OLYMPIA – Washingtonians with serious behavioral health issues that pose a threat to themselves or others would have better access to treatment in the community without hospitalization, under legislation proposed by Sen. Manka Dhingra (D-Redmond) and Rep. Jamila Taylor (D-Federal Way).
SB 5645 (HB 1773) sets out conditions under which a court can direct people with a severe behavioral health disorder to assisted outpatient treatment (AOT), which puts a judge and a care team in charge of coordinating consistent care using the least restrictive form of treatment necessary to ensure patients’ recovery and stability.
“This bill will make it easier for families to get their loved ones the help they need prior to the need for hospitalization,” said Dhingra. “We shouldn’t wait for people to hit rock bottom before providing them the structure, support and services they require. Assisted outpatient treatment is an effective way to get people on the path to recovery.”
“We have been working closely with treatment providers, people with lived experience, and family members to design these policies,” said Taylor. “We’re all working together to make sure that patients can be connected to treatment that can help them return to living the lives they want to live.”
Jerri Clark, founder of MOMI – Mothers of the Mentally Ill, expressed strong support of the bill. Her son, Calvin Clark, died of suicide March 18, 2019, after a four-year struggle with a persistent and disabling severe mental illness. His illness led him into episodes of homelessness, incarcerations, and multiple hospitalizations that failed to initiate recovery and led to immediate relapses.
“I believe Assisted Outpatient Treatment (AOT) was the missing ingredient in my son’s care that might have saved his life.
“He was discharged from multiple hospitalizations with a court document that looks like it will require adherence to treatment to help a person maintain stability, but the words on the page didn’t mean anything. No one was accountable to make sure he was doing okay unless he went to scheduled appointments with his care coordinator.
“He frequently didn’t show up exactly because he wasn’t doing well. One care coordinator disclosed to me that she was managing 80 patients at once. She couldn’t possibly try to track my son down if he failed to show up. No one else had him in their radar, least of all the judge who signed the court document.
“That system failed by design. AOT is designed for success.
“A judge and a full care team share responsibility to organize consistent care coordination meetings. If a client goes missing, the team is responsible to find that person and make sure they are okay. If a higher level of care is necessary to restore stability, an AOT team has the agility to make that happen before something goes terribly wrong. Our current system is actually designed to wait until something goes terribly wrong.
“That’s why I believe AOT would have saved my son. Professionals would have caught him and helped him back up on his feet before it was too late.”
The bill would make several changes to create a clear and streamlined pathway for service providers to submit AOT petitions while incorporating appropriate guardrails. It would also remove AOT from the designated crisis responder investigation process and establish a system for service providers to petition a superior court for AOT. The petition would need to include a declaration by a medical provider who has examined the person within 10 days of filing the petition.
The bill would also extend AOT to include treatment of adolescents between the ages of 13 and 17.
The 60-day legislative session begins on Jan. 10.