House Bill 2453 (H-2774.1) amends several provisions of chapter 71.05 RCW governing involuntary evaluation, commitment, and assisted outpatient treatment (AOT). The bill revises the definitions section (RCW 71.05.020), adds or clarifies definitions and standards for secure withdrawal management and stabilization facilities, defines “video” for behavioral health evaluations, recognizes board‑certified psychiatric pharmacists as a type of qualified clinician, and amends rules governing petitions, hearings, less restrictive alternative treatment (LRAT), and facility certification (amendments cited to RCW 71.05.148, 71.05.230, and 71.05.585 are included in the bill). The changes are primarily procedural and regulatory rather than criminal: they expand who may file AOT or involuntary treatment petitions and who may provide supporting clinical declarations (including physicians, physician assistants, advanced practice nurses, and board‑certified psychiatric pharmacists), require clinician declarations based on an examination within 10 days (or documented attempts), specify petition contents and service like a summons, set hearing timing (generally 3–7 days after service, up to 30 days for good cause), and require appointment of counsel at filing. The bill sets eligibility criteria for AOT to be proven by clear, cogent, and convincing evidence with defined lookback periods for treatment noncompliance and violent behavior, authorizes LRAT orders of up to 18 months, establishes care coordinator duties and reporting of individualized treatment plans to the court, requires providers of LRAT and intensive treatment to be certified or licensed (including the authority’s ability to certify single evaluation and treatment beds), and limits detention for examination/transport ordered by a court to no longer than necessary and in no event longer than 24 hours. It also prescribes requirements for secure withdrawal management and stabilization facilities and clarifies telehealth (“video”) use for designated crisis responder evaluations. Several provisions and timing details are incomplete in the extracted text and some sections include expiration or delayed effective dates (for example, parts of the act expire June 30, 2027, and other parts take effect June 30, 2027 or upon a contingency in prior legislation). The provided excerpts are truncated in multiple places (including portions of the definitions, the full amended text of RCW 71.05.148, and certain detention and facility certification clauses), so some specific language and any additional changes referenced in the bill header are not available here.

If enacted, this bill tightens who can start and support assisted outpatient treatment (AOT) cases, speeds up court timelines, and creates clearer duties for the people and programs that must run AOT and less restrictive alternative treatment (LRAT). Hospitals, behavioral health providers, designated crisis responders, emergency room doctors, and certain treating clinicians can file petitions, and the petition must include a recent clinician declaration (now explicitly allowed to come from a board‑certified psychiatric pharmacist among other clinicians) and a personal interview by the petitioner unless refused. Courts must hold hearings quickly (generally 3–7 days, up to 30 days for good cause), AOT orders can last up to 18 months, and the law formalizes care coordinators’ responsibilities to file individualized treatment plans promptly and update them when services change. Secure withdrawal management and stabilization facilities must meet new service, security, and licensing standards, and the department of health is given more certification duties; peace officers with crisis training may be directed to detain someone for up to 24 hours for examination when ordered. These changes will most affect hospitals, behavioral health providers, the Department of Health, courts, care coordinators, designated crisis responders, and trained peace officers by increasing reporting, documentation, and certification duties and by shifting more responsibility onto providers who must agree to assume LRAT care. Providers may face new costs and liability tied to certification, rapid plan development, and possible court-ordered enforcement; courts and public defenders will face faster timelines and workload for hearings; tribes and Indian health providers must receive quick notice in some cases. Important parts of the bill text are missing from the provided excerpts (full details on several amended sections and the complete role or limits for psychiatric pharmacists and some certification procedures), so some implementation details and exact responsibilities remain unclear.