Unless the context clearly requires otherwise, the definitions in this
section apply throughout this chapter.
(1) "Acutely mentally ill" means a condition which is limited to a
short-term severe crisis episode of:
(a) A mental disorder as defined in RCW 71.05.020 or, in the case of a
child, as defined in RCW 71.34.020;
(b) Being gravely disabled as defined in RCW 71.05.020 or, in the case of a
child, a gravely disabled minor as defined in RCW 71.34.020; or
(c) Presenting a likelihood of serious harm as defined in RCW 71.05.020 or,
in the case of a child, as defined in RCW 71.34.020.
(2) "Available resources" means funds appropriated for the purpose of
providing community mental health programs under RCW 71.24.045, federal
funds, except those provided according to Title XIX of the Social Security
Act, and state funds appropriated under this chapter or chapter 71.05 RCW by
the legislature during any biennium for the purpose of providing residential
services, resource management services, community support services, and
other mental health services. This does not include funds appropriated for
the purpose of operating and administering the state psychiatric hospitals,
except as negotiated according to RCW 71.24.300(1)(d).
(3) "Child" means a person under the age of eighteen years.
(4) "Chronically mentally ill adult" means an adult who has a mental
disorder and meets at least one of the following criteria:
(a) Has undergone two or more episodes of hospital care for a mental
disorder within the preceding two years; or
(b) Has experienced a continuous psychiatric hospitalization or residential
treatment exceeding six months' duration within the preceding year; or
(c) Has been unable to engage in any substantial gainful activity by reason
of any mental disorder which has lasted for a continuous period of not less
than twelve months. "Substantial gainful activity" shall be defined by the
department by rule consistent with Public Law 92-603, as amended.
(5) "Community mental health program" means all mental health services,
activities, or programs using available resources.
(6) "Community mental health service delivery system" means public or
private agencies that provide services specifically to persons with mental
disorders as defined under RCW 71.05.020 and receive funding from public
(7) "Community support services" means services authorized, planned, and
coordinated through resource management services including, at least,
assessment, diagnosis, emergency crisis intervention available twenty-four
hours, seven days a week, prescreening determinations for mentally ill
persons being considered for placement in nursing homes as required by
federal law, screening for patients being considered for admission to
residential services, diagnosis and treatment for acutely mentally ill and
severely emotionally disturbed children discovered under screening through
the federal Title XIX early and periodic screening, diagnosis, and treatment
program, investigation, legal, and other nonresidential services under
chapter 71.05 RCW, case management services, psychiatric treatment including
medication supervision, counseling, psychotherapy, assuring transfer of
relevant patient information between service providers, other services
determined by regional support networks, and maintenance of a patient
tracking system for chronically mentally ill adults and severely emotionally
(8) "County authority" means the board of county commissioners, county
council, or county executive having authority to establish a community
mental health program, or two or more of the county authorities specified in
this subsection which have entered into an agreement to provide a community
mental health program.
(9) "Department" means the department of social and health services.
(10) "Licensed service provider" means an entity licensed according to this
chapter or chapter 71.05 RCW that meets state minimum standards or
individuals licensed under chapter 18.57, 18.71, 18.83, or 18.79 RCW, as it
applies to registered nurses and advanced registered nurse practitioners.
(11) "Mental health services" means all services provided by regional
support networks and other services provided by the state for the mentally
(12) "Mentally ill persons" and "the mentally ill" mean persons and
conditions defined in subsections (1), (4), (17), and (18) of this section.
(13) "Regional support network" means a county authority or group of county
authorities recognized by the secretary that enter into joint operating
agreements to contract with the secretary pursuant to this chapter.
(14) "Residential services" means a complete range of residences and
supports authorized by resource management services and which may involve a
facility, a distinct part thereof, or services which support community
living, for acutely mentally ill persons, chronically mentally ill adults,
severely emotionally disturbed children, or seriously disturbed adults
determined by the regional support network to be at risk of becoming acutely
or chronically mentally ill. The services shall include at least evaluation
and treatment services as defined in chapter 71.05 RCW, acute crisis respite
care, long-term adaptive and rehabilitative care, and supervised and
supported living services, and shall also include any residential services
developed to service mentally ill persons in nursing homes. Residential
services for children in out-of-home placements related to their mental
disorder shall not include the costs of food and shelter, except for
children's long-term residential facilities existing prior to January 1,
(15) "Resource management services" mean the planning, coordination, and
authorization of residential services and community support services
administered pursuant to an individual service plan for: (a) Acutely
mentally ill adults and children; (b) chronically mentally ill adults; (c)
severely emotionally disturbed children; or (d) seriously disturbed adults
determined solely by a regional support network to be at risk of becoming
acutely or chronically mentally ill. Such planning, coordination, and
authorization shall include mental health screening for children eligible
under the federal Title XIX early and periodic screening, diagnosis, and
treatment program. Resource management services include seven day a week,
twenty-four hour a day availability of information regarding mentally ill
adults' and children's enrollment in services and their individual service
plan to county-designated mental health professionals, evaluation and
treatment facilities, and others as determined by the regional support
(16) "Secretary" means the secretary of social and health services.
(17) "Seriously disturbed person" means a person who:
(a) Is gravely disabled or presents a likelihood of serious harm to himself
or herself or others, or to the property of others, as a result of a mental
disorder as defined in chapter 71.05 RCW;
(b) Has been on conditional release status, or under a less restrictive
alternative order, at some time during the preceding two years from an
evaluation and treatment facility or a state mental health hospital;
(c) Has a mental disorder which causes major impairment in several areas of
(d) Exhibits suicidal preoccupation or attempts; or
(e) Is a child diagnosed by a mental health professional, as defined in
chapter 71.34 RCW, as experiencing a mental disorder which is clearly
interfering with the child's functioning in family or school or with peers
or is clearly interfering with the child's personality development and
(18) "Severely emotionally disturbed child" means a child who has been
determined by the regional support network to be experiencing a mental
disorder as defined in chapter 71.34 RCW, including those mental disorders
that result in a behavioral or conduct disorder, that is clearly interfering
with the child's functioning in family or school or with peers and who meets
at least one of the following criteria:
(a) Has undergone inpatient treatment or placement outside of the home
related to a mental disorder within the last two years;
(b) Has undergone involuntary treatment under chapter 71.34 RCW within the
last two years;
(c) Is currently served by at least one of the following child-serving
systems: Juvenile justice, child-protection/welfare, special education, or
(d) Is at risk of escalating maladjustment due to:
(i) Chronic family dysfunction involving a mentally ill or inadequate
(ii) Changes in custodial adult;
(iii) Going to, residing in, or returning from any placement outside of the
home, for example, psychiatric hospital, short-term inpatient, residential
treatment, group or foster home, or a correctional facility;
(iv) Subject to repeated physical abuse or neglect;
(v) Drug or alcohol abuse; or
(19) "State minimum standards" means minimum requirements established by
rules adopted by the secretary and necessary to implement this chapter for:
(a) Delivery of mental health services; (b) licensed service providers for
the provision of mental health services; (c) residential services; and (d)
community support services and resource management services.
(20) "Tribal authority," for the purposes of this section and RCW 71.24.300
only, means: The federally recognized Indian tribes and the major Indian
organizations recognized by the secretary insofar as these organizations do
not have a financial relationship with any regional support network that
would present a conflict of interest.
[1999 c 10 § 2; 1997 c 112 § 38; 1995 c 96 § 4. Prior: 1994 sp.s. c 9 § 748;
1994 c 204 § 1; 1991 c 306 § 2; 1989 c 205 § 2; 1986 c 274 § 2; 1982 c 204 §
Purpose -- Intent -- 1999 c 10: "The purpose of this act is to eliminate
dates and provisions in chapter 71.24 RCW which are no longer needed. The
legislature does not intend this act to make, and no provision of this act
shall be construed as, a substantive change in the service delivery system
or funding of the community mental health services law." [1999 c 10 § 1.]
Alphabetization of section -- 1999 c 10 § 2: "The code reviser shall
alphabetize the definitions in RCW 71.24.025 and correct any
cross-references." [1999 c 10 § 14.]
Effective date -- 1995 c 96: See note following RCW 71.24.400.
Severability -- Headings and captions not law -- Effective date -- 1994
sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Conflict with federal requirements -- 1991 c 306: See note following RCW
Effective date -- 1986 c 274 §§ 1, 2, 3, 5, 9: See note following RCW
Findings -- Developmentally disabled.
The legislature finds that among those persons who endanger the safety of
others by committing crimes are a small number of persons with developmental
disabilities. While their conduct is not typical of the vast majority of
persons with developmental disabilities who are responsible citizens, for
their own welfare and for the safety of others the state may need to
exercise control over those few dangerous individuals who are
developmentally disabled, have been charged with crimes that involve a
threat to public safety or security, and have been found either incompetent
to stand trial or not guilty by reason of insanity. The legislature finds,
however, that the use of civil commitment procedures under chapter 71.05 RCW
to effect state control over dangerous developmentally disabled persons has
resulted in their commitment to institutions for the mentally ill. The
legislature finds that existing programs in mental institutions may be
inappropriate for persons who are developmentally disabled because the
services provided in mental institutions are oriented to persons with mental
illness, a condition not necessarily associated with developmental
disabilities. Therefore, the legislature believes that, where appropriate,
and subject to available funds, persons with developmental disabilities who
have been charged with crimes that involve a threat to public safety or
security and have been found incompetent to stand trial or not guilty by
reason of insanity should receive state services addressing their needs,
that such services must be provided in conformance with an individual
habilitation plan, and that their initial treatment should be separate and
discrete from treatment for persons involved in any other treatment or
habilitation program in a manner consistent with the needs of public safety.
[1998 c 297 § 5; 1989 c 420 § 2.]
Effective dates -- Severability -- Intent -- 1998 c 297: See notes following
For the purposes of this chapter the following words and phrases shall have
the following meanings unless the context clearly requires otherwise:
(1) "Alcoholic" means a person who suffers from the disease of alcoholism.
(2) "Alcoholism" means a disease, characterized by a dependency on alcoholic
beverages, loss of control over the amount and circumstances of use,
symptoms of tolerance, physiological or psychological withdrawal, or both,
if use is reduced or discontinued, and impairment of health or disruption of
social or economic functioning.
(3) "Approved treatment program" means a discrete program of chemical
dependency treatment provided by a treatment program certified by the
department of social and health services as meeting standards adopted under
(4) "Chemical dependency" means alcoholism or drug addiction, or dependence
on alcohol and one or more other psychoactive chemicals, as the context
(5) "Chemical dependency program" means expenditures and activities of the
department designed and conducted to prevent or treat alcoholism and other
drug addiction, including reasonable administration and overhead.
(6) "Department" means the department of social and health services.
(7) "Designated chemical dependency specialist" means a person designated by
the county alcoholism and other drug addiction program coordinator
designated under RCW 70.96A.310 to perform the commitment duties described
in RCW 70.96A.140 and qualified to do so by meeting standards adopted by the
(8) "Director" means the person administering the chemical dependency
program within the department.
(9) "Drug addict" means a person who suffers from the disease of drug
(10) "Drug addiction" means a disease characterized by a dependency on
psychoactive chemicals, loss of control over the amount and circumstances of
use, symptoms of tolerance, physiological or psychological withdrawal, or
both, if use is reduced or discontinued, and impairment of health or
disruption of social or economic functioning.
(11) "Emergency service patrol" means a patrol established under RCW
(12) "Gravely disabled by alcohol or other drugs" means that a person, as a
result of the use of alcohol or other drugs: (a) Is in danger of serious
physical harm resulting from a failure to provide for his or her essential
human needs of health or safety; or (b) manifests severe deterioration in
routine functioning evidenced by a repeated and escalating loss of cognition
or volitional control over his or her actions and is not receiving care as
essential for his or her health or safety.
(13) "Incapacitated by alcohol or other psychoactive chemicals" means that a
person, as a result of the use of alcohol or other psychoactive chemicals,
has his or her judgment so impaired that he or she is incapable of realizing
and making a rational decision with respect to his or her need for treatment
and presents a likelihood of serious harm to himself or herself, to any
other person, or to property.
(14) "Incompetent person" means a person who has been adjudged incompetent
by the superior court.
(15) "Intoxicated person" means a person whose mental or physical
functioning is substantially impaired as a result of the use of alcohol or
other psychoactive chemicals.
(16) "Licensed physician" means a person licensed to practice medicine or
osteopathic medicine and surgery in the state of Washington.
(17) "Likelihood of serious harm" means either: (a) A substantial risk that
physical harm will be inflicted by an individual upon his or her own person,
as evidenced by threats or attempts to commit suicide or inflict physical
harm on one's self; (b) a substantial risk that physical harm will be
inflicted by an individual upon another, as evidenced by behavior that has
caused the harm or that places another person or persons in reasonable fear
of sustaining the harm; or (c) a substantial risk that physical harm will be
inflicted by an individual upon the property of others, as evidenced by
behavior that has caused substantial loss or damage to the property of
(18) "Medical necessity" for inpatient care of a minor means a requested
certified inpatient service that is reasonably calculated to: (a) Diagnose,
arrest, or alleviate a chemical dependency; or (b) prevent the worsening of
chemical dependency conditions that endanger life or cause suffering and
pain, or result in illness or infirmity or threaten to cause or aggravate a
handicap, or cause physical deformity or malfunction, and there is no
adequate less restrictive alternative available.
(19) "Minor" means a person less than eighteen years of age.
(20) "Parent" means the parent or parents who have the legal right to
custody of the child. Parent includes custodian or guardian.
(21) "Peace officer" means a law enforcement official of a public agency or
governmental unit, and includes persons specifically given peace officer
powers by any state law, local ordinance, or judicial order of appointment.
(22) "Person" means an individual, including a minor.
(23) "Professional person in charge" or "professional person" means a
physician or chemical dependency counselor as defined in rule by the
department, who is empowered by a certified treatment program with authority
to make assessment, admission, continuing care, and discharge decisions on
behalf of the certified program.
(24) "Secretary" means the secretary of the department of social and health
(25) "Treatment" means the broad range of emergency, detoxification,
residential, and outpatient services and care, including diagnostic
evaluation, chemical dependency education and counseling, medical,
psychiatric, psychological, and social service care, vocational
rehabilitation and career counseling, which may be extended to alcoholics
and other drug addicts and their families, persons incapacitated by alcohol
or other psychoactive chemicals, and intoxicated persons.
(26) "Treatment program" means an organization, institution, or corporation,
public or private, engaged in the care, treatment, or rehabilitation of
alcoholics or other drug addicts.
[1998 c 296 § 22. Prior: 1996 c 178 § 23; 1996 c 133 § 33; 1994 c 231 § 1;
1991 c 364 § 8; 1990 c 151 § 2; prior: 1989 c 271 § 305; 1989 c 270 § 3;
1972 ex.s. c 122 § 2.]
Findings -- Intent -- Part headings not law -- Short title -- 1998 c 296:
See notes following RCW 74.13.025.
Effective date -- 1996 c 178: See note following RCW 18.35.110.
Findings -- Short title -- Intent -- Construction -- 1996 c 133: See notes
following RCW 13.32A.197.
Effective date -- 1994 c 231: "This act is necessary for the immediate
preservation of the public peace, health, or safety, or support of the state
government and its existing public institutions, and shall take effect
immediately [April 1, 1994]." [1994 c 231 § 3.]
Findings -- 1991 c 364: "The legislature finds that the use of alcohol and
illicit drugs continues to be a primary crippler of our youth. This
translates into incredible costs to individuals, families, and society in
terms of traffic fatalities, suicides, criminal activity including
homicides, sexual promiscuity, familial incorrigibility, and conduct
disorders, and educational fallout. Among children of all socioeconomic
groups lower expectations for the future, low motivation and self-esteem,
alienation, and depression are associated with alcohol and drug abuse.
Studies reveal that deaths from alcohol and other drug-related injuries rise
sharply through adolescence, peaking in the early twenties. But second peak
occurs in later life, where it accounts for three times as many deaths from
chronic diseases. A young victim's life expectancy is likely to be reduced
by an average of twenty-six years.
Yet the cost of treating alcohol and drug addicts can be recouped in the
first three years of abstinence in health care savings alone. Public money
spent on treatment saves not only the life of the chemical abuser, it makes
us safer as individuals, and in the long-run costs less.
The legislature further finds that many children who abuse alcohol and other
drugs may not require involuntary treatment, but still are not adequately
served. These children remain at risk for future chemical dependency, and
may become mentally ill or a juvenile offender or need out-of-home
placement. Children placed at risk because of chemical abuse may be better
served by the creation of a comprehensive integrated system for children in
The legislature declares that an emphasis on the treatment of youth will pay
the largest dividend in terms of preventable costs to individuals
themselves, their families, and to society. The provision of augmented
involuntary alcohol treatment services to youths, as well as involuntary
treatment for youths addicted by other drugs, is in the interest of the
public health and safety." [1991 c 364 § 7.]
Construction -- 1991 c 364 §§ 7-12: "The purpose of sections 7 through 12 of
this act is solely to provide authority for the involuntary commitment of
minors addicted by drugs within available funds and current programs and
facilities. Nothing in sections 7 through 12 of this act shall be construed
to require the addition of new facilities nor affect the department's
authority for the uses of existing programs and facilities authorized by
law. Nothing in sections 7 through 12 of this act shall prevent a parent or
guardian from requesting the involuntary commitment of a minor through a
county designated chemical dependency specialist on an ability to pay
basis." [1991 c 364 § 13.]
Conflict with federal requirements -- 1991 c 364: "If any part of this act
is found to be in conflict with federal requirements that are a prescribed
condition to the allocation of federal funds to the state, the conflicting
part of this act is inoperative solely to the extent of the conflict and
with respect to the agencies directly affected, and this finding does not
affect the operation of the remainder of this act in its application to the
agencies concerned. The rules under this act shall meet federal requirements
that are a necessary condition to the receipt of federal funds by the
state." [1991 c 364 § 15.]
Severability -- 1989 c 271: See note following RCW 9.94A.310.
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