in directly 14
treating or working with persons with developmental disabilities and 15
is a psychiatrist, physician assistant working with a psychiatrist 16
who is acting as a participating physician as defined in RCW 17
18.71A.010, psychologist, psychiatric advanced registered nurse 18
practitioner, or social worker, and such other developmental 19
disabilities professionals as may be defined by rules adopted by the 20
secretary of the department. 21
(21) "Developmental disability" has the same meaning as defined 22
in RCW 71A.10.020. 23
(22) "Director" means the director of the authority.24
(23) "Discharge" means the termination of hospital medical 25
authority. The commitment may remain in place, be terminated, or be 26
amended by court order. 27
(24) "Evaluation and treatment facility" means a public or 28
private facility or unit that is licensed or certified by the 29
department of health to provide emergency, inpatient, residential, or 30
outpatient mental health evaluation and treatment services for 31
minors. A physically separate and separately operated portion of a 32
state hospital may be designated as an evaluation and treatment 33
facility for minors. A facility which is part of or operated by the 34
state or federal agency does not require licensure or certification. 35
No correctional institution or facility, juvenile court detention 36
facility, or jail may be an evaluation and treatment facility within 37
the meaning of this chapter. 38
(25) "Evaluation and treatment program" means the total system of 39
services and facilities coordinated and approved by a county or 40
p. 23 HB 1787
combination of counties for the evaluation and treatment of minors 1
under this chapter. 2
(26) "Gravely disabled minor" means a minor who((, as)):3
(a) As a result of a ((behavioral health )) mental disorder, 4
(((a))) (i) is in danger of serious physical harm resulting from a 5
failure to provide for his or her essential human needs of health or 6
safety, or (((b))) (ii) manifests severe deterioration in routine 7
functioning evidenced by repeated and escalating loss of cognitive or 8
volitional control over his or her actions and is not receiving such 9
care as is essential for his or her health or safety; or10
(b) As a result of a substance use disorder, (i) is in danger of 11
serious physical harm resulting from a failure to provide for his or 12
her essential human needs of health or safety, or (ii) manifests 13
severe deterioration from safe behavior evidenced by repeated and 14
escalating loss of cognitive or volitional control over his or her 15
actions and is not receiving such care as is essential for his or her 16
health or safety. 17
(27) "Habilitative services" means those services provided by 18
program personnel to assist minors in acquiring and maintaining life 19
skills and in raising their levels of physical, behavioral, social, 20
and vocational functioning. Habilitative services include education, 21
training for employment, and therapy. 22
(28) "Hearing" means any proceeding conducted in open court that 23
conforms to the requirements of RCW 71.34.910. 24
(29) "History of one or more violent acts" refers to the period 25
of time five years prior to the filing of a petition under this 26
chapter, excluding any time spent, but not any violent acts 27
committed, in a mental health facility, a long-term substance use 28
disorder treatment facility, or in confinement as a result of a 29
criminal conviction. 30
(30) "Individualized service plan" means a plan prepared by a 31
developmental disabilities professional with other professionals as a 32
team, for a person with developmental disabilities, which states:33
(a) The nature of the person's specific problems, prior charged 34
criminal behavior, and habilitation needs; 35
(b) The conditions and strategies necessary to achieve the 36
purposes of habilitation; 37
(c) The intermediate and long-range goals of the habilitation 38
program, with a projected timetable for the attainment;39
p. 24 HB 1787
(d) The rationale for using this plan of habilitation to achieve 1
those intermediate and long-range goals; 2
(e) The staff responsible for carrying out the plan;3
(f) Where relevant in light of past criminal behavior and due 4
consideration for public safety, the criteria for proposed movement 5
to less-restrictive settings, criteria for proposed eventual 6
discharge or release, and a projected possible date for discharge or 7
release; and 8
(g) The type of residence immediately anticipated for the person 9
and possible future types of residences. 10
(31)(a) "Inpatient treatment" means twenty-four-hour-per-day 11
mental health care provided within a general hospital, psychiatric 12
hospital, residential treatment facility licensed or certified by the 13
department of health as an evaluation and treatment facility for 14
minors, secure withdrawal management and stabilization facility for 15
minors, or approved substance use disorder treatment program for 16
minors. 17
(b) For purposes of family-initiated treatment under RCW 18
71.34.600 through 71.34.670, "inpatient treatment" has the meaning 19
included in (a) of this subsection and any other residential 20
treatment facility licensed under chapter 71.12 RCW.21
(32) "Intoxicated minor" means a minor whose mental or physical 22
functioning is substantially impaired as a result of the use of 23
alcohol or other psychoactive chemicals. 24
(33) "Judicial commitment" means a commitment by a court pursuant 25
to the provisions of this chapter. 26
(34) "Kinship caregiver" has the same meaning as in RCW 27
74.13.031(((22)(a))). 28
(35) "Legal counsel" means attorneys and staff employed by county 29
prosecutor offices or the state attorney general acting in their 30
capacity as legal representatives of public behavioral health service 31
providers under RCW 71.05.130. 32
(36) "Less restrictive alternative" or "less restrictive setting" 33
means outpatient treatment provided to a minor as a program of 34
individualized treatment in a less restrictive setting than inpatient 35
treatment that includes the services described in RCW 71.34.755, 36
including residential treatment. 37
(37) "Licensed physician" means a person licensed to practice 38
medicine or osteopathic medicine and surgery in the state of 39
Washington. 40
p. 25 HB 1787
(38) "Likelihood of serious harm" means: 1
(a) With respect to a minor with a mental disorder:2
(i) A substantial risk that: (((i))) (A) Physical harm will be 3
inflicted by a minor upon his or her own person, as evidenced by 4
threats or attempts to commit suicide or inflict physical harm on 5
oneself; (((ii))) (B) physical harm will be inflicted by a minor upon 6
another individual, as evidenced by behavior which has caused such 7
harm or which places another person or persons in reasonable fear of 8
sustaining such harm; or (((iii))) (C) physical harm will be 9
inflicted by a minor upon the property of others, as evidenced by 10
behavior which has caused substantial loss or damage to the property 11
of others; or 12
(((b))) (ii) The minor has threatened the physical safety of 13
another and has a history of one or more violent acts; or14
(b) With respect to a minor with a substance use disorder:15
(i) A substantial risk that: (A) Physical harm will be inflicted 16
by a minor upon his or her own person, as evidenced by threats or 17
attempts to commit suicide or inflict physical harm on oneself; (B) 18
physical harm will be inflicted by a minor upon another individual, 19
as evidenced by behavior which has caused harm, substantial pain, or 20
which places another person or persons in reasonable fear of harm to 21
themselves or others; or (C) physical harm will be inflicted by a 22
minor upon the property of others, as evidenced by behavior which has 23
caused substantial loss or damage to the property of others; or24
(ii) The minor has threatened the physical safety of another and 25
has a history of one or more violent acts. 26
(39) "Managed care organization" has the same meaning as provided 27
in RCW 71.24.025. 28
(40) "Medical clearance" means a physician or other health care 29
provider, including an Indian health care provider, has determined 30
that a person is medically stable and ready for referral to the 31
designated crisis responder or facility. For a person presenting in 32
the community, no medical clearance is required prior to 33
investigation by a designated crisis responder. 34
(41) "Medical necessity" for inpatient care means a requested 35
service which is reasonably calculated to: (a) Diagnose, correct, 36
cure, or alleviate a mental disorder or substance use disorder; or 37
(b) prevent the progression of a mental disorder or substance use 38
disorder that endangers life or causes suffering and pain, or results 39
in illness or infirmity or threatens to cause or aggravate a 40
p. 26 HB 1787
disability, or causes physical deformity or malfunction, and there is 1
no adequate less restrictive alternative available.2
(42) "Mental disorder" means any organic, mental, or emotional 3
impairment that has substantial adverse effects on an individual's 4
cognitive or volitional functions. The presence of alcohol abuse, 5
drug abuse, juvenile criminal history, antisocial behavior, or 6
intellectual disabilities alone is insufficient to justify a finding 7
of "mental disorder" within the meaning of this section.8
(43) "Mental health professional" means a psychiatrist, 9
psychiatric advanced registered nurse practitioner, physician 10
assistant working with a psychiatrist who is acting as a 11
participating physician as defined in RCW 18.71A.010, psychologist, 12
psychiatric nurse, social worker, and such other mental health 13
professionals as defined by rules adopted by the secretary of the 14
department of health under this chapter. 15
(44) "Minor" means any person under the age of eighteen years.16
(45) "Outpatient treatment" means any of the nonresidential 17
services mandated under chapter 71.24 RCW and provided by licensed or 18
certified behavioral health agencies as identified by RCW 71.24.025.19
(46)(a) "Parent" has the same meaning as defined in RCW 20
26.26A.010, including either parent if custody is shared under a 21
joint custody agreement, or a person or agency judicially appointed 22
as legal guardian or custodian of the child. 23
(b) For purposes of family-initiated treatment under RCW 24
71.34.600 through 71.34.670, "parent" also includes a person to whom 25
a parent defined in (a) of this subsection has given a signed 26
authorization to make health care decisions for the adolescent, a 27
stepparent who is involved in caring for the adolescent, a kinship 28
caregiver who is involved in caring for the adolescent, or another 29
relative who is responsible for the health care of the adolescent, 30
who may be required to provide a declaration under penalty of perjury 31
stating that he or she is a relative responsible for the health care 32
of the adolescent pursuant to chapter 5.50 RCW. If a dispute arises 33
between individuals authorized to act as a parent for the purpose of 34
RCW 71.34.600 through 71.34.670, the disagreement must be resolved 35
according to the priority established under RCW 7.70.065(2)(a).36
(47) "Peace officer" means a law enforcement official of a public 37
agency or governmental unit, and includes persons specifically given 38
peace officer powers by any state law, local ordinance, or judicial 39
order of appointment. 40
p. 27 HB 1787
(48) "Physician assistant" means a person licensed as a physician 1
assistant under chapter 18.71A RCW. 2
(49) "Private agency" means any person, partnership, corporation, 3
or association that is not a public agency, whether or not financed 4
in whole or in part by public funds, that constitutes an evaluation 5
and treatment facility or private institution, or hospital, or 6
approved substance use disorder treatment program, that is conducted 7
for, or includes a distinct unit, floor, or ward conducted for, the 8
care and treatment of persons with mental illness, substance use 9
disorders, or both mental illness and substance use disorders.10
(50) "Professional person in charge" or "professional person" 11
means a physician, other mental health professional, or other person 12
empowered by an evaluation and treatment facility, secure withdrawal 13
management and stabilization facility, or approved substance use 14
disorder treatment program with authority to make admission and 15
discharge decisions on behalf of that facility. 16
(51) "Psychiatric nurse" means a registered nurse who has 17
experience in the direct treatment of persons who have a mental 18
illness or who are emotionally disturbed, such experience gained 19
under the supervision of a mental health professional.20
(52) "Psychiatrist" means a person having a license as a 21
physician in this state who has completed residency training in 22
psychiatry in a program approved by the American Medical Association 23
or the American Osteopathic Association, and is board eligible or 24
board certified in psychiatry. 25
(53) "Psychologist" means a person licensed as a psychologist 26
under chapter 18.83 RCW. 27
(54) "Public agency" means any evaluation and treatment facility 28
or institution, or hospital, or approved substance use disorder 29
treatment program that is conducted for, or includes a distinct unit, 30
floor, or ward conducted for, the care and treatment of persons with 31
mental illness, substance use disorders, or both mental illness and 32
substance use disorders if the agency is operated directly by 33
federal, state, county, or municipal government, or a combination of 34
such governments. 35
(55) "Release" means legal termination of the commitment under 36
the provisions of this chapter. 37
(56) "Resource management services" has the meaning given in 38
chapter 71.24 RCW. 39
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(57) "Responsible other" means the minor, the minor's parent or 1
estate, or any other person legally responsible for support of the 2
minor. 3
(58) "Secretary" means the secretary of the department or 4
secretary's designee. 5
(59) "Secure withdrawal management and stabilization facility" 6
means a facility operated by either a public or private agency or by 7
the program of an agency which provides care to voluntary individuals 8
and individuals involuntarily detained and committed under this 9
chapter for whom there is a likelihood of serious harm or who are 10
gravely disabled due to the presence of a substance use disorder. 11
Secure withdrawal management and stabilization facilities must:12
(a) Provide the following services: 13
(i) Assessment and treatment, provided by certified substance use 14
disorder professionals or co-occurring disorder specialists;15
(ii) Clinical stabilization services; 16
(iii) Acute or subacute detoxification services for intoxicated 17
individuals; and 18
(iv) Discharge assistance provided by certified substance use 19
disorder professionals or co-occurring disorder specialists, 20
including facilitating transitions to appropriate voluntary or 21
involuntary inpatient services or to less restrictive alternatives as 22
appropriate for the individual; 23
(b) Include security measures sufficient to protect the patients, 24
staff, and community; and 25
(c) Be licensed or certified as such by the department of health.26
(60) "Severe deterioration from safe behavior" means that a 27
person will, if not treated, suffer or continue to suffer severe and 28
abnormal mental, emotional, or physical distress, and this distress 29
is associated with significant impairment of judgment, reason, or 30
behavior.31
(61) "Social worker" means a person with a master's or further 32
advanced degree from a social work educational program accredited and 33
approved as provided in RCW 18.320.010. 34
(((61))) (62) "Start of initial detention" means the time of 35
arrival of the minor at the first evaluation and treatment facility, 36
secure withdrawal management and stabilization facility, or approved 37
substance use disorder treatment program offering inpatient treatment 38
if the minor is being involuntarily detained at the time. With regard 39
to voluntary patients, "start of initial detention" means the time at 40
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which the minor gives notice of intent to leave under the provisions 1
of this chapter. 2
(((62))) (63) "Store and forward technology" means use of an 3
asynchronous transmission of a person's medical information from a 4
mental health service provider to the designated crisis responder 5
which results in medical diagnosis, consultation, or treatment.6
(((63))) (64) "Substance use disorder" means a cluster of 7
cognitive, behavioral, and physiological symptoms indicating that an 8
individual continues using the substance despite significant 9
substance-related problems. The diagnosis of a substance use disorder 10
is based on a pathological pattern of behaviors related to the use of 11
the substances. 12
(((64))) (65) "Substance use disorder professional" means a 13
person certified as a substance use disorder professional by the 14
department of health under chapter 18.205 RCW. 15
(((65))) (66) "Therapeutic court personnel" means the staff of a 16
mental health court or other therapeutic court which has jurisdiction 17
over defendants who are dually diagnosed with mental disorders, 18
including court personnel, probation officers, a court monitor, 19
prosecuting attorney, or defense counsel acting within the scope of 20
therapeutic court duties. 21
(((66))) (67) "Treatment records" include registration and all 22
other records concerning persons who are receiving or who at any time 23
have received services for mental illness, which are maintained by 24
the department, the department of health, the authority, behavioral 25
health organizations and their staffs, and by treatment facilities. 26
Treatment records include mental health information contained in a 27
medical bill including but not limited to mental health drugs, a 28
mental health diagnosis, provider name, and dates of service stemming 29
from a medical service. Treatment records do not include notes or 30
records maintained for personal use by a person providing treatment 31
services for the department, the department of health, the authority, 32
behavioral health organizations, or a treatment facility if the notes 33
or records are not available to others. 34
(((67))) (68) "Tribe" has the same meaning as in RCW 71.24.025.35
(((68))) (69) "Video" means the delivery of behavioral health 36
services through the use of interactive audio and video technology, 37
permitting real-time communication between a person and a designated 38
crisis responder, for the purpose of evaluation. "Video" does not 39
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include the use of audio-only telephone, facsimile, email, or store 1
and forward technology. 2
(((69))) (70) "Violent act" means behavior that resulted in 3
homicide, attempted suicide, injury, or substantial loss or damage to 4
property. 5
NEW SECTION. Sec. 5. A new section is added to chapter 71.05 6
RCW to read as follows: 7
The substance use disorder treatment facilities construction 8
account is created in the state treasury. The account shall consist 9
of funds appropriated by the legislature. Moneys in the account may 10
be spent only after appropriation. Expenditures from the account may 11
be used only to support the siting, design, and construction of 12
secure withdrawal management and stabilization facilities. Any 13
facilities sited or constructed with funds appropriated from the 14
account must be sited in a county with the highest level of single 15
bed certifications according to authority reports, a county with a 16
population of over 500,000 located on the east side of the crest of 17
the Cascade mountains, or a county located on the west side of the 18
crest of the Cascade mountains that shares a land border with Canada.19
NEW SECTION. Sec. 6. Section 2 of this act expires when section 20
18, chapter 371, Laws of 2024 takes effect.21
NEW SECTION. Sec. 7. Sections 3 and 4 of this act expire when 22
section 8, chapter 209, Laws of 2024 takes effect.23
NEW SECTION. Sec. 8. This act takes effect July 1, 2027.24
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