(1) 
Less restrictive alternative treatment is an individualized treatment program in a less restrictive setting than inpatient treatment that includes, at a minimum, the following services either provided by the Tulalip Tribes, through contract with another provider, or other jurisdiction:
(a) 
Assignment of a care coordinator;
(b) 
An intake evaluation with the provider of the less restrictive alternative treatment;
(c) 
A psychiatric evaluation;
(d) 
A schedule of regular contacts with the provider of the less restrictive alternative treatment services for the duration of the order;
(e) 
A transition plan addressing access to continued services at the expiration of the order;
(f) 
An individual crisis plan; and
(g) 
Notification to the care coordinator assigned in subsection (1)(a) of this section if reasonable efforts to engage the client fail to produce substantial compliance with court-ordered conditions.
(2) 
Less restrictive alternative treatment may additionally include requirements to participate in the following services:
(a) 
Traditional healing and cultural activities;
(b) 
Medication management;
(c) 
Psychotherapy;
(d) 
Nursing;
(e) 
Substance abuse counseling;
(f) 
Residential treatment; and
(g) 
Support for housing, benefits, education, and employment.
(3) 
If the person was provided with involuntary medication under this chapter or pursuant to a Tribal Court order during the involuntary commitment period, the less restrictive alternative treatment order may authorize the less restrictive alternative treatment provider or its designee to administer involuntary antipsychotic medication to the person if:
(a) 
The provider has attempted and failed to obtain the informed consent of the person; and
(b) 
There is a concurring medical opinion approving the medication by a psychiatrist, physician assistant working with a supervising psychiatrist, psychiatric advanced registered nurse practitioner, or physician or physician assistant in consultation with an independent mental health professional with prescribing authority.
(4) 
Less restrictive alternative treatment must be administered by a provider that is approved by the Tulalip Tribes to provide or coordinate the full scope of services required under the less restrictive alternative order and that has agreed to assume this responsibility.
(5) 
The care coordinator assigned to a person ordered to less restrictive alternative treatment must submit an individualized plan for the person’s treatment services to the Tribal Court. An initial plan must be submitted as soon as possible following the intake evaluation and a revised plan must be submitted upon any subsequent modification in which a type of service is removed from or added to the treatment plan.
(6) 
The court shall not consider less restrictive alternative treatment unless the Tulalip Tribal Designated Crisis Responder or Tribal Prosecutor petitions or provides the Tribal Court with a recommendation for less restrictive alternative treatment.
(Res. 2023-513 § 1)
(1) 
The Tribes may file a petition for a substance abuse treatment intervention for a person detained pursuant to this chapter.
(2) 
A petition for substance abuse treatment intervention must allege that:
(a) 
The person has a substance abuse disorder; the person may also but need not have one or more co-occurring behavioral health disorder(s).
(b) 
The person is likely to benefit from substance abuse treatment.
(c) 
Based on a clinical determination and in view of the person’s treatment history and behavior, at least one of the following is true:
(i) 
The person’s condition has substantially deteriorated as a result of substance abuse and the person is unlikely to survive safely in the community without supervision;
(ii) 
The person needs the assistance of a substance abuse treatment intervention to prevent a relapse or deterioration that would be likely to result in death, grave disability, or a likelihood of serious harm to the person or to others.
(d) 
The person has a history of lack of compliance with treatment for their disorder(s) that has:
(i) 
At least twice within the 36 months prior to the filing of the petition been a significant factor in necessitating emergency medical care or hospitalization of the person, or incarceration; provided, that the 36-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred within the 36-month period; or
(ii) 
Resulted in one or more violent acts, threats, or attempts to cause serious physical harm to the person or another within the 48 months prior to the filing of the petition; provided, that the 48-month period shall be extended by the length of any hospitalization or incarceration of the person that occurred during the 48-month period; and
(e) 
Participation in a substance abuse treatment intervention program is the least restrictive available option to ensure the person’s recovery and stability.
(3) 
A petition for substance abuse treatment intervention may request the Court to require any services or conditions allowed in a less restrictive alternative treatment program and shall at a minimum request that the Court impose an individualized treatment plan that includes the following services either provided by the Tulalip Tribes, through contract with another provider, or other jurisdiction:
(a) 
Assignment of a care coordinator;
(b) 
A substance abuse disorder assessment;
(c) 
Recommended treatment based on the results of a substance abuse disorder assessment;
(d) 
Steps to be taken if the client falls out of compliance with the individualized plan.
(4) 
The Tribal Court, at the time a petition is filed and before the probable cause hearing, must appoint counsel to represent the respondent. The respondent has a right to counsel at the Tribes’ expense in all substance abuse treatment intervention proceedings.
(5) 
The Court shall hold a probable cause hearing within two judicial days following filing of the petition. If the Court finds probable cause for the allegations in the petition then the respondent may be detained in an inpatient treatment facility until graduation from that facility and thereafter in an aftercare setting for a total period not to exceed 90 days.
(6) 
Bench Trial. The Court shall schedule a bench trial within 90 days of the filing of the petition at a time when the responded is expected to have graduated from inpatient treatment. If the Tribes prove the allegations of the petition by clear and convincing evidence, the Court shall impose the requested services or conditions and/or any other such services and conditions reasonably calculated to assist the respondent in recovery from their disorder(s).
(7) 
Time Limit. A Court order for substance abuse treatment intervention may be effective for up to 24 months.
(Res. 2023-513 § 1)
(1) 
A Tulalip Tribal Designated Crisis Responder or other designated crisis responder may take action to enforce, modify, or revoke a less restrictive alternative, substance abuse treatment intervention, or conditional release order. The designated crisis responder must determine that:
(a) 
The person is failing to adhere to the terms and conditions of the Tribal Court order;
(b) 
Substantial deterioration in the person’s functioning has occurred;
(c) 
There is evidence of substantial decompensation with a reasonable probability the decompensation can be reversed by further evaluation, intervention, or treatment; or
(d) 
The person poses a likelihood of serious harm.
(2) 
Actions taken under this section must include a flexible range of responses of varying levels of intensity appropriate to the circumstances and consistent with the interests of the individual and the public in personal autonomy, safety, recovery, and compliance. Available actions may include, but are not limited to, any of the following:
(a) 
To counsel or advise the person as to their rights and responsibilities under the Tribal Court order, and to offer appropriate incentives to motivate compliance;
(b) 
To increase the intensity of outpatient services provided to the person by increasing the frequency of contacts with the provider, referring the person for an assessment for assertive community services, or by other means;
(c) 
To request a Tribal Court hearing for review and modification of the Tribal Court order. The request must be made to the Tribal Court and specify the circumstances that give rise to the request and what modification is being sought. The Tribal Prosecutor shall assist the agency or facility or Tulalip Tribal Designated Crisis Responder in requesting this hearing and issuing an appropriate summons to the person. This subsection does not limit the inherent authority of a treatment provider to alter conditions of treatment for clinical reasons, and is intended to be used only when Tribal Court intervention is necessary or advisable to secure the person’s compliance and prevent decompensation or deterioration;
(d) 
To cause the person to be transported by a Tulalip law enforcement officer, Tulalip Tribal Designated Crisis Responder, designated crisis responder, or other means to the agency or facility monitoring or providing services under the Tribal Court order, or to a triage facility, crisis stabilization unit, emergency department, evaluation and treatment facility, secure withdrawal management and stabilization facility, or an approved substance use disorder treatment program. The person may be detained at the facility for up to 12 hours for an evaluation to determine whether modification, revocation, or commitment proceedings are necessary and appropriate to stabilize the person and prevent decompensation, deterioration, or physical harm. Temporary detention for evaluation under this subsection is intended to occur only following a pattern of noncompliance or the failure of reasonable attempts at outreach and engagement. This subsection does not limit the ability or obligation to pursue revocation procedures under subsection (4) of this section in appropriate circumstances; and
(e) 
To initiate revocation procedures under subsection (4) of this section or, if the current commitment is solely based on substance abuse treatment intervention, initial inpatient detention procedures under subsection (5) of this section.
(3) 
The facility or agency designated to provide outpatient treatment shall notify the Tulalip Tribal Designated Crisis Responder when a person fails to adhere to terms and conditions of Court-ordered treatment or experiences substantial deterioration in his or her condition and, as a result, presents an increased likelihood of serious harm.
(4) 
Custody and Detainment Procedures for Conditional Releases and Less Restrictive Alternatives.
(a) 
A Tulalip Tribal Designated Crisis Responder can move the Tribal Court for an order to apprehend and/or temporarily detain a person subject to a conditional release or less restrictive alternative in an evaluation and treatment facility, in a secure withdrawal management and stabilization facility, or in an approved substance use disorder treatment program. If the Court finds that there is probable cause that the person has not complied with the conditions of his or her conditional release or less restrictive alternative, the Court shall order the person to be apprehended and detained. A revocation and detention petition may be filed under subsection (4)(c) of this section without a prior Court apprehension and detention order.
(b) 
A person detained under this subsection (4) must be held until such time, not exceeding five days, as a hearing can be scheduled to determine whether or not the person should be returned to the hospital or facility from which he or she had been released. If the person is not detained, the hearing must be scheduled within five days of service on the person.
(c) 
The Designated Crisis Responder may file a revocation petition and order of detention with the Tribal Court. The Designated Crisis Responder shall serve the person and their attorney, guardian, and conservator, if any.
(d) 
Trial. A bench trial shall be held within 10 judicial days of the filing of the petition. The issues for the Tribal Court to determine are whether:
(i) 
The person adhered to the terms and conditions of the Tribal Court order;
(ii) 
Substantial deterioration in the person’s functioning has occurred;
(iii) 
There is evidence of substantial decompensation with a reasonable probability that the decompensation can be reversed by further inpatient treatment;
(iv) 
There is a likelihood of serious harm; and
(v) 
If any of the above conditions apply, whether the Tribal Court should reinstate or modify the person’s less restrictive alternative or conditional release order or order the person’s detention for inpatient treatment. The person may waive the Tribal Court hearing and allow the Court to enter a stipulated order upon the agreement of all parties.
(5) 
Detention for Conducting an Inpatient Evaluation – Substance Abuse Treatment Intervention Orders.
(a) 
A Tulalip Tribal Designated Crisis Responder or other authorized person may initiate inpatient detention procedures under this chapter, when appropriate, for individuals subject to a substance abuse treatment intervention order. Proceedings under this subsection (5) may be initiated without ordering the apprehension and detention of the person.
(b) 
A Tulalip Tribal Designated Crisis Responder or the Tribal Prosecutor may move the Tulalip Tribal Court for an order that an individual subject to a substance abuse treatment intervention order be taken into custody and temporarily detained for inpatient evaluation in an evaluation and treatment facility, in a secure withdrawal management and stabilization facility, or in an approved substance use disorder treatment program. The Court shall grant the motion if it finds probable cause that the person is out of compliance with the terms of their substance abuse intervention treatment order and reevaluation of their service needs and/or inpatient treatment is in their best interest.
(c) 
A person detained under this subsection (5) may be held for evaluation for up to 120 hours, excluding weekends and holidays, pending a court hearing.
(d) 
The Court shall hold a hearing within 120 hours of the person’s detention, excluding weekends and holidays. Counsel shall be provided to the detained person at the Tribes’ expense if they are not already represented. The issues for the Tribal Court to determine are whether to continue the detention of the person for inpatient treatment or whether the Court should reinstate or modify the person’s substance abuse treatment intervention order. To continue detention after the 120-hour period, the Tribal Court must find that inpatient treatment is a clinically appropriate response to the person’s behavior and that if released without inpatient treatment, the person is unlikely to survive safely in the community or would likely relapse or deteriorate in condition in such a way as to likely result in death, grave disability, or serious harm to the person or to others. The burden of proof is on the Tribes and shall be by clear and convincing evidence.
(Res. 2023-513 § 1)
A Tribal Court order for substance abuse treatment intervention must be terminated prior to the expiration of the order when, in the opinion of the professional person in charge of the treatment provider:
(1) 
The person is prepared to accept voluntary treatment; or
(2) 
The outpatient treatment ordered is no longer necessary to prevent a relapse, decompensation, or deterioration of condition likely to result in death, grave disability, or serious harm to the person or to others.
(Res. 2023-513 § 1)