Bill Summary – FastDemocracy

S-4419.1
                      SECOND SUBSTITUTE SENATE BILL 5807
     State of Washington         67th Legislature     2022 Regular Session
     By Senate Ways & Means (originally sponsored by Senators Warnick and
     Dhingra)
     READ FIRST TIME 02/07/22.
      AN ACT Relating to improving behavioral health outcomes for
  adults and children by enhancing engagement of state hospitals with
  the patients, their family members, and natural supports; amending
  RCW 72.23.010, 72.23.020, 72.23.025, 72.23.170, and 72.23.200; and
  adding new sections to chapter 72.23 RCW.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
     NEW SECTION.   Sec. 1.   A new section is added to chapter 72.23
 RCW to read as follows:
     (1) There is established within each state hospital by January 1,
 2024, a bureau of family experience devoted to enhancing engagement
 between state hospitals and a patient's family or natural supports.
 The mission of the bureau is to provide information, guidance, and
 support to family and caregivers to help them be effective in
 supporting the patient's recovery, and to provide a source of
 training for state hospital staff using cognitive behavioral therapy
 principles and the psychosis REACH model.
     (2) The bureau shall establish contact with at least one family
 member or natural support and provide them with systems navigation
 information, education, and training, to include the following:
     (a) A checklist of what their loved one can expect in the
 hospital, starting at admission;
                                       p. 1                         2SSB 5807
     (b) An overview of hospital systems including unit structure,
 treatment team composition, and approach to working with patients;
     (c) Discharge process information, including who determines
 discharge criteria and how discharge readiness is determined;
     (d) An overview of the role of the hospital in relation to
 relevant external systems such as corrections systems and social
 support systems;
     (e) Access to the psychosis REACH training program;
     (f) Access to family-to-family peer support from a family
 bridger;
     (g) Information about patient privacy;
     (h) Information about legal processes related to the patient's
 commitment status and criminal offense if applicable; and
     (i) Preparation to support the patient in the community.
     (3) The bureau shall comply with state and federal privacy laws
 when contacting a patient's family or natural supports to offer the
 services described in subsection (2) of this section. The legislature
 finds that disclosure of the following does not violate privacy laws:
     (a) The fact that the person contacted has been identified as a
 person who may benefit from the information, education, or training
 provided under subsection (2) of this section;
     (b) Relevant patient health information under circumstances
 authorized under RCW 70.02.205;
     (c) Relevant patient health information to persons the patient
 has involved in their health care with the patient's verbal
 agreement, written consent, or lack of objection which can be
 reasonably inferred from the circumstances;
     (d) Relevant health information if the patient does not have
 capacity and based on professional judgment that disclosure to the
 patient's family or natural supports is in the best interest of the
 patient; or
     (e) Matters contained in the public record.
     (4) If the patient consents to involvement of family members or
 natural supports in the patient's care, services offered by the
 bureau under subsection (2) of this section shall additionally
 include:
     (a) Orientation to visitation policies and procedures and
 assistance with navigation, including any needed paperwork;
                                     p. 2                        2SSB 5807
     (b) Guidance for communicating with the treatment team, including
 what to expect, best practices, dos and don'ts, and orientation to
 treatment planning meetings;
     (c) Guidance for communication with loved one during treatment;
     (d) Development of a family crisis support plan; and
     (e) Guidance for working effectively with the social work team on
 discharge planning.
     (5) The bureau shall conduct a needs assessment to determine the
 kinds of parent and caregiver training under subsection (2) of this
 section which will be most appropriate and determine how to source
 this training from relevant experts.
     (6) The bureau shall provide or source initial training and
 annual competency renewal for state hospital staff which incorporates
 the following topics:
     (a) Best practices for engaging families and natural supports in
 mental health services;
     (b) The evidence base and rationale for family interventions for
 psychosis;
     (c) Mental health stigma;
     (d) Psychosis REACH training principles; and
     (e) Effective coordination with family or natural supports for
 care and discharge planning.
     (7) Subject to the amounts appropriated for this specific
 purpose, the staffing of each bureau of family experience shall
 include a director, one or more individuals licensed to provide
 social work or counseling services, and one or more individuals
 qualified to provide family peer specialist services. The department
 shall develop a staffing ratio reflecting an appropriate level of
 staffing per state hospital patient in consultation with the
 University of Washington.
     (8) Each state hospital shall include in its admission process
 identification of family and natural supports for the patient, an
 explanation to each patient of the role of the bureau, and
 determination of whether informed consent exists for involvement of
 family or natural supports in the patient's care. If the patient does
 not have the capacity to provide informed consent for this purpose,
 the involvement of family or natural supports shall be determined by
 consulting the patient's guardian or in a manner consistent with RCW
 70.02.205.
                                     p. 3                        2SSB 5807
     (9) The bureau shall coordinate with the office of behavioral
 health consumer advocacy under chapter 71.40 RCW as appropriate and
 may make appropriate referrals. A state hospital may expand the scope
 of the bureau to integrate with the activities of any internal
 consumer advocacy office.
     (10) For purposes of this section:
     (a) "Bureau" means the bureau of family experience.
     (b) "Family bridger" means a family peer specialist who is not a
 member of the patient's treatment team who works directly with the
 patient's family members or natural supports, in a manner consistent
 with the family bridger program developed at the University of
 Washington.
     (c) "Family peer specialist" means a person who self-identifies
 as a family member of a person with serious mental illness and who
 receives training specific to this role based on a curriculum
 developed by the University of Washington.
     (d) "Natural support" means an individual who provides support
 and assistance that naturally flows from the associations and
 relationships typically developed in natural settings such as the
 family, school, work, and community.
     (e) "Psychosis REACH" means an evidence-based training for family
 and friends caring for a loved one with psychosis promoted by the
 University of Washington department of psychiatry and behavioral
 sciences that incorporates teaching of cognitive behavioral therapy
 principles and skills for the purpose of enabling caregivers to
 better communicate with and support their loved ones and to connect
 them with others who have similar experiences, and which by December
 31, 2022, shall be adapted to address the needs of caregivers of
 individuals who are either minors or adults.
     NEW SECTION.   Sec. 2.  A new section is added to chapter 72.23
 RCW to read as follows:
     (1) The department shall contract with the University of
 Washington department of psychiatry and behavioral sciences to assist
 with the development and implementation of a bureau of family
 experience at each state hospital and other activities under section
 1 of this act. The department and each state hospital shall cooperate
 with any efforts to monitor fidelity and provide research into
 effectiveness.
                                     p. 4                        2SSB 5807
      (2) The University of Washington shall develop a           training
  curriculum for family peer specialists by December 31, 2022.
     Sec. 3. RCW 72.23.010 and 2000 c 22 s 2 are each amended to read
 as follows:
     The definitions in this section apply throughout this chapter,
 unless the context clearly requires otherwise.
     (1) "Court" means the superior court of the state of Washington.
     (2) "Department" means the department of social and health
 services.
     (3) "Employee" means an employee as defined in RCW 49.17.020.
     (4) "Licensed physician" means an individual permitted to
 practice as a physician under the laws of the state, or a medical
 officer, similarly qualified, of the government of the United States
 while in this state in performance of his or her official duties.
     (5) (("Mentally ill person" means any person who, pursuant to the
 definitions contained in RCW 71.05.020, as a result of a mental
 disorder presents a likelihood of serious harm to others or himself
 or herself or is gravely disabled.
     (6))) "Patient" means a person under observation, care, or
 treatment in a state hospital, or a person found ((mentally ill)) to
 have a mental illness by the court, and not discharged from a state
 hospital, or other facility, to which such person had been ordered
 hospitalized.
     (6) "Person with mental illness" means any person who, pursuant
 to the definitions contained in RCW 71.05.020 and 71.34.020, as a
 result of a mental disorder presents a likelihood of serious harm to
 others or himself or herself or is gravely disabled, or who is
 committed to a state hospital under chapter 10.77 RCW.
     (7) "Resident" means a resident of the state of Washington.
     (8) "Secretary" means the secretary of the department of social
 and health services.
     (9) "State hospital" means any hospital, including a child study
 and treatment center, operated and maintained by the state of
 Washington for the care of ((the mentally ill)) persons with mental
 illness.
     (10) "Superintendent" means the superintendent of a state
 hospital.
                                     p. 5                           2SSB 5807
     (11) "Violence" or "violent act" means any physical assault or
 attempted physical assault against an employee or patient of a state
 hospital.
     Wherever used in this chapter, the masculine shall include the
 feminine and the singular shall include the plural.
     Sec. 4. RCW 72.23.020 and 1959 c 28 s 72.23.020 are each amended
 to read as follows:
     There are hereby permanently located and established the
 following state hospitals: Western state hospital at Fort Steilacoom,
 Pierce county; eastern state hospital at Medical Lake, Spokane
 county; and ((northern state hospital near Sedro Woolley, Skagit
 county)) the child study and treatment center in Lakewood, Pierce
 county.
     Sec. 5. RCW 72.23.025 and 2019 c 325 s 5028 are each amended to
 read as follows:
     (1) It is the intent of the legislature to improve the quality of
 service at state hospitals, eliminate overcrowding, and more
 specifically define the role of the state hospitals. The legislature
 intends that eastern and western state hospitals and the child study
 and treatment center shall become clinical centers for handling the
 most complicated long-term care needs of patients with a primary
 diagnosis of mental disorder. To this end, the legislature intends
 that funds appropriated for mental health programs, including funds
 for behavioral health administrative services organizations, managed
 care organizations contracted with the health care authority, and the
 state hospitals, be used for persons with primary diagnosis of mental
 disorder. The legislature finds that establishment of institutes for
 the study and treatment of mental disorders at ((both)) eastern state
 hospital ((and)), western state hospital, and the child study and
 treatment center will be instrumental in implementing the legislative
 intent.
     (2)(a) There is established at eastern state hospital ((and)),
 western state hospital, and the child study and treatment center
 institutes for the study and treatment of mental disorders. The
 institutes shall be operated by joint operating agreements between
 state colleges and universities and the department of social and
 health services. The institutes are intended to conduct training,
 research, and clinical program development activities that will
                                     p. 6                        2SSB 5807
 directly benefit persons with mental illness who are receiving
 treatment in Washington state by performing the following activities:
     (i) Promote recruitment and retention of highly qualified
 professionals at the state hospitals and community mental health
 programs;
     (ii) Improve clinical care by exploring new, innovative, and
 scientifically   based  treatment   models   for  persons   presenting
 particularly difficult and complicated clinical syndromes;
     (iii) Provide expanded training opportunities for existing staff
 at the state hospitals and community mental health programs;
     (iv) Promote bilateral understanding of treatment orientation,
 possibilities, and challenges between state hospital professionals
 and community mental health professionals.
     (b) To accomplish these purposes the institutes may, within funds
 appropriated for this purpose:
     (i) Enter joint operating agreements with state universities or
 other institutions of higher education to accomplish the placement
 and training of students and faculty in psychiatry, psychology,
 social work, occupational therapy, nursing, and other relevant
 professions at the state hospitals and community mental health
 programs;
     (ii) Design and implement clinical research projects to improve
 the quality and effectiveness of state hospital services and
 operations;
     (iii) Enter into agreements with community mental health service
 providers to accomplish the exchange of professional staff between
 the state hospitals and community mental health service providers;
     (iv) Establish a student loan forgiveness and conditional
 scholarship program to retain qualified professionals at the state
 hospitals and community mental health providers when the secretary
 has determined a shortage of such professionals exists.
     (c) Notwithstanding any other provisions of law to the contrary,
 the institutes may enter into agreements with the department or the
 state hospitals which may involve changes in staffing necessary to
 implement improved patient care programs contemplated by this
 section.
     (d) The institutes are authorized to seek and accept public or
 private gifts, grants, contracts, or donations to accomplish their
 purposes under this section.
                                     p. 7                        2SSB 5807
     Sec. 6.   RCW 72.23.170 and 2003 c 53 s 364 are each amended to
 read as follows:
     Any person who procures the escape of any patient of any state
 hospital ((for the mentally ill, or institutions for psychopaths to
 which such patient has been lawfully committed)), or who advises,
 connives at, aids, or assists in such escape or conceals any such
 escape, is guilty of a class C felony and shall be punished by
 imprisonment in a state correctional institution for a term of not
 more than five years or by a fine of not more than ((five hundred
 dollars)) $500 or by both imprisonment and fine.
     Sec. 7. RCW 72.23.200 and    2012 c 117 s 468 are each amended to
 read as follows:
     No ((mentally ill)) person   under the age of ((sixteen)) 16 years
 shall be regularly confined in    any ward in any state hospital which
 ward is designed and operated     for the care of ((the mentally ill
 eighteen)) persons 18 years of age or over.    No person of the ages of
 ((sixteen)) 16 and ((seventeen)) 17 shall be   placed in any such ward,
 when in the opinion of the superintendent      such placement would be
 detrimental to the mental condition of such    a person or would impede
 his or her recovery or treatment.
                                  --- END ---
                                       p. 8                        2SSB 5807
Statutes affected: 
Original Bill: 72.23.010, 72.23.020, 72.23.025, 72.23.170, 72.23.200
Substitute Bill: 72.23.010, 72.23.020, 72.23.025, 72.23.170, 72.23.200
Second Substitute: 72.23.010, 72.23.020, 72.23.025, 72.23.170, 72.23.200