WSR 08-18-047

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

(Mental Health Division)

[ Filed August 29, 2008, 11:17 a.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 08-01-107.

     Title of Rule and Other Identifying Information: The department is amending WAC 388-865-0105 What the mental health division does and how it is organized, 388-865-0410 Consumer rights, 388-865-0484 Process to certify providers of involuntary services, 388-865-0511 Evaluation and treatment facility certification, and 388-865-0526 Single bed certification; and creating WAC 388-865-0106 When local services are administered by the mental health division.

     Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on October 7, 2008, at 10:00 a.m.

     Date of Intended Adoption: Not sooner than October 8, 2008.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on October 7, 2008.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by September 30, 2008, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The mental health division (MHD) is codifying its policy on how it administers community mental health services in the event of a nonparticipating regional support network. The proposed rule change allows a community mental health agency (CMHA) to contract directly with MHD on a fee-for-service basis when the local RSN chooses not to administer mental health services for the state.

     Reasons Supporting Proposal: Contracting directly with MHD on a fee-for-service basis is the only mechanism for a CMHA to receive payment for providing mental health services in areas of the state where there is no managed care entity (RSN) in place to manage the local mental health services on behalf of the state.

     Statutory Authority for Adoption: RCW 71.05.560, 71.24.035, 71.34.380, and 74.08.090.

     Statute Being Implemented: RCW 71.24.035.

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

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

     Name of Agency Personnel Responsible for Drafting: Kevin Sullivan, P.O. Box 45504, Olympia, WA 98504-5504, (360) 725-1344; Implementation: Fran Collison, P.O. Box 45320, Olympia, WA 98504-5320, (360) 902-0864; and Enforcement: Melena Thompson, P.O. Box 45320, Olympia, WA 98504-5320, (360) 902-0840.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule will impose no new or disproportionate costs on small businesses.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kevin Sullivan, P.O. Box 45504, Olympia, WA 98504-5504, phone (360) 725-1344, fax (360) 586-9727, e-mail sullikm@dshs.wa.gov.

August 26, 2008

Stephanie E. Schiller

Rules Coordinator

3940.3
AMENDATORY SECTION(Amending WSR 06-17-114, filed 8/18/06, effective 9/18/06)

WAC 388-865-0105   What the mental health division does and how it is organized.   (1) The department of social and health services is designated by the legislature as the state mental health authority, and has designated the mental health division to administer the state mental health program.

     (2) Local services are administered by regional support networks or by the mental health division.

     (3) Telephone numbers for the mental health division or regional support networks are located in the local telephone directory and can also be obtained by calling the mental health division at the telephone number in subsection (4) of this section.

     (4) To request an organizational chart, contact the mental health division at 1-888-713-6010 or (360) 902-8070, or write to the Mental Health Division Director, P.O. Box 45320, Olympia, WA 98504.

     (((3) Local services are administered by regional support networks (RSN), whose telephone number is located in the local telephone directory and can also be obtained by calling the mental health division at the above telephone number.))

[Statutory Authority: RCW 71.24.035, 71.05.560, and chapters 71.24 and 71.05 RCW. 06-17-114, § 388-865-0105, filed 8/18/06, effective 9/18/06. Statutory Authority: RCW 71.05.560, 71.24.035 (5)(c), 71.34.800, 9.41.047, 43.20B.020, and 43.20B.335. 01-12-047, § 388-865-0105, filed 5/31/01, effective 7/1/01.]


NEW SECTION
WAC 388-865-0106   When local services are administered by the mental health division.   (1) The mental health division administers local services if:

     (a) A regional support network fails to meet state minimum standards or refuses to exercise responsibilities under RCW 71.24.045; or

     (b) The DSHS secretary assumes the duties assigned to a nonparticipating regional support network under RCW 71.24.035(16).

     (2) Within available resources as defined in RCW 71.24.025(2), consumers residing within the boundaries of a nonparticipating regional support network may receive services from any community support service provider that is contracted with the department under the provisions of chapter 388-502 WAC and licensed by or certified by the mental health division;

     (3) When the DSHS secretary assumes the duties assigned to a nonparticipating regional support network, the following standards and services continue to apply:

     (a) WAC 388-865-0217, psychiatric indigent inpatient program;

     (b) WAC 388-865-0222, advisory board;

     (c) WAC 388-865-0225, resource management;

     (d) WAC 388-865-0229, inpatient services;

     (e) WAC 388-865-0230, community support services;

     (f) WAC 388-865-0235, residential and housing services;

     (g) WAC 388-865-0240, consumer employment services;

     (h) WAC 388-865-0245, administration of ITA;

     (i) WAC 388-865-0250, ombuds services; and

     (j) WAC 388-865-0284, standards for contractors and subcontractors.

[]


AMENDATORY SECTION(Amending WSR 01-12-047, filed 5/31/01, effective 7/1/01)

WAC 388-865-0410   Consumer rights.   (1) The provider must document that consumers, prospective consumers, or legally responsible others are informed of consumer rights at admission to community support services in a manner that is understandable to the individual. Consumer rights must be written in alternative format for consumers who are blind or deaf, and must also be translated to the most commonly used languages in the service area consistent with WAC 388-865-0260(3);

     (2) The provider must post a written statement of consumer rights in public areas, with a copy available to consumers on request. Providers of telephone only services (e.g., crisis lines) must post the statement of consumer rights in a location visible to staff and volunteers during working hours;

     (3) The provider must develop a statement of consumer rights that incorporates the following statement or a variation approved by the mental health division: "You have the right to:

     (a) Be treated with respect, dignity and privacy;

     (b) Develop a plan of care and services which meets your unique needs;

     (c) The services of a certified language or sign language interpreter and written materials and alternate format to accommodate disability consistent with Title VI of the Civil Rights Act;

     (d) Refuse any proposed treatment, consistent with the requirements in chapters 71.05 and 71.34 RCW;

     (e) Receive care which does not discriminate against you, and is sensitive to your gender, race, national origin, language, age, disability, and sexual orientation;

     (f) Be free of any sexual exploitation or harassment;

     (g) Review your clinical record and be given an opportunity to make amendments or corrections;

     (h) Receive an explanation of all medications prescribed, including expected effect and possible side effects;

     (i) Confidentiality, as described in chapters 70.02, 71.05, and 71.34 RCW and regulations;

     (j) All research concerning consumers whose cost of care is publicly funded must be done in accordance with all applicable laws, including DSHS rules on the protection of human research subjects as specified in chapter 388-04 WAC;

     (k) Make an advance directive, stating your choices and preferences regarding your physical and mental health treatment if you are unable to make informed decisions;

     (l) Appeal any denial, termination, suspension, or reduction of services and to continue to receive services at least until your appeal is heard by a fair hearing judge;

     (m) If you are Medicaid eligible, receive all services which are medically necessary to meet your care needs. In the event that there is a disagreement, you have the right to a second opinion from:

     (i) A provider within the regional support network about what services are medically necessary; or

     (ii) For consumers not enrolled in a prepaid health plan, a provider under contract with the mental health division.

     (n) Lodge a complaint with the ombuds, regional support network, or provider if you believe your rights have been violated. If you lodge a complaint or grievance, you must be free of any act of retaliation. The ombuds may, at your request, assist you in filing a grievance. The ombuds' phone number is:__________;

     (o) Ask for an administrative hearing if you believe that any rule in this chapter was incorrectly applied in your case."

[Statutory Authority: RCW 71.05.560, 71.24.035 (5)(c), 71.34.800, 9.41.047, 43.20B.020, and 43.20B.335. 01-12-047, § 388-865-0410, filed 5/31/01, effective 7/1/01.]


AMENDATORY SECTION(Amending WSR 01-12-047, filed 5/31/01, effective 7/1/01)

WAC 388-865-0484   Process to certify providers of involuntary services.   In order to be certified to provide services to consumers on an involuntary basis, the provider must comply with the following process:

     (1) Be licensed as a community support provider consistent with this section or licensed as a community hospital by the department of health;

     (2) Complete and submit an application for certification to the regional support network or the mental health division if the DSHS secretary has assumed the duties assigned to the nonparticipating regional support network;

     (3) The regional support network selects providers for certification and makes a request to the mental health division for certification;

     (4) The mental health division conducts an on-site review to examine agency policies and procedures, personnel records, clinical records, financial documents, and any other information that may be necessary to confirm compliance with minimum standards of this section;

     (5) The mental health division grants certification based on compliance with the minimum standards of this section and chapter 71.05 RCW;

     (6) The certificate may be renewed annually ((at the request of)) if:

     (a) Requested by the regional support network or those providers contracted with the mental health division directly; and

     (b) The provider(('s continued compliance)) continues to comply with the minimum standards of this section;

     (7) The procedures to suspend or revoke a certificate are the same as outlined in WAC 388-865-0468;

     (8) The appeal process to contest a decision of the mental health decision is the same as outlined in WAC 388-865-0482.

[Statutory Authority: RCW 71.05.560, 71.24.035 (5)(c), 71.34.800, 9.41.047, 43.20B.020, and 43.20B.335. 01-12-047, § 388-865-0484, filed 5/31/01, effective 7/1/01.]


AMENDATORY SECTION(Amending WSR 04-07-014, filed 3/4/04, effective 4/4/04)

WAC 388-865-0511   Evaluation and treatment facility certification.   To obtain and maintain certification to provide inpatient evaluation and treatment services under chapter 71.05 and 71.34 RCW, a facility must meet the following requirements:

     (1) Be licensed by the department of health as:

     (a) A hospital as defined in chapter 70.41 RCW;

     (b) A psychiatric hospital as defined in chapter 246-322 WAC;

     (c) A mental health inpatient evaluation and treatment facility consistent with chapter 246-337 WAC; or

     (d) A mental health child long-term inpatient treatment facility consistent with chapter 246-337 WAC.

     (2) Be approved by the regional support network, or the mental health division ((in the case of mental health)). Child long-term inpatient treatment facilities((; and)) can only be approved by the mental health division.

     (3) Successfully complete a provisional and annual on-site review by the mental health division to determine facility compliance with the minimum standards of this section and chapters 71.05 and 71.34 RCW.

[Statutory Authority: RCW 71.05.560, 71.34.800, and chapters 71.05 and 71.34 RCW. 04-07-014, § 388-865-0511, filed 3/4/04, effective 4/4/04.]


AMENDATORY SECTION(Amending WSR 04-07-014, filed 3/4/04, effective 4/4/04)

WAC 388-865-0526   Single bed certification.   At the discretion of the mental health division, an exception may be granted to allow treatment to an adult on a seventy-two hour detention or fourteen-day commitment in a facility that is not certified under WAC 388-865-0500; or for a maximum of thirty days to allow a community facility to provide treatment to an adult on a ninety- or one hundred eighty-day inpatient involuntary commitment order. For involuntarily detained or committed children, the exception may be granted to allow treatment in a facility not certified under WAC 388-865-0500 until the child's discharge from that setting to the community, or until they transfer to a bed in a children's long-term inpatient program (CLIP).

     (1) The regional support network or its designee must submit a written request for a single bed certification to the mental health division prior to the commencement of the order. In the case of a child, the facility must submit the written request directly to the mental health division. If the DSHS secretary has assumed the duties assigned to a nonparticipating regional support network, a single bed certification may be requested by a mental health division designee contracted to provide inpatient authorization or designated crisis response services.

     (2) The facility receiving the single bed certification must meet all requirements of this section unless specifically waived by the mental health division.

     (3) The request for single bed certification must describe why the consumer meets at least one of the following criteria:

     (a) The consumer requires services that are not available at a facility certified under this chapter or a state psychiatric hospital; or

     (b) The consumer is expected to be ready for discharge from inpatient services within the next thirty days and being at a community facility would facilitate continuity of care, consistent with the consumer's individual treatment needs.

     (4) The mental health division director or the director's designee makes the decision and gives written notification to the requesting ((regional support network)) entity in the form of a single bed certification. The single bed certification must not contradict a specific provision of federal law or state statute.

     (5) The mental health division may make site visits at any time to verify that the terms of the single bed certification are being met. Failure to comply with any term of this exception may result in corrective action. If the mental health division determines that the violation places consumers in imminent jeopardy, immediate revocation of this exception can occur.

     (6) Neither consumers nor facilities have fair hearing rights as defined under chapter 388-02 WAC regarding single bed certification decisions by mental health division staff.

[Statutory Authority: RCW 71.05.560, 71.34.800, and chapters 71.05 and 71.34 RCW. 04-07-014, § 388-865-0526, filed 3/4/04, effective 4/4/04.]

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