WSR 17-22-007
(Washington Apple Health)
[Filed October 18, 2017, 4:00 p.m., effective October 18, 2017, 4:00 p.m.]
Effective Date of Rule: Immediately upon filing.
Purpose: The agency is creating new WAC 182-546-4600 for ambulance transportation for involuntary substance use disorder treatment as directed by the Washington state legislature in E3SHB 1713, also known as the Ricky Garcia Act.
Citation of Rules Affected by this Order: New WAC 182-546-4600.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160; ESHB [E3SHB] 1713 (chapter 29, Laws of 2016 1st sp. sess.)
Under RCW 34.05.350 the agency for good cause finds 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: As directed by the Washington state legislature to implement under E3SHB 1713, this emergency filing continues the current emergency rule filed under WSR 17-14-002 which is set to expire on October 19, 2017. Finalizing of the permanent rule was delayed because of issues in implementing a training program for designated crisis responders who are licensed and credentialed to provide both mental health and substance use disorder services. This training program is directly related to the permanent rule making for WAC 182-546-4600. Since the last emergency filing, the training issues have been resolved and the permanent rule making is moving forward.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Date Adopted: October 18, 2017.
Wendy Barcus
Rules Coordinator
WAC 182-546-4600 Ambulance transportationInvoluntary substance use disorder treatmentRicky Garcia Act.
(1) Definitions. For the purposes of this section, the following definitions and those found in chapter 182-500 WAC apply:
(a) "Behavioral health organization (BHO)" - See WAC 182-500-0015.
(b) "Designated chemical dependency specialist" means a person appointed by the behavioral health organization (BHO) or by the BHO-designated county substance use disorder treatment program coordinator to perform the duties specified in this section.
(c) "Detention" or "detain" means the lawful confinement of a person, under the provisions of this chapter.
(d) "Evaluation and treatment facility" means any facility which can provide directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and timely and appropriate inpatient care to people suffering from a mental disorder, and which is certified as such by the department of social and health services (DSHS). DSHS may certify single beds as temporary evaluation and treatment beds under RCW 71.05.745. A physically separate and separately operated portion of a state hospital may be designated as an evaluation and treatment facility. A facility which is part of, or operated by, DSHS or any federal agency will not require certification. No correctional institution or facility, or jail, shall be an evaluation and treatment facility under this chapter.
(e) "Gravely disabled" means that a person experiences a loss of cognition or control over the person's actions, is not receiving care essential for the person's health or safety, and is in danger of serious physical harm.
(f) "Involuntary Treatment Act" means, for adults, chapter 71.05 RCW; for juveniles, chapter 71.34 RCW. See also chapter 388-865 WAC.
(g) "Less restrictive alternative treatment" means a program of individualized treatment in a less restrictive setting than inpatient treatment that includes the services described in RCW 71.05.585.
(h) "Nearest and most appropriate destination" means the nearest facility able and willing to accept the involuntarily detained person for treatment, not the closest facility based solely on driving distance.
(2) The medicaid agency pays for transportation services for a person detained for involuntary chemical dependency treatment when the following apply:
(a) The person has been assessed by a designated chemical dependency specialist and found to be:
(i) A danger to self;
(ii) A danger to others;
(iii) Gravely disabled as a result of chemical dependency.
(b) The transportation is from:
(i) The site of the initial detention;
(ii) An evaluation and treatment facility designated by DSHS; or
(iii) A court hearing.
(c) The transportation is to:
(i) An evaluation and treatment facility;
(ii) A less restrictive alternative setting, except when ambulance transport to a client's home is not covered; or
(iii) A court hearing.
(d) The transportation is provided by a qualified transportation provider. The qualified transportation provider must:
(i) Be substance use disorder treatment provider designated as such by:
(A) The local community mental health center; or
(B) The BHO.
(ii) Comply with DSHS requirements for drivers, driver training, vehicle and equipment standards and maintenance.
(3) The transportation must be to the nearest and most appropriate destination. The reason for the diversion to a more distant facility must be clearly documented in the person's file.
(4) The designated chemical dependency specialist authorizes the level of transportation provided to and from covered facilities based on the person's need. A copy of the agency's Authorization for Substance Use Disorder (SUD) Ambulance Transportation form by the designated chemical dependency specialist must be kept in the person's file.
(5) The DSHS chemical dependency division establishes payment for substance use disorder transportation. Providers must clearly identify Involuntary Treatment Act transportation on the claim form when submitting claims to the agency.