Status Summary

First reading, referred to Health & Long Term Care on 2.13.19. Executive action taken in the Senate Committee on Health & Long Term Care on 2.13.19; referred to Behavioral Health Subcommittee to Health & Long Term Care. Public hearing and executive action taken in the Senate Committee on Behavioral Health Subcommittee to Health & Long Term Care on 2.22.19; 1st substitute bill passed. Passed to Rules Committee for second reading on 2.22.19. Placed on second reading by Rules Committee on 3.5.19. (updated 3.15.19)

Legislative Session

2019

Status

In Progress

Sponsor

Warnick

SB 5904 establishes the Adolescent Behavioral Health Care Access Act.

This bill defines an “adolescent” as a minor aged 13 or older by amending RCW 71.34.500.

Parents of adolescents are authorized to admit a child to an evaluation and treatment center for

inpatient mental health or substance use disorder treatment without the consent of the adolescent

if the professional person agrees that there is a need for that level of treatment. The treatment team must convene a treatment review at least every 30 days after this admission.

Also amends RCW to expand the definition of “chemical dependency professional” to include a person certified as a chemical dependency professional trainee under the direct supervision of a certified chemical dependency professional.  The definition for “mental health professional” is also expanded to include a provider from a licensed community mental health agency under the direction of a licensed mental health professional.

Another amendment includes the addition of legal guardians and kinship caregivers. RCW 71.34.530 is amended to include that parents of adolescents may request and receive medically necessary outpatient mental health treatment or substance use disorder treatment without the consent of the adolescent for:

  • as many as 12 out-patient sessions; or
  • three months of outpatient treatment.

Regarding confidentiality, a new section is added to RCW 71.34 to detail treatment information that may be disclosed to the parent/legal guardian without the consent of the adolescent. However, the mental health professional must provide notice of the disclosure to the adolescent, and shall document any objections.

Finally, amends RCW 74.13.280 to allow DCYF to share specific mental health treatment records with care providers, regardless of the adolescents’ consent.  Care  provider is defined as a person with whom a child is placed in out-of-home care, or a designated official for a group care facility licensed by the department.

*Companion to HB 1874*

Amendments:

Updated 2/26/19:

  • Provisions for parent-initiated outpatient treatment are expanded to specify that a parent of an adolescent who has been determined to be in need of outpatient treatment may request and receive up to 12 outpatient treatment sessions occurring within a three-month period for a nonconsenting adolescent. After this period, the adolescent must provide consent for continuing treatment.
  • Outpatient treatment may include partial hospitalization or intensive outpatient treatment.
  • If an entity providing outpatient treatment pursuant to parent-initiated treatment is providing solely mental health treatment, the provider must:
    • Convene a treatment review at least every 30 days involving the adolescent, parent, and treatment team to determine if treatment should continue;
    • Notify HCA within 24 hours of the adolescent's receipt of treatment for the purpose of an independent review of whether treatment is necessary, which must be renewed at least every 45 days thereafter.
  • If the entity is providing substance use disorder treatment, treatment reviews may only occur if the minor provides written consent to the disclosure of substance use disorder treatment information unless permitted by federal law.
  • When a mental health professional (MHP) provides mental health treatment but not substance use disorder treatment to an adolescent, the MHP may provide limited mental health treatment information about the adolescent to a parent that consists of:
    • diagnosis;
    • treatment plan and progress in treatment;
    • recommended medications, including risks, benefits, side effects, typical efficacy, dose, and schedule;
    • psychoeducation about the adolescent's mental health;
    • referrals to community resources;
    • coaching on parenting or behavioral management strategies; and
    • crisis prevention planning and safety planning.
  • The MHP must determine that sharing the information would not be detrimental to the adolescent, and must not proactively provide this information to a parent unless the adolescent states a clear and documented desire to do so, except in instances concerning the imminent health and safety of the youth.
  • An MHP must provide notice to an adolescent about disclosure and give ample time for the adolescent to express concerns to the MHP well in advance of disclosure.
  • The MHP must document objections by the adolescent if the MHP discloses information over the adolescent's objection, and reasons for withholding information if the MHP determines that disclosure of information would be detrimental to the adolescent.
  • The Department of Children, Youth, and Families may share the same information to a person with whom a child is placed in out-of-home care.
  • Either an adolescent or parent may authorize disclosure of records to a current treatment provider or to a potential treatment provider to facilitate referrals for additional mental health treatment services.
  • The family must make efforts to jointly agree on the release of mental health treatment information, and the provider may refuse if the provider believes that release of information would be detrimental to the minor and documents the reasoning.
  • Treatment records may not be released for the purpose of conversion therapy.
  • Disclosure of substance use disorder records requires the adolescent's written consent, unless permitted by federal law.
  • An MHP is not liable for releasing or not releasing mental health treatment information to a parent based on the MHP's determination of whether release will be detrimental.
  • Parental notice provisions when an adolescent self-admits to inpatient treatment or gives notice of an intent to leave are limited to the context of an evaluation and treatment facility when the minor is admitted solely for mental health treatment and not for substance use disorder treatment.
  • Parental notification when an adolescent self-admits for substance use disorder treatment may be provided only when the adolescent provides written consent to the disclosure.
  • A parent is defined, in order of priority, as:
    • an appointed guardian or legal custodian;
    • a person authorized by court to consent to medical care for a child in out-of-home placement;
    • a biological or adoptive parent with legal custody; and
    • individual to whom the minor's parent has given a signed authorization to make health care decisions for the minor; or a competent adult acting as a relative.

Adolescent is defined as a minor aged thirteen through seventeen.