PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Health and Rehabilitative Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 02-10-112.
Title of Rule: Chapter 388-805 WAC, Certification requirements for chemical dependency service providers.
Purpose: Establishes the level of quality and patient care standards for chemical dependency service providers seeking certification by DSHS/Division of Alcohol and Substance Abuse (DASA).
Statutory Authority for Adoption: RCW 70.96A.090.
Statute Being Implemented: Chapter 70.96A RCW.
Summary: 1. DASA is proposing amendments to chapter 388-805 WAC. The key new rules and amendments proposed will implement:
a. 42 C.F.R., Part 8, Certification of Opioid Treatment Programs, effective May 18, 2001, which include major changes to the federal requirements adopted by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration.
b. RCW 70.96A.400 - [70.96A.]420, effective July 22, 2001 (chapter 242, Laws of 2001), amended by the 2001 Washington state legislature.
In response, emergency WAC adoptions were submitted to the Code Reviser's Office on March 8, 2002, July 5, 2002, November 1, 2002, and February 28, 2003, effective for one hundred twenty days each. The emergency rules amended Washington state administrative codes to recognize CSAT certification standards and implement the changes made to RCW 70.96A.400, [70.96A.]410, and [70.96A.]420.
2. In addition, DASA stakeholders recommended using the American Society of Addiction Medicine, Patient Placement Criteria (PPC), primarily for patient placement, continued service, and discharge criteria. The proposed WAC revision reduces regulatory use of PPC for treatment planning activities. Other revisions include:
a. A new WAC section is proposed to require agencies to report critical incidents to DASA within 48 hours of the critical incident.
b. Language to clarify the requirements for outcomes evaluation, outpatient treatment requirements for patients convicted of DUI or physical control pursuant to chapter 46.61 RCW, and definitions of court ordered treatment in WAC 388-805-330.
c. Language to revise the WAC section on fees collected by DASA for change of agency ownership applications.
d. Language to revise ADATSA assessment center certification and ADATSA requirements.
e. Language to acknowledge faith-based programs.
f. Language to recognize Chemical Dependency Professionals as Alcohol/Drug School Instructors.
g. Language to correct inaccurate WAC section citations and typographical errors.
3. In addition, other sections of this chapter were subject to review and amendment deemed appropriate as required by Governor Locke's Executive Order 97-02 on regulatory improvement.
Proposed amended and new rules in chapter 388-805 WAC: Amending WAC 388-805-005 What definitions are important throughout this chapter?, 388-805-010 What chemical dependency services are certified by the department?, 388-805-015 How do I apply for certification as a chemical dependency service provider?, 388-805-030 What are the requirements for opiate treatment substitution treatment program certification? (amended caption and rule text), 388-805-065 How does the department determine disqualification or denial of an application?, 388-805-075 How do I apply for an exemption?, 388-805-085 What are the fees for agency certification?, 388-805-090 May certification fees be waived?, 388-805-100 What do I need to do to maintain agency certification?, 388-805-120 How does the department assess penalties?, 388-805-130 How does the department suspend or revoke certification?, 388-805-140 What are the requirements for a provider's governing body?, 388-805-145 What are the key responsibilities required of an agency administrator?, 388-805-150 What must be included in an agency administration manual?, 388-805-205 What are agency personnel file requirements?, 388-805-210 What are the responsibilities for approved supervisors of persons who are in training to become a chemical dependency professional? (caption and text amended), 388-805-220 What are the requirements to be a probation assessment officer?, 388-805-250 What are the requirements to be an information school instructor?, 388-805-300 What must be included in the agency clinical manual?, 388-805-305 What are patient's rights requirements in certified agencies?, 388-805-310 What are the requirements for chemical dependency assessments?, 388-805-315 What are the requirements for treatment, continuing care, transfer, and discharge plans?, 388-805-320 What are the requirements for a patient record system?, 388-805-325 What are the requirements for patient record content?, 388-805-350 What are the requirements for outcome evaluation?, 388-805-400 What are the requirements for detoxification providers?, 388-805-410 What are the requirements for detox staffing and services?, 388-805-500 What are the requirements for residential providers?, 388-805-520 What are the requirements for youth behavior management? (caption and text amended), 388-805-530 What are the requirements for incentive inpatient services? 388-805-540 What are the requirements for recovery house services?, 388-805-550 What are the requirements for long-term treatment services?, 388-805-600 What are the requirements for outpatient providers?, 388-805-610 What are the requirements for intensive outpatient treatment services?, 388-805-625 What are the requirements for outpatient services for persons subject to RCW 46.61.5056?, 388-805-700 What are the requirements for opiate substitution treatment program providers? (caption and text amended), 388-805-710 What are the requirements for opiate substitution treatment medical management?, 388-805-720 What are the requirements for drug testing in opiate substitution treatment? (caption and text amended), 388-805-730 What are the requirements for opiate substitution treatment dispensaries?, 388-805-740 What are the requirements for opiate substitution treatment counseling?, 388-805-750 What are the requirements for opiate substitution treatment take-home medications?, 388-805-800 What are the requirements for ADATSA assessment services? (caption and text amended), 388-805-810 What are the requirements for DUI assessment providers?, 388-805-820 What are the requirements for alcohol and other drug information school? and 388-805-850 What are the requirements for treatment accountability for safer communities (TASC) providers and services? (caption and text amended); and new sections WAC 388-805-035 What are the responsibilities for the department when an applicant applies for approval of an opiate substitution treatment program?, 388-805-040 How does the department determine there is a need in the community for opiate substitution treatment?, and 388-805-715 What are the requirements for opiate substitution medication management?
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Dennis Malmer, Division of Alcohol and Substance Abuse, P.O. Box 45330, Olympia, WA 98504-5330, (360) 438-8086, (877) 301-4557 (toll free).
Name of Proponent: Department of Social and Health Services, governmental.
Rule is necessary because of federal law, 42 C.F.R., Part 8.
Explanation of Rule, its Purpose, and Anticipated Effects: See Summary above.
Proposal Changes the Following Existing Rules: See Summary above.
A small business economic impact statement has been prepared under chapter 19.85 RCW.
The purpose of this chapter is to describe the standards and processes necessary for certifying chemical dependency treatment service providers.
The proposed amendments to this chapter include:
• The Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration adopted 42 C.F.R., Part 8, Certification of Opioid Treatment Programs, on January 17, 2001, effective May 18, 2001. The federal rules made changes to the federal requirements for certifying opiate substitution treatment programs.
• The 2001 Washington state legislature amended RCW 70.96A.400-[70.96A.]420, effective July 22, 2001.
In response, emergency WAC adoptions were submitted to the Code Reviser's Office on March 8, 2002, July 5, 2002, November 1, 2002, and February 28, 2003, effective for one hundred twenty days each. The emergency rules amended Washington state administrative codes to recognize CSAT certification standards and implement the changes made to RCW 70.96A.400, [70.96A.]410, and [70.96A.]420.
• DASA stakeholders recommended using the American Society of Addiction Medicine, Patient Placement Criteria (PPC), primarily for patient placement, continued service, and discharge criteria. The proposed WAC revision reduces regulatory use of PPC for treatment planning activities.
• A new WAC section is proposed to require agencies to report critical incidents to DASA within 48 hours of the critical incident.
• Language is proposed to clarify the requirements for outcomes evaluation, outpatient treatment requirements for patients convicted of DUI or physical control pursuant to chapter 46.61 RCW, and definitions of court ordered treatment in WAC 388-805-330.
• Language is proposed to revise the WAC section on fees collected by DASA for change of agency ownership applications.
• Language is proposed to revise ADATSA assessment center certification and ADATSA requirements.
• Language is proposed to acknowledge faith-based programs.
• Language is proposed to recognize chemical dependency professionals as alcohol/drug information school instructors.
• Language is proposed to correct inaccurate WAC section citations and typographical errors.
• In addition, other sections of this chapter were subject to review and amendment deemed appropriate as required by Governor Locke's Executive Order 97-02 on regulatory improvement.
This chapter has been rewritten in plain English, using a question and answer format to make it more understandable to our customers. Unnecessary rules have been eliminated and others have been clarified.
SMALL BUSINESS ECONOMIC IMPACT STATEMENT: Chapter 19.85 RCW, the Regulatory Fairness Act, requires that the economic impact of proposed regulations be analyzed in relation to small businesses and that it outlines the information that must be included in a small business economic impact statement (SBEIS). Preparation of an SBEIS is required when a proposed rule has the potential of placing a more than minor economic impact on business. DASA has analyzed the proposed amendments to its rules and has determined that small businesses will not be impacted by these changes.
INDUSTRY ANALYSIS: DASA is responsible for certifying chemical dependency treatment agencies. As part of its monitoring, DASA keeps a current internal database that identifies all certified agencies. Since internal industry information can be obtained at a more accurate level than is required by chapter 19.85 RCW, it is unnecessary to conduct an industry analysis using the four-digit standard industrial classification (SIC) codes.
DASA previously determined that there were one hundred twenty-six existing agencies (private and for-profit) that meet the criteria for small businesses under RCW 19.85.020. In 2003, DASA decided to consider economic impacts on all DASA certified agencies (private, for-profit, and public funded) therefore the industry analysis includes five hundred eighteen certified agencies.
INVOLVEMENT OF SMALL BUSINESSES AND OTHER DASA CERTIFIED AGENCIES: Many small businesses have been involved in writing the proposed rules and in ascertaining the costs associated with proposed rule changes. DASA engaged assistance of a writing group, which included representation from small businesses. DASA met and talked several times with a number of small businesses to consider costs that would impact their businesses.
Attached to this document is a list of the WAC Revision Committee members who participated in determining the costs associated with new rules [no further information supplied by agency].
COST OF COMPLIANCE: To consider costs of compliance, DASA elected to look at cost per patient. This is because:
• Patients drive the businesses that provide chemical dependency treatment and so using the cost per patient is a more accurate depiction of costs than costs per employee;
• Business decisions and planning are based on the number of patients served; and,
• The number of patients also influences the total amount that the most significant proposed changes will cost.
The costs of proposed rule changes fall in one main area. With proposed changes to WAC 388-805-030 through 388-805-040, and 388-805-700 through 388-805-750, opiate substitution treatment programs will experience increased costs as a result of changes in federal rule 42 C.F.R. Part 8, which requires OTPs to become accredited by a nationally recognized accreditation body. A number of Washington state OTPs have elected to become accredited by DASA and therefore were able to offset the initial costs of accreditation because DASA received a federal grant on April 15, 2002, to assist these agencies in meeting accreditation requirements.
CONCLUSION: DASA, in collaboration with the members of the WAC Revision Committee of 2003, have given careful consideration to the impact on small businesses and other DASA certified agencies of proposed rules in chapter 388-805 WAC, Certification requirements for chemical dependence service providers. In accordance with the Regulatory Fairness Act, chapter 19.85 RCW, DASA has analyzed impacts on small businesses and other DASA certified agencies and has determined that the costs of implementing revisions to chapter 388-805 WAC will generally be reduced.
OTPs will experience increased costs as a result of changes in federal rule 42 C.F.R. Part 8, which requires OTPs to become accredited by a nationally recognized accreditation body. A number of Washington state OTPs have elected to become accredited by DASA. Therefore, the initial costs of accreditation were offset because DASA received a federal grant on April 15, 2002, to assist these agencies in meeting accreditation requirements.
DASA recognizes that there are costs associated with rule making on all DASA certified agencies to change policy and procedure manuals after implementation of new or revised rules.
The majority of the rule changes, however, offer cost and time savings by eliminating, reducing, or streamlining requirements.
A copy of the statement may be obtained by writing to Dennis W. Malmer, Division of Alcohol and Substance Abuse, P.O. Box 45330, Olympia, WA 98504-5330, phone (360) 438-8086, fax (360) 438-8057, toll free (877) 301-4557, e-mail malmedw@dshs.wa.gov.
RCW 34.05.328 applies to this rule adoption. A copy of the cost benefit analysis may be obtained by contacting the person in Name of Agency Personnel above.
Hearing Location: Blake Office Park (East) (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Lacey, WA 98503, on August 5, 2003, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by August 1, 2003, phone (360) 664-6097, TTY (360) 664-6178, e-mail swensfh@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, e-mail swensfh@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. on August 5, 2003.
Date of Intended Adoption: Not sooner than August 6, 2003.
May 29, 2003
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
3240.3"Addiction counseling competencies" means the knowledge, skills, and attitudes of chemical dependency counselor professional practice as described in Technical Assistance Publication No. 21, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services 1998.
"Administrator" means the person designated responsible for the operation of the certified treatment service.
"Adult" means a person eighteen years of age or older.
"Alcoholic" means a person who has the disease of alcoholism.
"Alcoholism" means a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.
"Approved supervisor" means a person who meets the education and experience requirements described in WAC 246-811-030 and 246-811-045 through 246-811-049 and who is available to the person being supervised.
"Authenticated" means written, permanent verification of an entry in a patient treatment record by an individual, by means of an original signature including first initial, last name, and professional designation or job title, or initials of the name if the file includes an authentication record, and the date of the entry. If patient records are maintained electronically, unique electronic passwords, biophysical or passcard equipment are acceptable methods of authentication.
"Authentication record" means a document that is part of a patient's treatment record, with legible identification of all persons initialing entries in the treatment record, and includes:
(1) Full printed name;
(2) Signature including the first initial and last name; and
(3) Initials and abbreviations indicating professional designation or job title.
"Bloodborne pathogens" means pathogenic microorganisms that are present in human blood and can cause disease in humans. The pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
"Branch site" means a physically separate certified site where qualified staff provides a certified treatment service, governed by a parent organization. The branch site is an extension of a certified provider's services to one or more sites.
"Certified treatment service" means a discrete program of chemical dependency treatment offered by a service provider who has a certificate of approval from the department of social and health services, as evidence the provider meets the standards of chapter 388-805 WAC.
"Change in ownership" means one of the following conditions:
(1) When the ownership of a certified chemical dependency treatment provider changes from one distinct legal entity (owner) to a distinct other;
(2) When the type of business changes from one type to another; or
(3) When the current ownership takes on a new owner of five percent or more of the organizational assets.
"Chemical dependency" means a person's alcoholism or drug addiction or both.
"Chemical dependency counseling" means face-to-face individual or group contact using therapeutic techniques that are:
(1) Led by a chemical dependency professional (CDP), or CDP trainee under supervision of a CDP;
(2) Directed toward patients and others who are harmfully affected by the use of mood-altering chemicals or are chemically dependent; and
(3) Directed toward a goal of abstinence for chemically dependent persons.
"Chemical dependency professional" means a person certified as a chemical dependency professional by the Washington state department of health under chapter 18.205 RCW.
"Child" means a person less than eighteen years of age, also known as adolescent, juvenile, or minor.
"Clinical indicators" include, but are not limited to, inability to maintain abstinence from alcohol or other nonprescribed drugs, positive drug screens, patient report of a subsequent alcohol/drug arrest, patient leaves program against program advice, unexcused absences from treatment, lack of participation in self-help groups, and lack of patient progress in any part of the treatment plan.
"County coordinator" means the person designated by the chief executive officer of a county to carry out administrative and oversight responsibilities of the county chemical dependency program.
"Criminal background check" means a search by the Washington state patrol for any record of convictions or civil adjudication related to crimes against children or other persons, including developmentally disabled and vulnerable adults, per RCW 43.43.830 through 43.43.842 relating to the Washington state patrol.
"Critical incidents" includes serious injury or sexual assault of patients, staff members, or public citizens on the premises; a natural disaster presenting a threat to facility operation or patient safety; a bomb threat; a break in or a burglary of patient identifying information; suicide attempt at the facility; or, a case alleging abuse or neglect of an adult patient by an agency staff member that was not resolved by the agency's grievance procedure.
"CSAT" means the Federal Center For Substance Abuse Treatment, a Substance Abuse Service Center of the Substance Abuse and Mental Health Services Administration.
"Danger to self or others," for purposes of WAC 388-805-520, means a youth who resides in a chemical dependency treatment agency and creates a risk of serious harm to the health, safety, or welfare to self or others. Behaviors considered a danger to self or others include:
(1) Suicide threat or attempt;
(2) Assault or threat of assault; or
(3) Attempt to run from treatment, potentially resulting in a dangerous or life-threatening situation.
"Department" means the Washington state department of social and health services.
"Determination of need" means a process used by the department for opiate substitution treatment program certification applications as described in WAC 388-805-040.
"Detoxification" or "detox" means care and treatment of a person while the person recovers from the transitory effects of acute or chronic intoxication or withdrawal from alcohol or other drugs.
"Disability, a person with" means a person whom:
(1) Has a physical or mental impairment that substantially limits one or more major life activities of the person;
(2) Has a record of such an impairment; or
(3) Is regarded as having such an impairment.
"Discrete treatment service" means a chemical dependency treatment service that:
(1) Provides distinct chemical dependency supervision and treatment separate from any other services provided within the facility;
(2) Provides a separate treatment area for ensuring confidentiality of chemical dependency treatment services; and
(3) Has separate accounting records and documents identifying the provider's funding sources and expenditures of all funds received for the provision of chemical dependency treatment services.
"Domestic violence" means:
(1) Physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury, or assault between family or household members;
(2) Sexual assault of one family or household member by another;
(3) Stalking as defined in RCW 9A.46.110 of one family or household member by another family or household member; or
(4) As defined in RCW 10.99.020, 26.50.010, or other Washington state statutes.
"Drug addiction" means a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. Drug addiction is characterized by impaired control over use of drugs, preoccupation with drugs, use of a drug despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic.
"Essential requirement" means a critical element of chemical dependency treatment services that must be present in order to provide effective treatment.
"Faith-based organization" means an agency or organization such as a church, religiously affiliated entity, or religious organization.
"First steps" means a program available across the state for low-income pregnant women and their infants. First steps provides maternity care for pregnant and postpartum women and health care for infants and young children.
"Governing body" means the legal entity responsible for the operation of the chemical dependency treatment service.
"HIV/AIDS brief risk intervention (BRI)" means an individual face-to-face interview with a client or patient, to help that person assess personal risk for HIV/AIDS infection and discuss methods to reduce infection transmission.
"HIV/AIDS education" means education, in addition to the brief risk intervention, designed to provide a person with information regarding HIV/AIDS risk factors, HIV antibody testing, HIV infection prevention techniques, the impact of alcohol and other drug use on risks and the disease process, and trends in the spread of the disease.
"Medical practitioner" means a physician, advanced registered nurse practitioner (ARNP), or certified physician's assistant. ARNPs and midwives with prescriptive authority may perform practitioner functions related only to indicated specialty services.
(("Misuse" means use of alcohol or other drugs by a
person in:
(1) Violation of any law; or
(2) Breach of agency policies relating to the drug-free work place.))
"Off-site treatment" means provision of chemical dependency treatment by a certified provider at a location where treatment is not the primary purpose of the site; such as in schools, hospitals, or correctional facilities.
"Opiate substitution treatment ((agency)) program" means
an organization that administers or dispenses an approved drug
as specified in 212 CFR Part 291 for treatment or
detoxification of opiate substitution. The agency is:
(1) ((Approved by the Federal Food and Drug)) Certified
as an opioid treatment program by the Federal Center for
Substance Abuse Treatment, Substance Abuse and Mental Health
Services Administration;
(2) ((Registered with)) Licensed by the Federal Drug
Enforcement Administration;
(3) Registered ((with)) by the State Board of Pharmacy;
(4) ((Licensed by the county in which it operates))
Accredited by an opioid treatment program accreditation body
approved by the Federal Center for Substance Abuse Treatment,
Substance Abuse and Mental Health Services Administration; and
(5) Certified as an opiate substitution treatment
((agency)) program by the department.
"Outcomes evaluation" means a system for determining the
effectiveness ((and efficiency)) of results achieved by
patients during or following service delivery, and patient
satisfaction with those results for the purpose of program
improvement.
"Patient" is a person receiving chemical dependency treatment services from a certified program.
"Patient contact" means time spent with a client or patient to do assessments, individual or group counseling, or education.
"Patient placement criteria (PPC)" means admission,
continued service, and discharge criteria found in the Patient
Placement Criteria for the Treatment of Substance-Related
Disorders as published ((and revised)) by the American Society
of Addiction Medicine (ASAM).
"Probation assessment officer (PAO)" means a person employed at a certified district or municipal court probation assessment service that meets the PAO requirements of WAC 388-805-220.
"Probation assessment service" means a certified assessment service offered by a misdemeanant probation department or unit within a county or municipality.
"Progress notes" are a permanent record of ongoing assessments of a patient's participation in and response to treatment, and progress in recovery.
"Qualified personnel" means trained, qualified staff, consultants, trainees, and volunteers who meet appropriate legal, licensing, certification, and registration requirements.
"Registered counselor" means a person registered, or certified by the state department of health as required by chapter 18.19 RCW.
"Relocation" means change in location from one office space to a new office space, or moving from one office building to another.
"Remodeling" means expansion of existing office space to additional office space at the same address, or remodeling of interior walls and space within existing office space.
(("Restraint," for purposes of WAC 388-805-520, means the
use of methods, by a trained staff person, to prevent or limit
free body movement in case of out-of-control behavior.
"Restraint" includes:
(1) Containment or seclusion in an unlocked quiet room;
(2) Physical restraint, meaning a person physically holds or restricts another person in a safe manner for a short time in an immediate crisis; or
(3) Use of a safe and humane apparatus, which the person cannot release by oneself.))
"SAMHSA" means the Federal Substance Abuse and Mental Health Services Administration.
"Self-help group" means community based support groups that address chemical dependency.
"Service provider" or "provider" means a legally operated entity certified by the department to provide chemical dependency services. The components of a service provider are:
(1) Legal entity/owner;
(2) Facility; and
(3) Staff and services.
"Sexual abuse" means sexual assault, incest, or sexual exploitation.
"Sexual harassment" means unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when:
(1) Submission to such conduct is made either explicitly or implicitly a term or condition of employment or treatment; or
(2) Such conduct interferes with work performance or creates an intimidating, hostile, or offensive work or treatment environment.
"Substance abuse" means a recurring pattern of alcohol or other drug use that substantially impairs a person's functioning in one or more important life areas, such as familial, vocational, psychological, physical, or social.
"Summary suspension" means an immediate suspension of certification, per RCW 34.05.422(4), by the department pending administrative proceedings for suspension, revocation, or other actions deemed necessary by the department.
"Supervision" means:
(1) Regular monitoring of the administrative, clinical, or clerical work performance of a staff member, trainee, student, volunteer, or employee on contract by a person with the authority to give directions and require change; and
(2) "Direct supervision" means the supervisor is on the premises and available for immediate consultation.
"Suspend" means termination of the department's certification of a provider's treatment services for a specified period or until specific conditions have been met and the department notifies the provider of reinstatement.
"TARGET" means the treatment and assessment report generation tool.
"Treatment plan review" means a review of active problems on the patient's individualized treatment plan, the need to address new problems, and patient placement.
"Treatment services" means the broad range of emergency, detoxification, residential, and outpatient services and care. Treatment services include diagnostic evaluation, chemical dependency education, individual and group counseling, medical, psychiatric, psychological, and social services, vocational rehabilitation and career counseling that may be extended to alcoholics and other drug addicts and their families, persons incapacitated by alcohol or other drugs, and intoxicated persons.
"Urinalysis" means analysis of a patient's urine sample for the presence of alcohol or controlled substances by a licensed laboratory or a provider who is exempted from licensure by the department of health:
(1) "Negative urine" is a urine sample in which the lab does not detect specific levels of alcohol or other specified drugs; and
(2) "Positive urine" is a urine sample in which the lab confirms specific levels of alcohol or other specified drugs.
"Vulnerable adult" means a person who lacks the functional, mental, or physical ability to care for oneself.
"Young adult" means an adult who is eighteen, nineteen, or twenty years old.
"Youth" means a person seventeen years of age or younger.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-005, filed 11/21/00, effective 1/1/01.]
(a) Detoxification services, which assist patients in withdrawing from alcohol and other drugs including:
(i) Acute detox, which provides medical care and physician supervision for withdrawal from alcohol or other drugs; and
(ii) Subacute detox, which is nonmedical detoxification or patient self-administration of withdrawal medications ordered by a physician, provided in a home-like environment.
(b) Residential treatment services, which provide chemical dependency treatment for patients and include room and board in a twenty-four-hour-a-day supervised facility, including:
(i) Intensive inpatient, a concentrated program of individual and group counseling, education, and activities for detoxified alcoholics and addicts, and their families;
(ii) Recovery house, a program of care and treatment with social, vocational, and recreational activities to aid in patient adjustment to abstinence and to aid in job training, employment, or other types of community activities; and
(iii) Long-term treatment, a program of treatment with personal care services for chronically impaired alcoholics and addicts with impaired self-maintenance capabilities. These patients need personal guidance to maintain abstinence and good health.
(c) Outpatient treatment services, which provide chemical dependency treatment to patients less than twenty-four hours a day, including:
(i) Intensive outpatient, a concentrated program of individual and group counseling, education, and activities for detoxified alcoholics and addicts and their families;
(ii) Outpatient, individual and group treatment services of varying duration and intensity according to a prescribed plan; and
(iii) Opiate substitution outpatient treatment, which meets both outpatient and opiate substitution treatment program service requirements.
(d) Assessment services, which include:
(i) ADATSA assessments, alcohol and other drug assessments of clients seeking financial assistance from the department due to the incapacity of chemical dependency. Services include assessment, referral, case monitoring, and assistance with employment; and
(ii) DUI assessments, diagnostic services requested by the courts to determine a client's involvement with alcohol and other drugs and to recommend a course of action.
(e) Information and assistance services, which include:
(i) Alcohol and drug information school, an education program about the use and abuse of alcohol and other drugs, for persons referred by the courts and others, who do not present a significant chemical dependency problem, to help those persons make informed decisions about the use of alcohol and other drugs;
(ii) Information and crisis services, response to persons having chemical dependency needs, by phone or in person;
(iii) Emergency service patrol, assistance provided to intoxicated persons in the streets and other public places;
(iv) Treatment ((alternatives to street crime))
accountability for safer communities (TASC), is a referral and
case management service. TASC providers furnish a link
between the criminal justice system and the treatment system. TASC identifies, assesses, and refers appropriate alcohol and
other drug dependent offenders to community-based substance
abuse treatment and monitors the outcome for the criminal
justice system.
(2) The department may certify a provider for more than one of the services listed under subsection (1) of this section when the provider complies with the specific requirements of the selected services.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-010, filed 11/21/00, effective 1/1/01.]
(a) Request from the department an application packet of information on how to become a certified chemical dependency service provider; and
(b) Obtain a license as a residential treatment facility from the department of health, if planning to offer residential services.
(2) The applicant must submit a completed application to the department that includes:
(a) If the applicant is a sole provider: The name and address of the applicant, and a statement of sole proprietorship;
(b) If the applicant is a partnership: The name and address of every partner, and a copy of the written partnership agreement;
(c) If the applicant is a limited liability company: The name and addresses of its officers, and any owner of five percent or more of the organizational assets, and a copy of the certificate of formation issued by the state of Washington, secretary of state;
(d) If the applicant is a corporation: The names and addresses of its officers, board of directors and trustees, and any owner of five percent or more or the organizational assets, and a copy of the corporate articles of incorporation and bylaws;
(e) A copy of the master business license authorizing the organization to do business in Washington state;
(f) The social security number or Federal Employer Identification Number for the governing organization or person;
(g) The name of the individual administrator under whose management or supervision the services will be provided;
(h) A copy of the report of findings from a criminal background check of any owner of five percent or more of the organizational assets and the administrator;
(i) Additional disclosure statements or background inquiries if the department has reason to believe that offenses, specified under RCW 43.43.830, have occurred since completion of the original application;
(j) The physical location of the facility where services will be provided including, in the case of a location known only by postal route and box numbers, and the street address;
(k) A plan of the premises assuring the chemical dependency treatment service is discrete from other programs, indicating capacities of the location for the proposed uses;
(l) Floor plan showing use of each room and location of:
(i) Windows and doors;
(ii) Restrooms;
(iii) Floor to ceiling walls;
(iv) Areas serving as confidential counseling rooms;
(v) Other therapy and recreation areas and rooms;
(vi) Confidential patient records storage; and
(vii) Sleeping rooms, if a residential facility.
(m) A completed facility accessibility self-evaluation form;
(n) Policy and procedure manuals specific to the agency at the proposed site, and meet the manual requirements described later in this regulation, including the:
(i) Administrative manual;
(ii) Personnel manual; and
(iii) Clinical manual.
(o) Sample patient records for each treatment service applied for; and
(p) Evidence of sufficient qualified staff to deliver services.
(3) In addition to the requirements in this section, a faith-based organization may implement the requirements of the federal Public Health Act, Sections 581-584 and Section 1955 of 24 U.S.C. 290 and 42 U.S.C. 300x-65.
(4) The agency owner or legal representative must:
(a) Sign the completed application form and submit the original to the department;
(b) Send a copy of the completed application form to the county coordinator in the county where services will be provided;
(c) Submit the application fee with the application materials; and
(d) Report any changes occurring during the certification process.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-015, filed 11/21/00, effective 1/1/01.]
(1) ((Evidence of licensure from the county served, or
evidence the county has authorized a specific certified agency
to provide opiate substitution treatment, per RCW 70.96A.400
through 70.96A.420)) Documentation the provider has
communicated with the county legislative authority and if
applicable, the city legislative authority, in order to secure
a location for the new opiate substitution treatment program
that:
(a) Meets county or city land use ordinances; and
(b) Includes a plan to minimize the impact of the opiate substitution treatment programs upon the business and residential neighborhoods in which the program is located. The plan must include strategies used to:
(i) Obtain and document community input regarding the proposed location;
(ii) Strategies used to address any concerns identified by the community; and
(iii) An ongoing community relations plan to address new concerns expressed by community members as they arise.
(2) A copy of the application for a registration certificate from the Washington state board of pharmacy.
(3) A copy of the application for licensure to the Federal Drug Enforcement Administration.
(4) A copy of the application for certification to the
Federal ((Food and Drug Administration)) CSAT SAMHSA.
(5) A copy of the application for accreditation by an accreditation body approved as an opioid treatment program accreditation body by the Federal CSAT SAMHSA.
(6) Policies and procedures identified under WAC 388-805-700 through 388-805-750.
(((6) Certification for opiate substitution treatment is
contingent on the concurrent approval by the applicable
county, state, and federal regulatory authorities))
(7) Documentation that transportation systems will provide reasonable opportunities to persons in need of treatment to access the services of the program.
(8) At least three letters of support from other providers within the existing health care system in the area the applicant proposes to establish a new opiate substitution treatment program to demonstrate an appropriate relationship to the service area's existing health care system.
(9) A declaration to limit the number of individual program participants to three hundred fifty as specified in RCW 70.96A.410 (1)(e).
(10) For new applicants, who operate opiate substitution treatment programs in another state, copies of national and state certification/accreditation documentation, and copies of all survey reports written by national and/or state certification or accreditation organizations for each site they have operated an opiate substitution program in over the past six years.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-030, filed 11/21/00, effective 1/1/01.]
(1) Consult with the county legislative authority in the area in which an applicant proposes to locate a program and the city legislative authority in any city in which an applicant proposes to locate a program. The department will request the county and city legislative authority to notify the department of any applicable requirements or other issues that the department should consider in order to fulfill the requirements of WAC 388-805-030 (6) and (7), or 388-805-040 (1) through (5);
(2) Not discriminate in its certification decision on the basis of the corporate structure of the applicant;
(3) Consider the size of the population in need of treatment in the area in which the program would be located and certify only applicants whose programs meet the necessary treatment needs of the population;
(4) Determine there is a need in the community for opiate substitution treatment and not certify more program slots than justified by the need in that community as described in WAC 388-805-040;
(5) Consider whether the applicant has the capability, or has in the past demonstrated the capability to provide appropriate treatment services to assist persons in meeting legislative goals of abstinence from opiates and opiate substitutes, obtaining mental health treatment, improving economic independence, and reducing adverse consequences associated with illegal use of controlled substances;
(6) Hold at least one public hearing in the county in which the facility is proposed to be located and one public hearing in the area in which the facility is proposed to be located. After consultation with the county legislative authority, the department may have the public hearing in the adjacent county with the largest population, the adjacent county with the largest underserved population, or the county nearest to the proposed site. The hearing must be held at a time and location most likely to permit the largest number of interested persons to attend and present testimony. The department must notify appropriate media outlets of the time, date, and location of the hearing at least three weeks in advance of the hearing.
[]
(1) For the number of potential clients in an area, the department will consider the size of the population in need of treatment in the area in which the program would be located using adult population statistics from the most recent area population trend reports. The department will use the established ratio of .7 percent of the adult population as an estimate for the number of potential clients with an opiate diagnosis in need of treatment services.
(2) For the number of anticipated program slots in an area, the department will multiply the sum of the established ratio of .7 percent of the adult population in subsection (1) of this section by thirty-five percent to determine an estimate of the anticipated need for the number of opiate substitution treatment program slots in the area in which the program would be located.
(3) Demographic and trend data from the area in which the program would be located including the most recent department county trend data, TARGET admission data for opiate substitution treatment from the area, hospital and emergency department admission data from the area, needle exchange data from the area, and other relevant reports and data from city and county health organizations demonstrating the need for opiate substitution treatment program services.
(4) Availability of other opiate substitution treatment programs near the area of the applicant's proposed program. The department will determine the number of patients, capacity, and accessibility of existing opiate substitution treatment programs near the area of the applicant's proposed program and whether existing programs have the capacity to assume additional patients for treatment services.
(5) Whether the population served or to be served has need for the proposed program and whether other existing services and facilities of the type proposed are available or accessible to meet that need. The assessment will include, but not limited to, consideration of the following:
(a) The extent to which the proposed program meets the need of the population presently served;
(b) The extent to which the underserved need will be met adequately by the proposed program; and
(c) The impact of the service on the ability of low-income persons, racial and ethnic minorities, women, handicapped persons, the elderly, and other underserved groups to obtain needed health care.
(6) The department will review agency policies and procedures that describe the cost of services to clients, sliding fee scales, and charity care policies, procedures, and goals.
[]
(1) The department must deny an applicant's certification when any of the following conditions occurred and was not satisfactorily resolved, or when any owner or administrator:
(a) Had a license or certification for a chemical dependency treatment service or health care agency denied, revoked, or suspended;
(b) Was convicted of child abuse or adjudicated as a perpetrator of substantiated child abuse;
(c) Obtained or attempted to obtain a health provider license, certification, or registration by fraudulent means or misrepresentation;
(d) Committed, permitted, aided, or abetted the commission of an illegal act or unprofessional conduct as defined under RCW 18.130.180;
(e) Demonstrated cruelty, abuse, negligence, misconduct, or indifference to the welfare of a patient or displayed acts of discrimination;
(f) Misappropriated patient property or resources;
(g) Failed to meet financial obligations or contracted service commitments that affect patient care;
(h) Has a history of noncompliance with state or federal regulations in an agency with which the applicant has been affiliated;
(i) Knowingly, or with reason to know, made a false statement of fact or failed to submit necessary information in:
(i) The application or materials attached; and
(ii) Any matter under department investigation.
(j) Refused to allow the department access to records, files, books, or portions of the premises relating to operation of the chemical dependency service;
(k) Willfully interfered with the preservation of material information or attempted to impede the work of an authorized department representative;
(l) Is in violation of any provision of chapter 70.96A RCW; or
(m) Does not meet criminal background check requirements.
(2) The department may deny certification when an applicant:
(a) Fails to provide satisfactory application materials; or
(b) Advertises itself as certified when certification has not been granted, or has been revoked or canceled.
(3) The department may deny an application for certification of an opiate substitution treatment program when:
(a) There is not a demonstrated need in the community for opiate substitution treatment and/or there is not a demonstrated need for more program slots justified by the need in that community;
(b) There is sufficient availability, accessibility, and capacity of other certified programs near the area in which the applicant proposes to locate the program;
(c) The applicant has not demonstrated in the past, the capability to provide the appropriate services to assist the persons who will utilize the program in meeting goals established by the legislature, including:
(i) Abstinence from opiates and opiate substitutes,
(ii) Obtaining mental health treatment,
(iii) Improving economic independence, and
(iv) Reducing adverse consequences associated with illegal use of controlled substances.
(4) The applicant may appeal department decisions in accord with chapter 34.05 RCW, the Washington Administrative Procedure Act and chapter 388-02 WAC.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-065, filed 11/21/00, effective 1/1/01.]
(a) ((Jeopardize the safety, health, or treatment of
patients; and)) An existing federal or state law; or
(b) ((Impede fair competition of another service
provider)) An existing tribal law.
(2) Providers must submit a signed letter requesting the
exemption to the Supervisor, Certification Section, Division
of Alcohol and Substance Abuse, P.O. Box ((45331)) 45330,
Olympia, WA 98504-((5331))5330. The provider must assure the
exemption request does not:
(a) Jeopardize the safety, health, or treatment of patients; and
(b) Impede fair competition of another service provider.
(3) The department must approve or deny all exemption requests in writing.
(4) The department and the provider must maintain a copy of the decision.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-075, filed 11/21/00, effective 1/1/01.]
| (a) New agency | $500 |
| (b) Branch agency | $500 |
| (c) Application for adding one or more services | $200 |
| (d) Change in ownership | $500 |
| (a) For detoxification and residential services: | $26 per licensed bed |
| (b) For nonresidential services: | |
| (i) Large size agencies: 3,000 or more clients served per year | $1,125 per year |
| (ii) Medium size agencies: 1,000-2,999 clients served per year | $750 per year |
| (iii) Small size agencies: 0-999 clients served per year | $375 per year |
| (c) For agencies certified
through deeming per WAC
(( |
$200 per year |
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-085, filed 11/21/00, effective 1/1/01.]
(a) The fees would not be in the interest of public
health and safety((, or when)); or
(b) The fees would be to the financial disadvantage of the state; or
(c) The department determines that the cost of processing the application is so small that it warrants granting an application fee waiver.
(2) Providers may submit a letter requesting a waiver of fees to the Supervisor, Certification Section, Division of Alcohol and Substance Abuse, P.O. Box 45331, Olympia, Washington, 98504-5331.
(3) Fee waivers may be granted to qualified providers who receive funding from tribal, federal, state or county government resources as follows:
(a) For residential providers: The twenty-six dollar per bed annual fee will be assessed only for those beds not funded by a governmental source;
(b) For nonresidential providers: The amount of the fee waiver must be determined by the percent of the provider's revenues that come from governmental sources, according to the following schedule:
| Percent Government Revenues | 90-100% | 75-89% | 50-74% | 0-49% |
| Small agency | No fee | $90 | $185 | $375 |
| Medium agency | No fee | $185 | $375 | $750 |
| Large agency | No fee | $285 | $565 | $1,125 |
(a) The reason for the request;
(b) For residential providers:
(i) Documentation of the number of beds currently licensed by the department of health;
(ii) Documentation showing the number of beds funded by a government entity including, tribal, federal, state or county government sources.
(c) For nonresidential providers:
(i) Documentation of the number of clients served during the previous twelve-month period;
(ii) Documentation showing the amount of government revenues received during the previous twelve-month period;
(iii) Documentation showing the amount of private revenues received during the previous twelve-month period.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-090, filed 11/21/00, effective 1/1/01.]
upon:
(a) Completion of an annual declaration of certification; and
(b) Payment of certification fees, if applicable.
(2) Providing the essential requirements for chemical dependency treatment, including the following elements:
(a) Treatment process:
(i) Assessments, as described in WAC 388-805-310;
(ii) Treatment planning, as described in WAC 388-805-315
(2)(a) and 388-805-325(((11)))(10);
(iii) Documenting patient progress, as described in WAC 388-805-315 (1)(((c)))(b) and 388-805-325(((13)))(12);
(iv) Treatment plan reviews and updates, as described in
WAC 388-805-315 (2)(((b)))(a), 388-805-325 (((11)(g)))(10) and
388-805-325 (((13)))(12)(c);
(v) Patient compliance reports, as described in WAC 388-805-315 (4)(b), 388-805-325(((17)))(16), and 388-805-330;
(vi) Continuing care, and discharge planning, as
described in WAC 388-805-315 (2)(((e)(f)))(c)(d) and (7)(a),
and 388-805-325 (((18)))(17) and (((19)))(18); and
(vii) Conducting individual and group counseling, as described in WAC 388-805-315 (2)(b) and 388-805-325(12).
(b) Staffing: Provide sufficient qualified personnel for
the care of patients as described in WAC 388-805-140(((4)))(5)
and 388-805-145(((4)))(5);
(c) Facility:
(i) Provide sufficient facilities, equipment, and
supplies for the care and safety of patients as described in
WAC 388-805-140 (((4)))(5) and (((5)))(6);
(ii) If a residential provider, be licensed by the department of health as described by WAC 388-805-015 (1)(b).
(3) Findings during periodic on-site surveys and complaint investigations to determine the provider's compliance with this chapter. During on-site surveys and complaint investigations, provider representatives must cooperate with department representatives to:
(a) Examine any part of the facility at reasonable times and as needed;
(b) Review and evaluate records, including patient clinical records, personnel files, policies, procedures, fiscal records, data, and other documents as the department requires to determine compliance; and
(c) Conduct individual interviews with patients and staff members.
(4) The provider must post the notice of a scheduled department on-site survey in a conspicuous place accessible to patients and staff.
(5) The provider must correct compliance deficiencies found at such surveys immediately or as agreed by a plan of correction approved by the department.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-100, filed 11/21/00, effective 1/1/01.]
(a) Assess fees to cover costs of added certification activities;
(b) Cease referrals of new patients who are recipients of state or federal funds; and
(c) Notify the county alcohol and drug coordinator and local media of ceased referrals, involuntary cancellations, suspensions, revocations, or nonrenewal of certification.
(2) When the department determines a service provider
knowingly failed to report ((to)), as ordered by the court
pursuant to chapter 46.61 RCW, a patient's noncompliance with
treatment ((ordered by the court under chapter 46.61 RCW)),
the department must assess the provider a fine of two hundred
fifty dollars for each incident of nonreporting.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-120, filed 11/21/00, effective 1/1/01.]
(2) The department must revoke a provider's certification
when the provider knowingly failed to report ((to)), as
ordered by the court pursuant to chapter 46.61 RCW, within a
continuous twelve-month period, three incidents of patient
noncompliance with treatment ordered by the court ((under
chapter 46.61 RCW)).
(3) The department may suspend or revoke a provider's certification when any of the following provider deficiencies or circumstances occur:
(a) A provider fails to provide the essential requirements of chemical dependency treatment as described in WAC 388-805-100(2), and one or more of the following conditions occur:
(i) Violation of a rule threatens or results in harm to a patient;
(ii) A reasonably prudent provider should have been aware of a condition resulting in significant violation of a law or rule;
(iii) A provider failed to investigate or take corrective or preventive action to deal with a suspected or identified patient care problem;
(iv) Noncompliance occurs repeatedly in the same or similar areas;
(v) There is an inability to attain compliance with laws or rules within a reasonable period of time.
(b) The provider fails to submit an acceptable and timely plan of correction for cited deficiencies; or
(c) The provider fails to correct cited deficiencies.
(4) The department may suspend certification upon receipt of a providers written request. Providers requesting voluntary suspension must submit a written request for reinstatement of certification within one year from the effective date of the suspension. The department will review the request for reinstatement, determine if the provider is able to operate in compliance with certification requirements, and notify the provider of the results of the review for reinstatement.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-130, filed 11/21/00, effective 1/1/01.]
(1) Appoint an administrator responsible for the day-to-day operation of the program.
(2) Maintain a current job description for the administrator including the administrator's authority and duties.
(3) Establish the philosophy and overall objectives for the treatment services.
(4) Notify the department within thirty days, of changes of the agency administrator.
(5) Provide personnel, facilities, equipment, and supplies necessary for the safety and care of patients.
(6) If a nonresidential provider, ensure:
(a) Safety of patients and staff; and
(b) Maintenance and operation of the facility.
(7) Review and approve written administrative, personnel, and clinical policies and procedures required under WAC 388-805-150, 388-805-200, and 388-805-300.
(8) Ensure the administration and operation of the agency is in compliance with:
(a) Chapter 388-805 WAC requirements;
(b) Applicable federal, state, tribal, and local laws and rules; and
(c) Applicable federal, state, tribal, and local licenses, permits, and approvals.
(9) The governing body of a certified opiate substitution treatment program must ensure that treatment is provided to patients in compliance with 42 Code of Federal Regulations, Part 8.12.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-140, filed 11/21/00, effective 1/1/01.]
(a) All administrative matters;
(b) Patient care services; and
(c) Meeting all applicable rules and ethical standards.
(2) When the administrator is not on duty or on call, a staff person must be delegated the authority and responsibility to act in the administrator's behalf.
(3) The administrator must ensure administrative, personnel, and clinical policy and procedure manuals:
(a) Are developed and adhered to; and
(b) Are reviewed and revised as necessary, and at least annually.
(4) The administrator must employ sufficient qualified personnel to provide adequate chemical dependency treatment, facility security, patient safety and other special needs of patients.
(5) The administrator must ensure all persons providing counseling services are registered, certified or licensed by the department of health.
(6) The administrator must ensure full-time chemical
dependency professionals (CDPs) ((or)), CDP trainees, or other
licensed or registered counselors in training to become a CDP
do not exceed one hundred twenty hours of patient contact per
month.
(7) The administrator must assign the responsibilities
for a clinical supervisor to ((a)) at least one person within
the organization.
(8) The administrator of a certified opiate substitution treatment program must ensure that the number of patients will not exceed three hundred and fifty unless authorized by the county in which the program is located.
(9) The administrator or program sponsor of a certified opiate substitution treatment program must ensure that treatment is provided to patients in compliance with 42 Code of Federal Regulations, Part 8.12.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-145, filed 11/21/00, effective 1/1/01.]
(1) The organization's:
(a) Articles and certificate of incorporation if the owner is a corporation;
(b) Partnership agreement if the owner is a partnership; or
(c) Statement of sole proprietorship.
(2) The agency's bylaws if the owner is a corporation.
(3) Copies of a current master license and state business licenses or a current declaration statement that they are updated as required.
(4) The provider's philosophy on and objectives of chemical dependency treatment with a goal of total abstinence, consistent with RCW 70.96A.011.
(5) ((Policies)) A policy and procedures describing how
services will be made sensitive to the needs of each patient,
including assurance that:
(a) Certified interpreters or other acceptable alternatives are available for persons with limited English-speaking proficiency and persons having a sensory impairment; and
(b) Assistance will be provided to persons with disabilities in case of an emergency.
(6) A policy addressing special needs and protection for youth and young adults, and for determining whether a youth or young adult can fully participate in treatment, before admission of:
(a) A youth to a treatment service caring for adults; or
(b) A young adult to a treatment service caring for youth.
(7) An organization chart specifying:
(a) The governing body;
(b) Each staff position by job title, including volunteers, students, and persons on contract; and
(c) The number of full- or part-time persons for each position.
(8) A delegation of authority policy.
(9) A copy of current fee schedules.
(10) ((Policies)) A policy and procedures implementing
state and federal regulations on patient confidentiality,
including provision of a summary of 42 CFR Part 2.22 (a)(1)
and (2) to each patient.
(11) ((Policies)) A policy and procedures for reporting
suspected child abuse and neglect.
(12) ((Policies)) A policy and procedures for reporting
the death of a patient to the department within one business
day when:
(a) The patient is in residence; or
(b) An outpatient dies on the premises.
(13) Patient grievance policy and procedures.
(14) ((Policies)) A policy and procedures on reporting of
critical incidents and actions taken to the department within
two business days when an unexpected event occurs.
(15) ((Smoking policies)) A smoking policy consistent
with the Washington Clean Indoor Air Act, chapter 70.160 RCW.
(16) For a residential provider, a facility security policy and procedures, including:
(a) Preventing entry of unauthorized visitors; and
(b) Use of passes for leaves of patients.
(17) For a nonresidential provider, an evacuation plan for use in the event of a disaster, addressing:
(a) Communication methods for patients, staff, and visitors including persons with a visual or hearing impairment or limitation;
(b) Evacuation of mobility-impaired persons;
(c) Evacuation of children if child care is offered;
(d) Different types of disasters;
(e) Placement of posters showing routes of exit; and
(f) The need to mention evacuation routes at public meetings.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-150, filed 11/21/00, effective 1/1/01.]
(2) The administrator must designate a person to be responsible for management of personnel files.
(3) Each person's file must contain:
(a) A copy of the results of a tuberculin skin test or evidence the person has completed a course of treatment approved by a physician or local health officer if the results are positive;
(b) Documentation of training on bloodborne pathogens, including HIV/AIDS and hepatitis B for all employees, volunteers, students, and treatment consultants on contract;
(i) At the time of staff's initial assignment to tasks where occupational exposure may take place;
(ii) Annually thereafter for bloodborne pathogens;
(c) A signed and dated commitment to maintain patient confidentiality in accordance with state and federal confidentiality requirements; and
(d) A record of an orientation to the agency as described in WAC 388-805-200(5).
(4) For residential facilities, documentation of current cardiopulmonary resuscitation (CPR) and first-aid training for at least one person on each shift.
(5) Documentation of health department training and approval for any staff administering or reading a TB test.
(6) Employees who ((are patients or)) have been patients
of the agency must have personnel records:
(a) Separate from clinical records; and
(b) Have no indication of current or previous patient status.
(7) In addition, each patient care staff member's personnel file must contain:
(a) Verification of qualifications for their assigned position including:
(i) For a chemical dependency professional (CDP): A copy of the person's valid CDP certification issued by the department of health (DOH);
(ii) For approved supervisors: Documentation to
substantiate the person meets the qualifications of an
approved supervisor as defined in WAC 246-811-010((.));
(iii) For ((other persons providing counseling, a copy of
a valid registration, certification, or license issued by the
DOH.)) each person engaged in the treatment of chemical
dependency, including counselors, physicians, nurses, and
other registered, certified, or licensed health care
professionals, evidence they comply with the credentialing
requirements of their respective professions;
(iv) For probation assessment officers (PAO): Documentation that the person has met the education and experience requirements described in WAC 388-805-220;
(v) For probation assessment officer trainees:
(A) Documentation that the person meets the qualification requirements described in WAC 388-805-225; and
(B) Documentation of the PAO trainee's supervised experience as described in WAC 388-805-230 including an individual education and experience plan and documentation of progress toward completing the plan.
(vi) For information school instructors:
(A) A copy of a certificate of completion of an alcohol and other drug information school instructor's training course approved by the department; and
(B) Documentation of continuing education as specified in WAC 388-805-250.
(b) A copy of a current job description, signed and dated by the employee and supervisor which includes:
(i) Job title;
(ii) Minimum qualifications for the position;
(iii) Summary of duties and responsibilities;
(iv) For contract staff, formal agreements or personnel contracts, which describe the nature and extent of patient care services, may be substituted for job descriptions.
(c) A written performance evaluation for each year of employment:
(i) Conducted by the immediate supervisor of each staff member; and
(ii) Signed and dated by the employee and supervisor.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-205, filed 11/21/00, effective 1/1/01.]
(2) Approved supervisors must provide the ((CDP
trainees)) CDPT or other licensed or registered counselor
assigned to them with documentation substantiating their
qualifications as an approved supervisor before the initiation
of training.
(3) Approved supervisors must decrease the hours of
patient contact allowed under WAC 388-805-145(6) by twenty
percent for each full-time ((CDP trainee)) CDPT or other
licensed or registered counselor supervised.
(4) Approved supervisors are responsible for all patients
assigned to the ((CDP trainees)) CDPT or other licensed or
registered counselor under their supervision.
(5) An approved supervisor must provide supervision to a
((CDP trainee)) CDPT or other licensed or registered counselor
as required by WAC 246-811-048.
(6) CDPs must review and co-authenticate all clinical
documentation of ((CDP trainees)) CDPTs or other licensed or
registered counselors.
(7) Approved supervisors must supervise, assess and document the progress the CDP trainees or other licensed or registered counselors under their supervision are making toward meeting the requirements described in WAC 246-811-030 and 246-811-047. This documentation must be provided to CDP trainees or other licensed or registered counselors upon request.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-210, filed 11/21/00, effective 1/1/01.]
(1) Be employed as a probation officer at a misdemeanant probation department or unit within a county or municipality;
(2) Be certified as a chemical dependency professional, or
(3) Have obtained a bachelor's or graduate degree in a social or health sciences field and have completed twelve quarter or eight semester credits from an accredited college or university in courses that include the following topics:
(a) Understanding addiction and the disease of chemical dependency;
(b) Pharmacological actions of alcohol and other drugs;
(c) Substance abuse and addiction treatment methods;
(d) Understanding addiction placement, continuing care, and discharge criteria, including ASAM PPC criteria;
(e) Cultural diversity including people with disabilities and it's implication for treatment;
(f) Chemical dependency clinical evaluation (screening and referral to include co-morbidity);
(g) HIV/AIDS brief risk intervention for the chemically dependent;
(h) Chemical dependency confidentiality;
(i) Chemical dependency rules and regulations.
(4) In addition, a PAO must complete:
(a) Two thousand hours of supervised experience as a PAO trainee in a state-certified DUI assessment service program if a PAO possesses a baccalaureate degree;
(b) One thousand five hundred hours of experience as a PAO trainee in a state-certified DUI assessment service program if a PAO possesses a masters or higher degree.
(5) PAOs, must complete fifteen clock hours each year or
thirty clock hours every two years of continuing education
((each year)) in chemical dependency subject areas which will
enhance competency as a PAO beginning on January 1 of the year
following the year of initial qualification.
(((6) A PAO is grandparented if they were qualified as a
PAO by June 30, 2000, under WAC 440-22-240(2).))
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-220, filed 11/21/00, effective 1/1/01.]
Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 00-23-107, filed 11/21/00,
effective 1/1/01)
WAC 388-805-250
What are the requirements to be an
information school instructor?
(1) An information school
instructor must((:
(a))) have a certificate of completion of an alcohol and
other drug information school instructor's training course
approved by the department((; and
(b) Not have a history of alcohol or other drug misuse for two years before being qualified by the department)) if not a chemical dependency professional (CDP).
(2) To remain qualified, the information school
instructor must((:
(a) Not display misuse of alcohol or other drugs while serving as an information school instructor; and
(b))) maintain information school instructor status by completing fifteen clock hours of continuing education if not a CDP:
(((i))) (a) During each two-year period beginning January
of the year following initial qualification; and
(((ii))) (b) In subject areas that increase knowledge and
skills in training, teaching techniques, curriculum planning
and development, presentation of educational material, laws
and rules, and developments in the chemical dependency field.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-250, filed 11/21/00, effective 1/1/01.]
(1) How the provider meets WAC 388-805-305 through 388-805-350 requirements.
(2) How the provider will meet applicable certified
service standards for the level of program service
requirements ((of WAC 388-805-400 through 388-805-840,
including a description of each service offered, detailing:
(a) The number of hours of treatment and education for each certified service; and
(b))):
Allowance of up to twenty percent of education time to consist of film or video presentations.
(3) Identification of resources and referral options so staff can make referrals required by law and as indicated by patient needs.
(4) Assurance that there is an identified clinical supervisor who:
(a) Is a chemical dependency professional (CDP);
(b) Reviews a sample of patient records of each CDP quarterly; and
(c) Ensures implementation of assessment, treatment, continuing care, transfer and discharge plans in accord with WAC 388-805-315.
(5) Patient admission, continued service, and discharge
criteria using PPC((:)).
(6) Policies and procedures to implement the following requirements:
(a) The administrator must not admit or retain a person unless the person's treatment needs can be met;
(b) A chemical dependency professional (CDP), or a CDP trainee under supervision of a CDP, must assess and refer each patient to the appropriate treatment service; and
(c) A person needing detoxification must immediately be referred to a detoxification provider, unless the person needs acute care in a hospital.
(((6)))
(7) Additional requirements for opiate substitution treatment programs:
(a) A program physician must ensure that a person is currently addicted to an opioid drug and that the person became addicted at least one year before admission to treatment;
(b) A program physician must ensure that each patient voluntarily chooses maintenance treatment and provides informed written consent to treatment;
(c) A program physician must ensure that all relevant facts concerning the use of the opioid drug are clearly and adequately explained to the patient;
(d) A person under eighteen years of age needing opiate substitution treatment is required to have had two documented attempts at short-term detoxification or drug-free treatment within a twelve-month period. A waiting period of no less than seven days is required between the first and second short-term detoxification treatment;
(e) No person under eighteen years of age may be admitted to maintenance treatment unless a parent, legal guardian, or responsible adult designated by the relevant state authority consents in writing to treatment;
(f) A program physician may waive the requirement of a one year history of addiction under subsection (7)(a) of this section, for patients released from penal institutions (within six months after release), for pregnant patients (program physician must certify pregnancy), and for previously treated patients (up to two years after discharge);
(g) Documentation in each patient's record that the service provider made a good faith effort to review if the patient is enrolled in any other opiate substitution treatment service;
(h) When the medical director or program physician of an opiate substitution treatment program provider in which the patient is enrolled determines that exceptional circumstances exist, the patient may be granted permission to seek concurrent treatment at another opiate substitution treatment program provider. The justification for finding exceptional circumstances for double enrollment must be documented in the patient's record at both treatment program providers.
(8) Tuberculosis screening for prevention and control of TB in all detox, residential, and outpatient programs, including:
(a) Obtaining a history of preventive or curative therapy;
(b) Screening and related procedures for coordinating with the local health department; and
(c) Implementing TB control as provided by the department of health TB control program.
(((7))) (9) HIV/AIDS information, brief risk
intervention, and referral.
(((8))) (10) Limitation of group counseling sessions to
twelve or fewer patients.
(((9))) (11) Counseling sessions with nine to twelve
youths to include a second adult staff member.
(((10))) (12) Provision of education to each patient on:
(a) Alcohol, other drugs, and chemical dependency;
(b) Relapse prevention; and
(c) HIV/AIDS, hepatitis, and TB.
(((11))) (13) Provision of education or information to
each patient on:
(a) The impact of chemical use during pregnancy, risks to the fetus, and the importance of informing medical practitioners of chemical use during pregnancy;
(b) Emotional, physical, and sexual abuse; and
(c) Nicotine addiction.
(((12))) (14) An outline of each lecture and education
session included in the service, sufficient in detail for
another trained staff person to deliver the session in the
absence of the regular instructor.
(((13))) (15) Assigning of work to a patient by a CDP
when the assignment:
(a) Is part of the treatment program; and
(b) Has therapeutic value.
(((14))) (16) Use of self-help groups.
(((15))) (17) Patient rules and responsibilities,
including disciplinary sanctions for noncomplying patients.
(((16))) (18) If youth are admitted, a policy and
procedure for assessing the need for referral to child welfare
services.
(((17))) (19) Implementation of the deferred prosecution
program.
(((18))) (20) Policy and procedures for reporting status
of persons convicted under chapter 46.61 RCW to the department
of licensing.
(((19))) (21) Nonresidential providers must have policies
and procedures on:
(a) Medical emergencies;
(b) Suicidal and mentally ill patients;
(c) ((Medical oversight, including provision of a
physical examination by a medical practitioner, on a person
who:
(i) Is at risk of withdrawal from barbiturates or benzodiazepines; or
(ii) Used intravenous drugs in the thirty days before admission;
(d))) Laboratory tests, including UA's and drug testing;
(((e))) (d) Services and resources for pregnant women:
(i) A pregnant woman who is not seen by a private physician must be referred to a physician or the local first steps maternity care program for determination of prenatal care needs; and
(ii) Services include discussion of pregnancy specific issues and resources.
(((f) If using medication services:
(i) A medical practitioner must evaluate each patient who is taking disulfiram at least once every ninety days;
(ii) Patient medications are stored, disbursed, and recorded in accord with chapter 246-326 WAC; and
(iii) Only a licensed nurse or medical practitioner may administer medication.))
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-300, filed 11/21/00, effective 1/1/01.]
(a) Is admitted to treatment without regard to race, color, creed, national origin, religion, sex, sexual orientation, age, or disability, except for bona fide program criteria;
(b) Is reasonably accommodated in case of sensory or physical disability, limited ability to communicate, limited English proficiency, and cultural differences;
(c) Is treated in a manner sensitive to individual needs and which promotes dignity and self-respect;
(d) Is protected from invasion of privacy except that staff may conduct reasonable searches to detect and prevent possession or use of contraband on the premises;
(e) Has all clinical and personal information treated in accord with state and federal confidentiality regulations;
(f) Has the opportunity to review their own treatment records in the presence of the administrator or designee;
(g) Has the opportunity to have clinical contact with a same gender counselor, if requested and determined appropriate by the supervisor, either at the agency or by referral;
(h) Is fully informed regarding fees charged, including fees for copying records to verify treatment and methods of payment available;
(i) Is provided reasonable opportunity to practice the religion of their choice as long as the practice does not infringe on the rights and treatment of others or the treatment service. The patient has the right to refuse participation in any religious practice;
(j) Is allowed necessary communication:
(i) Between a minor and a custodial parent or legal guardian;
(ii) With an attorney; and
(iii) In an emergency.
(k) Is protected from abuse by staff at all times, or from other patients who are on agency premises, including:
(i) Sexual abuse or harassment;
(ii) Sexual or financial exploitation;
(iii) Racism or racial harassment; and
(iv) Physical abuse or punishment.
(l) Is fully informed and receives a copy of counselor
disclosure requirements established under RCW ((18.170.060))
18.19.060;
(m) Receives a copy of patient grievance procedures upon request; and
(n) In the event of an agency closure or treatment service cancellation, each patient must be:
(i) Given thirty days notice;
(ii) Assisted with relocation;
(iii) Given refunds to which the person is entitled; and
(iv) Advised how to access records to which the person is entitled.
(2) A faith-based service provider must ensure the right of patients to receive treatment without religious coercion by ensuring that:
(a) Patients must not be discriminated against when seeking services;
(b) Patients must have the right to decide whether or not to take part in inherently religious activities; and
(c) Patients have the right to receive a referral to another service provider if they object to a religious provider.
(3) A service provider must obtain patient consent for each release of information to any other person or entity. This consent for release of information must include:
(a) Name of the consenting patient;
(b) Name or designation of the provider authorized to make the disclosure;
(c) Name of the person or organization to whom the information is to be released;
(d) Nature of the information to be released, as limited as possible;
(e) Purpose of the disclosure, as specific as possible;
(f) Specification of the date or event on which the consent expires;
(g) Statement that the consent can be revoked at any time, except to the extent that action has been taken in reliance on it;
(h) Signature of the patient or parent, guardian, or authorized representative, when required, and the date; and
(i) A statement prohibiting further disclosure unless expressly permitted by the written consent of the person to whom it pertains.
(((3))) (4) A service provider must notify patients that
outside persons or organizations which provide services to the
agency are required by written agreement to protect patient
confidentially.
(((4))) (5) A service provider must notify an ADATSA
recipient of the recipient's additional rights as required by
WAC 388-800-0090.
(((5))) (6) The administrator must ensure a copy of
patients' rights is given to each patient receiving services,
both at admission and in case of disciplinary discharge.
(((6))) (7) The administrator must post a copy of
patients' rights in a conspicuous place in the facility
accessible to patients and staff.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-305, filed 11/21/00, effective 1/1/01.]
(1) A face-to-face diagnostic interview with each client to obtain, review, evaluate, and document the following:
(a) A history of the client's involvement with alcohol and other drugs, including:
(i) The type of substances used;
(ii) The route of administration; and
(iii) Amount, frequency, and duration of use.
(b) History of alcohol or other drug treatment or education;
(c) The client's self-assessment of use of alcohol and other drugs;
(d) A relapse history; and
(e) A legal history.
(2) If the client is in need of treatment, a
((multidimensional assessment of the person's:
(a) Acute intoxication and/or withdrawal risk;
(b) Biomedical conditions and complications;
(c) Emotional/behavioral conditions and complications;
(d) Treatment acceptance/resistance;
(e) Relapse/continued use potential; and
(f) Recovery environment)) CDP or CDP trainee under supervision of a CDP must evaluate the assessment using PPC dimensions for the patient placement decision.
(3) If an assessment is conducted on a youth, and the client is in need of treatment, the CDP, or CDP trainee under supervision of a CDP, must also obtain the following information:
(a) Parental and sibling use of drugs;
(b) History of school assessments for learning disabilities or other problems, which may affect ability to understand written materials;
(c) Past and present parent/guardian custodial status, including running away and out-of-home placements;
(d) History of emotional or psychological problems;
(e) History of child or adolescent developmental problems; and
(f) Ability of parents/guardians to participate in treatment.
(4) Documentation of the information collected, including:
(a) ((A written summary interpreting the data gathered in
subsections (1), (2), and (3) of this section including
patient strengths and needs for each dimension;
(b))) A diagnostic assessment statement including
((applicable criteria and severity of involvement with alcohol
and other drugs)) sufficient data to determine a patient
diagnosis supported by criteria of substance abuse or
substance dependence;
(b) A written summary of the data gathered in subsections (1), (2), and (3) of this section that supports the treatment recommendation;
(c) A statement regarding provision of an HIV/AIDS brief risk intervention, and referrals made; and
(d) Evidence the client:
(i) Was notified of the assessment results; and
(ii) Documentation of treatment options provided, and the client's choice; or
(iii) If the client was not notified of the results and advised of referral options, the reason must be documented.
(5) ((Documentation of the treatment recommended, using
PPC.
(6))) Completion and submission of all reports required by the courts, department of licensing, and department of social and health services in a timely manner.
(((7))) (6) Referral of an adult or minor who requires
assessment for involuntary chemical dependency treatment to
the county-designated chemical dependency specialist.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-310, filed 11/21/00, effective 1/1/01.]
(a) Patient involvement in treatment planning;
(b) Documentation of progress toward patient attainment of goals; and
(c) Completeness of patient records.
(2) A CDP or a CDP trainee under supervision of a CDP must:
(a) Develop the individualized treatment plan based ((on
PPC)) upon the assessment and update the treatment plan based
upon achievement of goals, or when new problems are
identified;
(b) Conduct individual and group counseling;
(c) ((Evaluate the patient and conduct ongoing
assessments in accord with PPC. In cases where it is not
possible to place or provide the patient with the clinically
indicated treatment, the reason must be documented as well as
whether other treatment will be provided;
(d) Update the treatment plan, and determine continued service needs using PPC;
(e))) Develop the continuing care plan ((using PPC)); and
(((f))) (d) Complete the discharge summary ((using PPC)).
(3) A CDP, or CDP trainee under supervision of a CDP, must also include in the treatment plan for youth problems identified in specific youth assessment, including any referrals to school and community support services.
(4) A CDP, or CDP trainee under supervision of a CDP, must follow up when a patient misses an appointment to:
(a) Try to motivate the patient to stay in treatment; and
(b) Report a noncompliant patient to the committing authority as appropriate.
(5) A CDP, or CDP trainee under supervision of a CDP, must involve each patient's family or other support persons, when the patient gives written consent:
(a) In the treatment program; and
(b) In self-help groups.
(6) When transferring a patient from one certified treatment service to another within the same agency, at the same location, a CDP, or a CDP trainee under supervision of a CDP, must:
(a) Update the patient assessment and treatment plan
((using PPC)); and
(b) Provide a summary report of the patient's treatment
and progress, in the patient's record((. In detox, this may
be done by a nurse or physician)).
(7) A CDP, or CDP trainee under supervision of a CDP, must meet with each patient at the time of discharge from any treatment agency, unless in detox or when a patient leaves treatment without notice, to:
(a) Finalize a continuing care plan ((using PPC)) to
assist in determining appropriate recommendation for care;
(b) Assist the patient in making contact with necessary agencies or services; and
(c) Provide the patient a copy of the plan.
(8) When transferring a patient to another treatment provider, the current provider must forward copies of the following information to the receiving provider when a release of confidential information is signed by the patient:
(a) Patient demographic information;
(b) Diagnostic assessment statement and other assessment information, including:
(i) Documentation of the HIV/AIDS intervention;
(ii) TB test result;
(iii) A record of the patient's detox and treatment history;
(iv) The reason for the transfer((, based on using PPC));
and
(v) Court mandated or agency recommended follow-up treatment.
(c) Discharge summary; and
(d) The plan for continuing care or treatment.
(9) A CDP, or CDP trainee under supervision of a CDP, must complete a discharge summary, within seven days of each patient's discharge from the agency, which includes:
(a) The date of discharge or transfer; and
(b) A summary of the patient's progress toward each
treatment goal, except in detox((; and
(c) In detox, a summary of the patient's physical condition)).
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-315, filed 11/21/00, effective 1/1/01.]
(1) A designated individual is responsible for the record system;
(2) A secure storage system which:
(a) Promotes confidentiality of and limits access to both active and inactive records; and
(b) Protects active and inactive files from damage during storage.
(3) Patient record policies and procedures on:
(a) Who has access to records;
(b) Content of active and inactive patient records;
(c) A systematic method of identifying and filing individual patient records so each can be readily retrieved;
(d) Assurance that each patient record is complete and authenticated by the person providing the observation, evaluation, or service;
(e) Retention of patient records for a minimum of
((five)) six years after the discharge or transfer of the
patient; and
(f) Destruction of patient records.
(4) In addition to subsection (1) through (3) of this section, an opiate substitution treatment program provider must ensure that the patient record system comply with all federal and state reporting requirements relevant to opioid drugs approved for use in treatment of opioid addiction.
(5) In addition to subsection (1) through (3) of this section, providers maintaining electronic patient records must:
(a) Make records available in paper form upon request:
(i) For review by the department;
(ii) By patients requesting record review as authorized by WAC 388-805-305 (1)(f).
(b) Provide secure, limited access through means that prevent modification or deletion after initial preparation;
(c) Provide for back up of records in the event of equipment, media or human error;
(d) Provide for protection from unauthorized access, including network and Internet access.
(((5))) (6) In case of an agency closure, the provider
closing its treatment agency must arrange for the continued
management of all patient records. The closing provider must
notify the department in writing of the mailing and street
address where records will be stored and specify the person
managing the records. The closing provider may:
(a) Continue to manage the records and give assurance they will respond to authorized requests for copies of patient records within a reasonable period of time;
(b) Transfer records of patients who have given written consent to another certified provider;
(c) Enter into a qualified service organization agreement with a certified provider to store and manage records, when the outgoing provider will no longer be a chemical dependency treatment provider; or
(d) In the event none of the arrangements listed in (a) through (c) of this subsection can be made, the closing provider must arrange for transfer of patient records to the department.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-320, filed 11/21/00, effective 1/1/01.]
(1) Demographic information;
(2) A chemical dependency assessment and history of involvement with alcohol and other drugs;
(3) Documentation the patient was informed of the diagnostic assessment and options for referral or the reason not informed;
(4) ((A report of a physical examination by a medical
practitioner in accord with a nonresidential provider's policy
on medical oversight, when a patient is at risk of withdrawal
from barbiturates or benzodiazepines, or used intravenous
drugs within thirty days of admission;
(5))) Documentation the patient was informed of federal confidentiality requirements and received a copy of the patient notice required under 42 CFR, Part 2;
(((6))) (5) Documentation the patient was informed of
treatment service rules, translated when needed, signed and
dated by the patient before beginning treatment;
(((7))) (6) Voluntary consent to treatment signed and
dated by the patient, parent or legal guardian, except as
authorized by law for protective custody ((and)), involuntary
treatment, or the department of corrections;
(((8) Evidence of))
(7) Documentation the patient received counselor disclosure information, acknowledged by the provider and patient by signature and date;
(((9) Evidence of a))
(8) Documentation of the patient's tuberculosis test and results;
(((10) Evidence of))
(9) Documentation the patient received the HIV/AIDS brief risk intervention;
(((11))) (10) Initial and updated individual treatment
plans, including results of the initial assessment and
periodic reviews, addressing:
(a) Patient biopsychosocial problems;
(b) ((Short- and long-term)) Treatment goals;
(c) Estimated dates or conditions for completion of each treatment goal;
(d) Approaches to resolve the problems;
(e) Identification of persons responsible for implementing the approaches;
(f) Medical orders, if appropriate.
(((12))) (11) Documentation of referrals made for
specialized care or services;
(((13))) (12) At least weekly individualized
documentation of ongoing services in residential services, and
as required in intensive outpatient and outpatient services,
including:
(a) Date, duration, and content of counseling and other treatment sessions;
(b) Ongoing assessments of each patient's participation in and response to treatment and other activities;
(c) Progress notes as events occur, ((each shift in
detox,)) and treatment plan reviews as specified under each
treatment service of chapter 388-805 WAC; and
(d) Documentation of missed appointments.
(((14))) (13) Medication records, if applicable;
(((15))) (14) Laboratory reports, if applicable;
(((16))) (15) Properly completed authorizations for
release of information;
(((17))) (16) Copies of all correspondence related to the
patient, including reports of noncompliance;
(((18))) (17) A copy of the continuing care plan signed
and dated by the CDP and the patient; and
(((19))) (18) The discharge summary.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-325, filed 11/21/00, effective 1/1/01.]
(1) A program description of:
(a) Measurable program objectives in the areas of effectiveness, efficiency, and patient satisfaction;
(b) Baseline measurement of program objectives; and measurement of outcomes at least two of the following times:
(i) During treatment, or
(ii) At discharge, or
(iii) After treatment.
(2) Use of the results.
(3) Measurement of a representative sample of patients served by the treatment provider.))
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-350, filed 11/21/00, effective 1/1/01.]
(1) Meet WAC 388-805-001 through 388-805-320, 388-805-330, and 388-805-350 requirements; and
(2) Meet relevant requirements of chapter ((246-326))
246-337 WAC.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-400, filed 11/21/00, effective 1/1/01.]
(a) A chemical dependency professional (CDP), or a CDP
trainee under supervision of a CDP, ((must)) to assess,
counsel, and attempt to motivate each patient for referral;
(b) Other staff as necessary to provide services needed by each patient;
(c) All personnel providing patient care, except licensed staff and CDPs, must complete a minimum of forty hours of documented training before assignment of patient care duties. The personnel training must include:
(i) Chemical dependency;
(ii) HIV/AIDS and hepatitis B education;
(iii) TB prevention and control; and
(iv) Detox screening, admission, and signs of trauma.
(d) All personnel providing patient care must have current training in:
(i) Cardio-pulmonary resuscitation (CPR); and
(ii) First aid.
(2) The service provider must ensure detoxification services include:
(a) ((Screening of each person before admission by a
person knowledgeable about alcoholism and other addictions and
skilled in observation and eliciting information)) A staff
member who demonstrates knowledge about addiction, and is
skilled in observation and eliciting information, will perform
a screening of each person prior to admission;
(b) ((A chemical dependency assessment, which must be
attempted within forty-eight hours of a patient's admission;
(c))) Counseling of each patient by a CDP, or CDP trainee under supervision of a CDP, at least once:
(i) Regarding the patient's chemical dependency; and
(ii) Attempting to motivate each person to accept referral into a continuum of care for chemical dependency treatment.
(((d))) (c) Sleeping arrangements that permit observation
of patients;
(((e))) (d) Separate sleeping rooms for youth and adults;
and
(((f))) (e) Referral of each patient to other appropriate
treatment services.
(3) The service provider must ensure detoxification patient records include:
(a) Demographic information;
(b) Documentation the patient was informed of federal confidentiality requirements and received a copy of the patient notice required under 42 CFR, Part 2;
(c) Documentation the patient was informed of treatment service rules, translated when needed, signed and dated by the patient before beginning treatment;
(d) Voluntary consent to treatment signed and dated by the patient, parent or legal guardian, except as authorized by law for protective custody and involuntary treatment;
(e) Documentation the patient receive counselor disclosure information, acknowledged by the provider and patient by signature and date;
(f) Documentation of the patient's tuberculosis test and results;
(g) Documentation the patient received the HIV/AIDS brief risk intervention;
(h) Progress notes each shift and as events occur;
(i) Medication records, if applicable;
(j) Laboratory reports, if applicable;
(k) Properly completed authorizations for release of information; and
(l) The discharge summary, which includes the patient's physical condition.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-410, filed 11/21/00, effective 1/1/01.]
(1) WAC 388-805-001 through 388-805-350;
(2) WAC 388-805-510 through 388-805-550 as applicable; and
(3) Chapter ((246-326)) 246-337 WAC as required for
department of health licensing.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-500, filed 11/21/00, effective 1/1/01.]
(a) Advise the youth's parent and other referring persons of the programmatic and physical plant capabilities and constraints in regard to providing treatment with or without a youth's consent;
(b) Obtain the parent's or other referring person's agreement to participate in the treatment process as appropriate and possible; and
(c) Obtain the parent's or other referring person's agreement to return and take custody of the youth as necessary and appropriate on discharge or transfer.
(2) The administrator must ensure policies and procedures are written and implemented which detail least to increasingly restrictive practices used by the provider to stabilize and protect youth who are a danger to self or others, including:
(a) Obtaining signed behavioral contracts from the youth, at admission and updated as necessary;
(b) Acknowledging positive behavior and fostering dignity and self respect;
(c) Supporting self-control and the rights of others;
(d) Increased individual counseling;
(e) Increased staff monitoring;
(f) Verbal de-escalation;
(g) Use of unlocked room for voluntary containment or
((seclusion)) time-out;
(h) Use of ((restraints)) therapeutic physical
intervention techniques during a time limited immediate crisis
to prevent or limit free body movement that may cause harm to
the person or others; and
(i) Emergency procedures, including notification of the parent, guardian or other referring person, and, when appropriate, law enforcement.
(3) The provider must ensure staff is trained in safe and therapeutic techniques for dealing with a youth's behavioral and emotional crises, including:
(a) Verbal de-escalation;
(b) Crisis intervention;
(c) Anger management;
(d) Suicide assessment and intervention;
(e) Conflict management and problem solving skills;
(f) Management of assaultive behavior;
(g) Proper use of ((restraint)) therapeutic physical
intervention techniques; and
(h) Emergency procedures.
(4) To ((prevent)) reduce the possibility of a youth's
unauthorized exit from the residential treatment site, the
provider may have:
(a) An unlocked room for voluntary containment or
((seclusion)) time-out;
(b) A secure perimeter, such as a nonscalable fence with locked gates; and
(c) Locked windows and exterior doors.
(5) Providers using holding mechanisms in subsection (4) of this section must meet current Uniform Building Code requirements, which include fire safety and special egress control devices, such as alarms and automatic releases.
(6) When less restrictive measures are not sufficient to
de-escalate a behavioral crisis, clinical staff may ((contain
or seclude)) use, for voluntary containment or time-out of a
youth, a quiet unlocked room which has a window for
observation and:
(a) The clinical supervisor or designated alternate must be notified immediately of the staff person's use of a quiet room for a youth, and must determine its appropriateness;
(b) A chemical dependency professional (CDP) or designated clinical alternate must consult with the youth immediately and at least every ten minutes, for counseling, assistance, and to maintain direct communication; and
(c) The clinical supervisor or designated alternate must evaluate the youth and determine the need for mental health consultation.
(7) Youth who demonstrate continuing refusal to participate in treatment or continuing to exhibit behaviors that present health and safety risks to self, other patients, or staff may be discharged or transferred to more appropriate care after:
(a) Interventions appropriate to the situation from those listed in subsection (2) of this section have been attempted without success;
(b) The person has been informed of the consequences and return options;
(c) The parents, guardian, or other referring person has been notified of the emergency and need to transfer or discharge the person; and
(d) Arrangements are made for the physical transfer of the person into the custody of the youth's parent, guardian, or other appropriate person or program.
(8) Involved staff must document the circumstances surrounding each incident requiring intervention in the youth's record and include:
(a) The precipitating circumstances;
(b) Measures taken to resolve the incident;
(c) Final resolution; and
(d) Record of notification of appropriate others.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-520, filed 11/21/00, effective 1/1/01.]
Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 00-23-107, filed 11/21/00,
effective 1/1/01)
WAC 388-805-530
What are the requirements for intensive
inpatient services?
(1) A chemical dependency professional
(CDP), or a CDP trainee under supervision of a CDP, must:
(a) Complete the initial treatment plan within five days of admission;
(b) Conduct at least one face-to-face individual chemical dependency counseling session with each patient each week;
(c) Provide a minimum of ten hours of chemical dependency counseling with each patient each week;
(d) Document a treatment plan review, at least weekly,
which updates patient status, progress toward goals((, and PPC
level of service)); and
(e) Refer each patient for ongoing treatment or support, as necessary, upon completion of treatment.
(2) The provider must ensure a minimum of twenty hours of treatment services for each patient each week; up to ten hours may be education.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-530, filed 11/21/00, effective 1/1/01.]
(a) Education regarding drug-free and sober living; and
(b) Individual or group counseling.
(2) A CDP, or CDP trainee under supervision of a CDP,
must ((update patient records)) document a treatment plan
review at least monthly; and
(3) Staff must assist patients with general reentry living skills and, for youth, continuation of educational or vocational training.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-540, filed 11/21/00, effective 1/1/01.]
(1) Education regarding alcohol, other drugs, and other addictions, at least two hours each week.
(2) Individual or group counseling by a chemical dependency professional (CDP), or CDP trainee under supervision of a CDP, a minimum of two hours each week.
(3) Education on social and coping skills.
(4) Social and recreational activities.
(5) Assistance in seeking employment, when appropriate.
(6) ((Patient record)) Document a treatment plan review
((and update)) at least monthly.
(7) Assistance with re-entry living skills.
(8) A living arrangement plan.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-550, filed 11/21/00, effective 1/1/01.]
(1) WAC 388-805-001 through 388-805-350;
(2) WAC 388-805-610 through 388-805-630, as applicable; and
(3) WAC 388-805-700 through 388-805-750, if offering opiate substitution treatment program services.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-600, filed 11/21/00, effective 1/1/01.]
(2) Each chemical dependency service provider must ensure intensive outpatient services are designed to deliver:
(a) A minimum of seventy-two hours of treatment services within a maximum of twelve weeks,
(b) The first four weeks of treatment must consist of:
(i) At least three sessions each week;
(ii) Each group session must last at least one hour; and
(iii) Each session must be on separate days of the week.
(c) Individual chemical dependency counseling sessions
with each patient ((every twenty hours of treatment)) at least
once a month, or more if clinically indicated;
(d) Education totaling not more than fifty percent of
((the)) patient treatment services regarding alcohol, other
drugs, relapse prevention, HIV/AIDS, hepatitis B, hepatitis C,
and TB prevention, and other air/blood-borne pathogens;
(e) Self-help group attendance in addition to the seventy-two hours;
(f) A chemical dependency professional (CDP), or a CDP
trainee under supervision of a CDP, must conduct and document
a review of each patient's treatment plan ((every twenty hours
of treatment)) in individual chemical dependency counseling
sessions, if appropriate, to assess adequacy and attainment of
goals((, using PPC));
(g) Upon completion of intensive outpatient treatment, a
CDP, or a CDP trainee under the supervision of a CDP, must
refer each patient for ongoing treatment or support, as
necessary((, using PPC.
(3) Patients not under deferred prosecution orders, including youth patients, may be admitted to levels of care as determined appropriate using PPC)).
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-610, filed 11/21/00, effective 1/1/01.]
(2) A chemical dependency professional (CDP), or a CDP trainee under supervision of a CDP, must:
(a) For the first sixty days of treatment:
(i) Conduct group or individual chemical dependency counseling sessions for each patient, each week, according to an individual treatment plan.
(ii) Conduct at least one individual chemical dependency counseling session of no less than thirty minutes duration excluding a chemical dependency assessment for each patient, according to an individual treatment plan.
(iii) Conduct alcohol and drug basic education for each patient.
(iv) Document patient participation in self-help groups described in WAC 388-805-300(16) for patients with a diagnosis of substance dependence.
(v) For patients with a diagnosis of substance dependence who received intensive inpatient chemical dependency treatment services, the balance of the sixty-day time period will consist, at a minimum, of weekly outpatient counseling sessions according to an individual treatment plan.
(b) For the next one hundred twenty days of treatment:
(i) Conduct group or individual chemical dependency counseling sessions for each patient, every two weeks, according to an individual treatment plan.
(ii) Conduct at least one individual chemical dependency counseling session of no less than thirty minutes duration every sixty days for each patient, according to an individual treatment plan.
(c) Upon completion of one hundred eighty days of intensive treatment, a CDP, or a CDP trainee under the supervision of a CDP, must refer each patient for ongoing treatment or support, as necessary, using PPC.
(3) For client's that are assessed with insufficient evidence of substance dependence or substance abuse, a CDP must refer the client to alcohol/drug information school.
[]
(1) WAC 388-805-001 through 388-805-350;
(2) WAC ((388-805-610 and)) 388-805-620; ((and))
(3) WAC 388-805-700 through 388-805-750; and
(4) 42 Code of Federal Regulations, Part 8.12.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-700, filed 11/21/00, effective 1/1/01.]
(2) The medical director must be responsible for ensuring that the opiate substitution treatment program is in compliance with all applicable federal, state, and local laws and regulations.
(3) A program physician or authorized health care
professional under supervision of a program physician, must
provide oversight for determination of opiate physical
addiction and conducting a complete, fully documented physical
evaluation for each patient before admission ((unless the
patient is exempted by the Federal Food and Drug
Administration, and:
(a) Be available for consultation when an opiate physical addiction determination is conducted by anyone other than the program physician; and
(b) Conduct the opiate physical addiction determination for all youth patients.
(2))).
(4) A physical examination must be conducted on each patient:
(a) By a program physician or other medical practitioner; and
(b) Within ((twenty-one)) fourteen days of admission.
(((3))) (5) Following the patient's initial dose of
opiate substitution treatment, the physician must establish
adequacy of dose, considering:
(a) Signs and symptoms of withdrawal;
(b) Patient comfort; and
(c) Side effects from over medication.
(((4) At the appropriate time))
(6) Prior to the beginning of detox, a program physician must approve an individual detoxification schedule for each patient being detoxified.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-710, filed 11/21/00, effective 1/1/01.]
(2) In addition, an opiate substitution treatment program who is fully compliant with the protocol of an investigational use of a drug and other conditions set forth in the application may administer a drug that has been authorized by the Food and Drug Administration under an investigational new drug application under section 505(i) of the Federal Food, Drug, and Cosmetic Act for investigational use in the treatment of opioid addiction. Currently the following opioid agonist treatment medications will be considered to be approved by the Food and Drug Administration for use in the treatment of opioid addiction:
(a) Methadone;
(b) Levomethadyl acetate (LAAM); and
(c) Buprenorphine distributed as Subutex and suboxone.
(3) An opiate substitution treatment program must maintain current procedures that are adequate to ensure that the following dosage form and initial dosing requirements are met:
(a) Methadone must be administered or dispensed only in oral form and must be formulated in such a way as to reduce its potential for parenteral abuse;
(b) For each new patient enrolled in a program, the initial dose of methadone must not exceed thirty milligrams and the total dose for the first day must not exceed forty milligrams, unless the program physician documents in the patient's record that forty milligrams did not suppress opiate abstinence symptoms.
(4) An opiate substitution treatment program must maintain current procedures adequate to ensure that each opioid agonist treatment medication used by the program is administered and dispensed in accordance with its approved product labeling. Dosing and administration decisions must be made by a program physician familiar with the most up-to-date product labeling. These procedures must ensure that any significant deviations from the approved labeling, including deviations with regard to dose, frequency, or the conditions of use described in the approved labeling, are specifically documented in the patient's record.
[]
(a) At least ((once each month)) eight times per year;
and
(b) Randomly, without notice to the patient.
(2) Staff must observe the collection of each ((urine))
specimen sample and use proper chain of custody techniques
when handling each sample;
(3) When a patient refuses to provide a ((urine))
specimen sample or initial the log of sample numbers, staff
must consider the ((urine)) specimen positive; and
(4) Staff must document a positive ((urine)) specimen and
discuss the findings with the patient ((in a)) at the next
scheduled counseling session ((within seven days of receiving
the results of the test)).
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-720, filed 11/21/00, effective 1/1/01.]
(2) The administrator must ensure written policies and procedures to verify the identity of patients.
(3) Dispensary staff must maintain a file with a photograph of each patient. Dispensary staff must ensure pictures are updated when:
(a) The patient's physical appearance changes significantly; or
(b) Every two years, whichever comes first.
(4) In addition to notifying the ((Food and)) Federal
CSAT, SAMHSA and the Federal Drug Enforcement Administration,
the administrator must immediately notify the department and
the state board of pharmacy of any theft or significant loss
of a controlled substance.
(5) The administrator must have a written diversion control plan that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use and that assigns specific responsibility to the medical and administrative staff members for carrying out the diversion control measures and functions described in the plan.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-730, filed 11/21/00, effective 1/1/01.]
(a) Week, for the first ninety days, for a new patient or a patient readmitted more than ninety days since the person's most recent discharge from opiate substitution treatment;
(b) Week, for the first month, for a patient readmitted within ninety days of the most recent discharge from opiate substitution treatment; and
(c) Month, for a patient transferring from another opiate
substitution treatment ((agency)) program where the patient
stayed for ninety or more days.
(2) A CDP, or a CDP trainee under supervision of a CDP, must conduct and document a continuing care review with each patient to review progress, discuss facts, and determine the need for continuing opiate substitution treatment:
(a) Between six and seven months after admission; and
(b) Once every six months thereafter.
(3) A CDP, or a CDP trainee under supervision of a CDP, must provide counseling in a location that is physically separate from other activities.
(4) ((The administrator must ensure at least one
full-time CDP, or a CDP trainee under supervision of a CDP,
for each fifty patients:
(a) A CDP with one or more CDP trainees may be assigned as primary counselor for up to seventy-five patients, including those assigned to the CDP trainee; and
(b) A CDP trainee may be assigned up to thirty-five patients.
(5))) A pregnant woman and any other patient who requests, must receive at least one-half hour of counseling and education each month on:
(a) Matters relating to pregnancy and street drugs;
(b) Pregnancy spacing and planning; and
(c) The effects of opiate substitution treatment on the woman and fetus, when opiate substitution treatment occurs during pregnancy.
(((6))) (5) Staff must provide at least one-half hour of
counseling on family planning with each patient through either
individual or group counseling.
(((7))) (6) The administrator must ensure there is one
staff member who has training in family planning, prenatal
health care, and parenting skills.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-740, filed 11/21/00, effective 1/1/01.]
(a) The medication is for a Sunday or legal holiday, as identified under RCW 1.16.050; or
(b) Travel to the facility presents a safety risk for patients or staff due to inclement weather.
(2) A service provider may permit take-home medications on other days for a stabilized patient who:
(a) Has received opiate substitution treatment medication for a minimum of ninety days; and
(b) Had negative urines for the last sixty days.
(3) The provider must meet ((21)) 42 CFR, Part ((291))
8.12(i)(1-5) requirements.
(4) The provider may arrange for opiate substitution treatment medication to be administered by licensed staff or self-administered by a pregnant woman receiving treatment at a certified residential treatment agency when:
(a) The woman had been receiving treatment medication for ninety or more days; and
(b) The woman's use of treatment medication can be supervised.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-750, filed 11/21/00, effective 1/1/01.]
(a) WAC 388-805-001 through 388-805-310;
(b) WAC 388-805-020 and 388-805-325 (1), (2), (3), (((5),
(10), (16), (17))) (4), (9), (15), (16), 388-805-330; and
388-805-350; and
(c) Chapter 388-800 WAC.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-800, filed 11/21/00, effective 1/1/01.]
(a) WAC 388-805-001 through 388-805-135,
(b) WAC 388-805-145 (4), (5), and (6);
(c) WAC 388-805-150, the administrative manual, subsections (4), (7) through (11), (13), and (14);
(d) WAC 388-805-155, facilities, subsections (1)(b), (c), (d), and (2)(b);
(e) WAC 388-805-200 (1), (4), and (5);
(f) WAC 388-805-205 (1), (2), (3)(a) through (((e))) (d),
(4), (6), and (7)((, and (8)));
(g) WAC 388-805-220, 388-805-225, and 388-805-230;
(h) WAC 388-805-260, volunteers;
(i) WAC 388-805-300, clinical manual, subsections (1),
(2), (3), (((7), (14), (18))) (9), and (((19))) (20)(e);
(j) WAC 388-805-305, patients' rights;
(k) WAC 388-805-310, assessments;
(l) WAC 388-805-320, patient record system, subsections
(3)(a) through (f), and (((4)))(5);
(m) WAC 388-805-325, record content, subsections (1),
(2), (3), (((5), (8), (10), (12), (16))) (4), (7), (9), (11),
(15), and (17); and
(n) WAC 388-805-350, outcomes evaluation;
(o) WAC 388-805-815, DUI assessment services.
(2) If located in another certified chemical dependency treatment facility, the DUI service provider must meet the requirements of:
(a) WAC 388-805-001 through 388-805-260; 388-805-305 and 388-805-310;
(b) WAC 388-805-300, 388-805-320, 388-805-325 as noted in subsection (1) of this section, 388-805-350; and
(c) WAC 388-805-815.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-810, filed 11/21/00, effective 1/1/01.]
(a) WAC 388-805-001 through 388-805-135; and
(b) This section.
(2) The provider must:
(a) Inform each student of fees at the time of enrollment; and
(b) Ensure adequate and comfortable seating in well-lit and ventilated rooms.
(3) A certified information school instructor or a chemical dependency professional must teach the course and:
(a) Advise each student there is no assumption the student is an alcoholic or drug addict, and this is not a therapy session;
(b) Discuss the class rules;
(c) Review the course objectives;
(d) Follow curriculum contained in "Alcohol and Other
Drugs Information School Training Curriculum," published in
((1991)) 2001, or later amended;
(e) Ensure not less than eight and not more than fifteen hours of class room instruction;
(f) Administer the post-test from the above reference to each enrolled student after the course is completed;
(g) Ensure individual client records include:
(i) Intake form;
(ii) Hours and date or dates in attendance;
(iii) Source of referral;
(iv) Copies of all reports, letters, certificates, and other correspondence;
(v) A record of any referrals made; and
(vi) A copy of the scored post-test.
(h) Complete and submit reports required by the courts and the department of licensing, in a timely manner.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-820, filed 11/21/00, effective 1/1/01.]
(a) WAC 388-805-001 through 388-805-210;
(b) WAC 388-805-240, students;
(c) WAC 388-805-260, volunteers;
(d) WAC 388-805-300, clinical manual, subsections (1)
through (((7), (13))) (6), (9) through (((18))) (15), and
(((19))) (21)(a), (b), (((d),)) and (e)((, and (f)));
(e) WAC 388-805-305, patients' rights, subsections (1)
((through (3), and (5) through (6))) (3), (4), (6), and (7);
(f) WAC 388-805-310, assessments, subsections (1) through
(((7))) (6);
(g) WAC 388-805-315, treatment, continuing care,
transfer, and discharge plans, subsections (1), (2)(a), (c),
(d), (((e), and (f),)) (5), and (7) through (9);
(i) A CDP, or a CDP trainee under supervision of a CDP,
must substitute referral and case management plans for
treatment plan requirements in WAC 388-805-315 (1) and
(2)(a)(((d)));
(ii) A CDP, or a CDP trainee under supervision of a CDP, must coordinate the referral of patients with the appropriate treatment provider for each identified problem, ensure they receive adequate treatment, and add new problems to the case management plan as they are identified;
(iii) A CDP, or a CDP trainee under supervision of a CDP, must coordinate the continuing care plan of the patient with appropriate treatment providers; and,
(iv) When transferring a patient to another treatment provider, a TASC provider will substitute a summary of the patient's progress toward each referral and case management goal.
(h) WAC 388-805-320, patient record system;
(i) WAC 388-805-325, patient record content, subsections
(1) through (((3))) (4), (5) through (((10))) (9), and
(((12))) (11) through (((19))) (18);
(j) WAC 388-805-330, reporting patient noncompliance; and
(k) WAC 388-805-350, outcomes evaluation.
(2) A CDP, or a CDP trainee under supervision of a CDP, must assess and document the adequacy of each client's referral and case management plan and attainment of goals once each month.
[Statutory Authority: RCW 70.96A.090 and chapter 70.96A RCW. 00-23-107, § 388-805-850, filed 11/21/00, effective 1/1/01.]
The following sections of the Washington Administrative Code are repealed:
| WAC 388-805-900 | What are the requirements for outpatient child care when a parent is in treatment? |
| WAC 388-805-905 | What are the requirements for outpatient child care admission and health history? |
| WAC 388-805-910 | What are the requirements for outpatient child care policies? |
| WAC 388-805-915 | What are the requirements for an outpatient child care activity program? |
| WAC 388-805-920 | What are the requirements for outpatient child care behavior management and discipline? |
| WAC 388-805-925 | What are the requirements for outpatient child care diaper changing? |
| WAC 388-805-930 | What are the requirements for outpatient child care food service? |
| WAC 388-805-935 | What are the staffing requirements for outpatient child care services? |