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Washington State Definition of Consumer and Peer
Summary:
There is nothing in federal, state or county law which defines people who do not have serious mental illness as “consumers” except the in one instance. For purposes of becoming Certified Peer Counselors parents of of children under 13 or parents who are involved in the treatment plan of their children, apparently of whatever age, are eligible for this program. On the other hand, various references are made to family members in the law. The law has a more restrictive definition of“peer services” and it provides that peers provide the service, not just “consumers” The people who provide the peer services are supposed to be people who themselves have the serious mental illness.
In another instance of how the word “consumer” is used, in the composition of boards, committees and councils, the distinction is made between family members and consumer participation, so that it is better to talk about family and consumer involvement in these boards and committees, rather than perpetuate the outdated and now disfavored definition of “consumer” as including family members. As people with serious mental illness almost universally find the definition of the term “consumer”, when it includes family members. to be offensive, it should be ended. Rightly or wrongly, this use of the term "consumer" to include family members is seen as an attempt by family members to push them aside politically. It should be ended.
In the rare case where “consumer” is continued as a term to include family members, in certification of family members as counselors, there is even there some question whether it was only intended for family members of minors. A “child” is normally legally defined as a minor, in most circumstances, and it is legally tenuous to interpret “children” as meaning adult children in a narrow context, where the law, at the federal, state and county level do not generally recognize legal relationships or legal obligations or duties between adults and adult off spring. To attempt to interpret the law to make parents of grown children as having some special legal relationship with these adult children, absent, a legal guardianship, is not warranted.
Sources:
Entries in square barckets are interpretive notes, otherwise items are direct quotes from the RCW or WACS.
[Neither the RCW nor WAC include family members as consumers ]
RCW 71.24.350—except in one instance]
388-865 Community mental health and involuntary treatment programs.
WAC 388-865-0150 Definitions "Consumer" means a person who has applied for, is eligible for or who has received mental health services. For a child, under the age of thirteen, or for a child age thirteen or older whose parents or legal guardians are involved in the treatment plan, the definition of consumer includes parents or legal guardians.
Mental health ombudsman office.
The department shall require each regional support network to provide for a separately funded mental health ombudsman office in each regional support network that is independent of the regional support network. The ombudsman office shall maximize the use of consumer advocates.
[2005 c 504 § 803.]
NOTES:
Findings -- Intent -- Severability -- Application -- Construction -- Captions, part headings, subheadings not law -- Adoption of rules -- Effective dates -- 2005 c 504:
WAC 388-865-0420 Intake evaluation. (1) The intake evaluation or brief intake evaluation must be provided by a mental health professional and: [Language here does not support inclusion of family member in definition of “consumer.” ]
WAC 388-865-0107 Peer counselor certification. The mental health division certifies consumers to provide peer support services.
(1) In order to be certified as a peer counselor, all applicants must meet the following requirements:
(a) Be a self-identified consumer of mental health services, as defined;
WAC 388-865-0200 Regional support networks. The mental health division contracts with certified regional support networks to administer all mental health services activities or programs within their jurisdiction using available resources. The regional support network must ensure services are responsive in an age and culturally competent manner to the mental health needs of its community. To gain and maintain certification, the regional support network must comply with all applicable federal, state and local laws and regulations, and all of the minimum standards of this section. The community mental health program administered by the regional support network includes the following programs:
(1) Administration of the involuntary treatment program, including investigation, detention, transportation, court related and other services required by chapters 71.05 and 71.34 RCW;
(2) Resource management program as defined in RCW 71.24.025(15) and this section;
(3) Community support services as defined in RCW 71.24.025(7);
(4) Residential and housing services as defined in RCW 71.24.025(14);
(5) Ombuds services;
(6) Quality review teams;
(7) Inpatient services as defined in chapters 71.05 and 71.34 RCW; and
(8) Services operated or staffed by consumers, former consumers, family members of consumers, or other advocates. If the service is clinical, the service must comply with the requirements for licensed services. Consumer or advocate run services may include, but are not limited to:
(a) Consumer and/or advocate operated businesses;
(b) Consumer and/or advocate operated and managed clubhouses;
(c) Advocacy and referral services;
(d) Consumer and/or advocate operated household assistance programs;
(e) Self-help and peer support groups;
(f) Ombuds service; and
(g) Other services.
WAC 388-106-1475 How do I end enrollment in New Freedom consumer directed services (NFCDS)? (1) You may choose to voluntarily end your enrollment from NFCDS without cause at any time. To do so, you must give notice to the department. If you give notice:
(a) Before the fifteenth of the month, the department will end your enrollment at the end of the month; or
(b) After the fifteenth, the department will end your enrollment the end of the following month.
(2) Your enrollment may also end involuntarily if you:
(a) Move out of the designated service area or are out of the service area for more than thirty consecutive days, unless you have documented the purpose of the longer absence in the NFSP; or
(b) Do not meet the terms for consumer direction of services outlined in the NFCDS enrollment agreement when:
(i) Even with help from a representative, you are unable to develop a NFSP or self-direct services or manage your individual budget or NFSP;
(ii) Any one factor or several factors of such a magnitude jeopardize the health, welfare, and safety of you and others, requiring termination of services under WAC 388-106-0047;
(iii) You become financially ineligible for Medicaid services; or
(iv) You no longer meet the nursing facility level of care requirement as defined in WAC 388-106-0355.
[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. 06-16-035, § 388-106-1475, filed 7/25/06,
effective 8/25/06.]
RCW 70.02.030
Patient authorization of disclosure.
[see 70.02.050]
RCW 70.02.050
Disclosure without patient's authorization.
(1) A health care provider or health care facility may disclose health care information about a patient without the patient's authorization to the extent a recipient needs to know the information, if the disclosure is:
(a) To a person who the provider or facility reasonably believes is providing health care to the patient;
(b) To any other person who requires health care information for health care education, or to provide planning, quality assurance, peer review, or administrative, legal, financial, actuarial services to, or other health care operations for or on behalf of the health care provider or health care facility; or for assisting the health care provider or health care facility in the delivery of health care and the health care provider or health care facility reasonably believes that the person:
(i) Will not use or disclose the health care information for any other purpose; and
(ii) Will take appropriate steps to protect the health care information;
(c) To any other health care provider or health care facility reasonably believed to have previously provided health care to the patient, to the extent necessary to provide health care to the patient, unless the patient has instructed the health care provider or health care facility in writing not to make the disclosure;
(d) To any person if the health care provider or health care facility reasonably believes that disclosure will avoid or minimize an imminent danger to the health or safety of the patient or any other individual, however there is no obligation under this chapter on the part of the provider or facility to so disclose;[This provision for disclosure has significance in the discussion of whether a family member is a consumer]
(e) To immediate family members of the patient, including a patient's state registered domestic partner, or any other individual with whom the patient is known to have a close personal relationship, if made in accordance with good medical or other professional practice, unless the patient has instructed the health care provider or health care facility in writing not to make the disclosure;
(f) To a health care provider or health care facility who is the successor in interest to the health care provider or health care facility maintaining the health care information;
(g) For use in a research project that an institutional review board has determined:
(i) Is of sufficient importance to outweigh the intrusion into the privacy of the patient that would result from the disclosure;
(ii) Is impracticable without the use or disclosure of the health care information in individually identifiable form;
(iii) Contains reasonable safeguards to protect the information from redisclosure;
(iv) Contains reasonable safeguards to protect against identifying, directly or indirectly, any patient in any report of the research project; and
(v) Contains procedures to remove or destroy at the earliest opportunity, consistent with the purposes of the project, information that would enable the patient to be identified, unless an institutional review board authorizes retention of identifying information for purposes of another research project;
(h) To a person who obtains information for purposes of an audit, if that person agrees in writing to:
(i) Remove or destroy, at the earliest opportunity consistent with the purpose of the audit, information that would enable the patient to be identified; and
(ii) Not to disclose the information further, except to accomplish the audit or report unlawful or improper conduct involving fraud in payment for health care by a health care provider or patient, or other unlawful conduct by the health care provider;
(i) To an official of a penal or other custodial institution in which the patient is detained;
(j) To provide directory information, unless the patient has instructed the health care provider or health care facility not to make the disclosure;
(k) To fire, police, sheriff, or another public authority, that brought, or caused to be brought, the patient to the health care facility or health care provider if the disclosure is limited to the patient's name, residence, sex, age, occupation, condition, diagnosis, estimated or actual discharge date, or extent and location of injuries as determined by a physician, and whether the patient was conscious when admitted;
(l) To federal, state, or local law enforcement authorities and the health care provider, health care facility, or third-party payor believes in good faith that the health care information disclosed constitutes evidence of criminal conduct that occurred on the premises of the health care provider, health care facility, or third-party payor;
(m) To another health care provider, health care facility, or third-party payor for the health care operations of the health care provider, health care facility, or third-party payor that receives the information, if each entity has or had a relationship with the patient who is the subject of the health care information being requested, the health care information pertains to such relationship, and the disclosure is for the purposes described in RCW 70.02.010(8) (a) and (b); or
(n) For payment.
(2) A health care provider shall disclose health care information about a patient without the patient's authorization if the disclosure is:
(a) To federal, state, or local public health authorities, to the extent the health care provider is required by law to report health care information; when needed to determine compliance with state or federal licensure, certification or registration rules or laws; or when needed to protect the public health;
(b) To federal, state, or local law enforcement authorities to the extent the health care provider is required by law;
(c) To federal, state, or local law enforcement authorities, upon receipt of a written or oral request made to a nursing supervisor, administrator, or designated privacy official, in a case in which the patient is being treated or has been treated for a bullet wound, gunshot wound, powder burn, or other injury arising from or caused by the discharge of a firearm, or an injury caused by a knife, an ice pick, or any other sharp or pointed instrument which federal, state, or local law enforcement authorities reasonably believe to have been intentionally inflicted upon a person, or a blunt force injury that federal, state, or local law enforcement authorities reasonably believe resulted from a criminal act, the following information, if known:
(i) The name of the patient;
(ii) The patient's residence;
(iii) The patient's sex;
(iv) The patient's age;
(v) The patient's condition;
(vi) The patient's diagnosis, or extent and location of injuries as determined by a health care provider;
(vii) Whether the patient was conscious when admitted;
(viii) The name of the health care provider making the determination in (c)(v), (vi), and (vii) of this subsection;
(ix) Whether the patient has been transferred to another facility; and
(x) The patient's discharge time and date;
(d) To county coroners and medical examiners for the investigations of deaths;
(e) Pursuant to compulsory process in accordance with RCW 70.02.060.
(3) All state or local agencies obtaining patient health care information pursuant to this section shall adopt rules establishing their record acquisition, retention, and security policies that are consistent with this chapter.
[2007 c 156 § 12; 2006 c 235 § 3; 2005 c 468 § 4; 1998 c 158 § 1; 1993 c 448 § 4; 1991 c 335 § 204.]
Notes:
Purpose -- 2006 c 235: "The purpose of this act is to aid law enforcement in combating crime through the rapid identification of all persons who require medical treatment as a result of a criminal act and to assist in the rapid identification of human remains." [2006 c 235 § 1.]
Effective date -- 2006 c 235: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately [March 27, 2006]." [2006 c 235 § 5.]
Effective date -- 1993 c 448: See note following RCW 70.02.010.
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WAC 388-865-0310 Mental health prepaid health plans -- Minimum standards. To be eligible for a contract, a mental health prepaid health plan must comply with all applicable federal, state, and local statutes and regulations and meet all of the minimum standards of WAC 388-865-300 through 388-865-355. The mental health prepaid health plan must:
(1) Provide medically necessary mental health services that are age and culturally competent for all Medicaid recipients in the service area within a capitated rate;
(2) Provide outreach to consumers, including homeless persons and families as defined in Public Law 100-77, and home-bound individuals;
(3) Demonstrate working partnerships with tribal authorities for the delivery of services that blend with tribal values, beliefs and culture;
(4) Develop and maintain written subcontracts that clearly recognize that legal responsibility for administration of the service delivery system remains with the mental health prepaid health plan, as identified in the agreement with the mental health division;
(5) Retain responsibility to ensure that applicable standards of state and federal statute and regulations and this chapter are met even when it delegates duties to subcontractors;
(6) Ensure the protection of consumer and family rights as described in chapters 71.05 and 71.34 RCW;
WAC 388-865-0453 Peer support services. (1) Peer support services are a wide range of scheduled activities to assist consumers in exercising control over their own lives and recovery process (e.g., promoting socialization, self advocacy, developing natural supports and maintenance of community living skills). Peer support services may include but are not limited to self-help support groups, telephone support lines, drop-in centers, and sharing of the peer counselor's own life experiences. Services must be limited to four hours per day per consumer.
(2) The community support service provider that is licensed to provide peer support services must assure that all general minimum standards for community support services are met.
(3) Services must be provided by a peer counselor who has been certified consistent with WAC 388-865-0107 and who discloses him/herself to be a consumer of mental health services.
(4) Services must be documented in the clinical record at least monthly, including objective progress toward goals established in the individual service plan.
[Statutory Authority: RCW 71.24.035 (5)(c), 71.24.037. 05-17-156, § 388-865-0453, filed 8/22/05, effective 9/22/05.]
[key
[Key term, may be “consumer of mental health services” ] \
WAC 388-865-0453 Peer support services. (1) Peer support services are a wide range of scheduled activities to assist consumers in exercising control over their own lives and recovery process (e.g., promoting socialization, self advocacy, developing natural supports and maintenance of community living skills). Peer support services may include but are not limited to self-help support groups, telephone support lines, drop-in centers, and sharing of the peer counselor's own life experiences. Services must be limited to four hours per day per consumer.
(2) The community support service provider that is licensed to provide peer support services must assure that all general minimum standards for community support services are met.
(3) Services must be provided by a peer counselor who has been certified consistent with WAC 388-865-0107 and who discloses him/herself to be a consumer of mental health services.
(4) Services must be documented in the clinical record at least monthly, including objective progress toward goals established in the individual service plan.
[Statutory Authority: RCW 71.24.035 (5)(c), 71.24.037. 05-17-156, § 388-865-0453, filed 8/22/05, effective 9/22/05.]
[RCW 71 Mental Illness] family member no mention
[For the King County Mental Health Advisory Board, the membership is for consumers and family members. Family members are not consumers. ]
King County Ordiance 2.32.010 Community mental health advisory board (B) MEMBERSHIP…Membership of the board shall be broadly representative of the demographic character of the region and the mentally ill consumers served and shall include consumers, family and other advocates, and parents of mentally ill children.