When an amendment to Washington’s Involuntary Treatment Act allowing for court-mandated detox for acute drug addiction goes into effect on April 1, only one town in Western Washington will be ready to accept patients — Chehalis.
Specifically, the Chehalis location of American Behavioral Health Systems, or ABHS, has recently remodeled a portion of its facility at 500 Southeast Washington Ave. in Chehalis — the former site of the St. Helen Hospital — that had formerly been leased by a dialysis center.
The area is now a secure detox facility with space for 22 people.
“We remodeled that wing to fit the secure model because the state had asked for nine providers to potentially run these and ABHS was one of the companies that agreed to do that,” said Tony Prentice, ABHS’ Western Washington director.
However as of now, ABHS facilities in Chehalis and Spokane are the only ones that qualify for the Involuntary Treatment Act program.
This means all people who qualify for the program in Western Washington will go through Lewis County Superior Court and complete their involuntary commitment at ABHS.
“It’s going to be taxed almost immediately,” Lewis County Prosecutor Jonathan Meyer said.
Prentice said the future is uncertain, but that he believes other behavioral-health organizations similar to ABHS are looking to get involved as well.
“It kind of fits in our long term plans,” Prentice said of the new program. “ABHS likes to be at the forefront of new projects and providing the most up to date programs.”
The program added more than two-dozen jobs at ABHS and will add at least one attorney position in the Lewis County Prosecutor’s Office.
While the program is largely a positive one, Meyer said he had one concern about bringing so many people to Chehalis for short-term treatment.
“My concern is once treatment is done, I don’t want to see folks just turned out on the street,” he said.
State law previously allowed for involuntary commitments for treatment by courts for mental health but state law has only recently been changed to allow for compulsory court-ordered drug treatment, Meyer explained.
Cascade Mental Health Care’s new Evaluation and Treatment Center will take patients undergoing involuntary commitments for mental health reasons.
The change to state law, known as “Ricky’s Law” and passed as House Bill 1713 in 2016, instructed the state Department of Social and Health Services to ensure that at least one 16-bed secure detox facility was open in the state by this April, with a second facility operational by April 1, 2019, according to information from DSHS.
The bill added language into the state’s existing involuntary commitment law to include substance abuse.
“When a designated crisis responder receives information alleging that a person, as the result of (a) substance use disorder, presents an imminent likelihood of serious harm … the designated crisis responder may take the person, or cause by oral or written order the person to be taken into emergency custody in a secure detoxification facility or approved substance use disorder treatment program for not more than 72 hours,” RCW 71.05.153 reads.
ABHS’s Chehalis detox center is currently open for voluntary patients as well as court-ordered detox and treatment, Prentice said.
“We’re offering acute detox services. So someone would come in if they were court ordered form the (designated crisis responders),” he said.
A designated crisis responder is similar to a designated mental health professional, and would be trained to determine if a person meets the program’s criteria.
First, a patient would receive a medical exam and an evaluation, and get a recommendation for treatment from a psychiatric nurse practitioner, Prentice said.
The law requires that the detox facilities be medically monitored and have a regimen for evaluation and treatment.
“Our chemical dependency professionals will do onsite assessment to recommend the next level of care,” Prentice said.
After the initial 72-hour hold, a judge could order the patient held at the ABHS facility for up to 14 days for acute treatment, then for up to 90 days in a “less-restrictive alternative,” according to DSHS.
ABHS hired about two dozen new staff members for the detox facility, Prentice said.
Lewis County will also need to hire to accommodate the new workload. Meyer speculated the court would likely have hearings twice a week to handle the 72-hour deadlines, and said expects his office will have to file additional charges if patients are caught smuggling in drugs, as he said often happens in treatment facilities.
“We’re looking at one additional attorney plus one additional staff (member),” said Lewis County Prosecutor Jonathan Meyer.
Lewis County will also need to staff the superior court hearings necessary in the involuntary treatment process, he said, estimating a $150,000 budget impact to his office alone.
“We estimate about 30 hearings per week additionally for this office to handle,” Meyer said.
Locally, the process is funded through the Great Rivers Behavioral Health Organization, which serves Lewis County and other counties in southwest Washington.
Patients from other areas of the state will have treatment funded from BHOs in their own region, Prentice said.
Meyer said earlier this month that the county isn’t sure yet exactly how the funding mechanism will work, noting that implementing the change to state law is complicated.
“There’s a lot of moving parts,” he said.