WSR 06-22-089

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

(Mental Health Division)

[ Filed November 1, 2006, 9:19 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 06-07-145.

Title of Rule and Other Identifying Information: WAC 388-865-0420 Intake evaluation.

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on December 5, 2006, at 10:00 a.m.

Date of Intended Adoption: Not earlier than December 6, 2006.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. on December 5, 2006.

Assistance for Persons with Disabilities: Contact Stephanie Schiller, DSHS Rules Consultant, by December 1, 2006, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at schilse@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This rule would expand the options for intake evaluation to allow for an abbreviated process for intake evaluation when the individual is expected to need short term mental health services, or had full evaluation previously and is resuming services.

Reasons Supporting Proposal: Amended rules are needed to lessen burden of paperwork and create efficiencies for mental health provider's performing intake evaluations.

Statutory Authority for Adoption: RCW 71.24.035.

Statute Being Implemented: Chapter 71.24 RCW.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of social and health services, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Melena Thompson, P.O. Box 45320, Olympia, WA 98504-5320, (360) 902-0873.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The mental health division has analyzed the proposed rules and concludes that the rule changes proposed do not impose any additional compliance costs or administrative burdens on small businesses. Therefore, preparation of a small business economic impact statement is not required.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Melena Thompson, P.O. Box 45320, Olympia, WA 98504-5320, phone (360) 902-0873, fax (360) 902-0809, e-mail thompml@dshs.wa.gov.

October 27, 2006

Andy Fernando, Manager

Rules and Policies Assistance Unit

3810.2
AMENDATORY SECTION(Amending WSR 05-14-082, filed 6/30/05, effective 7/31/05)

WAC 388-865-0420   Intake evaluation.   ((The community support service provider must complete an intake evaluation in collaboration with the consumer within fourteen days of admission to service. If seeking this information presents a barrier to service, the item may be left incomplete provided that the reasons are documented in the clinical record. The following must be documented in the consumer's intake evaluation:

(1) A consent for treatment or copy of detention or involuntary treatment order;

(2) Consumer strengths, needs and desired outcomes in their own words. At the consumer's request also include the input of people who provide active support to the consumer;

(3) The consumer's age, culture/cultural history, and disability;

(4) History of substance use and abuse or other co-occurring disorders;

(5) Medical and mental health services history and a list of medications used;

(6) Documentation that consumers receiving court ordered treatment or treatment ordered by the department of corrections (DOC) have been asked if they are under supervision by the department of corrections. The consumer is required to disclose this information.

(7) For children:

(a) Developmental history; and

(b) Parent's goals and desired outcomes.

(8) Sufficient information to justify the diagnosis;

(9) Review of the intake evaluation by a mental health professional)) (1) Each consumer requesting services must receive an intake evaluation. The intake evaluation or brief intake evaluation must be provided by a Mental Health Professional and:

(a) Be initiated prior to the provision of any non-crisis mental health services;

(b) Be initiated within ten working days of the request for services;

(c) Be developed in collaboration with the consumer;

(d) Be inclusive of input of people who provide active support to the consumer, if the consumer requests or if the consumer is under age thirteen;

(e) Be completed within thirty working days of the initiation of the intake evaluation; and

(f) Include a consent for treatment or a copy of detention or involuntary treatment order.

(2) Except as when a brief intake evaluation as described in WAC 388-865-0420(4) is provided, a full intake evaluation must include:

(a) A description of the presenting problem, presented needs;

(b) A description of the consumer's and family's strengths;

(c) Consumer's needs and desired outcomes in the consumer's own words;

(d) Consumer's culture/cultural history (including, but not limited to, ethnicity or race, and religion);

(e) History of other disorders, substance/alcohol abuse, developmental disability, any other relevant disability, and treatment, if any;

(f) Medical history, hospitalizations, treatment, past and current medications;

(g) Mental health services history, past and current medication;

(h) Assessment of suicide/homicide and self harm risk. A referral for provision of emergency/crisis services, consistent with WAC 388-865-0452, must be made if indicated in the risk assessment;

(i) Sufficient information to justify the provisional diagnosis;

(j) Documentation showing the consumer has been asked if they are under the supervision of the department of corrections or juvenile court;

(k) If the consumer is a child:

(i) Developmental history;

(ii) Parental goals and desired outcomes (if consent is obtained or not required due to age or state custody); and

(iii) Family and/or placement issues, including, if appropriate, family dynamics, placement disruptions, and current placement needs.

(3) If seeking any of the information required in subsection (2) of this section presents a barrier to the provision of services for the consumer, any portion of the intake may be left incomplete providing the reason for the omission is clearly documented in the clinical record.

(4) A brief intake evaluation may be used when it is reasonably believed services to the consumer will be completed within a six-month period. A brief intake evaluation may also be substituted for a full intake evaluation if a consumer is resuming services after being out of services for a period of less than twelve months and had received a full intake evaluation as part of the previous service provision. A brief intake evaluation must include:

(a) A description of presenting problem, presented needs, desired outcomes, and consumer strengths identified by both the consumer and the clinician;

(b) Sufficient information to justify the provisional diagnosis;

(c) The consumer's current physician and prescribed medications;

(d) Current and historical substance use/abuse or other co-occurring disorders including developmental disabilities;

(e) Mental health services history including past and current medications;

(f) Assessment of suicide/homicide and self-harm risk. A referral for provision of emergency/crisis services, consistent with WAC 388-865-0452, must be made if indicated in the risk assessment;

(g) Documentation that the consumer has been asked if they are under the supervision by the department of corrections or juvenile court; and

(h) Identification of mutually agreed upon outcomes that are expected to be accomplished within the six-month period that will be the basis of the treatment plan.

(5) In cases where a consumer initially receives services based on a brief intake evaluation, the community support service provider must complete the additional elements required in a full intake evaluation if the consumer is expected to continue to receive services after six months.

(6) If seeking any of the information required in subsection (4) of this section presents a barrier to the provision of services for the consumer, any portion of the intake may be left incomplete providing the reason for the omission is clearly documented in the clinical record.

[Statutory Authority: RCW 71.05.445 and 71.05.390 as amended by 2004 c 166. 05-14-082, 388-865-0420, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 71.05.560, 71.24.035 (5)(c), 71.34.800, 9.41.047, 43.20B.020, and 43.20B.335. 01-12-047, 388-865-0420, filed 5/31/01, effective 7/1/01.]

Washington State Code Reviser's Office