Psychiatric pharmacists

AN ACT Relating to psychiatric pharmacists; amending RCW 1
71.05.148, 71.05.230, and 71.05.585; reenacting and amending RCW 2
71.05.020 and 71.05.020; providing a contingent effective date; and 3
providing a contingent expiration date. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
Sec. 1. RCW 71.05.020 and 2024 c 371 s 17, 2024 c 209 s 5, and 6
2024 c 62 s 18 are each reenacted and amended to read as follows:7
The definitions in this section apply throughout this chapter 8
unless the context clearly requires otherwise. 9
(1) "23-hour crisis relief center" has the same meaning as under 10
RCW 71.24.025; 11
(2) "Admission" or "admit" means a decision by a physician, 12
physician assistant, or psychiatric advanced registered nurse 13
practitioner that a person should be examined or treated as a patient 14
in a hospital; 15
(3) "Alcoholism" means a disease, characterized by a dependency 16
on alcoholic beverages, loss of control over the amount and 17
circumstances of use, symptoms of tolerance, physiological or 18
psychological withdrawal, or both, if use is reduced or discontinued, 19
and impairment of health or disruption of social or economic 20
functioning; 21
S-1581.1
SENATE BILL 5765
State of Washington 69th Legislature 2025 Regular Session
By Senators Slatter, Nobles, and Trudeau
Read first time 02/18/25. Referred to Committee on Health & Long-
Term Care.
p. 1 SB 5765
(4) "Antipsychotic medications" means that class of drugs 1
primarily used to treat serious manifestations of mental illness 2
associated with thought disorders, which includes, but is not limited 3
to atypical antipsychotic medications; 4
(5) "Approved substance use disorder treatment program" means a 5
program for persons with a substance use disorder provided by a 6
treatment program certified by the department as meeting standards 7
adopted under chapter 71.24 RCW; 8
(6) "Attending staff" means any person on the staff of a public 9
or private agency having responsibility for the care and treatment of 10
a patient; 11
(7) "Authority" means the Washington state health care authority;12
(8) "Behavioral health disorder" means either a mental disorder 13
as defined in this section, a substance use disorder as defined in 14
this section, or a co-occurring mental disorder and substance use 15
disorder; 16
(9) "Behavioral health service provider" means a public or 17
private agency that provides mental health, substance use disorder, 18
or co-occurring disorder services to persons with behavioral health 19
disorders as defined under this section and receives funding from 20
public sources. This includes, but is not limited to: Hospitals 21
licensed under chapter 70.41 RCW; evaluation and treatment facilities 22
as defined in this section; community mental health service delivery 23
systems or community behavioral health programs as defined in RCW 24
71.24.025; licensed or certified behavioral health agencies under RCW 25
71.24.037; an entity with a tribal attestation that it meets minimum 26
standards or a licensed or certified behavioral health agency as 27
defined in RCW 71.24.025; facilities conducting competency 28
evaluations and restoration under chapter 10.77 RCW; approved 29
substance use disorder treatment programs as defined in this section; 30
secure withdrawal management and stabilization facilities as defined 31
in this section; and correctional facilities operated by state, 32
local, and tribal governments; 33
(10) "Co-occurring disorder specialist" means an individual 34
possessing an enhancement granted by the department of health under 35
chapter 18.205 RCW that certifies the individual to provide substance 36
use disorder counseling subject to the practice limitations under RCW 37
18.205.105; 38
p. 2 SB 5765
(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 SB 5765
(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 SB 5765
(28) "History of one or more violent acts" refers to the period 1
of time ten 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 SB 5765
(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 SB 5765
(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 SB 5765
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) "Substance use disorder" means a cluster of cognitive, 37
behavioral, and physiological symptoms indicating that an individual 38
continues using the substance despite significant substance-related 39
problems. The diagnosis of a substance use disorder is based on a 40
p. 8 SB 5765
pathological pattern of behaviors related to the use of the 1
substances; 2
(55) "Substance use disorder professional" means a person 3
certified as a substance use disorder professional by the department 4
of health under chapter 18.205 RCW; 5
(56) "Therapeutic court personnel" means the staff of a mental 6
health court or other therapeutic court which has jurisdiction over 7
defendants who are dually diagnosed with mental disorders, including 8
court personnel, probation officers, a court monitor, prosecuting 9
attorney, or defense counsel acting within the scope of therapeutic 10
court duties; 11
(57) "Treatment records" include registration and all other 12
records concerning persons who are receiving or who at any time have 13
received services for behavioral health disorders, which are 14
maintained by the department of social and health services, the 15
department, the authority, behavioral health administrative services 16
organizations and their staffs, managed care organizations and their 17
staffs, and by treatment facilities. Treatment records include mental 18
health information contained in a medical bill including but not 19
limited to mental health drugs, a mental health diagnosis, provider 20
name, and dates of service stemming from a medical service. Treatment 21
records do not include notes or records maintained for personal use 22
by a person providing treatment services for the department of social 23
and health services, the department, the authority, behavioral health 24
administrative services organizations, managed care organizations, or 25
a treatment facility if the notes or records are not available to 26
others; 27
(58) "Tribe" has the same meaning as in RCW 71.24.025;28
(59) "Video," unless the context clearly indicates otherwise, 29
means the delivery of behavioral health services through the use of 30
interactive audio and video technology, permitting real-time 31
communication between a person and a designated crisis responder, for 32
the purpose of evaluation. "Video" does not include the use of audio-33
only telephone, facsimile, email, or store and forward technology. 34
"Store and forward technology" means use of an asynchronous 35
transmission of a person's medical information from a mental health 36
service provider to the designated crisis responder which results in 37
medical diagnosis, consultation, or treatment; 38
(60) "Violent act" means behavior that resulted in homicide, 39
attempted suicide, injury, or substantial loss or damage to property;40
p. 9 SB 5765
(61) "Board-certified psychiatric pharmacist" is a pharmacist 1
licensed under chapter 18.64 RCW who holds a psychiatric pharmacy 2
specialty certification. 3
Sec. 2. RCW 71.05.020 and 2024 c 371 s 18, 2024 c 209 s 6, and 4
2024 c 62 s 19 are each reenacted and amended to read as follows:5
The definitions in this section apply throughout this chapter 6
unless the context clearly requires otherwise. 7
(1) "23-hour crisis relief center" has the same meaning as under 8
RCW 71.24.025; 9
(2) "Admission" or "admit" means a decision by a physician, 10
physician assistant, or psychiatric advanced registered nurse 11
practitioner that a person should be examined or treated as a patient 12
in a hospital; 13
(3) "Alcoholism" means a disease, characterized by a dependency 14
on alcoholic beverages, loss of control over the amount and 15
circumstances of use, symptoms of tolerance, physiological or 16
psychological withdrawal, or both, if use is reduced or discontinued, 17
and impairment of health or disruption of social or economic 18
functioning; 19
(4) "Antipsychotic medications" means that class of drugs 20
primarily used to treat serious manifestations of mental illness 21
associated with thought disorders, which includes, but is not limited 22
to atypical antipsychotic medications; 23
(5) "Approved substance use disorder treatment program" means a 24
program for persons with a substance use disorder provided by a 25
treatment program certified by the department as meeting standards 26
adopted under chapter 71.24 RCW; 27
(6) "Attending staff" means any person on the staff of a public 28
or private agency having responsibility for the care and treatment of 29
a patient; 30
(7) "Authority" means the Washington state health care authority;31
(8) "Behavioral health disorder" means either a mental disorder 32
as defined in this section, a substance use disorder as defined in 33
this section, or a co-occurring mental disorder and substance use 34
disorder; 35
(9) "Behavioral health service provider" means a public or 36
private agency that provides mental health, substance use disorder, 37
or co-occurring disorder services to persons with behavioral health 38
disorders as defined under this section and receives funding from 39
p. 10 SB 5765
public sources. This includes, but is not limited to: Hospitals 1
licensed under chapter 70.41 RCW; evaluation and treatment facilities 2
as defined in this section; community mental health service delivery 3
systems or community behavioral health programs as defined in RCW 4
71.24.025; licensed or certified behavioral health agencies under RCW 5
71.24.037; an entity with a tribal attestation that it meets minimum 6
standards or a licensed or certified behavioral health agency as 7
defined in RCW 71.24.025; facilities conducting competency 8
evaluations and restoration under chapter 10.77 RCW; approved 9
substance use disorder treatment programs as defined in this section; 10
secure withdrawal management and stabilization facilities as defined 11
in this section; and correctional facilities operated by state, 12
local, and tribal governments; 13
(10) "Co-occurring disorder specialist" means an individual 14
possessing an enhancement granted by the department of health under 15
chapter 18.205 RCW that certifies the individual to provide substance 16
use disorder counseling subject to the practice limitations under RCW 17
18.205.105; 18
(11) "Commitment" means the determination by a court that a 19
person should be detained for a period of either evaluation or 20
treatment, or both, in an inpatient or a less restrictive setting;21
(12) "Community behavioral health agency" has the same meaning as 22
"licensed or certified behavioral health agency" defined in RCW 23
71.24.025; 24
(13) "Conditional release" means a revocable modification of a 25
commitment, which may be revoked upon violation of any of its terms;26
(14) "Crisis stabilization unit" means a short-term facility or a 27
portion of a facility licensed or certified by the department, such 28
as an evaluation and treatment facility or a hospital, which has been 29
designed to assess, diagnose, and treat individuals experiencing an 30
acute crisis without the use of long-term hospitalization, or to 31
determine the need for involuntary commitment of an individual;32
(15) "Custody" means involuntary detention under the provisions 33
of this chapter or chapter 10.77 RCW, uninterrupted by any period of 34
unconditional release from commitment from a facility providing 35
involuntary care and treatment; 36
(16) "Department" means the department of health;37
(17) "Designated crisis responder" means a mental health 38
professional appointed by the county, by an entity appointed by the 39
county, or by the authority in consultation with a tribe or after 40
p. 11 SB 5765
meeting and conferring with an Indian health care provider, to 1
perform the duties specified in this chapter; 2
(18) "Detention" or "detain" means the lawful confinement of a 3
person, under the provisions of this chapter; 4
(19) "Developmental disabilities professional" means a person who 5
has specialized training and three years of experience in directly 6
treating or working with persons with developmental disabilities and 7
is a psychiatrist, physician assistant working with a psychiatrist 8
who is acting as a participating physician as defined in RCW 9
18.71A.010, psychologist, psychiatric advanced registered nurse 10
practitioner, or social worker, and such other developmental 11
disabilities professionals as may be defined by rules adopted by the 12
secretary of the department of social and health services;13
(20) "Developmental disability" means that condition defined in 14
RCW 71A.10.020(6); 15
(21) "Director" means the director of the authority;16
(22) "Discharge" means the termination of hospital medical 17
authority. The commitment may remain in place, be terminated, or be 18
amended by court order; 19
(23) "Drug addiction" means a disease, characterized by a 20
dependency on psychoactive chemicals, loss of control over the amount 21
and circumstances of use, symptoms of tolerance, physiological or 22
psychological withdrawal, or both, if use is reduced or discontinued, 23
and impairment of health or disruption of social or economic 24
functioning; 25
(24) "Evaluation and treatment facility" means any facility which 26
can provide directly, or by direct arrangement with other public or 27
private agencies, emergency evaluation and treatment, outpatient 28
care, and timely and appropriate inpatient care to persons suffering 29
from a mental disorder, and which is licensed or certified as such by 30
the department. The authority may certify single beds as temporary 31
evaluation and treatment beds under RCW 71.05.745. A physically 32
separate and separately operated portion of a state hospital may be 33
designated as an evaluation and treatment facility. A facility which 34
is part of, or operated by, the department of social and health 35
services or any federal agency will not require certification. No 36
correctional institution or facility, or jail, shall be an evaluation 37
and treatment facility within the meaning of this chapter;38
(25) "Gravely disabled" means a condition in which a person, as a 39
result of a behavioral health disorder: (a) Is in danger of serious 40
p. 12 SB 5765
physical harm resulting from a failure to provide for his or her 1
essential human needs of health or safety; or (b) manifests severe 2
deterioration from safe behavior evidenced by repeated and escalating 3
loss of cognitive or volitional control over his or her actions and 4
is not receiving such care as is essential for his or her health or 5
safety; 6
(26) "Habilitative services" means those services provided by 7
program personnel to assist persons in acquiring and maintaining life 8
skills and in raising their levels of physical, mental, social, and 9
vocational functioning. Habilitative services include education, 10
training for employment, and therapy. The habilitative process shall 11
be undertaken with recognition of the risk to the public safety 12
presented by the person being assisted as manifested by prior charged 13
criminal conduct; 14
(27) "Hearing" means any proceeding conducted in open court that 15
conforms to the requirements of RCW 71.05.820; 16
(28) "History of one or more violent acts" refers to the period 17
of time ten years prior to the filing of a petition under this 18
chapter, excluding any time spent, but not any violent acts 19
committed, in a behavioral health facility, or in confinement as a 20
result of a criminal conviction; 21
(29) "Imminent" means the state or condition of being likely to 22
occur at any moment or near at hand, rather than distant or remote;23
(30) "In need of assisted outpatient treatment" refers to a 24
person who meets the criteria for assisted outpatient treatment 25
established under RCW 71.05.148; 26
(31) "Individualized service plan" means a plan prepared by a 27
developmental disabilities professional with other professionals as a 28
team, for a person with developmental disabilities, which shall 29
state: 30
(a) The nature of the person's specific problems, prior charged 31
criminal behavior, and habilitation needs; 32
(b) The conditions and strategies necessary to achieve the 33
purposes of habilitation; 34
(c) The intermediate and long-range goals of the habilitation 35
program, with a projected timetable for the attainment;36
(d) The rationale for using this plan of habilitation to achieve 37
those intermediate and long-range goals; 38
(e) The staff responsible for carrying out the plan;39
p. 13 SB 5765
(f) Where relevant in light of past criminal behavior and due 1
consideration for public safety, the criteria for proposed movement 2
to less-restrictive settings, criteria for proposed eventual 3
discharge or release, and a projected possible date for discharge or 4
release; and 5
(g) The type of residence immediately anticipated for the person 6
and possible future types of residences; 7
(32) "Intoxicated person" means a person whose mental or physical 8
functioning is substantially impaired as a result of the use of 9
alcohol or other psychoactive chemicals; 10
(33) "Judicial commitment" means a commitment by a court pursuant 11
to the provisions of this chapter; 12
(34) "Legal counsel" means attorneys and staff employed by county 13
prosecutor offices or the state attorney general acting in their 14
capacity as legal representatives of public behavioral health service 15
providers under RCW 71.05.130; 16
(35) "Less restrictive alternative treatment" means a program of 17
individualized treatment in a less restrictive setting than inpatient 18
treatment that includes the services described in RCW 71.05.585. This 19
term includes: Treatment pursuant to a less restrictive alternative 20
treatment order under RCW 71.05.240 or 71.05.320; treatment pursuant 21
to a conditional release under RCW 71.05.340; and treatment pursuant 22
to an assisted outpatient treatment order under RCW 71.05.148;23
(36) "Licensed physician" means a person licensed to practice 24
medicine or osteopathic medicine and surgery in the state of 25
Washington; 26
(37) "Likelihood of serious harm" means: 27
(a) A substantial risk that: (i) Physical harm will be inflicted 28
by a person upon his or her own person, as evidenced by threats or 29
attempts to commit suicide or inflict physical harm on oneself; (ii) 30
physical harm will be inflicted by a person upon another, as 31
evidenced by behavior which has caused harm, substantial pain, or 32
which places another person or persons in reasonable fear of harm to 33
themselves or others; or (iii) physical harm will be inflicted by a 34
person upon the property of others, as evidenced by behavior which 35
has caused substantial loss or damage to the property of others; or36
(b) The person has threatened the physical safety of another and 37
has a history of one or more violent acts; 38
(38) "Medical clearance" means a physician or other health care 39
provider, including an Indian health care provider, has determined 40
p. 14 SB 5765
that a person is medically stable and ready for referral to the 1
designated crisis responder or facility. For a person presenting in 2
the community, no medical clearance is required prior to 3
investigation by a designated crisis responder; 4
(39) "Mental disorder" means any organic, mental, or emotional 5
impairment which has substantial adverse effects on a person's 6
cognitive or volitional functions; 7
(40) "Mental health professional" means an individual practicing 8
within the mental health professional's statutory scope of practice 9
who is: 10
(a) A psychiatrist, psychologist, physician assistant working 11
with a psychiatrist who is acting as a participating physician as 12
defined in RCW 18.71A.010, psychiatric advanced registered nurse 13
practitioner, psychiatric nurse, or social worker, as defined in this 14
chapter and chapter 71.34 RCW; 15
(b) A mental health counselor, mental health counselor associate, 16
marriage and family therapist, or marriage and family therapist 17
associate, as defined in chapter 18.225 RCW; 18
(c) A certified or licensed agency affiliated counselor, as 19
defined in chapter 18.19 RCW; or 20
(d) A licensed psychological associate as described in chapter 21
18.83 RCW; 22
(41) "Peace officer" means a law enforcement official of a public 23
agency or governmental unit, and includes persons specifically given 24
peace officer powers by any state law, local ordinance, or judicial 25
order of appointment; 26
(42) "Physician assistant" means a person licensed as a physician 27
assistant under chapter 18.71A RCW; 28
(43) "Private agency" means any person, partnership, corporation, 29
or association that is not a public agency, whether or not financed 30
in whole or in part by public funds, which constitutes an evaluation 31
and treatment facility or private institution, or hospital, or 32
approved substance use disorder treatment program, which is conducted 33
for, or includes a department or ward conducted for, the care and 34
treatment of persons with behavioral health disorders;35
(44) "Professional person" means a mental health professional, 36
substance use disorder professional, or designated crisis responder 37
and shall also mean a physician, physician assistant, psychiatric 38
advanced registered nurse practitioner, registered nurse, and such 39
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others as may be defined by rules adopted by the secretary pursuant 1
to the provisions of this chapter; 2
(45) "Psychiatric advanced registered nurse practitioner" means a 3
person who is licensed as an advanced registered nurse practitioner 4
pursuant to chapter 18.79 RCW; and who is board certified in advanced 5
practice psychiatric and mental health nursing; 6
(46) "Psychiatrist" means a person having a license as a 7
physician and surgeon in this state who has in addition completed 8
three years of graduate training in psychiatry in a program approved 9
by the American medical association or the American osteopathic 10
association and is certified or eligible to be certified by the 11
American board of psychiatry and neurology; 12
(47) "Psychologist" means a person who has been licensed as a 13
psychologist pursuant to chapter 18.83 RCW; 14
(48) "Public agency" means any evaluation and treatment facility 15
or institution, secure withdrawal management and stabilization 16
facility, approved substance use disorder treatment program, or 17
hospital which is conducted for, or includes a department or ward 18
conducted for, the care and treatment of persons with behavioral 19
health disorders, if the agency is operated directly by federal, 20
state, county, or municipal government, or a combination of such 21
governments; 22
(49) "Release" means legal termination of the commitment under 23
the provisions of this chapter; 24
(50) "Resource management services" has the meaning given in 25
chapter 71.24 RCW; 26
(51) "Secretary" means the secretary of the department of health, 27
or his or her designee; 28
(52) "Secure withdrawal management and stabilization facility" 29
means a facility operated by either a public or private agency or by 30
the program of an agency which provides care to voluntary individuals 31
and individuals involuntarily detained and committed under this 32
chapter for whom there is a likelihood of serious harm or who are 33
gravely disabled due to the presence of a substance use disorder. 34
Secure withdrawal management and stabilization facilities must:35
(a) Provide the following services: 36
(i) Assessment and treatment, provided by certified substance use 37
disorder professionals or co-occurring disorder specialists;38
(ii) Clinical stabilization services; 39
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(iii) Acute or subacute detoxification services for intoxicated 1
individuals; and 2
(iv) Discharge assistance provided by certified substance use 3
disorder professionals or co-occurring disorder specialists, 4
including facilitating transitions to appropriate voluntary or 5
involuntary inpatient services or to less restrictive alternatives as 6
appropriate for the individual; 7
(b) Include security measures sufficient to protect the patients, 8
staff, and community; and 9
(c) Be licensed or certified as such by the department of health;10
(53) "Severe deterioration from safe behavior" means that a 11
person will, if not treated, suffer or continue to suffer severe and 12
abnormal mental, emotional, or physical distress, and this distress 13
is associated with significant impairment of judgment, reason, or 14
behavior; 15
(54) "Social worker" means a person with a master's or further 16
advanced degree from a social work educational program accredited and 17
approved as provided in RCW 18.320.010; 18
(55) "Substance use disorder" means a cluster of cognitive, 19
behavioral, and physiological symptoms indicating that an individual 20
continues using the substance despite significant substance-related 21
problems. The diagnosis of a substance use disorder is based on a 22
pathological pattern of behaviors related to the use of the 23
substances; 24
(56) "Substance use disorder professional" means a person 25
certified as a substance use disorder professional by the department 26
of health under chapter 18.205 RCW; 27
(57) "Therapeutic court personnel" means the staff of a mental 28
health court or other therapeutic court which has jurisdiction over 29
defendants who are dually diagnosed with mental disorders, including 30
court personnel, probation officers, a court monitor, prosecuting 31
attorney, or defense counsel acting within the scope of therapeutic 32
court duties; 33
(58) "Treatment records" include registration and all other 34
records concerning persons who are receiving or who at any time have 35
received services for behavioral health disorders, which are 36
maintained by the department of social and health services, the 37
department, the authority, behavioral health administrative services 38
organizations and their staffs, managed care organizations and their 39
staffs, and by treatment facilities. Treatment records include mental 40
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health information contained in a medical bill including but not 1
limited to mental health drugs, a mental health diagnosis, provider 2
name, and dates of service stemming from a medical service. Treatment 3
records do not include notes or records maintained for personal use 4
by a person providing treatment services for the department of social 5
and health services, the department, the authority, behavioral health 6
administrative services organizations, managed care organizations, or 7
a treatment facility if the notes or records are not available to 8
others; 9
(59) "Tribe" has the same meaning as in RCW 71.24.025;10
(60) "Video," unless the context clearly indicates otherwise, 11
means the delivery of behavioral health services through the use of 12
interactive audio and video technology, permitting real-time 13
communication between a person and a designated crisis responder, for 14
the purpose of evaluation. "Video" does not include the use of audio-15
only telephone, facsimile, email, or store and forward technology. 16
"Store and forward technology" means use of an asynchronous 17
transmission of a person's medical information from a mental health 18
service provider to the designated crisis responder which results in 19
medical diagnosis, consultation, or treatment; 20
(61) "Violent act" means behavior that resulted in homicide, 21
attempted suicide, injury, or substantial loss or damage to property;22
(62) "Board-certified psychiatric pharmacist" is a pharmacist 23
licensed under chapter 18.64 RCW who holds a psychiatric pharmacy 24
specialty certification. 25
Sec. 3. RCW 71.05.148 and 2024 c 209 s 9 are each amended to 26
read as follows: 27
(1) A person is in need of assisted outpatient treatment if the 28
court finds by clear, cogent, and convincing evidence pursuant to a 29
petition filed under this section that: 30
(a) The person has a behavioral health disorder;31
(b) Based on a clinical determination and in view of the person's 32
treatment history and current behavior, at least one of the following 33
is true: 34
(i) The person is unlikely to survive safely in the community 35
without supervision and the person's condition is substantially 36
deteriorating; or 37
(ii) The person is in need of assisted outpatient treatment in 38
order to prevent a relapse or deterioration that would be likely to 39
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result in grave disability or a likelihood of serious harm to the 1
person or to others; 2
(c) The person has a history of lack of compliance with treatment 3
for his or her behavioral health disorder that has:4
(i) At least twice within the 36 months prior to the filing of 5
the petition been a significant factor in necessitating 6
hospitalization of the person, or the person's receipt of services in 7
a forensic or other mental health unit of a state or tribal 8
correctional facility or local correctional facility, provided that 9
the 36-month period shall be extended by the length of any 10
hospitalization or incarceration of the person that occurred within 11
the 36-month period; 12
(ii) At least twice within the 36 months prior to the filing of 13
the petition been a significant factor in necessitating emergency 14
medical care or hospitalization for behavioral health-related medical 15
conditions including overdose, infected abscesses, sepsis, 16
endocarditis, or other maladies, or a significant factor in behavior 17
which resulted in the person's incarceration in a state, tribal, or 18
local correctional facility; or 19
(iii) Resulted in one or more violent acts, threats, or attempts 20
to cause serious physical harm to the person or another within the 48 21
months prior to the filing of the petition, provided that the 48-22
month period shall be extended by the length of any hospitalization 23
or incarceration of the person that occurred during the 48-month 24
period; 25
(d) Participation in an assisted outpatient treatment program 26
would be the least restrictive alternative necessary to ensure the 27
person's recovery and stability; and 28
(e) The person will benefit from assisted outpatient treatment.29
(2) The following individuals may directly file a petition for 30
less restrictive alternative treatment on the basis that a person is 31
in need of assisted outpatient treatment: 32
(a) The director of a hospital where the person is hospitalized 33
or the director's designee; 34
(b) The director of a behavioral health service provider 35
providing behavioral health care or residential services to the 36
person or the director's designee; 37
(c) The person's treating mental health professional or substance 38
use disorder professional or one who has evaluated the person;39
(d) A designated crisis responder; 40
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(e) A release planner from a corrections facility; or1
(f) An emergency room physician. 2
(3) A court order for less restrictive alternative treatment on 3
the basis that the person is in need of assisted outpatient treatment 4
may be effective for up to 18 months. The petitioner must personally 5
interview the person, unless the person refuses an interview, to 6
determine whether the person will voluntarily receive appropriate 7
treatment. 8
(4) The petitioner must allege specific facts based on personal 9
observation, evaluation, or investigation, and must consider the 10
reliability or credibility of any person providing information 11
material to the petition. 12
(5) The petition must include: 13
(a) A statement of the circumstances under which the person's 14
condition was made known and the basis for the opinion, from personal 15
observation or investigation, that the person is in need of assisted 16
outpatient treatment. The petitioner must state which specific facts 17
come from personal observation and specify what other sources of 18
information the petitioner has relied upon to form this belief;19
(b) A declaration from a physician, physician assistant, advanced 20
practice registered nurse ((practitioner)), board-certified 21
psychiatric pharmacist, or the person's treating mental health 22
professional or substance use disorder professional, who has examined 23
the person no more than 10 days prior to the submission of the 24
petition and who is willing to testify in support of the petition, or 25
who alternatively has made appropriate attempts to examine the person 26
within the same period but has not been successful in obtaining the 27
person's cooperation, and who is willing to testify to the reasons 28
they believe that the person meets the criteria for assisted 29
outpatient treatment. If the declaration is provided by the person's 30
treating mental health professional or substance use disorder 31
professional, it must be cosigned by a supervising physician, 32
physician assistant, or advanced practice registered nurse 33
((practitioner)) who certifies that they have reviewed the 34
declaration; 35
(c) The declarations of additional witnesses, if any, supporting 36
the petition for assisted outpatient treatment; 37
(d) The name of an agency, provider, or facility that agrees to 38
provide less restrictive alternative treatment if the petition is 39
granted by the court; and 40
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(e) If the person is detained in a state hospital, inpatient 1
treatment facility, jail, or correctional facility at the time the 2
petition is filed, the anticipated release date of the person and any 3
other details needed to facilitate successful reentry and transition 4
into the community. 5
(6)(a) Upon receipt of a petition meeting all requirements of 6
this section, the court shall fix a date for a hearing:7
(i) No sooner than three days or later than seven days after the 8
date of service or as stipulated by the parties or, upon a showing of 9
good cause, no later than 30 days after the date of service; or10
(ii) If the respondent is hospitalized at the time of filing of 11
the petition, before discharge of the respondent and in sufficient 12
time to arrange for a continuous transition from inpatient treatment 13
to assisted outpatient treatment. 14
(b) A copy of the petition and notice of hearing shall be served, 15
in the same manner as a summons, on the petitioner, the respondent, 16
the qualified professional whose affidavit accompanied the petition, 17
a current provider, if any, and a surrogate decision maker or agent 18
under chapter 71.32 RCW, if any. 19
(c) If the respondent has a surrogate decision maker or agent 20
under chapter 71.32 RCW who wishes to provide testimony at the 21
hearing, the court shall afford the surrogate decision maker or agent 22
an opportunity to testify. 23
(d) The respondent shall be represented by counsel at all stages 24
of the proceedings. 25
(e) If the respondent fails to appear at the hearing after 26
notice, the court may conduct the hearing in the respondent's 27
absence; provided that the respondent's counsel is present.28
(f) If the respondent has refused to be examined by the qualified 29
professional whose affidavit accompanied the petition, the court may 30
order a mental examination of the respondent. The examination of the 31
respondent may be performed by the qualified professional whose 32
affidavit accompanied the petition. If the examination is performed 33
by another qualified professional, the examining qualified 34
professional shall be authorized to consult with the qualified 35
professional whose affidavit accompanied the petition.36
(g) If the respondent has refused to be examined by a qualified 37
professional and the court finds reasonable grounds to believe that 38
the allegations of the petition are true, the court may issue a 39
written order directing a peace officer who has completed crisis 40
p. 21 SB 5765
intervention training to detain and transport the respondent to a 1
provider for examination by a qualified professional. A respondent 2
detained pursuant to this subsection shall be detained no longer than 3
necessary to complete the examination and in no event longer than 24 4
hours. 5
(7) If the petition involves a person whom the petitioner or 6
behavioral health administrative services organization knows, or has 7
reason to know, is an American Indian or Alaska Native who receives 8
medical or behavioral health services from a tribe within this state, 9
the petitioner or behavioral health administrative services 10
organization shall notify the tribe and Indian health care provider. 11
Notification shall be made in person or by telephonic or electronic 12
communication to the tribal contact listed in the authority's tribal 13
crisis coordination plan as soon as possible, but before the hearing 14
and no later than 24 hours from the time the petition is served upon 15
the person and the person's guardian. The notice to the tribe or 16
Indian health care provider must include a copy of the petition, 17
together with any orders issued by the court and a notice of the 18
tribe's right to intervene. The court clerk shall provide copies of 19
any court orders necessary for the petitioner or the behavioral 20
health administrative services organization to provide notice to the 21
tribe or Indian health care provider under this section.22
(8) A petition for assisted outpatient treatment filed under this 23
section shall be adjudicated under RCW 71.05.240. 24
(9) After January 1, 2023, a petition for assisted outpatient 25
treatment must be filed on forms developed by the administrative 26
office of the courts. 27
Sec. 4. RCW 71.05.230 and 2022 c 210 s 11 are each amended to 28
read as follows: 29
A person detained for ((one hundred twenty )) 120 hours of 30
evaluation and treatment may be committed for not more than 31
((fourteen)) 14 additional days of involuntary intensive treatment or 32
((ninety)) 90 additional days of a less restrictive alternative 33
treatment. A petition may only be filed if the following conditions 34
are met: 35
(1) The professional staff of the facility providing evaluation 36
services has analyzed the person's condition and finds that the 37
condition is caused by a behavioral health disorder and results in: 38
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(a) A likelihood of serious harm; or (b) the person being gravely 1
disabled; and are prepared to testify those conditions are met; and2
(2) The person has been advised of the need for voluntary 3
treatment and the professional staff of the facility has evidence 4
that he or she has not in good faith volunteered; and5
(3) The facility providing intensive treatment is certified to 6
provide such treatment by the department or under RCW 71.05.745; and7
(4)(a)(i) The professional staff of the facility or the 8
designated crisis responder has filed a petition with the court for a 9
((fourteen)) 14 day involuntary detention or a ((ninety)) 90 day less 10
restrictive alternative. The petition must be signed by:11
(A) One physician, physician assistant, board-certified 12
psychiatric pharmacist, or psychiatric advanced registered nurse 13
practitioner; and 14
(B) One physician, physician assistant, psychiatric advanced 15
registered nurse practitioner, or mental health professional.16
(ii) If the petition is for substance use disorder treatment, the 17
petition may be signed by a substance use disorder professional 18
instead of a mental health professional and by an advanced practice 19
registered nurse ((practitioner)) instead of a psychiatric advanced 20
registered nurse practitioner. The persons signing the petition must 21
have examined the person. 22
(b) If involuntary detention is sought the petition shall state 23
facts that support the finding that such person, as a result of a 24
behavioral health disorder, presents a likelihood of serious harm, or 25
is gravely disabled and that there are no less restrictive 26
alternatives to detention in the best interest of such person or 27
others. The petition shall state specifically that less restrictive 28
alternative treatment was considered and specify why treatment less 29
restrictive than detention is not appropriate. If an involuntary less 30
restrictive alternative is sought, the petition shall state facts 31
that support the finding that such person, as a result of a 32
behavioral health disorder, presents a likelihood of serious harm or 33
is gravely disabled and shall set forth any recommendations for less 34
restrictive alternative treatment services; and 35
(5) A copy of the petition has been served on the detained 36
person, his or her attorney, and his or her guardian, if any, prior 37
to the probable cause hearing; and 38
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(6) The court at the time the petition was filed and before the 1
probable cause hearing has appointed counsel to represent such person 2
if no other counsel has appeared; and 3
(7) The petition reflects that the person was informed of the 4
loss of firearm rights if involuntarily committed for mental health 5
treatment; and 6
(8) At the conclusion of the initial commitment period, the 7
professional staff of the agency or facility or the designated crisis 8
responder may petition for an additional period of either 90 days of 9
less restrictive alternative treatment or 90 days of involuntary 10
intensive treatment as provided in RCW 71.05.290; and11
(9) If the hospital or facility designated to provide less 12
restrictive alternative treatment is other than the facility 13
providing involuntary treatment, the outpatient facility so 14
designated to provide less restrictive alternative treatment has 15
agreed to assume such responsibility. 16
Sec. 5. RCW 71.05.585 and 2024 c 62 s 22 are each amended to 17
read as follows: 18
(1) Less restrictive alternative treatment, at a minimum, 19
includes the following services: 20
(a) Assignment of a care coordinator; 21
(b) An intake evaluation with the provider of the less 22
restrictive alternative treatment; 23
(c) A psychiatric evaluation, a substance use disorder 24
evaluation, or both; 25
(d) A schedule of regular contacts with the provider of the 26
treatment services for the duration of the order; 27
(e) A transition plan addressing access to continued services at 28
the expiration of the order; 29
(f) An individual crisis plan; 30
(g) Consultation about the formation of a mental health advance 31
directive under chapter 71.32 RCW; and 32
(h) Notification to the care coordinator assigned in (a) of this 33
subsection if reasonable efforts to engage the client fail to produce 34
substantial compliance with court-ordered treatment conditions.35
(2) Less restrictive alternative treatment may additionally 36
include requirements to participate in the following services:37
(a) Medication management; 38
(b) Psychotherapy; 39
p. 24 SB 5765
(c) Nursing; 1
(d) Substance use disorder counseling; 2
(e) Residential treatment; 3
(f) Partial hospitalization; 4
(g) Intensive outpatient treatment; 5
(h) Support for housing, benefits, education, and employment; and6
(i) Periodic court review. 7
(3) If the person was provided with involuntary medication under 8
RCW 71.05.215 or pursuant to a judicial order during the involuntary 9
commitment period, the less restrictive alternative treatment order 10
may authorize the less restrictive alternative treatment provider or 11
its designee to administer involuntary antipsychotic medication to 12
the person if the provider has attempted and failed to obtain the 13
informed consent of the person and there is a concurring medical 14
opinion approving the medication by a psychiatrist, physician 15
assistant working with a psychiatrist who is acting as a 16
participating physician as defined in RCW 18.71A.010, psychiatric 17
advanced registered nurse practitioner, board-certified psychiatric 18
pharmacist, or physician or physician assistant in consultation with 19
an independent mental health professional with prescribing authority.20
(4) Less restrictive alternative treatment must be administered 21
by a provider that is certified or licensed to provide or coordinate 22
the full scope of services required under the less restrictive 23
alternative order and that has agreed to assume this responsibility.24
(5) The care coordinator assigned to a person ordered to less 25
restrictive alternative treatment must submit an individualized plan 26
for the person's treatment services to the court that entered the 27
order. An initial plan must be submitted as soon as possible 28
following the intake evaluation and a revised plan must be submitted 29
upon any subsequent modification in which a type of service is 30
removed from or added to the treatment plan. 31
(6) A care coordinator may disclose information and records 32
related to mental health services pursuant to RCW 70.02.230(2)(k) for 33
purposes of implementing less restrictive alternative treatment.34
(7) For the purpose of this section, "care coordinator" means a 35
clinical practitioner who coordinates the activities of less 36
restrictive alternative treatment. The care coordinator coordinates 37
activities with the designated crisis responders that are necessary 38
for enforcement and continuation of less restrictive alternative 39
orders and is responsible for coordinating service activities with 40
p. 25 SB 5765
other agencies and establishing and maintaining a therapeutic 1
relationship with the individual on a continuing basis.2
NEW SECTION. Sec. 6. Section 1 of this act expires when section 3
2 of this act takes effect.4
NEW SECTION. Sec. 7. Section 2 of this act takes effect when 5
the contingency in section 26, chapter 433, Laws of 2023 takes 6
effect.7
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