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NAMI Washington 2013 legislative agenda
You can see the latest update on mental-health legislation in Olympia here.
NAMI Washington's 2013 legislative positions are guided by the following principles:
- The laws in this state must require that there be fair and just access to medical treatment and related supportive services for individuals with mental illnesses and their families and/or other support networks.
- Early intensive care and treatment - including hospitalization in some cases - has proven to reduce long-term illness and disability. It is the best way to reduce the State's long-term costs for the mental health system and, most importantly, to promote the potential for recovery for as many people as possible. In order to ensure the highest possible quality of service, the State should require programs, treatments and other services to be evidence-based or promising practices.
- Treatment and related assistance need to be holistic and comprehensive and should include the person's psychiatric and general physical health, employment potential, housing, social network and mobility. These programs need to work in collaboration with one another and be recovery based.
- Involved family members, friends and others in an individual's chosen support network should have a positive, pro-active role in treatment planning and evaluating treatment effectiveness.
- Community mental health organizations, private business and government entities must come together as collaborative partners in the treatment of mental illnesses and the reduction of societal stigma surrounding mental health issues.
1. Change the content of fiscal notes attached to bills in the Legislature to include costs of not implementing proposed legislation.
Currently the fiscal notes provided to legislators give only the projected cost of enactment and implementation of proposed legislation. They do not show the cost of not implementing the legislation-an important consideration in any reliable cost/benefit analysis. We have seen the perils of the current system in last year's postponement until 2015 of the implementation of HB 3076 sec. 2 (2010), codified at R.C.W.§71.05.212, (concerning family input into involuntary treatment decisions that we worked so hard to get passed in 2010), based on estimated implementation costs. As we move forward with our strategic plan, it will become more and more important for legislators to understand that larger picture so that they can make truly informed decisions.
2. Resurrect the delayed portions HB 3076 for immediate implementation.
Among other measures, HB 3076 sec. 2 (2010), codified at R.C.W.§71.05.212, provides for family input to be considered in involuntary treatment decisions. NAMI WA fought very hard for this legislation in 2010. It was supposed to take effect in January of 2012. While a financial responsibility portion of the law requiring court to find an ability to pay fines and court costs before imposing them was left intact, the family input provision has been pushed out to a July 1, 2015 implementation date based on a less-than-complete cost/benefit analysis. It is important that we not let this legislation, which will enhance decision-making ability of those who make these important decisions be forgotten.
3. Expand the Involuntary Treatment Act (ITA) to provide better intervention tools.
Currently, the ITA provides for emergency involuntary hospitalization if a person "presents an imminent likelihood of serious harm, or is in imminent danger because of being gravely disabled," R.C.W.§71.05.153 (2012). The "imminent" standard is used only in this statutory section; other code sections simply use "likelihood of serious harm. We want the "imminence" requirement removed from the emergency detention statute and replaced with a "substantial" standard to allow more of those who really need help get it before life-threatening danger gets so close as to be "imminent." Along with that less demanding standard, we want to establish universally available assisted outpatient treatment as an alternative to hospitalization that would allow those who meet criteria to remain in the community under close supervision rather than actually being hospitalized. Because this provides a less restrictive as well as less costly alternative to hospitalization, these provisions go hand in hand and meet the intent and policy statements of R.C.W.§71.24.01.
4. Increase access to PEER-infused Crisis Stabilization Units/Triage Centers.
Because there are few mental health crisis stabilization units/triage centers in the state, many people living with mental illnesses who need crisis intervention and stabilization service instead are being booked into jails or brought to hospital emergency rooms –at great public cost and contrary to the stated "least-restrictive treatment alternative" intent of R.C.W.§71.24.015. Where these centers do exist, they operate with extraordinary cost-effectiveness and positive effect. Further, trained PEER Counselors are increasingly being recognized as effective, empathetic advocates, whose understanding and credibility with people in mental health crises comes from their own recovery experience. Use of PEER counselors in such centers will maximize the positive effects of diversion from the criminal justice system and help encourage stabilization without hospitalization. It is both fiscally and humanely imperative that we establish universal access to these important facilities and programs throughout the State.
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