(b)

1. (1) Prior to the admission of the first patient into the last pilot ETP, the State Department of Public Health may adopt emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code) to implement this section. The adoption of an emergency regulation under this paragraph is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the State Department of Public Health is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
2. (2) As an alternative to paragraph (1) and notwithstanding the rulemaking provisions of Administrative Procedures Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), the director of the State Department of Public Health may implement this section, in whole or in part, by means of an all facility letter or other similar instruction.

(c) An ETP shall meet all of the following requirements:

1. (1) Maintain a staff-to-patient ratio of one to five.
2. (2) Limit each room to one patient.
3. (3) Each patient room shall allow visual access by staff 24 hours per day.
4. (4) Each patient room shall have a toilet and sink in the room.
5. (5) Each patient room door shall have the capacity to be locked externally. The door may be locked when clinically indicated and determined to be the least restrictive treatment environment for the patient’s care and treatment pursuant to Section 4144 of the Welfare and Institutions Code, but shall not be considered seclusion, as defined in subdivision (e) of Section 1180.1, for purposes of Division 1.5 (commencing with Section 1180).
6. (6) Provide emergency egress for ETP patients.
7. (7) In the event that seclusion or restraints, as defined in Section 1180.1, are used in an ETP, all state licensing and regulations shall be followed.
8. (8) A full-time independent patients’ rights advocate who provides patients’ rights advocacy services shall be assigned to each ETP.

(d) The ETPs shall adopt and implement policies and procedures necessary to encourage patient improvement, recovery, and a return to a standard treatment environment, and to create identifiable facility requirements and benchmarks. The policies and procedures shall also provide all of the following:

1. (1) Criteria and process for admission into an ETP pursuant to Section 4144 of the Welfare and Institutions Code.
2. (2) Clinical assessment and review focused on behavior, history, high risk of most dangerous behavior, and clinical need for patients to receive treatment in an ETP as the least restrictive treatment environment.
3. (3) A process for identifying an ETP along a continuum of care that will best meet the patient’s needs, including least restrictive treatment environment.
4. (4) A process for creating and implementing a treatment plan with regular clinical review and reevaluation of placement back into a standard treatment environment and discharge and reintegration planning as specified in subdivision (e) of Section 4144 of the Welfare and Institutions Code.