Psychiatric pharmacists

AN ACT Relating to psychiatric pharmacists; amending RCW 1
71.05.020, 71.05.020, 71.05.148, 71.05.148, 71.05.230, 71.05.230, 2
71.05.585, and 71.05.585; providing an effective date; providing a 3
contingent effective date; providing an expiration date; and 4
providing a contingent expiration date. 5
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:6
Sec. 1. RCW 71.05.020 and 2025 c 226 s 1 are each amended to 7
read as follows: 8
The definitions in this section apply throughout this chapter 9
unless the context clearly requires otherwise. 10
(1) "23-hour crisis relief center" has the same meaning as under 11
RCW 71.24.025; 12
(2) "Admission" or "admit" means a decision by a physician, 13
physician assistant, or psychiatric advanced registered nurse 14
practitioner that a person should be examined or treated as a patient 15
in a hospital; 16
(3) "Alcoholism" means a disease, characterized by a dependency 17
on alcoholic beverages, loss of control over the amount and 18
circumstances of use, symptoms of tolerance, physiological or 19
psychological withdrawal, or both, if use is reduced or discontinued, 20
H-2774.1
HOUSE BILL 2453
State of Washington 69th Legislature 2026 Regular Session
By Representatives Farivar, Thai, Scott, and Reed
Read first time 01/13/26. Referred to Committee on Civil Rights &
Judiciary.
p. 1 HB 2453
and impairment of health or disruption of social or economic 1
functioning; 2
(4) "Antipsychotic medications" means that class of drugs 3
primarily used to treat serious manifestations of mental illness 4
associated with thought disorders, which includes, but is not limited 5
to atypical antipsychotic medications; 6
(5) "Approved substance use disorder treatment program" means a 7
program for persons with a substance use disorder provided by a 8
treatment program certified by the department as meeting standards 9
adopted under chapter 71.24 RCW; 10
(6) "Attending staff" means any person on the staff of a public 11
or private agency having responsibility for the care and treatment of 12
a patient; 13
(7) "Authority" means the Washington state health care authority;14
(8) "Behavioral health disorder" means either a mental disorder 15
as defined in this section, a substance use disorder as defined in 16
this section, or a co-occurring mental disorder and substance use 17
disorder; 18
(9) "Behavioral health service provider" means a public or 19
private agency that provides mental health, substance use disorder, 20
or co-occurring disorder services to persons with behavioral health 21
disorders as defined under this section and receives funding from 22
public sources. This includes, but is not limited to: Hospitals 23
licensed under chapter 70.41 RCW; evaluation and treatment facilities 24
as defined in this section; community mental health service delivery 25
systems or community behavioral health programs as defined in RCW 26
71.24.025; licensed or certified behavioral health agencies under RCW 27
71.24.037; an entity with a tribal attestation that it meets minimum 28
standards or a licensed or certified behavioral health agency as 29
defined in RCW 71.24.025; facilities conducting competency 30
evaluations and restoration under chapter 10.77 RCW; approved 31
substance use disorder treatment programs as defined in this section; 32
secure withdrawal management and stabilization facilities as defined 33
in this section; and correctional facilities operated by state, 34
local, and tribal governments; 35
(10) "Co-occurring disorder specialist" means an individual 36
possessing an enhancement granted by the department of health under 37
chapter 18.205 RCW that certifies the individual to provide substance 38
use disorder counseling subject to the practice limitations under RCW 39
18.205.105; 40
p. 2 HB 2453
(11) "Commitment" means the determination by a court that a 1
person should be detained for a period of either evaluation or 2
treatment, or both, in an inpatient or a less restrictive setting;3
(12) "Community behavioral health agency" has the same meaning as 4
"licensed or certified behavioral health agency" defined in RCW 5
71.24.025; 6
(13) "Conditional release" means a revocable modification of a 7
commitment, which may be revoked upon violation of any of its terms;8
(14) "Crisis stabilization unit" means a short-term facility or a 9
portion of a facility licensed or certified by the department, such 10
as an evaluation and treatment facility or a hospital, which has been 11
designed to assess, diagnose, and treat individuals experiencing an 12
acute crisis without the use of long-term hospitalization, or to 13
determine the need for involuntary commitment of an individual;14
(15) "Custody" means involuntary detention under the provisions 15
of this chapter or chapter 10.77 RCW, uninterrupted by any period of 16
unconditional release from commitment from a facility providing 17
involuntary care and treatment; 18
(16) "Department" means the department of health;19
(17) "Designated crisis responder" means a mental health 20
professional appointed by the county, by an entity appointed by the 21
county, or by the authority in consultation with a tribe or after 22
meeting and conferring with an Indian health care provider, to 23
perform the duties specified in this chapter; 24
(18) "Detention" or "detain" means the lawful confinement of a 25
person, under the provisions of this chapter; 26
(19) "Developmental disabilities professional" means a person who 27
has specialized training and three years of experience in directly 28
treating or working with persons with developmental disabilities and 29
is a psychiatrist, physician assistant working with a psychiatrist 30
who is acting as a participating physician as defined in RCW 31
18.71A.010, psychologist, psychiatric advanced registered nurse 32
practitioner, or social worker, and such other developmental 33
disabilities professionals as may be defined by rules adopted by the 34
secretary of the department of social and health services;35
(20) "Developmental disability" means that condition defined in 36
RCW 71A.10.020(6); 37
(21) "Director" means the director of the authority;38
p. 3 HB 2453
(22) "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
(23) "Drug addiction" means a disease, characterized by a 4
dependency on psychoactive chemicals, loss of control over the amount 5
and 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
(24) "Evaluation and treatment facility" means any facility which 10
can provide directly, or by direct arrangement with other public or 11
private agencies, emergency evaluation and treatment, outpatient 12
care, and timely and appropriate inpatient care to persons suffering 13
from a mental disorder, and which is licensed or certified as such by 14
the department. The authority may certify single beds as temporary 15
evaluation and treatment beds under RCW 71.05.745. A physically 16
separate and separately operated portion of a state hospital may be 17
designated as an evaluation and treatment facility. A facility which 18
is part of, or operated by, the department of social and health 19
services or any federal agency will not require certification. No 20
correctional institution or facility, or jail, shall be an evaluation 21
and treatment facility within the meaning of this chapter;22
(25) "Gravely disabled" means a condition in which a person, as a 23
result of a behavioral health disorder: (a) Is in danger of serious 24
physical harm resulting from a failure to provide for his or her 25
essential human needs of health or safety; or (b) manifests severe 26
deterioration in routine functioning evidenced by repeated and 27
escalating loss of cognitive or volitional control over his or her 28
actions and is not receiving such care as is essential for his or her 29
health or safety; 30
(26) "Habilitative services" means those services provided by 31
program personnel to assist persons in acquiring and maintaining life 32
skills and in raising their levels of physical, mental, social, and 33
vocational functioning. Habilitative services include education, 34
training for employment, and therapy. The habilitative process shall 35
be undertaken with recognition of the risk to the public safety 36
presented by the person being assisted as manifested by prior charged 37
criminal conduct; 38
(27) "Hearing" means any proceeding conducted in open court that 39
conforms to the requirements of RCW 71.05.820; 40
p. 4 HB 2453
(28) "History of one or more violent acts" refers to the period 1
of time ((ten)) 10 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 behavioral health facility, or in confinement as a 4
result of a criminal conviction; 5
(29) "Imminent" means the state or condition of being likely to 6
occur at any moment or near at hand, rather than distant or remote;7
(30) "In need of assisted outpatient treatment" refers to a 8
person who meets the criteria for assisted outpatient treatment 9
established under RCW 71.05.148; 10
(31) "Individualized service plan" means a plan prepared by a 11
developmental disabilities professional with other professionals as a 12
team, for a person with developmental disabilities, which shall 13
state: 14
(a) The nature of the person's specific problems, prior charged 15
criminal behavior, and habilitation needs; 16
(b) The conditions and strategies necessary to achieve the 17
purposes of habilitation; 18
(c) The intermediate and long-range goals of the habilitation 19
program, with a projected timetable for the attainment;20
(d) The rationale for using this plan of habilitation to achieve 21
those intermediate and long-range goals; 22
(e) The staff responsible for carrying out the plan;23
(f) Where relevant in light of past criminal behavior and due 24
consideration for public safety, the criteria for proposed movement 25
to less-restrictive settings, criteria for proposed eventual 26
discharge or release, and a projected possible date for discharge or 27
release; and 28
(g) The type of residence immediately anticipated for the person 29
and possible future types of residences; 30
(32) "Intoxicated person" means a person whose mental or physical 31
functioning is substantially impaired as a result of the use of 32
alcohol or other psychoactive chemicals; 33
(33) "Judicial commitment" means a commitment by a court pursuant 34
to the provisions of this chapter; 35
(34) "Legal counsel" means attorneys and staff employed by county 36
prosecutor offices or the state attorney general acting in their 37
capacity as legal representatives of public behavioral health service 38
providers under RCW 71.05.130; 39
p. 5 HB 2453
(35) "Less restrictive alternative treatment" means a program of 1
individualized treatment in a less restrictive setting than inpatient 2
treatment that includes the services described in RCW 71.05.585. This 3
term includes: Treatment pursuant to a less restrictive alternative 4
treatment order under RCW 71.05.240 or 71.05.320; treatment pursuant 5
to a conditional release under RCW 71.05.340; and treatment pursuant 6
to an assisted outpatient treatment order under RCW 71.05.148;7
(36) "Licensed physician" means a person licensed to practice 8
medicine or osteopathic medicine and surgery in the state of 9
Washington; 10
(37) "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 to commit suicide or inflict physical harm on oneself; (ii) 14
physical harm will be inflicted by a person upon another, as 15
evidenced by behavior which has caused such harm or which places 16
another person or persons in reasonable fear of sustaining such harm; 17
or (iii) physical harm will be inflicted by a person upon the 18
property of others, as evidenced by behavior which has caused 19
substantial loss or damage to the property of others; or20
(b) The person has threatened the physical safety of another and 21
has a history of one or more violent acts; 22
(38) "Medical clearance" means a physician or other health care 23
provider, including an Indian health care provider, has determined 24
that a person is medically stable and ready for referral to the 25
designated crisis responder or facility. For a person presenting in 26
the community, no medical clearance is required prior to 27
investigation by a designated crisis responder; 28
(39) "Mental disorder" means any organic, mental, or emotional 29
impairment which has substantial adverse effects on a person's 30
cognitive or volitional functions; 31
(40) "Mental health professional" means an individual practicing 32
within the mental health professional's statutory scope of practice 33
who is: 34
(a) A psychiatrist, psychologist, physician assistant working 35
with a psychiatrist who is acting as a participating physician as 36
defined in RCW 18.71A.010, psychiatric advanced registered nurse 37
practitioner, psychiatric nurse, or social worker, as defined in this 38
chapter and chapter 71.34 RCW; 39
p. 6 HB 2453
(b) A mental health counselor, mental health counselor associate, 1
marriage and family therapist, or marriage and family therapist 2
associate, as defined in chapter 18.225 RCW; 3
(c) A certified or licensed agency affiliated counselor, as 4
defined in chapter 18.19 RCW; or 5
(d) A licensed psychological associate as described in chapter 6
18.83 RCW; 7
(41) "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
(42) "Physician assistant" means a person licensed as a physician 12
assistant under chapter 18.71A RCW; 13
(43) "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, which constitutes an evaluation 16
and treatment facility or private institution, or hospital, or 17
approved substance use disorder treatment program, which is conducted 18
for, or includes a department or ward conducted for, the care and 19
treatment of persons with behavioral health disorders;20
(44) "Professional person" means a mental health professional, 21
substance use disorder professional, or designated crisis responder 22
and shall also mean a physician, physician assistant, psychiatric 23
advanced registered nurse practitioner, registered nurse, and such 24
others as may be defined by rules adopted by the secretary pursuant 25
to the provisions of this chapter; 26
(45) "Psychiatric advanced registered nurse practitioner" means a 27
person who is licensed as an advanced registered nurse practitioner 28
pursuant to chapter 18.79 RCW; and who is board certified in advanced 29
practice psychiatric and mental health nursing; 30
(46) "Psychiatrist" means a person having a license as a 31
physician and surgeon in this state who has in addition completed 32
three years of graduate training in psychiatry in a program approved 33
by the American medical association or the American osteopathic 34
association and is certified or eligible to be certified by the 35
American board of psychiatry and neurology; 36
(47) "Psychologist" means a person who has been licensed as a 37
psychologist pursuant to chapter 18.83 RCW; 38
(48) "Public agency" means any evaluation and treatment facility 39
or institution, secure withdrawal management and stabilization 40
p. 7 HB 2453
facility, approved substance use disorder treatment program, or 1
hospital which is conducted for, or includes a department or ward 2
conducted for, the care and treatment of persons with behavioral 3
health disorders, if the agency is operated directly by federal, 4
state, county, or municipal government, or a combination of such 5
governments; 6
(49) "Release" means legal termination of the commitment under 7
the provisions of this chapter; 8
(50) "Resource management services" has the meaning given in 9
chapter 71.24 RCW; 10
(51) "Secretary" means the secretary of the department of health, 11
or his or her designee; 12
(52) "Secure withdrawal management and stabilization facility" 13
means a facility operated by either a public or private agency or by 14
the program of an agency which provides care to voluntary individuals 15
and individuals involuntarily detained and committed under this 16
chapter for whom there is a likelihood of serious harm or who are 17
gravely disabled due to the presence of a substance use disorder. 18
Secure withdrawal management and stabilization facilities must:19
(a) Provide the following services: 20
(i) Assessment and treatment, provided by certified substance use 21
disorder professionals or co-occurring disorder specialists;22
(ii) Clinical stabilization services; 23
(iii) Acute or subacute detoxification services for intoxicated 24
individuals; and 25
(iv) Discharge assistance provided by certified substance use 26
disorder professionals or co-occurring disorder specialists, 27
including facilitating transitions to appropriate voluntary or 28
involuntary inpatient services or to less restrictive alternatives as 29
appropriate for the individual; 30
(b) Include security measures sufficient to protect the patients, 31
staff, and community; and 32
(c) Be licensed or certified as such by the department of health;33
(53) "Social worker" means a person with a master's or further 34
advanced degree from a social work educational program accredited and 35
approved as provided in RCW 18.320.010; 36
(54) "State facility" means: 37
(a) The center for behavioral health and learning located on the 38
University of Washington medical center northwest campus; and39
p. 8 HB 2453
(b) Facilities owned or operated by the department of social and 1
health services that are not state hospitals that provide inpatient 2
services to individuals under this chapter; 3
(55) "State hospital" means a hospital designated under RCW 4
72.23.020; 5
(56) "Substance use disorder" means a cluster of cognitive, 6
behavioral, and physiological symptoms indicating that an individual 7
continues using the substance despite significant substance-related 8
problems. The diagnosis of a substance use disorder is based on a 9
pathological pattern of behaviors related to the use of the 10
substances; 11
(57) "Substance use disorder professional" means a person 12
certified as a substance use disorder professional by the department 13
of health under chapter 18.205 RCW; 14
(58) "Therapeutic court personnel" means the staff of a mental 15
health court or other therapeutic court which has jurisdiction over 16
defendants who are dually diagnosed with mental disorders, including 17
court personnel, probation officers, a court monitor, prosecuting 18
attorney, or defense counsel acting within the scope of therapeutic 19
court duties; 20
(59) "Treatment records" include registration and all other 21
records concerning persons who are receiving or who at any time have 22
received services for behavioral health disorders, which are 23
maintained by the department of social and health services, the 24
department, the authority, behavioral health administrative services 25
organizations and their staffs, managed care organizations and their 26
staffs, and by treatment facilities. Treatment records include mental 27
health information contained in a medical bill including but not 28
limited to mental health drugs, a mental health diagnosis, provider 29
name, and dates of service stemming from a medical service. Treatment 30
records do not include notes or records maintained for personal use 31
by a person providing treatment services for the department of social 32
and health services, the department, the authority, behavioral health 33
administrative services organizations, managed care organizations, or 34
a treatment facility if the notes or records are not available to 35
others; 36
(60) "Tribe" has the same meaning as in RCW 71.24.025;37
(61) "Video," unless the context clearly indicates otherwise, 38
means the delivery of behavioral health services through the use of 39
interactive audio and video technology, permitting real-time 40
p. 9 HB 2453
communication between a person and a designated crisis responder, for 1
the purpose of evaluation. "Video" does not include the use of audio-2
only telephone, facsimile, email, or store and forward technology. 3
"Store and forward technology" means use of an asynchronous 4
transmission of a person's medical information from a mental health 5
service provider to the designated crisis responder which results in 6
medical diagnosis, consultation, or treatment; 7
(62) "Violent act" means behavior that resulted in homicide, 8
attempted suicide, injury, or substantial loss or damage to property;9
(63) "Board-certified psychiatric pharmacist" means a pharmacist 10
licensed under chapter 18.64 RCW who holds a psychiatric pharmacy 11
specialty certification. 12
Sec. 2. RCW 71.05.020 and 2025 c 226 s 2 are each amended to 13
read as follows: 14
The definitions in this section apply throughout this chapter 15
unless the context clearly requires otherwise. 16
(1) "23-hour crisis relief center" has the same meaning as under 17
RCW 71.24.025; 18
(2) "Admission" or "admit" means a decision by a physician, 19
physician assistant, or psychiatric advanced registered nurse 20
practitioner that a person should be examined or treated as a patient 21
in a hospital; 22
(3) "Alcoholism" means a disease, characterized by a dependency 23
on alcoholic beverages, loss of control over the amount and 24
circumstances of use, symptoms of tolerance, physiological or 25
psychological withdrawal, or both, if use is reduced or discontinued, 26
and impairment of health or disruption of social or economic 27
functioning; 28
(4) "Antipsychotic medications" means that class of drugs 29
primarily used to treat serious manifestations of mental illness 30
associated with thought disorders, which includes, but is not limited 31
to atypical antipsychotic medications; 32
(5) "Approved substance use disorder treatment program" means a 33
program for persons with a substance use disorder provided by a 34
treatment program certified by the department as meeting standards 35
adopted under chapter 71.24 RCW; 36
(6) "Attending staff" means any person on the staff of a public 37
or private agency having responsibility for the care and treatment of 38
a patient; 39
p. 10 HB 2453
(7) "Authority" means the Washington state health care authority;1
(8) "Behavioral health disorder" means either a mental disorder 2
as defined in this section, a substance use disorder as defined in 3
this section, or a co-occurring mental disorder and substance use 4
disorder; 5
(9) "Behavioral health service provider" means a public or 6
private agency that provides mental health, substance use disorder, 7
or co-occurring disorder services to persons with behavioral health 8
disorders as defined under this section and receives funding from 9
public sources. This includes, but is not limited to: Hospitals 10
licensed under chapter 70.41 RCW; evaluation and treatment facilities 11
as defined in this section; community mental health service delivery 12
systems or community behavioral health programs as defined in RCW 13
71.24.025; licensed or certified behavioral health agencies under RCW 14
71.24.037; an entity with a tribal attestation that it meets minimum 15
standards or a licensed or certified behavioral health agency as 16
defined in RCW 71.24.025; facilities conducting competency 17
evaluations and restoration under chapter 10.77 RCW; approved 18
substance use disorder treatment programs as defined in this section; 19
secure withdrawal management and stabilization facilities as defined 20
in this section; and correctional facilities operated by state, 21
local, and tribal governments; 22
(10) "Co-occurring disorder specialist" means an individual 23
possessing an enhancement granted by the department of health under 24
chapter 18.205 RCW that certifies the individual to provide substance 25
use disorder counseling subject to the practice limitations under RCW 26
18.205.105; 27
(11) "Commitment" means the determination by a court that a 28
person should be detained for a period of either evaluation or 29
treatment, or both, in an inpatient or a less restrictive setting;30
(12) "Community behavioral health agency" has the same meaning as 31
"licensed or certified behavioral health agency" defined in RCW 32
71.24.025; 33
(13) "Conditional release" means a revocable modification of a 34
commitment, which may be revoked upon violation of any of its terms;35
(14) "Crisis stabilization unit" means a short-term facility or a 36
portion of a facility licensed or certified by the department, such 37
as an evaluation and treatment facility or a hospital, which has been 38
designed to assess, diagnose, and treat individuals experiencing an 39
p. 11 HB 2453
acute crisis without the use of long-term hospitalization, or to 1
determine the need for involuntary commitment of an individual;2
(15) "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
(16) "Department" means the department of health;7
(17) "Designated crisis responder" means a mental health 8
professional appointed by the county, by an entity appointed by the 9
county, or by the authority in consultation with a tribe or after 10
meeting and conferring with an Indian health care provider, to 11
perform the duties specified in this chapter; 12
(18) "Detention" or "detain" means the lawful confinement of a 13
person, under the provisions of this chapter; 14
(19) "Developmental disabilities professional" means a person who 15
has specialized training and three years of experience in directly 16
treating or working with persons with developmental disabilities and 17
is a psychiatrist, physician assistant working with a psychiatrist 18
who is acting as a participating physician as defined in RCW 19
18.71A.010, psychologist, psychiatric advanced registered nurse 20
practitioner, or social worker, and such other developmental 21
disabilities professionals as may be defined by rules adopted by the 22
secretary of the department of social and health services;23
(20) "Developmental disability" means that condition defined in 24
RCW 71A.10.020(6); 25
(21) "Director" means the director of the authority;26
(22) "Discharge" means the termination of hospital medical 27
authority. The commitment may remain in place, be terminated, or be 28
amended by court order; 29
(23) "Drug addiction" means a disease, characterized by a 30
dependency on psychoactive chemicals, loss of control over the amount 31
and circumstances of use, symptoms of tolerance, physiological or 32
psychological withdrawal, or both, if use is reduced or discontinued, 33
and impairment of health or disruption of social or economic 34
functioning; 35
(24) "Evaluation and treatment facility" means any facility which 36
can provide directly, or by direct arrangement with other public or 37
private agencies, emergency evaluation and treatment, outpatient 38
care, and timely and appropriate inpatient care to persons suffering 39
from a mental disorder, and which is licensed or certified as such by 40
p. 12 HB 2453
the department. The authority may certify single beds as temporary 1
evaluation and treatment beds under RCW 71.05.745. A physically 2
separate and separately operated portion of a state hospital may be 3
designated as an evaluation and treatment facility. A facility which 4
is part of, or operated by, the department of social and health 5
services or any federal agency will not require certification. No 6
correctional institution or facility, or jail, shall be an evaluation 7
and treatment facility within the meaning of this chapter;8
(25) "Gravely disabled" means a condition in which a person, as a 9
result of a behavioral health disorder: (a) Is in danger of serious 10
physical harm resulting from a failure to provide for his or her 11
essential human needs of health or safety; or (b) manifests severe 12
deterioration from safe behavior evidenced by repeated and escalating 13
loss of cognitive or volitional control over his or her actions and 14
is not receiving such care as is essential for his or her health or 15
safety; 16
(26) "Habilitative services" means those services provided by 17
program personnel to assist persons in acquiring and maintaining life 18
skills and in raising their levels of physical, mental, social, and 19
vocational functioning. Habilitative services include education, 20
training for employment, and therapy. The habilitative process shall 21
be undertaken with recognition of the risk to the public safety 22
presented by the person being assisted as manifested by prior charged 23
criminal conduct; 24
(27) "Hearing" means any proceeding conducted in open court that 25
conforms to the requirements of RCW 71.05.820; 26
(28) "History of one or more violent acts" refers to the period 27
of time ((ten)) 10 years prior to the filing of a petition under this 28
chapter, excluding any time spent, but not any violent acts 29
committed, in a behavioral health facility, or in confinement as a 30
result of a criminal conviction; 31
(29) "Imminent" means the state or condition of being likely to 32
occur at any moment or near at hand, rather than distant or remote;33
(30) "In need of assisted outpatient treatment" refers to a 34
person who meets the criteria for assisted outpatient treatment 35
established under RCW 71.05.148; 36
(31) "Individualized service plan" means a plan prepared by a 37
developmental disabilities professional with other professionals as a 38
team, for a person with developmental disabilities, which shall 39
state: 40
p. 13 HB 2453
(a) The nature of the person's specific problems, prior charged 1
criminal behavior, and habilitation needs; 2
(b) The conditions and strategies necessary to achieve the 3
purposes of habilitation; 4
(c) The intermediate and long-range goals of the habilitation 5
program, with a projected timetable for the attainment;6
(d) The rationale for using this plan of habilitation to achieve 7
those intermediate and long-range goals; 8
(e) The staff responsible for carrying out the plan;9
(f) Where relevant in light of past criminal behavior and due 10
consideration for public safety, the criteria for proposed movement 11
to less-restrictive settings, criteria for proposed eventual 12
discharge or release, and a projected possible date for discharge or 13
release; and 14
(g) The type of residence immediately anticipated for the person 15
and possible future types of residences; 16
(32) "Intoxicated person" means a person whose mental or physical 17
functioning is substantially impaired as a result of the use of 18
alcohol or other psychoactive chemicals; 19
(33) "Judicial commitment" means a commitment by a court pursuant 20
to the provisions of this chapter; 21
(34) "Legal counsel" means attorneys and staff employed by county 22
prosecutor offices or the state attorney general acting in their 23
capacity as legal representatives of public behavioral health service 24
providers under RCW 71.05.130; 25
(35) "Less restrictive alternative treatment" means a program of 26
individualized treatment in a less restrictive setting than inpatient 27
treatment that includes the services described in RCW 71.05.585. This 28
term includes: Treatment pursuant to a less restrictive alternative 29
treatment order under RCW 71.05.240 or 71.05.320; treatment pursuant 30
to a conditional release under RCW 71.05.340; and treatment pursuant 31
to an assisted outpatient treatment order under RCW 71.05.148;32
(36) "Licensed physician" means a person licensed to practice 33
medicine or osteopathic medicine and surgery in the state of 34
Washington; 35
(37) "Likelihood of serious harm" means: 36
(a) A substantial risk that: (i) 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; (ii) 39
physical harm will be inflicted by a person upon another, as 40
p. 14 HB 2453
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 (iii) 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
(b) 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. 15 HB 2453
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 registered nurse practitioner 12
pursuant to chapter 18.79 RCW; and who is board certified in advanced 13
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. 16 HB 2453
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) "Severe deterioration from safe behavior" means that a 18
person will, if not treated, suffer or continue to suffer severe and 19
abnormal mental, emotional, or physical distress, and this distress 20
is associated with significant impairment of judgment, reason, or 21
behavior; 22
(54) "Social worker" means a person with a master's or further 23
advanced degree from a social work educational program accredited and 24
approved as provided in RCW 18.320.010; 25
(55) "State facility" means: 26
(a) The center for behavioral health and learning located on the 27
University of Washington medical center northwest campus; and28
(b) Facilities owned or operated by the department of social and 29
health services that are not state hospitals that provide inpatient 30
services to individuals under this chapter; 31
(56) "State hospital" means a hospital designated under RCW 32
72.23.020; 33
(57) "Substance use disorder" means a cluster of cognitive, 34
behavioral, and physiological symptoms indicating that an individual 35
continues using the substance despite significant substance-related 36
problems. The diagnosis of a substance use disorder is based on a 37
pathological pattern of behaviors related to the use of the 38
substances; 39
p. 17 HB 2453
(58) "Substance use disorder professional" means a person 1
certified as a substance use disorder professional by the department 2
of health under chapter 18.205 RCW; 3
(59) "Therapeutic court personnel" means the staff of a mental 4
health court or other therapeutic court which has jurisdiction over 5
defendants who are dually diagnosed with mental disorders, including 6
court personnel, probation officers, a court monitor, prosecuting 7
attorney, or defense counsel acting within the scope of therapeutic 8
court duties; 9
(60) "Treatment records" include registration and all other 10
records concerning persons who are receiving or who at any time have 11
received services for behavioral health disorders, which are 12
maintained by the department of social and health services, the 13
department, the authority, behavioral health administrative services 14
organizations and their staffs, managed care organizations and their 15
staffs, and by treatment facilities. Treatment records include mental 16
health information contained in a medical bill including but not 17
limited to mental health drugs, a mental health diagnosis, provider 18
name, and dates of service stemming from a medical service. Treatment 19
records do not include notes or records maintained for personal use 20
by a person providing treatment services for the department of social 21
and health services, the department, the authority, behavioral health 22
administrative services organizations, managed care organizations, or 23
a treatment facility if the notes or records are not available to 24
others; 25
(61) "Tribe" has the same meaning as in RCW 71.24.025;26
(62) "Video," unless the context clearly indicates otherwise, 27
means the delivery of behavioral health services through the use of 28
interactive audio and video technology, permitting real-time 29
communication between a person and a designated crisis responder, for 30
the purpose of evaluation. "Video" does not include the use of audio-31
only telephone, facsimile, email, or store and forward technology. 32
"Store and forward technology" means use of an asynchronous 33
transmission of a person's medical information from a mental health 34
service provider to the designated crisis responder which results in 35
medical diagnosis, consultation, or treatment; 36
(63) "Violent act" means behavior that resulted in homicide, 37
attempted suicide, injury, or substantial loss or damage to property;38
p. 18 HB 2453
(64) "Board-certified psychiatric pharmacist" means a pharmacist 1
licensed under chapter 18.64 RCW who holds a psychiatric pharmacy 2
specialty certification. 3
Sec. 3. RCW 71.05.148 and 2024 c 209 s 9 are each amended to 4
read as follows: 5
(1) A person is in need of assisted outpatient treatment if the 6
court finds by clear, cogent, and convincing evidence pursuant to a 7
petition filed under this section that: 8
(a) The person has a behavioral health disorder;9
(b) Based on a clinical determination and in view of the person's 10
treatment history and current behavior, at least one of the following 11
is true: 12
(i) The person is unlikely to survive safely in the community 13
without supervision and the person's condition is substantially 14
deteriorating; or 15
(ii) The person is in need of assisted outpatient treatment in 16
order to prevent a relapse or deterioration that would be likely to 17
result in grave disability or a likelihood of serious harm to the 18
person or to others; 19
(c) The person has a history of lack of compliance with treatment 20
for his or her behavioral health disorder that has:21
(i) At least twice within the 36 months prior to the filing of 22
the petition been a significant factor in necessitating 23
hospitalization of the person, or the person's receipt of services in 24
a forensic or other mental health unit of a state or tribal 25
correctional facility or local correctional facility, provided that 26
the 36-month period shall be extended by the length of any 27
hospitalization or incarceration of the person that occurred within 28
the 36-month period; 29
(ii) At least twice within the 36 months prior to the filing of 30
the petition been a significant factor in necessitating emergency 31
medical care or hospitalization for behavioral health-related medical 32
conditions including overdose, infected abscesses, sepsis, 33
endocarditis, or other maladies, or a significant factor in behavior 34
which resulted in the person's incarceration in a state, tribal, or 35
local correctional facility; or 36
(iii) Resulted in one or more violent acts, threats, or attempts 37
to cause serious physical harm to the person or another within the 48 38
months prior to the filing of the petition, provided that the 48-39
p. 19 HB 2453
month period shall be extended by the length of any hospitalization 1
or incarceration of the person that occurred during the 48-month 2
period; 3
(d) Participation in an assisted outpatient treatment program 4
would be the least restrictive alternative necessary to ensure the 5
person's recovery and stability; and 6
(e) The person will benefit from assisted outpatient treatment.7
(2) The following individuals may directly file a petition for 8
less restrictive alternative treatment on the basis that a person is 9
in need of assisted outpatient treatment: 10
(a) The director of a hospital where the person is hospitalized 11
or the director's designee; 12
(b) The director of a behavioral health service provider 13
providing behavioral health care or residential services to the 14
person or the director's designee; 15
(c) The person's treating mental health professional or substance 16
use disorder professional or one who has evaluated the person;17
(d) A designated crisis responder; 18
(e) A release planner from a corrections facility; or19
(f) An emergency room physician. 20
(3) A court order for less restrictive alternative treatment on 21
the basis that the person is in need of assisted outpatient treatment 22
may be effective for up to 18 months. The petitioner must personally 23
interview the person, unless the person refuses an interview, to 24
determine whether the person will voluntarily receive appropriate 25
treatment. 26
(4) The petitioner must allege specific facts based on personal 27
observation, evaluation, or investigation, and must consider the 28
reliability or credibility of any person providing information 29
material to the petition. 30
(5) The petition must include: 31
(a) A statement of the circumstances under which the person's 32
condition was made known and the basis for the opinion, from personal 33
observation or investigation, that the person is in need of assisted 34
outpatient treatment. The petitioner must state which specific facts 35
come from personal observation and specify what other sources of 36
information the petitioner has relied upon to form this belief;37
(b) A declaration from a physician, physician assistant, advanced 38
registered nurse practitioner, board-certified psychiatric 39
pharmacist, or the person's treating mental health professional or 40
p. 20 HB 2453
substance use disorder professional, who has examined the person no 1
more than 10 days prior to the submission of the petition and who is 2
willing to testify in support of the petition, or who alternatively 3
has made appropriate attempts to examine the person within the same 4
period but has not been successful in obtaining the person's 5
cooperation, and who is willing to testify to the reasons they 6
believe that the person meets the criteria for assisted outpatient 7
treatment. If the declaration is provided by the person's treating 8
mental health professional or substance use disorder professional, it 9
must be cosigned by a supervising physician, physician assistant, or 10
advanced registered nurse practitioner who certifies that they have 11
reviewed the declaration; 12
(c) The declarations of additional witnesses, if any, supporting 13
the petition for assisted outpatient treatment; 14
(d) The name of an agency, provider, or facility that agrees to 15
provide less restrictive alternative treatment if the petition is 16
granted by the court; and 17
(e) If the person is detained in a state hospital, inpatient 18
treatment facility, jail, or correctional facility at the time the 19
petition is filed, the anticipated release date of the person and any 20
other details needed to facilitate successful reentry and transition 21
into the community. 22
(6)(a) Upon receipt of a petition meeting all requirements of 23
this section, the court shall fix a date for a hearing:24
(i) No sooner than three days or later than seven days after the 25
date of service or as stipulated by the parties or, upon a showing of 26
good cause, no later than 30 days after the date of service; or27
(ii) If the respondent is hospitalized at the time of filing of 28
the petition, before discharge of the respondent and in sufficient 29
time to arrange for a continuous transition from inpatient treatment 30
to assisted outpatient treatment. 31
(b) A copy of the petition and notice of hearing shall be served, 32
in the same manner as a summons, on the petitioner, the respondent, 33
the qualified professional whose affidavit accompanied the petition, 34
a current provider, if any, and a surrogate decision maker or agent 35
under chapter 71.32 RCW, if any. 36
(c) If the respondent has a surrogate decision maker or agent 37
under chapter 71.32 RCW who wishes to provide testimony at the 38
hearing, the court shall afford the surrogate decision maker or agent 39
an opportunity to testify. 40
p. 21 HB 2453
(d) The respondent shall be represented by counsel at all stages 1
of the proceedings. 2
(e) If the respondent fails to appear at the hearing after 3
notice, the court may conduct the hearing in the respondent's 4
absence; provided that the respondent's counsel is present.5
(f) If the respondent has refused to be examined by the qualified 6
professional whose affidavit accompanied the petition, the court may 7
order a mental examination of the respondent. The examination of the 8
respondent may be performed by the qualified professional whose 9
affidavit accompanied the petition. If the examination is performed 10
by another qualified professional, the examining qualified 11
professional shall be authorized to consult with the qualified 12
professional whose affidavit accompanied the petition.13
(g) If the respondent has refused to be examined by a qualified 14
professional and the court finds reasonable grounds to believe that 15
the allegations of the petition are true, the court may issue a 16
written order directing a peace officer who has completed crisis 17
intervention training to detain and transport the respondent to a 18
provider for examination by a qualified professional. A respondent 19
detained pursuant to this subsection shall be detained no longer than 20
necessary to complete the examination and in no event longer than 24 21
hours. 22
(7) If the petition involves a person whom the petitioner or 23
behavioral health administrative services organization knows, or has 24
reason to know, is an American Indian or Alaska Native who receives 25
medical or behavioral health services from a tribe within this state, 26
the petitioner or behavioral health administrative services 27
organization shall notify the tribe and Indian health care provider. 28
Notification shall be made in person or by telephonic or electronic 29
communication to the tribal contact listed in the authority's tribal 30
crisis coordination plan as soon as possible, but before the hearing 31
and no later than 24 hours from the time the petition is served upon 32
the person and the person's guardian. The notice to the tribe or 33
Indian health care provider must include a copy of the petition, 34
together with any orders issued by the court and a notice of the 35
tribe's right to intervene. The court clerk shall provide copies of 36
any court orders necessary for the petitioner or the behavioral 37
health administrative services organization to provide notice to the 38
tribe or Indian health care provider under this section.39
p. 22 HB 2453
(8) A petition for assisted outpatient treatment filed under this 1
section shall be adjudicated under RCW 71.05.240. 2
(9) After January 1, 2023, a petition for assisted outpatient 3
treatment must be filed on forms developed by the administrative 4
office of the courts. 5
Sec. 4. RCW 71.05.148 and 2025 c 58 s 5145 are each amended to 6
read as follows: 7
(1) A person is in need of assisted outpatient treatment if the 8
court finds by clear, cogent, and convincing evidence pursuant to a 9
petition filed under this section that: 10
(a) The person has a behavioral health disorder;11
(b) Based on a clinical determination and in view of the person's 12
treatment history and current behavior, at least one of the following 13
is true: 14
(i) The person is unlikely to survive safely in the community 15
without supervision and the person's condition is substantially 16
deteriorating; or 17
(ii) The person is in need of assisted outpatient treatment in 18
order to prevent a relapse or deterioration that would be likely to 19
result in grave disability or a likelihood of serious harm to the 20
person or to others; 21
(c) The person has a history of lack of compliance with treatment 22
for his or her behavioral health disorder that has:23
(i) At least twice within the 36 months prior to the filing of 24
the petition been a significant factor in necessitating 25
hospitalization of the person, or the person's receipt of services in 26
a forensic or other mental health unit of a state or tribal 27
correctional facility or local correctional facility, provided that 28
the 36-month period shall be extended by the length of any 29
hospitalization or incarceration of the person that occurred within 30
the 36-month period; 31
(ii) At least twice within the 36 months prior to the filing of 32
the petition been a significant factor in necessitating emergency 33
medical care or hospitalization for behavioral health-related medical 34
conditions including overdose, infected abscesses, sepsis, 35
endocarditis, or other maladies, or a significant factor in behavior 36
which resulted in the person's incarceration in a state, tribal, or 37
local correctional facility; or 38
p. 23 HB 2453
(iii) Resulted in one or more violent acts, threats, or attempts 1
to cause serious physical harm to the person or another within the 48 2
months prior to the filing of the petition, provided that the 48-3
month period shall be extended by the length of any hospitalization 4
or incarceration of the person that occurred during the 48-month 5
period; 6
(d) Participation in an assisted outpatient treatment program 7
would be the least restrictive alternative necessary to ensure the 8
person's recovery and stability; and 9
(e) The person will benefit from assisted outpatient treatment.10
(2) The following individuals may directly file a petition for 11
less restrictive alternative treatment on the basis that a person is 12
in need of assisted outpatient treatment: 13
(a) The director of a hospital where the person is hospitalized 14
or the director's designee; 15
(b) The director of a behavioral health service provider 16
providing behavioral health care or residential services to the 17
person or the director's designee; 18
(c) The person's treating mental health professional or substance 19
use disorder professional or one who has evaluated the person;20
(d) A designated crisis responder; 21
(e) A release planner from a corrections facility; or22
(f) An emergency room physician. 23
(3) A court order for less restrictive alternative treatment on 24
the basis that the person is in need of assisted outpatient treatment 25
may be effective for up to 18 months. The petitioner must personally 26
interview the person, unless the person refuses an interview, to 27
determine whether the person will voluntarily receive appropriate 28
treatment. 29
(4) The petitioner must allege specific facts based on personal 30
observation, evaluation, or investigation, and must consider the 31
reliability or credibility of any person providing information 32
material to the petition. 33
(5) The petition must include: 34
(a) A statement of the circumstances under which the person's 35
condition was made known and the basis for the opinion, from personal 36
observation or investigation, that the person is in need of assisted 37
outpatient treatment. The petitioner must state which specific facts 38
come from personal observation and specify what other sources of 39
information the petitioner has relied upon to form this belief;40
p. 24 HB 2453
(b) A declaration from a physician, physician assistant, advanced 1
practice registered nurse, board-certified psychiatric pharmacist, or 2
the person's treating mental health professional or substance use 3
disorder professional, who has examined the person no more than 10 4
days prior to the submission of the petition and who is willing to 5
testify in support of the petition, or who alternatively has made 6
appropriate attempts to examine the person within the same period but 7
has not been successful in obtaining the person's cooperation, and 8
who is willing to testify to the reasons they believe that the person 9
meets the criteria for assisted outpatient treatment. If the 10
declaration is provided by the person's treating mental health 11
professional or substance use disorder professional, it must be 12
cosigned by a supervising physician, physician assistant, or advanced 13
practice registered nurse who certifies that they have reviewed the 14
declaration; 15
(c) The declarations of additional witnesses, if any, supporting 16
the petition for assisted outpatient treatment; 17
(d) The name of an agency, provider, or facility that agrees to 18
provide less restrictive alternative treatment if the petition is 19
granted by the court; and 20
(e) If the person is detained in a state hospital, inpatient 21
treatment facility, jail, or correctional facility at the time the 22
petition is filed, the anticipated release date of the person and any 23
other details needed to facilitate successful reentry and transition 24
into the community. 25
(6)(a) Upon receipt of a petition meeting all requirements of 26
this section, the court shall fix a date for a hearing:27
(i) No sooner than three days or later than seven days after the 28
date of service or as stipulated by the parties or, upon a showing of 29
good cause, no later than 30 days after the date of service; or30
(ii) If the respondent is hospitalized at the time of filing of 31
the petition, before discharge of the respondent and in sufficient 32
time to arrange for a continuous transition from inpatient treatment 33
to assisted outpatient treatment. 34
(b) A copy of the petition and notice of hearing shall be served, 35
in the same manner as a summons, on the petitioner, the respondent, 36
the qualified professional whose affidavit accompanied the petition, 37
a current provider, if any, and a surrogate decision maker or agent 38
under chapter 71.32 RCW, if any. 39
p. 25 HB 2453
(c) If the respondent has a surrogate decision maker or agent 1
under chapter 71.32 RCW who wishes to provide testimony at the 2
hearing, the court shall afford the surrogate decision maker or agent 3
an opportunity to testify. 4
(d) The respondent shall be represented by counsel at all stages 5
of the proceedings. 6
(e) If the respondent fails to appear at the hearing after 7
notice, the court may conduct the hearing in the respondent's 8
absence; provided that the respondent's counsel is present.9
(f) If the respondent has refused to be examined by the qualified 10
professional whose affidavit accompanied the petition, the court may 11
order a mental examination of the respondent. The examination of the 12
respondent may be performed by the qualified professional whose 13
affidavit accompanied the petition. If the examination is performed 14
by another qualified professional, the examining qualified 15
professional shall be authorized to consult with the qualified 16
professional whose affidavit accompanied the petition.17
(g) If the respondent has refused to be examined by a qualified 18
professional and the court finds reasonable grounds to believe that 19
the allegations of the petition are true, the court may issue a 20
written order directing a peace officer who has completed crisis 21
intervention training to detain and transport the respondent to a 22
provider for examination by a qualified professional. A respondent 23
detained pursuant to this subsection shall be detained no longer than 24
necessary to complete the examination and in no event longer than 24 25
hours. 26
(7) If the petition involves a person whom the petitioner or 27
behavioral health administrative services organization knows, or has 28
reason to know, is an American Indian or Alaska Native who receives 29
medical or behavioral health services from a tribe within this state, 30
the petitioner or behavioral health administrative services 31
organization shall notify the tribe and Indian health care provider. 32
Notification shall be made in person or by telephonic or electronic 33
communication to the tribal contact listed in the authority's tribal 34
crisis coordination plan as soon as possible, but before the hearing 35
and no later than 24 hours from the time the petition is served upon 36
the person and the person's guardian. The notice to the tribe or 37
Indian health care provider must include a copy of the petition, 38
together with any orders issued by the court and a notice of the 39
tribe's right to intervene. The court clerk shall provide copies of 40
p. 26 HB 2453
any court orders necessary for the petitioner or the behavioral 1
health administrative services organization to provide notice to the 2
tribe or Indian health care provider under this section.3
(8) A petition for assisted outpatient treatment filed under this 4
section shall be adjudicated under RCW 71.05.240. 5
(9) After January 1, 2023, a petition for assisted outpatient 6
treatment must be filed on forms developed by the administrative 7
office of the courts. 8
Sec. 5. RCW 71.05.230 and 2022 c 210 s 11 are each amended to 9
read as follows: 10
A person detained for ((one hundred twenty )) 120 hours of 11
evaluation and treatment may be committed for not more than 12
((fourteen)) 14 additional days of involuntary intensive treatment or 13
((ninety)) 90 additional days of a less restrictive alternative 14
treatment. A petition may only be filed if the following conditions 15
are met: 16
(1) The professional staff of the facility providing evaluation 17
services has analyzed the person's condition and finds that the 18
condition is caused by a behavioral health disorder and results in: 19
(a) A likelihood of serious harm; or (b) the person being gravely 20
disabled; and are prepared to testify those conditions are met; and21
(2) The person has been advised of the need for voluntary 22
treatment and the professional staff of the facility has evidence 23
that he or she has not in good faith volunteered; and24
(3) The facility providing intensive treatment is certified to 25
provide such treatment by the department or under RCW 71.05.745; and26
(4)(a)(i) The professional staff of the facility or the 27
designated crisis responder has filed a petition with the court for a 28
((fourteen)) 14 day involuntary detention or a ((ninety)) 90 day less 29
restrictive alternative. The petition must be signed by:30
(A) One physician, physician assistant, board-certified 31
psychiatric pharmacist, or psychiatric advanced registered nurse 32
practitioner; and 33
(B) One physician, physician assistant, psychiatric advanced 34
registered nurse practitioner, or mental health professional.35
(ii) If the petition is for substance use disorder treatment, the 36
petition may be signed by a substance use disorder professional 37
instead of a mental health professional and by an advanced registered 38
nurse practitioner instead of a psychiatric advanced registered nurse 39
p. 27 HB 2453
practitioner. The persons signing the petition must have examined the 1
person. 2
(b) If involuntary detention is sought the petition shall state 3
facts that support the finding that such person, as a result of a 4
behavioral health disorder, presents a likelihood of serious harm, or 5
is gravely disabled and that there are no less restrictive 6
alternatives to detention in the best interest of such person or 7
others. The petition shall state specifically that less restrictive 8
alternative treatment was considered and specify why treatment less 9
restrictive than detention is not appropriate. If an involuntary less 10
restrictive alternative is sought, the petition shall state facts 11
that support the finding that such person, as a result of a 12
behavioral health disorder, presents a likelihood of serious harm or 13
is gravely disabled and shall set forth any recommendations for less 14
restrictive alternative treatment services; and 15
(5) A copy of the petition has been served on the detained 16
person, his or her attorney, and his or her guardian, if any, prior 17
to the probable cause hearing; and 18
(6) The court at the time the petition was filed and before the 19
probable cause hearing has appointed counsel to represent such person 20
if no other counsel has appeared; and 21
(7) The petition reflects that the person was informed of the 22
loss of firearm rights if involuntarily committed for mental health 23
treatment; and 24
(8) At the conclusion of the initial commitment period, the 25
professional staff of the agency or facility or the designated crisis 26
responder may petition for an additional period of either 90 days of 27
less restrictive alternative treatment or 90 days of involuntary 28
intensive treatment as provided in RCW 71.05.290; and29
(9) If the hospital or facility designated to provide less 30
restrictive alternative treatment is other than the facility 31
providing involuntary treatment, the outpatient facility so 32
designated to provide less restrictive alternative treatment has 33
agreed to assume such responsibility. 34
Sec. 6. RCW 71.05.230 and 2025 c 58 s 5150 are each amended to 35
read as follows: 36
A person detained for ((one hundred twenty )) 120 hours of 37
evaluation and treatment may be committed for not more than 38
((fourteen)) 14 additional days of involuntary intensive treatment or 39
p. 28 HB 2453
((ninety)) 90 additional days of a less restrictive alternative 1
treatment. A petition may only be filed if the following conditions 2
are met: 3
(1) The professional staff of the facility providing evaluation 4
services has analyzed the person's condition and finds that the 5
condition is caused by a behavioral health disorder and results in: 6
(a) A likelihood of serious harm; or (b) the person being gravely 7
disabled; and are prepared to testify those conditions are met; and8
(2) The person has been advised of the need for voluntary 9
treatment and the professional staff of the facility has evidence 10
that he or she has not in good faith volunteered; and11
(3) The facility providing intensive treatment is certified to 12
provide such treatment by the department or under RCW 71.05.745; and13
(4)(a)(i) The professional staff of the facility or the 14
designated crisis responder has filed a petition with the court for a 15
((fourteen)) 14 day involuntary detention or a ((ninety)) 90 day less 16
restrictive alternative. The petition must be signed by:17
(A) One physician, physician assistant, board-certified 18
psychiatric pharmacist, or psychiatric advanced practice registered 19
nurse; and 20
(B) One physician, physician assistant, psychiatric advanced 21
practice registered nurse, or mental health professional.22
(ii) If the petition is for substance use disorder treatment, the 23
petition may be signed by a substance use disorder professional 24
instead of a mental health professional and by an advanced practice 25
registered nurse instead of a psychiatric advanced practice 26
registered nurse. The persons signing the petition must have examined 27
the person. 28
(b) If involuntary detention is sought the petition shall state 29
facts that support the finding that such person, as a result of a 30
behavioral health disorder, presents a likelihood of serious harm, or 31
is gravely disabled and that there are no less restrictive 32
alternatives to detention in the best interest of such person or 33
others. The petition shall state specifically that less restrictive 34
alternative treatment was considered and specify why treatment less 35
restrictive than detention is not appropriate. If an involuntary less 36
restrictive alternative is sought, the petition shall state facts 37
that support the finding that such person, as a result of a 38
behavioral health disorder, presents a likelihood of serious harm or 39
p. 29 HB 2453
is gravely disabled and shall set forth any recommendations for less 1
restrictive alternative treatment services; and 2
(5) A copy of the petition has been served on the detained 3
person, his or her attorney, and his or her guardian, if any, prior 4
to the probable cause hearing; and 5
(6) The court at the time the petition was filed and before the 6
probable cause hearing has appointed counsel to represent such person 7
if no other counsel has appeared; and 8
(7) The petition reflects that the person was informed of the 9
loss of firearm rights if involuntarily committed for mental health 10
treatment; and 11
(8) At the conclusion of the initial commitment period, the 12
professional staff of the agency or facility or the designated crisis 13
responder may petition for an additional period of either 90 days of 14
less restrictive alternative treatment or 90 days of involuntary 15
intensive treatment as provided in RCW 71.05.290; and16
(9) If the hospital or facility designated to provide less 17
restrictive alternative treatment is other than the facility 18
providing involuntary treatment, the outpatient facility so 19
designated to provide less restrictive alternative treatment has 20
agreed to assume such responsibility. 21
Sec. 7. RCW 71.05.585 and 2024 c 62 s 22 are each amended to 22
read as follows: 23
(1) Less restrictive alternative treatment, at a minimum, 24
includes the following services: 25
(a) Assignment of a care coordinator; 26
(b) An intake evaluation with the provider of the less 27
restrictive alternative treatment; 28
(c) A psychiatric evaluation, a substance use disorder 29
evaluation, or both; 30
(d) A schedule of regular contacts with the provider of the 31
treatment services for the duration of the order; 32
(e) A transition plan addressing access to continued services at 33
the expiration of the order; 34
(f) An individual crisis plan; 35
(g) Consultation about the formation of a mental health advance 36
directive under chapter 71.32 RCW; and 37
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(h) Notification to the care coordinator assigned in (a) of this 1
subsection if reasonable efforts to engage the client fail to produce 2
substantial compliance with court-ordered treatment conditions.3
(2) Less restrictive alternative treatment may additionally 4
include requirements to participate in the following services:5
(a) Medication management; 6
(b) Psychotherapy; 7
(c) Nursing; 8
(d) Substance use disorder counseling; 9
(e) Residential treatment; 10
(f) Partial hospitalization; 11
(g) Intensive outpatient treatment; 12
(h) Support for housing, benefits, education, and employment; and13
(i) Periodic court review. 14
(3) If the person was provided with involuntary medication under 15
RCW 71.05.215 or pursuant to a judicial order during the involuntary 16
commitment period, the less restrictive alternative treatment order 17
may authorize the less restrictive alternative treatment provider or 18
its designee to administer involuntary antipsychotic medication to 19
the person if the provider has attempted and failed to obtain the 20
informed consent of the person and there is a concurring medical 21
opinion approving the medication by a psychiatrist, physician 22
assistant working with a psychiatrist who is acting as a 23
participating physician as defined in RCW 18.71A.010, psychiatric 24
advanced registered nurse practitioner, board-certified psychiatric 25
pharmacist, or physician or physician assistant in consultation with 26
an independent mental health professional with prescribing authority.27
(4) Less restrictive alternative treatment must be administered 28
by a provider that is certified or licensed to provide or coordinate 29
the full scope of services required under the less restrictive 30
alternative order and that has agreed to assume this responsibility.31
(5) The care coordinator assigned to a person ordered to less 32
restrictive alternative treatment must submit an individualized plan 33
for the person's treatment services to the court that entered the 34
order. An initial plan must be submitted as soon as possible 35
following the intake evaluation and a revised plan must be submitted 36
upon any subsequent modification in which a type of service is 37
removed from or added to the treatment plan. 38
p. 31 HB 2453
(6) A care coordinator may disclose information and records 1
related to mental health services pursuant to RCW 70.02.230(2)(k) for 2
purposes of implementing less restrictive alternative treatment.3
(7) For the purpose of this section, "care coordinator" means a 4
clinical practitioner who coordinates the activities of less 5
restrictive alternative treatment. The care coordinator coordinates 6
activities with the designated crisis responders that are necessary 7
for enforcement and continuation of less restrictive alternative 8
orders and is responsible for coordinating service activities with 9
other agencies and establishing and maintaining a therapeutic 10
relationship with the individual on a continuing basis.11
Sec. 8. RCW 71.05.585 and 2025 c 58 s 5153 are each amended to 12
read as follows: 13
(1) Less restrictive alternative treatment, at a minimum, 14
includes the following services: 15
(a) Assignment of a care coordinator; 16
(b) An intake evaluation with the provider of the less 17
restrictive alternative treatment; 18
(c) A psychiatric evaluation, a substance use disorder 19
evaluation, or both; 20
(d) A schedule of regular contacts with the provider of the 21
treatment services for the duration of the order; 22
(e) A transition plan addressing access to continued services at 23
the expiration of the order; 24
(f) An individual crisis plan; 25
(g) Consultation about the formation of a mental health advance 26
directive under chapter 71.32 RCW; and 27
(h) Notification to the care coordinator assigned in (a) of this 28
subsection if reasonable efforts to engage the client fail to produce 29
substantial compliance with court-ordered treatment conditions.30
(2) Less restrictive alternative treatment may additionally 31
include requirements to participate in the following services:32
(a) Medication management; 33
(b) Psychotherapy; 34
(c) Nursing; 35
(d) Substance use disorder counseling; 36
(e) Residential treatment; 37
(f) Partial hospitalization; 38
(g) Intensive outpatient treatment; 39
p. 32 HB 2453
(h) Support for housing, benefits, education, and employment; and1
(i) Periodic court review. 2
(3) If the person was provided with involuntary medication under 3
RCW 71.05.215 or pursuant to a judicial order during the involuntary 4
commitment period, the less restrictive alternative treatment order 5
may authorize the less restrictive alternative treatment provider or 6
its designee to administer involuntary antipsychotic medication to 7
the person if the provider has attempted and failed to obtain the 8
informed consent of the person and there is a concurring medical 9
opinion approving the medication by a psychiatrist, physician 10
assistant working with a psychiatrist who is acting as a 11
participating physician as defined in RCW 18.71A.010, psychiatric 12
advanced practice registered nurse, board-certified psychiatric 13
pharmacist, or physician or physician assistant in consultation with 14
an independent mental health professional with prescribing authority.15
(4) Less restrictive alternative treatment must be administered 16
by a provider that is certified or licensed to provide or coordinate 17
the full scope of services required under the less restrictive 18
alternative order and that has agreed to assume this responsibility.19
(5) The care coordinator assigned to a person ordered to less 20
restrictive alternative treatment must submit an individualized plan 21
for the person's treatment services to the court that entered the 22
order. An initial plan must be submitted as soon as possible 23
following the intake evaluation and a revised plan must be submitted 24
upon any subsequent modification in which a type of service is 25
removed from or added to the treatment plan. 26
(6) A care coordinator may disclose information and records 27
related to mental health services pursuant to RCW 70.02.230(2)(k) for 28
purposes of implementing less restrictive alternative treatment.29
(7) For the purpose of this section, "care coordinator" means a 30
clinical practitioner who coordinates the activities of less 31
restrictive alternative treatment. The care coordinator coordinates 32
activities with the designated crisis responders that are necessary 33
for enforcement and continuation of less restrictive alternative 34
orders and is responsible for coordinating service activities with 35
other agencies and establishing and maintaining a therapeutic 36
relationship with the individual on a continuing basis.37
NEW SECTION. Sec. 9. Section 1 of this act expires when section 38
2 of this act takes effect.39
p. 33 HB 2453
NEW SECTION. Sec. 10. Section 2 of this act takes effect when 1
the contingency in section 26, chapter 433, Laws of 2023 takes 2
effect.3
NEW SECTION. Sec. 11. Sections 3, 5, and 7 of this act expire 4
June 30, 2027.5
NEW SECTION. Sec. 12. Sections 4, 6, and 8 of this act take 6
effect June 30, 2027.7
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