Protocols for Designated Crisis Responders (DCRs)

1 2020 Update RCW Washington State Health Care Authority Division of Behavioral Health and Recovery Box 42730 Olympia, WA 98504 for Designated Crisis Responders (DCRs) Page |2 Table of Contents Executive Summary .. 6 Conventions used in this report .. 8 Legislative intent and purpose .. 9 Recent legislation involving RCW and RCW .. 10 14 Referral and investigation .. 24 100 Referrals for an ITA Investigation .. 24 105 Timelines for Response .. 25 For Adults .. 26 For Minors .. 26 110 Rights of an Individual Being Investigated .. 26 115 Process for Conducting an ITA Investigation.

2 27 120 Video Assessment .. 27 Guidance for DCR coordination with assisting facility staff .. 30 125 Determining the Presence of a Behavioral Health Disorder .. 30 DSM-5 Diagnostic Criteria for Other (or Unknown) Substance Use Disorder .. 31 130 Determining Dangerousness and/or Grave Disability .. 32 Danger to Self or Others .. 32 Grave Disability .. 32 135 Use of Reasonably Available History .. 34 140 Interviewing Witnesses as Part of an Investigation .. 35 143 Investigation Outcomes Other Than Detention .. 36 Non-Emergent Detention Detention in the Absence of Imminent Harm.

3 36 Evaluation to Determine Need for Assisted Outpatient Behavioral Health Treatment .. 36 Consideration of Alternatives to Detention .. 36 Referring an Individual for Services when the Decision is not to Detain .. 37 145 Availability of Resources Single Bed Certification and No-Bed Reports .. 37 Single Bed Certification .. 38 E&T or SWMS not available .. 38 No-Bed Report (Unavailable Detention Facilities Report Form) .. 39 155 Considerations for Specific Populations and Locations; Minors .. 40 Page |3 Notification .. 40 Family Initiated Treatment (FIT).

4 40 Referrals of a Person Charged with Possessing Firearms or Dangerous Weapons on School Facilities .. 41 American Indian/Alaska Natives (AI/AN).. 41 Referrals of Members of a Federally Recognized Tribe .. 41 Referral of Members of a Federally Recognized Tribe on Tribal Land .. 41 Notification .. 42 Tribal DCRs .. 42 Culturally Appropriate Evaluations .. 42 Individuals with Dementia or Developmental/Intellectual Disability (DD/ID) .. 42 Referrals from an Emergency Department .. 43 Medical clearance and referral .. 43 Required Consultation with an Emergency Department 44 Referrals from a Licensed Residential Care Facility.

5 44 Referrals from Law Enforcement .. 45 Sheena s Law: Referrals from Law Enforcement in the Community .. 45 Documentation in DCR office .. 45 Triage .. 46 Contact .. 46 Referrals from a Jail or Prison .. 46 Discharge Review for Incarcerated Individuals .. 47 Forensic Evaluations .. 47 Referrals of Individuals in the Re-entry Community Services Program (RCSP) .. 47 Referrals of Veterans .. 47 160 Reporting Suspected Abuse or Neglect .. 48 Minors .. 48 48 Detentions .. 49 200 Notification of Guardians & Decision Makers .. 49 205 Procedure for Non-Emergent Detention.

6 49 207 Suspension of Firearm 49 Notice of Suspension of Firearm Rights .. 50 Page |4 Notification of Local Law Enforcement .. 50 210 Detention from a Licensed Residential Care Facility .. 50 215 Detention to a Facility in another County .. 50 220 Documentation of Petition for Initial Detention .. 51 225 Joel s Law .. 51 230 Notification if Detained Individual has a Developmental Disability .. 52 235 DCR Responsibilities if Detained Individual is a Foreign National .. 52 240 Detention of Individuals who have Fled from Another State who were Found Not Guilty by Reason of Insanity and Fled from Detention, Commitment or Conditional Release.

7 52 Less Restrictive Alternative Court Orders .. 53 300 Rights of an individual Evaluated and Detained for a Revocation Hearing .. 53 305 Procedure and Criteria for Modifying, Enforcing, or Revoking a CR/LRA Court Order for Adults 53 Revocation (for CR/LRA Orders) .. 53 Modification and Enforcement (For CR/LRA and AOBHT orders) .. 54 310 Procedures for Revoking a CR/LRA Court Order for Minors .. 54 315 Advising Licensed Mental Health Outpatient Treatment Providers in Documenting Compliance with CR/LRA Court Orders .. 55 320 Criteria for Extending CR/LRA Court Orders for Adults.

8 55 325 Petitions for Extending a LRA Court Order for Adults .. 56 Confidentiality .. 58 400 General Provisions on Confidentiality .. 58 405 Sharing Information in a Crisis or Emergency Situation .. 58 410 Sharing Information with Parents, Responsible Family Members, Other Legal Representatives .. 59 415 Sharing Information with Law Enforcement .. 59 420 Sharing Information with Department of Corrections Personnel .. 60 425 Sharing Information to Protect Identified 60 Appendix A: 2020 Designated Crisis Responders Protocol Workgroup Members .. 61 Appendix B: County Prosecutor s Office Phone 63 Appendix C: Requirements of Licensed Residential Care Facilities.

9 64 Appendix D: DCR Intervention Checklist .. 65 Treatment Suggestions .. 65 Behavioral Health Intervention Suggestions .. 65 Appendix E: DSHS Developmental Disabilities Administration Contacts .. 67 Page |5 Appendix F: Tribal Resources: Federally Recognized Tribes of Washington .. 68 Best practices .. 68 Appendix G: Map of BH-ASO Regions .. 69 Appendix H: List of Resources for Available History .. 70 Appendix I: Steps to Follow When a Foreign National is Detained .. 71 Statement 1 for all foreign nationals except those from mandatory notification countries.

10 71 Statement 2 For foreign nationals from mandatory notification countries .. 72 Appendix J: Links to DCR Forms .. 73 Appendix K: DCR Knowledge and Education .. 74 Appendix L: References and Resources .. 75 Page |6 Executive Summary The 2020 update of the Protocols for Designated Crisis Responders (DCRs) is provided by the Washington State Health Care Authority (HCA), as mandated by RCW HCA is required to develop statewide Protocols to be utilized by professionals and Designated Crisis Responders in the administration of chapters , , and RCW.