SB 5271 — Protecting patients in facilities regulated by the department of health by establishing uniform enforcement tools.

(I) Performs 1,000 or fewer surgical procedures;

(II) Performs between 1,001 and 5,000 surgical procedures;

and (III) Performs more than 5,000 surgical procedures.

(c) The department may suspend a specific category or categories of services or care or operating rooms or recovery rooms within the ambulatory surgical facility as related to the violation by imposing a limited stop service.

This may only be done p.if the department finds that noncompliance results in immediate jeopardy and is not confined to a specific category or categories of patients or a specific area of the ambulatory surgical facility.

32 ESSB 5271 if the department finds that noncompliance results in immediate jeopardy and is not confined to a specific category or categories of patients or a specific area of the ambulatory surgical facility.

The ambulatory surgical facility shall have 24 hours from notification to develop and implement a department- approvedp. plan to correct the deficient practices or conditions that constitute an immediate jeopardy.

32 SB 5271 approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy.

Adjudicative proceedings and hearings under this section are governed by the administrative p.procedure act, chapter 34.05 RCW.

33 ESSB 5271 procedure act, chapter 34.05 RCW.

(a) When the department determines a licensee's noncompliance results in immediate jeopardy, the department may make the imposition ofp. conditions on a licensee, a limited stop service, stop placement, or the suspension of a license effective immediately upon receipt of the notice by the licensee, pending any adjudicative proceeding.

33 SB 5271 of conditions on a licensee, a limited stop service, stop placement, or the suspension of a license effective immediately upon receipt of the notice by the licensee, pending any adjudicative proceeding.

p.(4) When the department determines an alleged violation, if true, would constitute an immediate jeopardy, and the licensee fails to cooperate with the department's investigation of such an alleged violation, the department may impose an immediate stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension.

34(a) ESSB 5271 (4) When the department determinesimposes an alleged violation, if true, would constitute an immediate jeopardy, and the licensee fails to cooperate with the department's investigation of such an alleged violation, the department may impose an immediate stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension.suspension for failure to cooperate, a licensee is p.

(a)34 WhenSB the5271 department imposes an immediate stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension for failure to cooperate, a licensee is entitled to a show cause hearing before a presiding officer within 14 days of making the request.

(f) If the presiding officer sustains the immediate action for failure to cooperate, the licensee may request an expedited full p.hearing on the merits of the department's action.

35 ESSB 5271 hearing on the merits of the department's action.

(2)(a)p. Except as otherwise provided in this section, the requirement to cease and desist unlicensed operation is effective 20 days after the person receives the notice.

35 SB 5271 (2)(a) Except as otherwise provided in this section, the requirement to cease and desist unlicensed operation is effective 20 days after the person receives the notice.

The presiding or reviewing officer may order the department to stay implementation of part or all of the adverse action while the proceedings are pending p.if staying implementation is in the public interest or for other good cause.

36 ESSB 5271 if staying implementation is in the public interest or for other good cause.

(c)p. The person against whom the department assesses a civil fine has the right to request an adjudicative proceeding.

36 SB 5271 (c) The person against whom the department assesses a civil fine has the right to request an adjudicative proceeding.

p.(a) When the department determines the ((psychiatric hospital)) private establishment has previously been subject to an enforcement action for the same or similar type of violation of the same statute or rule, or has been given any previous statement of deficiency that included the same or similar type of violation of the same or similar statute or rule, or when the ((psychiatric hospital)) private establishment failed to correct noncompliance with a statute or rule by a date established or agreed to by the department, the department may impose reasonable conditions on a license.

37Conditions ESSBmay 5271include (a)correction Whenwithin thea departmentspecified determinesamount the ((psychiatric hospital)) private establishment has previously been subject to an enforcement action for the same or similar type of violationtime, oftraining, the same statute or rule,hiring or has been given any previous statement of deficiency that included the same or similar type of violation of the same or similar statute or rule, or when the ((psychiatric hospital)) private establishment failed to correct noncompliance with a statutep. or rule by a date established or agreed to by the department, the department may impose reasonable conditions on a license.

Conditions37 maySB include5271 correction within a specified amount of time, training, or hiring a department-approved consultant if the ((hospital)) private establishment cannot demonstrate to the department that it has access to sufficient internal expertise.

Proceeds from these fines may only be used by the department to provide p.training or technical assistance to psychiatric hospitals and to offset costs associated with licensing psychiatric hospitals.

38 ESSB 5271 training or technical assistance to psychiatric hospitals and to offset costs associated with licensing psychiatric hospitals.

(i) Prior to imposing a limited stop placement, the department shall provide a ((psychiatric hospital)) private establishment written notification upon identifying deficient practices or conditions that constitute an immediate jeopardy, and the ((psychiatricp. hospital)) private establishment shall have ((twenty- four)) 24 hours from notification to develop and implement a department-approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy.

38 SB 5271 ((psychiatric hospital)) private establishment shall have ((twenty- four)) 24 hours from notification to develop and implement a department-approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy.

This may only be done if the department finds that noncompliance results in immediate jeopardy and is not confined to a p.specific category or categories of patients or a specific area of the ((psychiatric hospital)) private establishment.

39 ESSB 5271 specific category or categories of patients or a specific area of the ((psychiatric hospital)) private establishment.

If the deficient practicepractices s or conditions that constitutep. immediate jeopardy are not verified by the department as having been corrected within the same ((twenty-four)) 24-hour period, the department may issue the stop placement.

39 SB 5271 constitute immediate jeopardy are not verified by the department as having been corrected within the same ((twenty-four)) 24-hour period, the department may issue the stop placement.

The private establishment shall have 24 hours from notification to develop and implement a department-approved plan p.to correct the deficient practices or conditions that constitute an immediate jeopardy.

40 ESSB 5271 to correct the deficient practices or conditions that constitute an immediate jeopardy.

(iii)p. The department shall conduct a follow-up inspection within five business days or within the time period requested by the private establishment if more than five business days is needed to verify the violation necessitating the limited stop service has been corrected.

40 SB 5271 (iii) The department shall conduct a follow-up inspection within five business days or within the time period requested by the private establishment if more than five business days is needed to verify the violation necessitating the limited stop service has been corrected.

(b) When the department determines a licensee's noncompliance results in immediate jeopardy, the department may make the imposition of conditions on a licensee, a limited stop placement, stop placement, limited stop service, or the suspension of a license p.effective immediately upon receipt of the notice by the licensee, pending any adjudicative proceeding.

41 ESSB 5271 effective immediately upon receipt of the notice by the licensee, pending any adjudicative proceeding.

(ii)p. At the show cause hearing, the presiding officer may consider the notice and documents supporting the immediate suspension or immediate imposition of conditions and the licensee's response and must provide the parties with an opportunity to provide documentary evidence and written testimony, and to be represented by counsel.

41 SB 5271 (ii) At the show cause hearing, the presiding officer may consider the notice and documents supporting the immediate suspension or immediate imposition of conditions and the licensee's response and must provide the parties with an opportunity to provide documentary evidence and written testimony, and to be represented by counsel.

(a) When the department imposes an immediate stop placement, immediate limited stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension for failure to cooperate, a licensee is entitled to a show cause hearing p.before a presiding officer within 14 days of making the request.

42 ESSB 5271 before a presiding officer within 14 days of making the request.

(b) At the show cause hearing, the presiding officer may consider the notice and documents supporting the immediate stop placement, immediatep. limited stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension for failure to cooperate, and the licensee's response and shall provide the parties with an opportunity to provide documentary evidence and written testimony, and to be represented by counsel.

42 SB 5271 immediate limited stop placement, immediate limited stop service, immediate imposition of conditions, or immediate suspension for failure to cooperate, and the licensee's response and shall provide the parties with an opportunity to provide documentary evidence and written testimony, and to be represented by counsel.

p.(2) "Elopement" means any situation in which an admitted patient of a ((psychiatric hospital)) private establishment who is cognitively, physically, mentally, emotionally, and/or chemically impaired wanders, walks, runs away, escapes, or otherwise leaves a ((psychiatric hospital)) private establishment or the grounds of a ((psychiatric hospital)) private establishment prior to the patient's scheduled discharge unsupervised, unnoticed, and without the staff's knowledge.

43 ESSB 5271 (2) "Elopement" means any situation in which an admitted patient of a ((psychiatric hospital)) private establishment who is cognitively, physically, mentally, emotionally, and/or chemically impaired wanders, walks, runs away, escapes, or otherwise leaves a ((psychiatric hospital)) private establishment or the grounds of a ((psychiatric hospital)) private establishment prior to the patient's scheduled discharge unsupervised, unnoticed, and without the staff's knowledge.

(a) Every private or county or municipal hospital, including public hospital districts, ((sanatoriums,))((sanitariums,)) homes, ((psychiatric)) behavioralp. health hospitals, residential treatment facilities, or other places receiving or caring for any person with ((mental illness, mentally incompetent person, or chemically dependent person)) a behavioral health or substance use disorder;

43 SB 5271 behavioral health hospitals, residential treatment facilities, or other places receiving or caring for any person with ((mental illness, mentally incompetent person, or chemically dependent person)) a behavioral health or substance use disorder;

p.(9) "Technical assistance" means the provision of information on the state laws and rules applicable to the regulation of ((psychiatric)) behavioral health hospitals, the process to apply for a license, and methods and resources to avoid or address compliance problems.

44 ESSB 5271 (9) "Technical assistance" means the provision of information on the state laws and rules applicable to the regulation of ((psychiatric hospitals)) private establishments, the process to apply for a license, and methods and resources to avoid or address compliance problems.

Sec.p.

44 SB 5271 Sec.

When the department does so, it p.shall state the effective date and the reasons supporting the effective date in the written notice to cease and desist.

45 ESSB 5271 shall state the effective date and the reasons supporting the effective date in the written notice to cease and desist.

(4)(a) If the department gives a person 20 days' notice to cease and desist and the person requests an adjudicative proceeding before its effective date, the department shall not implement the notice untilp. the final order has been entered.

45 SB 5271 until the final order has been entered.

The request must be in writing, state the basis for contesting the fine, include a copy of the notice, be served on and received by the p.department within 20 days of the person receiving the notice of civil fine, and be served in a manner which shows proof of receipt.

46 ESSB 5271 department within 20 days of the person receiving the notice of civil fine, and be served in a manner which shows proof of receipt.

This method of enforcement of the final notice to cease and desist or civil fine may be used in addition to, or as an alternativep. to, any provisions for enforcement of agency orders set out in chapter 34.05 RCW.

46 SB 5271 alternative to, any provisions for enforcement of agency orders set out in chapter 34.05 RCW.

The cost of any studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the acquisition, improvement, expansion, or replacement of any plant or p.equipment with respect to which such expenditure is made shall be included in determining the amount of the expenditure.

47 ESSB 5271 equipment with respect to which such expenditure is made shall be included in determining the amount of the expenditure.

A continuing care contract is not excluded from this definition because the contract is mutually terminablep. or because shelter and services are not provided at the same location.

47 SB 5271 terminable or because shelter and services are not provided at the same location.

p.(7) "Health maintenance organization" means a public or private organization, organized under the laws of the state, which:

48 ESSB 5271 (7) "Health maintenance organization" means a public or private organization, organized under the laws of the state, which:

(ii) is compensated (except for copayments) for the provision of the basic health care services listed in (b)(i) to enrolled participants by a payment which is paid on a periodic basis without regard to the date the health care servicesp. are provided and which is fixed without regard to the frequency, extent, or kind of health service actually provided;

48 SB 5271 services are provided and which is fixed without regard to the frequency, extent, or kind of health service actually provided;

those actions in a community necessary to preserve, protect, and promote the health of the people for which government is p.responsible;

49 ESSB 5271 responsible;

Sec.p.

49 SB 5271 Sec.

or p.(c) A health care facility (or portion thereof) if (i) the facility is or will be leased by a health maintenance organization or combination of health maintenance organizations which has, in the service area of the organization or the service areas of the organizations in the combination, an enrollment of at least ((fifty thousand)) 50,000 individuals and, on the date the application is submitted under subsection (2) of this section, at least ((fifteen)) 15 years remain in the term of the lease, (ii) the facility is or will be geographically located so that the service will be reasonably accessible to such enrolled individuals, and (iii) at least ((seventy-five)) 75 percent of the patients who can reasonably be expected to receive the tertiary health service will be individuals enrolled with such organization;

50p. ESSB 5271 (c) A health care facility (or portion thereof) if (i) the facility is or will be leased by a health maintenance organization or combination of health maintenance organizations which has, in the service area of the organization or the service areas of the organizations in the combination, an enrollment of at least ((fifty thousand)) 50,000 individuals and, on the date the application is submitted under subsection (2) of this section, at least ((fifteen)) 15 years remain in the term of the lease, (ii) the facility is or will be geographically located so that the service will be reasonably accessible to such enrolled individuals, and (iii) at least ((seventy-five)) 75 percent of the patients who can reasonably be expected to receive the tertiary health service will be individuals enrolled with such organization;

50 SB 5271 if, with respect to such offering or obligation by a nursing home, the department has, upon application under subsection (2) of this section, granted an exemption from such requirement to the organization, combination of organizations, or facility.

The department shall approve an p.application submitted under this subsection if it determines that the applicable requirements of subsection (1) of this section are met.

51 ESSB 5271 application submitted under this subsection if it determines that the applicable requirements of subsection (1) of this section are met.

or (b) The department determines, upon application, that (i) the entity to which the facility is proposed to be sold or leased, which intends to acquire the controlling interest, or which intends to use thep. facility is a health maintenance organization or a combination of health maintenance organizations which meets the requirements of (1)(a)(i), and (ii) with respect to such facility, meets the requirements of (1)(a)(ii) or (iii) or the requirements of (1)(b)(i) and (ii).

51 SB 5271 the facility is a health maintenance organization or a combination of health maintenance organizations which meets the requirements of (1)(a)(i), and (ii) with respect to such facility, meets the requirements of (1)(a)(ii) or (iii) or the requirements of (1)(b)(i) and (ii).

(iii) Contractually assumes responsibility for the cost of services exceeding the member's financial responsibility under the contract, so that no third party, with the exception of insurance purchased by the retirement community or its members, but including p.the medicaid program, is liable for costs of care even if the member depletes his or her personal resources;

52 ESSB 5271 the medicaid program, is liable for costs of care even if the member depletes his or her personal resources;

(b)p. A continuing care retirement community shall not be exempt under this subsection from obtaining a certificate of need unless:

52 SB 5271 (b) A continuing care retirement community shall not be exempt under this subsection from obtaining a certificate of need unless:

(7) A rural health care facility licensed under RCW 70.175.100 formerly licensed as a hospital under chapter 70.41 RCW may, within three years of the effective date of the rural health care facility p.license, apply to the department for a hospital license and not be subject to the requirements of RCW 70.38.105(4)(a) as the construction, development, or other establishment of a new hospital, provided there is no increase in the number of beds previously licensed under chapter 70.41 RCW and there is no redistribution in the number of beds used for acute care or long-term care, the rural health care facility has been in continuous operation, and the rural health care facility has not been purchased or leased.

53(8) ESSBA 5271rural license,hospital applydetermined to theno departmentlonger formeet acritical access hospital licensestatus andfor notstate belaw subjectpurposes toas thea requirementsresult of RCWparticipation 70.38.105(4)(a)in as the construction,Washington development,rural orhealth otheraccess establishmentpreservation ofpilot aidentified newby hospital,the providedstate thereoffice isof norural increasehealth inand theformerly numberlicensed ofas bedsa previouslyhospital licensed under chapter 70.41 RCW andmay thereapply isto no redistribution in the numberdepartment ofto bedsrenew usedits forhospital acutelicense careand ornot long-termbe care,subject to the ruralrequirements healthof careRCW facility70.38.105(4)(a) hasas been in continuous operation, and the ruralconstruction, healthdevelopment, care facility has not been purchased or leased.other p.

(8)53 ASB rural5271 hospital determined to no longer meet critical access hospital status for state law purposes as a result of participation in the Washington rural health access preservation pilot identified by the state office of rural health and formerly licensed as a hospital under chapter 70.41 RCW may apply to the department to renew its hospital license and not be subject to the requirements of RCW 70.38.105(4)(a) as the construction, development, or other establishment of a new hospital, provided there is no increase in the number of beds previously licensed under chapter 70.41 RCW.

unless waivers from such requirements were issued, in which case the converted beds p.shall reflect the conditions or standards that then existed pursuant to the approved waivers.

54 ESSB 5271 shall reflect the conditions or standards that then existed pursuant to the approved waivers.

Prior to any license modificationp. to convert beds back to nursing home beds under this section, the licensee must demonstrate that the nursing home meets the certificate of need exemption requirements of this section.

54 SB 5271 modification to convert beds back to nursing home beds under this section, the licensee must demonstrate that the nursing home meets the certificate of need exemption requirements of this section.

(i) The hospice agency is designed to serve the unique religious or cultural needs of a religious group or an ethnic minority and p.commits to furnishing hospice services in a manner specifically aimed at meeting the unique religious or cultural needs of the religious group or ethnic minority;

55 ESSB 5271 commits to furnishing hospice services in a manner specifically aimed at meeting the unique religious or cultural needs of the religious group or ethnic minority;

(iv)p. The hospice agency has a census of no more than ((forty)) 40 patients;

55 SB 5271 (iv) The hospice agency has a census of no more than ((forty)) 40 patients;

p.(i) The addition of beds as described in RCW 70.38.260 (2) and (3);

56 ESSB 5271 (i) The addition of beds as described in RCW 70.38.260 (2) and (3);

and (iii)p. Was exempt from certificate of need requirements prior to January 19, 2018, because the facility either:

56 SB 5271 (iii) Was exempt from certificate of need requirements prior to January 19, 2018, because the facility either:

(1) For a grant awarded during fiscal years 2018 and 2019 by the department of commerce under this section, hospitals licensed under chapter 70.41 RCW and ((psychiatric)) behavioral health hospitals p.licensed as establishments under chapter 71.12 RCW are not subject to certificate of need requirements for the addition of the number of new psychiatric beds indicated in the grant.

57 ESSB 5271 licensed as establishments under chapter 71.12 RCW are not subject to certificate of need requirements for the addition of the number of new psychiatric beds indicated in the grant.

(i)p. Notify the department of the addition of new psychiatric beds.

57 SB 5271 (i) Notify the department of the addition of new psychiatric beds.

and p.(ii) A commitment to maintaining the payer mix in (a) of this subsection for a period of five consecutive years after the beds are made available for use by patients.

58 ESSB 5271 (ii) A commitment to maintaining the payer mix in (a) of this subsection for a period of five consecutive years after the beds are made available for use by patients.

(c) Beds granted an exemption under RCW 70.38.111(11)(b) must remain the types of psychiatric beds indicated to the department in the original exemption application unless a certificate of need is grantedp. to change their use or the ((psychiatric)) behavioral health hospital voluntarily reduces its licensed capacity.

58 SB 5271 granted to change their use or the ((psychiatric)) behavioral health hospital voluntarily reduces its licensed capacity.

p.Sec.

59 ESSB 5271 Sec.

RCW 71.24.025 and 20232021 c 454302 s 1402 and 2023 c 433 s 1 are each reenacted and amended to read as follows:

(1) "23-hour"988 crisis reliefhotline" center" means athe community-baseduniversal facilitytelephone ornumber portionwithin ofthe aUnited facilityStates servingdesignated adults,for whichthe ispurpose licensedof or certified by the departmentnational ofsuicide healthprevention and open 24 hours a day, seven days a week, offering access to mental health and substance use care for no more than 23 hours and 59 minutes at a time per patient, and which accepts all behavioral health crisis walk-inshotline drop-offssystem fromoperating first responders, and individuals referred through the 988national systemsuicide regardlessprevention oflifeline. behavioral health acuity, and meets the requirements under RCW 71.24.916.

(2) "988"Acutely crisismentally hotline"ill" means thea universalcondition telephonewhich numberis withinlimited theto Uniteda Statesshort-term designatedsevere for the purpose of the national suicide prevention and mental health crisis hotlineepisode systemof: operating through the national suicide prevention lifeline.

(3) "Acutely mentally ill" means a condition which is limited to a short-term severe crisis episode of:

(b)p. Being gravely disabled as defined in RCW 71.05.020 or, in the case of a child, a gravely disabled minor as defined in RCW 71.34.020;

59 SB 5271 (b) Being gravely disabled as defined in RCW 71.05.020 or, in the case of a child, a gravely disabled minor as defined in RCW 71.34.020;

(4)(3) "Alcoholism" means a disease, characterized by a dependency on alcoholic beverages, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued, and impairment of health or disruption of social or economic functioning.

(5)(4) "Approved substance use disorder treatment program" means a program for persons with a substance use disorder provided by a treatment program licensed or certified by the department as meeting standards adopted under this chapter.

(6)(5) "Authority" means the Washington state health care authority.

(7)(6) "Available resources" means funds appropriated for the purpose of providing community behavioral health programs, federal funds, except those provided according to Title XIX of the Social p.Security Act, and state funds appropriated under this chapter or chapter 71.05 RCW by the legislature during any biennium for the purpose of providing residential services, resource management services, community support services, and other behavioral health services.

60 ESSB 5271 Security Act, and state funds appropriated under this chapter or chapter 71.05 RCW by the legislature during any biennium for the purpose of providing residential services, resource management services, community support services, and other behavioral health services.

(8)(7) "Behavioral health administrative services organization" means an entity contracted with the authority to administer behavioral health services and programs under RCW 71.24.381, including crisis services and administration of chapter 71.05 RCW, the involuntary treatment act, for all individuals in a defined regional service area.

(9)(8) "Behavioral health aide" means a counselor, health educator, and advocate who helps address individual and community-based behavioral health needs, including those related to alcohol, drug, and tobacco abuse as well as mental health problems such as grief, depression, suicide, and related issues and is certified by a community health aide program of the Indian health service or one or more tribes or tribal organizations consistent with the provisions of 25 U.S.C.

(10)p. "Behavioral health provider" means a person licensed under chapter 18.57, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79 RCW, as it applies to registered nurses and advanced registered nurse practitioners.

(11)60 "BehavioralSB health5271 services"(9) means"Behavioral mental health services,provider" substancemeans usea disorderperson treatmentlicensed services,under and co-occurring disorder treatment services as described in this chapter and18.57, chapter18.71, 71.3618.71A, RCW18.83, that,18.205, depending18.225, on the type of service, are provided by licensed or certified18.79 behavioralRCW, healthas agencies,it behavioralapplies healthto providers,registered ornurses integratedand intoadvanced otherregistered healthnurse carepractitioners. providers.

(12)(10) "Child""Behavioral health services" means amental personhealth underservices as described in this chapter and chapter 71.36 RCW and substance use disorder treatment services as described in this chapter that, depending on the agetype of ((eighteen))service, 18are years.provided by licensed or certified behavioral health agencies, behavioral health providers, or integrated into other health care providers.

(13)(11) "Chronically"Child" mentally ill adult" or "adult who is chronically mentally ill" means an adult who has a mentalperson disorderunder andthe meetsage at least one of the((eighteen)) following18 criteria:years.

(12) "Chronically mentally ill adult" or "adult who is chronically mentally ill" means an adult who has a mental disorder and meets at least one of the following criteria:

or p.(c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than ((twelve)) 12 months.

61 ESSB 5271 (c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than ((twelve)) 12 months.

(14)(13) "Clubhouse" means a community-based program that provides rehabilitation services and is licensed or certified by the department.

(15)(14) "Community behavioral health program" means all expenditures, services, activities, or programs, including reasonable administration and overhead, designed and conducted to prevent or treat substance use disorder, mental illness, or both in the community behavioral health system.

(16)(15) "Community behavioral health service delivery system" means public, private, or tribal agencies that provide services specifically to persons with mental disorders, substance use disorders, or both, as defined under RCW 71.05.020 and receive funding from public sources.

(17)(16) "Community support services" means services authorized, planned, and coordinated through resource management services including,p. at a minimum, assessment, diagnosis, emergency crisis intervention available ((twenty-four)) 24 hours, seven days a week, prescreening determinations for persons who are mentally ill being considered for placement in nursing homes as required by federal law, screening for patients being considered for admission to residential services, diagnosis and treatment for children who are acutely mentally ill or severely emotionally or behaviorally disturbed discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program, investigation, legal, and other nonresidential services under chapter 71.05 RCW, case management services, psychiatric treatment including medication supervision, counseling, psychotherapy, assuring transfer of relevant patient information between service providers, recovery services, and other services determined by behavioral health administrative services organizations.

(18)61 "Community-basedSB crisis5271 team"including, meansat a teamminimum, thatassessment, isdiagnosis, partemergency ofcrisis anintervention emergencyavailable medical((twenty-four)) services24 agency,hours, seven days a fireweek, serviceprescreening agency,determinations afor publicpersons healthwho agency,are amentally medicalill facility,being aconsidered nonprofitfor crisisplacement responsein provider,nursing homes as required by federal law, screening for patients being considered for admission to residential services, diagnosis and treatment for children who are acutely mentally ill or aseverely cityemotionally or countybehaviorally governmentdisturbed entity,discovered under screening through the federal Title XIX early and periodic screening, diagnosis, and treatment program, investigation, legal, and other thannonresidential aservices lawunder enforcementchapter agency,71.05 thatRCW, providescase themanagement on-siteservices, community-basedpsychiatric p.treatment including medication supervision, counseling, psychotherapy, assuring transfer of relevant patient information between service providers, recovery services, and other services determined by behavioral health administrative services organizations.

62(17) ESSB"Consensus-based" 5271means interventionsa ofprogram aor mobilepractice rapidthat responsehas crisisgeneral teamsupport foramong individualstreatment whoproviders areand experiencingexperts, abased behavioralon healthexperience crisis.or professional literature, and may have anecdotal or case study support, or that is agreed but not possible to perform studies with random assignment and controlled groups.

(19)(18) "Consensus-based""County authority" means athe programboard orof practicecounty thatcommissioners, hascounty generalcouncil, supportor amongcounty treatmentexecutive providershaving andauthority experts,to basedestablish ona experiencebehavioral health administrative services organization, or professionaltwo literature,or andmore mayof havethe anecdotalcounty orauthorities casespecified studyin support,this orsubsection thatwhich ishave agreedentered butinto notan possibleagreement to performestablish studiesa withbehavioral randomhealth assignmentadministrative andservices controlledorganization. groups.

(20)(19) "County"Crisis authority"call meanscenter thehub" boardmeans of county commissioners, county council, or county executive having authority to establish a behavioralstate-designated healthcenter administrativeparticipating servicesin organization, or two or more of the countynational authoritiessuicide specifiedprevention inlifeline thisnetwork subsectionto whichrespond haveto enteredstatewide intoor anregional agreement988 tocalls establishthat ameets behavioralthe healthrequirements administrativeof servicesRCW organization.71.24.890.

(21)(20) "Crisis stabilization services" means services such as 23- hour crisis reliefstabilization centers,units based on the living room model, crisis stabilization units,units as provided in RCW 71.05.020, triage facilities as provided in RCW 71.05.020, short-term respite facilities, peer-run respite services, and same-day walk-in behavioral health services, including within the overall crisis system components that operate like hospital emergency departments that accept all walk-ins, and ambulance, fire, and police drop-offs,drop-offs. or determine the need for involuntary hospitalization of an individual.

(22)(21) "Crisis"Department" stabilizationmeans unit" has the samedepartment meaningof ashealth. under RCW 71.05.020.

(23) "Department" means the department of health.

(24) "Designated 988 contact hub" means a state-designated contact center that streamlines clinical interventions and access to resources for people experiencing a behavioral health crisis and participates in the national suicide prevention lifeline network to respond to statewide or regional 988 contacts that meets the requirements of RCW 71.24.890.

(25) "Designated crisis responder" has the same meaning as in RCW 71.05.020.

(26) "Director" means the director of the authority.

(27) "Drug addiction" means a disease characterized by a dependency on psychoactive chemicals, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or psychological withdrawal, or both, if use is reduced or discontinued, and impairment of health or disruption of social or economic functioning.

6362 ESSBSB 5271 (28)(22) "Early"Designated adopter"crisis meansresponder" ahas regional service area for which all of the countysame authoritiesmeaning have requested that the authority purchase medical and behavioral health services through a managed care health system as definedin under RCW 71.24.380(7).71.05.020.

(29)(23) "Emerging"Director" best practice" or "promising practice" means athe programdirector or practice that, based on statistical analyses or a well established theory of change, shows potential for meeting the evidence-basedauthority. or research-based criteria, which may include the use of a program that is evidence-based for outcomes other than those listed in subsection (30) of this section.

(30)(24) "Evidence-based""Drug addiction" means a programdisease characterized by a dependency on psychoactive chemicals, loss of control over the amount and circumstances of use, symptoms of tolerance, physiological or practicepsychological thatwithdrawal, hasor beenboth, testedif inuse heterogeneousis reduced or intendeddiscontinued, populationsand withimpairment multipleof randomized,health or statisticallydisruption controlledof evaluations,social or both;economic functioning.

(25) "Early adopter" means a regional service area for which all of the county authorities have requested that the authority purchase medical and behavioral health services through a managed care health system as defined under RCW 71.24.380(((6))) (7).

(26) "Emerging best practice" or "promising practice" means a program or practice that, based on statistical analyses or a well established theory of change, shows potential for meeting the evidence-based or research-based criteria, which may include the use of a program that is evidence-based for outcomes other than those listed in subsection (27) of this section.

(27) "Evidence-based" means a program or practice that has been tested in heterogeneous or intended populations with multiple randomized, or statistically controlled evaluations, or both;

(31)(28) "First"Immediate responders"jeopardy" includesmeans ambulance,a fire,situation mobilein rapidwhich responsethe crisislicensed team,or corespondercertified team,behavioral designatedhealth crisisagency's responder,noncompliance firewith departmentone mobileor integratedmore healthstatutory team,or communityregulatory assistancerequirements referralhas placed the health and educationsafety servicesof programpatients underin RCWits 35.21.930,care andat lawrisk enforcementfor personnel.serious injury, serious harm, serious impairment, or death.

(32)(29) "Immediate"Indian jeopardy"health care provider" means a situationhealth incare whichprogram theoperated licensedby orthe certifiedIndian behavioral health agency'sservice noncomplianceor withby onea ortribe, moretribal statutoryorganization, or regulatoryurban requirementsIndian hasorganization placedas thethose healthterms andare safetydefined ofin patientsthe inIndian itshealth care atimprovement riskact for(25 seriousU.S.C. injury, serious harm, serious impairment, or death.

(33) "Indian health care provider" means a health care program operated by the Indian health service or by a tribe, tribal organization, or urban Indian organization as those terms are defined in the Indian health care improvement act (25 U.S.C.

(((33)))(((29))) (34)(30) "Intensive behavioral health treatment facility" means a community-based specialized residential treatment facility for individuals with behavioral health conditions, including individuals discharging from or being diverted from state and local hospitals, whose impairment or behaviors do not meet, or no longer meet, criteria for involuntary inpatient commitment under chapter p.

6463 ESSBSB 5271 for individuals with behavioral health conditions, including individuals discharging from or being diverted from state and local hospitals, whose impairment or behaviors do not meet, or no longer meet, criteria for involuntary inpatient commitment under chapter 71.05 RCW, but whose care needs cannot be met in other community- based placement settings.

(((34)))(((30))) (35)(31) "Licensed or certified behavioral health agency" means:

(((35)))(((31))) (36)(32) "Licensed physician" means a person licensed to practice medicine or osteopathic medicine and surgery in the state of Washington.

(((36)))(((32))) (37)(33) "Long-term inpatient care" means inpatient services for persons committed for, or voluntarily receiving intensive treatment for, periods of ((ninety)) 90 days or greater under chapter 71.05 RCW.

(((37)))(((33))) (38)(34) "Managed care organization" means an organization, having a certificate of authority or certificate of registration from the office of the insurance commissioner, that contracts with the authority under a comprehensive risk contract to provide prepaid health care services to enrollees under the authority's managed care programs under chapter 74.09 RCW.

(((38)))(((34))) (39)(35) "Mental health peer-run respite center" means a peer-run program to serve individuals in need of voluntary, short- term, noncrisis services that focus on recovery and wellness.

(((39)))(((35))) (40)(36) Mental health "treatment records" include registration and all other records concerning persons who are receiving or who at any time have received services for mental illness, which are maintained by the department of social and health services or the authority, by behavioral health administrative services organizations and their staffs, by managed care p.

6564 ESSBSB 5271 receiving or who at any time have received services for mental illness, which are maintained by the department of social and health services or the authority, by behavioral health administrative services organizations and their staffs, by managed care organizations and their staffs, or by treatment facilities.

(((40)))(((36))) (41)(37) "Mentally ill persons," "persons who are mentally ill," and "the mentally ill" mean persons and conditions defined in subsections (3),(2), (13),(12), (((48)))(((44))) (49),(45), and (((49)))(((45))) (50)(46) of this section.

(((41)))(((37))) (42)(38) "Mobile rapid response crisis team" means a team that provides professional on-site community-based intervention such as outreach, de-escalation, stabilization, resource connection, and follow-up support for individuals who are experiencing a behavioral health crisis, that shall include certified peer counselors as a best practice to the extent practicable based on workforce availability, and that meets standards for response times established by the authority.

(((42)))(((38))) (43)(39) "Recovery" means a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

(((43)))(((39))) (44)(40) "Research-based" means a program or practice that has been tested with a single randomized, or statistically controlled evaluation, or both, demonstrating sustained desirable outcomes;

or where the weight of the evidence from a systemic review supports sustained outcomes as described in subsection (30)(27) of this section but does not meet the full criteria for evidence-based.

(((44)))(((40))) (45)(41) "Residential services" means a complete range of residences and supports authorized by resource management services and which may involve a facility, a distinct part thereof, or services which support community living, for persons who are acutely mentally ill, adults who are chronically mentally ill, children who are severely emotionally disturbed, or adults who are seriously disturbed and determined by the behavioral health administrative services organization or managed care organization to be at risk of becoming acutely or chronically mentally ill.

The services shall include at least evaluation and treatment services as defined in chapter 71.05 RCW, acute crisis respite care, long-term adaptive and rehabilitative care, and supervised and supported living services, and shall also include any residential services developed to service persons who are mentally ill in nursing homes, residential treatment p.

6665 ESSBSB 5271 chapter 71.05 RCW, acute crisis respite care, long-term adaptive and rehabilitative care, and supervised and supported living services, and shall also include any residential services developed to service persons who are mentally ill in nursing homes, residential treatment facilities, assisted living facilities, and adult family homes, and may include outpatient services provided as an element in a package of services in a supported housing model.

(((45)))(((41))) (46)(42) "Resilience" means the personal and community qualities that enable individuals to rebound from adversity, trauma, tragedy, threats, or other stresses, and to live productive lives.

(((46)))(((42))) (47)(43) "Resource management services" mean the planning, coordination, and authorization of residential services and community support services administered pursuant to an individual service plan for:

(((47)))(((43))) (48)(44) "Secretary" means the secretary of the department of health.

(((48)))(((44))) (49)(45) "Seriously disturbed person" means a person who:

(b) Has been on conditional release status, or under a less restrictive alternative order, at some time during the preceding two yearsp. from an evaluation and treatment facility or a state mental health hospital;

66 SB 5271 years from an evaluation and treatment facility or a state mental health hospital;

p.(d) Exhibits suicidal preoccupation or attempts;

67 ESSB 5271 (d) Exhibits suicidal preoccupation or attempts;

(((49)))(((45))) (50)(46) "Severely emotionally disturbed child" or "child who is severely emotionally disturbed" means a child who has been determined by the behavioral health administrative services organization or managed care organization, if applicable, to be experiencing a mental disorder as defined in chapter 71.34 RCW, including those mental disorders that result in a behavioral or conduct disorder, that is clearly interfering with the child's functioning in family or school or with peers and who meets at least one of the following criteria:

(((50)))(((46))) (51)(47) "State minimum standards" means minimum requirements established by rules adopted and necessary to implement this chapter by:

(a)p. The authority for:

67 SB 5271 (a) The authority for:

p.(b) The department of health for:

68 ESSB 5271 (b) The department of health for:

(((51)))(((47))) (52)(48) "Substance use disorder" means a cluster of cognitive, behavioral, and physiological symptoms indicating that an individual continues using the substance despite significant substance-related problems.

(((52)))(((48))) (53)(49) "Tribe," for the purposes of this section, means a federally recognized Indian tribe.

RCW 71.24.037 and 20232019 c 454446 s 223 and 2019 c 325 s 1007 are each reenacted and amended to read as follows:

(3) ((The department shall review reports or other information alleging a failure to comply with this chapter or the standards and rules adopted under this chapter and may initiate investigations and enforcement actions based on those reports.

6968 ESSBSB 5271 (4)(3) The((The department shall conductreview inspectionsreports ofor agenciesother andinformation facilities,alleging includinga reviewsfailure ofto recordscomply andwith documentsthis requiredchapter toor bethe maintainedstandards and rules adopted under this chapter orand rulesmay adoptedinitiate underinvestigations thisand chapter.enforcement actions based on those reports.

(4) The department shall conduct inspections of agencies and facilities, including reviews of records and documents required to be maintained under this chapter or rules adopted under this chapter.

(6))) No licensed or certified behavioral health ((service provider)) agency may advertise or represent itself as a licensed or certified behavioral health ((service provider)) agency if approval has not been granted or has been denied, suspended, revoked, or canceled.

(((7))) (4) Licensure or certification as a behavioral health ((service provider)) agency is effective for one calendar year from the date of issuance of the license or certification.

The license or certification must specify the types of services provided by the behavioral health ((service provider)) agency that meet the standards adopted under this chapter.

(((8))) (5) Licensure or certification as a licensed or certified behavioral health ((service provider)) agency must specify the types of services provided that meet the standards adopted under this chapter.

(((10))) (7) Licensed or certified behavioral health ((service providers)) agencies may not provide types of services for which the licensed or certified behavioral health ((service provider)) agency has not been certified.

Licensed or certified behavioral health agenciesp. may provide services for which approval has been sought and is pending, if approval for the services has not been previously revoked or denied.

(((11)69 TheSB department5271 periodically((service shallproviders)) inspectagencies licensedmay orprovide certifiedservices behavioralfor healthwhich agenciesapproval athas reasonablebeen timessought and inis apending, reasonableif manner.approval for the services has not been previously revoked or denied.

p.(((11) The department periodically shall inspect licensed or certified behavioral health service providers at reasonable times and in a reasonable manner.

70 ESSB 5271 (12) Upon petition of the department and after a hearing held upon reasonable notice to the facility, the superior court may issue a warrant to an officer or employee of the department authorizing him or her to enter and inspect at reasonable times, and examine the books and accounts of, any licensed or certified behavioral health agencyservice provider refusing to consent to inspection or examination by the department or which the department has reasonable cause to believe is operating in violation of this chapter.

(13))) (8) The department shall maintain and periodically publish a current list of licensed or certified behavioral health ((service providers)) agencies.

(((14) Each licensed or certified behavioral health agencyservice provider shall file with the department or the authority upon request, data, statistics, schedules, and information the department or the authority reasonably requires.

A licensed or certified behavioral health agencyservice provider that without good cause fails to furnish any data, statistics, schedules, or information as requested, or files fraudulent returns thereof, may have its license or certification revoked or suspended.

(16) Any settlement agreement entered into between the department and licensed or certified behavioral health agenciesservice providers to resolve administrative complaints, license or certification violations, license or certification suspensions, or license or certification revocations may not reduce the number of violations reportedp. by the department unless the department concludes, based on evidence gathered by inspectors, that the licensed or certified behavioral health agency did not commit one or more of the violations.

(17)70 InSB cases5271 inreported whichby athe behavioraldepartment healthunless agencythe thatdepartment isconcludes, inbased violationon ofevidence licensinggathered orby certificationinspectors, standardsthat attemptsthe tolicensed transfer or sellcertified the behavioral health agencyservice toprovider adid familynot member,commit theone transfer or salemore mayof only be made for the purposeviolations. of remedying p.

71(17) ESSBIn 5271cases in which a behavioral health service provider that is in violation of licensing or certification standards attempts to transfer or sell the behavioral health service provider to a family member, the transfer or sale may only be made for the purpose of remedying license or certification violations and achieving full compliance with the terms of the license or certification.

If the department finds that the owner intends to transfer or sell, or has completed the transfer or sale of, ownership of the behavioral health agencyservice provider to a family member solely for the purpose of resetting the number of violations found before the transfer or sale, the department may not renew the behavioral health agency'sservice provider's license or certification or issue a new license or certification to the behavioral health service provider.provider.)) NEW SECTION.

(18) Every licensed or certified outpatient behavioral health agency shall display the 988 crisis hotline number in common areas of the premises and include the number as a calling option on any phone message for persons calling the agency after business hours.

(19) Every licensed or certified inpatient or residential behavioral health agency must include the 988 crisis hotline number in the discharge summary provided to individuals being discharged from inpatient or residential services.)) NEW SECTION.

7271 ESSBSB 5271 (4) The authority shall use the data provided in subsection (3) of this section to evaluate each program that admits children to inpatient substance use disorder treatment upon application of their parents.

7372 ESSBSB 5271 (a) When the department determines the licensed or certified behavioral health agency has previously been subject to an enforcement action for the same or similar type of violation of the same statute or rule, or has been given any previous statement of deficiency that included the same or similar type of violation of the same or similar statute or rule, or when the licensed or certified behavioral health agency failed to correct noncompliance with a statute or rule by a date established or agreed to by the department, the department may impose reasonable conditions on a license.

7473 ESSBSB 5271 stop placement.

7574 ESSBSB 5271 develop and implement a department-approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy.

7675 ESSBSB 5271 services in the category or categories subject to the limited stop service to any new or existing individuals, unless otherwise allowed by the department, until the limited stop service is terminated.

7776 ESSBSB 5271 request the show cause hearing within 28 days of receipt of the notice of immediate suspension or immediate imposition of conditions.

7877 ESSBSB 5271 demonstrating that more probably than not the alleged violation, if true, would constitute an immediate jeopardy and the licensee failed to cooperate with the department's investigation.

7978 ESSBSB 5271 the care or to pay deductibles or coinsurance amounts required by a third-party payer, as determined by the department.

8079 ESSBSB 5271 is necessary.

8180 ESSBSB 5271 promote coordination of agencies responsible for ensuring compliance with controlled substances laws and to monitor observance of these laws and cooperation between these agencies.

8281 ESSBSB 5271 mixing of (a) sterile products according to federal food and drug administration-approved labeling does not constitute compounding if prepared pursuant to a prescription and administered immediately or in accordance with package labeling, and (b) nonsterile products according to federal food and drug administration-approved labeling does not constitute compounding if prepared pursuant to a prescription.

8382 ESSBSB 5271 (a) Articles recognized in the official United States pharmacopoeia or the official homeopathic pharmacopoeia of the United States;

8483 ESSBSB 5271 (20) "Long-term care facility" means a nursing home licensed under chapter 18.51 RCW, an assisted living facility licensed under chapter 18.20 RCW, or an adult family home licensed under chapter 70.128 RCW.

8584 ESSBSB 5271 (24) "Person" means an individual, corporation, government, governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity.

8685 ESSBSB 5271 authorizations, reviewing therapeutic interventions, or reviewing chart orders.

8786 ESSBSB 5271 agent.

8887 ESSBSB 5271 (6) The commission may accept the surrender of the licensee's license.

8988 ESSBSB 5271 rules adopted by the commission, except as otherwise limited in this section.

(iii) The commission shall adopt in rules under this chapter to establish specific fine amounts in relation to:to the severity of the noncompliance and at an adequate level to be a deterrent to future noncompliance.

(A) The severity of the noncompliance and at an adequate level to be a deterrent to future noncompliance;

and (B) The operation size of the licensee.

9089 ESSBSB 5271 limited stop service.

9190 ESSBSB 5271 receipt of the notice by the licensee, pending any adjudicative proceeding.

9291 ESSBSB 5271 (4) When the commission determines an alleged violation, if true, would constitute an immediate jeopardy, and the licensee fails to cooperate with the commission's investigation of such an alleged violation, the commission may impose an immediate limited stop service, immediate imposition of conditions, or immediate suspension or modification of a license.

9392 ESSBSB 5271 hearing on the merits of the commission's action.

9493 ESSBSB 5271 preparation without having registered to do so as provided in this section, is guilty of a misdemeanor and each sale or offer to sell shall constitute a separate offense.

9594 ESSBSB 5271 inspection by the commission or any law enforcement agency and must be maintained for two years.

9695 ESSBSB 5271 determine the nature of, and supervise the grading of the examinations.

9796 ESSBSB 5271 disciplinary act, chapter 18.130 RCW, governs unlicensed practice of persons required to obtain a license under this chapter.

9897 ESSBSB 5271 of the rules and regulations of the pharmacy quality assurance commission.

(((a)(a) [(1)])) (1) Every person who manufactures, distributes, or dispenses any controlled substance within this state or who proposes to engage in the manufacture, distribution, or dispensing of any controlled substance within this state, shall obtain annually a registration issued by the ((department)) commission in accordance with the commission's rules.

(((b)(b) [(2)])) (2) A person registered by the ((department)) commission under this chapter to manufacture, distribute, dispense, or conduct research with controlled substances may possess, manufacture, distribute, dispense, or conduct research with those substances to p.

9998 ESSBSB 5271 substances to the extent authorized by the registration and in conformity with this Article.

(((c)(c) [(3)])) (3) The following persons need not register and may lawfully possess controlled substances under this chapter:

(((1)(1) [(a)])) (a) An agent or employee of any registered manufacturer, distributor, or dispenser of any controlled substance if the agent or employee is acting in the usual course of business or employment.

(((2)(2) [(b)])) (b) A common or contract carrier or warehouse operator, or an employee thereof, whose possession of any controlled substance is in the usual course of business or employment;

(((3)(3) [(c)])) (c) An ultimate user or a person in possession of any controlled substance pursuant to a lawful order of a practitioner or in lawful possession of a substance included in Schedule V.

(((d)(d) [(4)])) (4) The commission may waive by rule the requirement for registration of certain manufacturers, distributors, or dispensers upon finding it consistent with the public health and safety.

(((e)(e) [(5)])) (5) A separate registration is required at each principal place of business or professional practice where the applicant manufactures, distributes, or dispenses controlled substances.

(((f)(f) [(6)])) (6) The department, at the direction of the commission, may inspect the establishment of a registrant or applicant for registration in accordance with rules adopted by the commission.

(((a)(a) [(1)])) (1) The ((department)) commission shall register an applicant to manufacture ((or)), distribute, dispense, or conduct research with controlled substances included in RCW 69.50.204, 69.50.206, 69.50.208, 69.50.210, and 69.50.212 unless the commission determines that the issuance of that registration would be p.inconsistent with the public interest.

100 ESSB 5271 inconsistent with the public interest.

(((1)p. [(a)])) (a) maintenance of effective controls against diversion of controlled substances into other than legitimate medical, scientific, research, or industrial channels;

(((2)99 [(b)]))SB (b)5271 compliance(1) withmaintenance applicableof stateeffective andcontrols localagainst law;diversion of controlled substances into other than legitimate medical, scientific, research, or industrial channels;

(((3)(2) [(c)]))compliance (c)with promotionapplicable ofstate technical advances in the art of manufacturing controlled substances and thelocal developmentlaw; of new substances;

(((4)(3) [(d)]))promotion (d)of anytechnical convictionsadvances ofin the applicantart under any laws of anothermanufacturing countrycontrolled orsubstances federaland orthe statedevelopment lawsof relatingnew tosubstances; any controlled substance;

(((5)(4) [(e)]))any (e)convictions past experience in the manufacture or distribution of controlled substances, and the existenceapplicant inunder theany applicant'slaws establishment of effectiveanother controlscountry againstor diversionfederal ofor controlledstate substanceslaws intorelating otherto thanany legitimatecontrolled medical,substance; scientific, research, or industrial channels;

(((6)(5) [(f)]))past (f)experience furnishingin by the applicantmanufacture or distribution of falsecontrolled orsubstances, fraudulentand materialthe existence in anythe applicationapplicant's filedestablishment underof thiseffective chapter;controls against diversion of controlled substances into other than legitimate medical, scientific, research, or industrial channels;

(((7)(6) [(g)]))furnishing (g)by suspensionthe orapplicant revocation of thefalse applicant's federal registration to manufacture, distribute, or dispensefraudulent controlledmaterial substancesin asany authorizedapplication byfiled federalunder law;this chapter;

and(7) (((8)suspension [(h)]))or (h)revocation anyof otherthe factorsapplicant's relevantfederal registration to andmanufacture, consistentdistribute, withor thedispense publiccontrolled healthsubstances andas safety.authorized by federal law;

(((b)and [(2)]))(8) (2)any Registrationother underfactors subsectionrelevant (((a) [(1)])) (1) of this section does not entitle a registrant to manufactureand orconsistent distributewith controlledthe substancespublic includedhealth inand Schedulesafety. I or II other than those specified in the registration.

(((c)(b) [(3)]))Registration (3)under Practitionerssubsection must(a) beof registered,this orsection exempteddoes undernot RCWentitle 69.50.302(((d)a [(4)]))registrant (4), to dispensemanufacture any controlled substances or todistribute conduct research with controlled substances included in SchedulesSchedule III throughor VII ifother theythan arethose authorizedspecified toin dispense or conduct research under the lawregistration. of this state.

(c) Practitioners must be registered, or exempted under RCW 69.50.302(d), to dispense any controlled substances or to conduct research with controlled substances included in Schedules II through V if they are authorized to dispense or conduct research under the law of this state.

Practitioners registered under federal law to conduct research with substances included in Schedule I may conduct research with substances included in Schedule p.I within this state upon furnishing the commission evidence of that federal registration.

101(d) ESSBA 5271manufacturer Ior withindistributor thisregistered stateunder upon furnishing the commissionfederal evidenceControlled ofSubstances thatAct, federal21 registration.U.S.C.

(((d) [(4)])) (4) A manufacturer or distributor registered under the federal Controlled Substances Act, 21 U.S.C.

801 et seq., may submit a copy of the federal application as an application for registration as ap. manufacturer or distributor under this section.

100 SB 5271 a manufacturer or distributor under this section.

(((a)(a) [(1)((A)) A])) (1) This chapter and chapter 18.64 RCW govern the denial of registrations and the discipline of registrations issued under RCW 69.50.303.

(2)(b) In addition to any other grounds, the commission may take action against the registration, or exemption from registration, under RCW 69.50.303 to manufacture, distribute, ((or)) dispense, or conduct research with a controlled substance ((may be suspended or revoked by the commission)) upon finding that the registrant has:

(((1)(1) [(a)])) (a) furnished false or fraudulent material information in any application filed under this chapter;

(((2)(2) [(b)])) (b) been convicted of a felony under any state or federal law relating to any controlled substance;

(((3)(3) [(c)])) (c) had the registrant's federal registration suspended or revoked and is no longer authorized by federal law to manufacture, distribute, ((or)) dispense, or conduct research with controlled substances;

or (((4)(4) [(d)])) (d) committed acts that would render registration under RCW 69.50.303 inconsistent with the public interest as determined under that section.

(((b)(((b))) [(2)]))(c) (3) The commission may limit revocation or suspension of a registration to the particular controlled substance or schedule of controlled substances, with respect to which grounds for revocation or suspension exist.

(((c)(((c))) [(3)]))(d) (4) If the commission suspends or revokes a registration, all controlled substances owned or possessed by the registrant at the time of suspension or the effective date of the p.revocation order may be placed under seal.

102 ESSB 5271 revocation order may be placed under seal.

(((d)p. [(4)])) (5) The ((department)) commission may seize or place under seal any controlled substance owned or possessed by a registrant whose registration has expired or who has ceased to practice or do business in the manner contemplated by the registration.

101 SB 5271 (((d))) (e) The ((department)) commission may seize or place under seal any controlled substance owned or possessed by a registrant whose registration has expired or who has ceased to practice or do business in the manner contemplated by the registration.

(((e)(((e))) [(5)]))(f) (6) The ((department)) commission shall promptly notify the drug enforcement administration of all orders restricting, suspending, or revoking registration and all forfeitures of controlled substances.

On and after September 21, 1977, a humane society and animal control agency may apply to the ((department)) commission for registration pursuant to the applicable provisions of this chapter for the sole purpose of being authorized to purchase, possess, and p.administer sodium pentobarbital to euthanize injured, sick, homeless, or unwanted domestic pets and animals.

103 ESSB 5271 administer sodium pentobarbital to euthanize injured, sick, homeless, or unwanted domestic pets and animals.

((The commission shall promulgatep. such rules as it deems necessary to insure strict compliance with the provisions of this section.

102 SB 5271 promulgate such rules as it deems necessary to insure strict compliance with the provisions of this section.

In addition to any other grounds, the commission ((shall)) may suspend or revoke a registration issued under this chapter upon p.determination that the person administering controlled substances has not demonstrated adequate knowledge as required by this section.

104 ESSB 5271 determination that the person administering controlled substances has not demonstrated adequate knowledge as required by this section.

Humanep. societies and animal control agencies registered with the ((pharmacy quality assurance)) commission under chapter 69.50 RCW and authorized to euthanize animals may purchase, possess, and administer approved legend drugs for the sole purpose of sedating animals prior to euthanasia, when necessary, and for use in chemical capture programs.

103 SB 5271 Humane societies and animal control agencies registered with the ((pharmacy quality assurance)) commission under chapter 69.50 RCW and authorized to euthanize animals may purchase, possess, and administer approved legend drugs for the sole purpose of sedating animals prior to euthanasia, when necessary, and for use in chemical capture programs.

((This authority is granted in addition to any other power to suspend or revoke a registration as provided by law.)) p.NEW SECTION.

105 ESSB 5271 NEW SECTION.

(1) RCW 18.64.200 (Refusal, suspension, and revocation of other licenses—Appeallicenses— Appeal procedure) and 2013 c 19 s 15, 1963 c 38 s 11, & 1909 c 213 s 11;

(2) RCW 18.64.390 (Nonresident pharmacies—Violations—Penalties)pharmacies —Violations — Penalties) and 2013 c 19 s 23 & 1991 c 87 s 5;

and (3)p. RCW 69.50.305 (Procedure for denial, suspension, or revocation of registration) and 2013 c 19 s 101 & 1971 ex.s.

104 SB 5271 (3) RCW 69.50.305 (Procedure for denial, suspension, or revocation of registration) and 2013 c 19 s 101 & 1971 ex.s.

106105 ESSBSB 5271