WSR 03-14-081

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Rehabilitative Services Administration)

[ Filed June 27, 2003, 2:07 p.m. ]

Date of Adoption: June 25, 2003.

Purpose: Adopting new WAC 388-865-0217, to implement a state funded eligible category, psychiatric indigent inpatient program, to provide emergent psychiatric inpatient service to qualified persons. This program will replace the psychiatric inpatient portion of medical indigent program, which is ending on June 30, 2003.

Statutory Authority for Adoption: RCW 71.05.560, 71.24.035, and 71.34.800.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

Reasons for this Finding: In adopting the 2003-2005 operating budget (ESSB 5404), the legislature eliminated funding for the medically indigent program effective June 30, 2003. Without adoption of this emergency rule, the suspension of medically indigent program will leave persons who need emergent psychiatric inpatient care without resources.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Effective Date of Rule: Immediately.

June 25, 2003

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3261.1
NEW SECTION
WAC 388-865-0217   Psychiatric indigent inpatient program.   (1) The psychiatric indigent inpatient (PII) program is a state funded, limited casualty (LCP) program specifically for mental health clients identified in need of inpatient psychiatric care by the regional support network (RSN).

(2) The psychiatric indigent inpatient (PII) program pays only for emergent voluntary inpatient psychiatric care in community hospitals within the state of Washington. Psychiatric indigent inpatient (PII) does not cover ancillary charges for physician, transportation, pharmacy or other costs associated with a voluntary inpatient psychiatric hospitalization.

(3) To be eligible for the psychiatric indigent inpatient (PII) program, a client is subject to the following conditions and limitations:

(a) The client must have a voluntary inpatient psychiatric admission authorized by a regional support network (RSN) in the month of application or within the three months immediately preceding the month of application.

(b) If a client's income and/or resources exceed the standard for medically needy (MN), as described in WAC 388-478-0070, the excess must be spend down as described in 388-519-0100 for the client to be eligible for the psychiatric indigent inpatient (PII) program.

(c) A client must have incurred an emergency medical expense requirement (EMER) of two thousand dollars over a twelve-month period.

(i) Qualifying emergency medical expense requirement (EMER) expenses are psychiatric indigent inpatient (PII) services in a community hospital.

(ii) The emergency medical expense requirement (EMER) period lasts for twelve calendar months, beginning on the first day of the month of certification for psychiatric indigent inpatient (PII) and continuing through the last day of the twelfth month.

(d) A client is limited to a single three-month period of psychiatric indigent inpatient (PII) eligibility per twelve-month emergency medical expense requirement (EMER) period.

(4) Consumers applying for the psychiatric indigent inpatient (PII) program are subject to the resource rules for TANF and TANF-related clients in chapter 388-470 WAC.

(5) Clients are not eligible for the psychiatric indigent inpatient (PII) program if they:

(a) Are eligible for, or receiving, any other cash or medical program; or

(b) Entered the Washington state specifically to obtain medical care; or

(c) Are an inmate of a federal or state prison.

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