WSR 18-09-125
[Filed April 18, 2018, 11:42 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 18-03-043.
Title of Rule and Other Identifying Information: WAC 182-531-1710 Alcohol and substance misuse counseling.
Hearing Location(s): On May 22, 2018, at 10:00 a.m., at the Health Care Authority (HCA), Cherry Street Plaza, Sue Crystal 106A, 626 8th Avenue, Olympia, WA 98504. Metered public parking is available street side around building. A map is available at or directions can be obtained by calling 360-725-1000.
Date of Intended Adoption: Not sooner than May 23, 2018.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email, fax 360-586-9727.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, TTY 800-848-5429 or 711, email
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is updating qualification requirements for providers who deliver screening, brief intervention, and referral to treatment (SBIRT) services and expanding the settings where SBIRT services can be delivered.
Reasons Supporting Proposal: This rule making adds dental offices to the list of places where SBIRT services are offered; removes the minimum four hours of training; and updates how to submit proof of addiction specialist certification to the agency.
Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.
Statute Being Implemented: RCW 41.05.021, 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Amy Emerson, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1348; Implementation and Enforcement: Jodi Kunkel, P.O. Box 45502, Olympia, WA 98504-5502, 360-725-9805.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The updates to WAC 182-531-1710 do not impose additional costs or requirements on providers.
April 18, 2018
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION (Amending WSR 15-03-041, filed 1/12/15, effective 2/12/15)
WAC 182-531-1710 Alcohol and substance misuse counseling.
(1) The medicaid agency covers alcohol and substance misuse counseling through screening, brief intervention, and referral to treatment (SBIRT) services when delivered by, or under the supervision of, a qualified licensed physician or other qualified licensed health care professional within the scope of their practice.
(2) SBIRT is a comprehensive, evidence-based public health practice designed to identify, reduce and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. SBIRT can be used to identify people who are at risk for or have some level of substance use disorder which can lead to illness, injury, or other long-term morbidity or mortality. SBIRT services are provided in a wide variety of medical and community health care settings such as primary care centers, hospital emergency rooms, ((and)) trauma centers, and dental offices.
(3) The following health care professionals are eligible to become qualified SBIRT providers to deliver SBIRT services or supervise qualified staff to deliver SBIRT services:
(a) Advanced registered nurse practitioners, in accordance with chapters 18.79 RCW and 246-840 WAC;
(b) Chemical dependency professionals, in accordance with chapters 18.205 RCW and 246-811 WAC;
(c) Licensed practical nurses, in accordance with chapters 18.79 RCW and 246-840 WAC;
(d) Mental health counselors, in accordance with chapters 18.225 RCW and 246-809 WAC;
(e) Marriage and family therapists, in accordance with chapters 18.225 RCW and 246-809 WAC;
(f) Independent and advanced social workers, in accordance with chapters 18.225 RCW and 246-809 WAC;
(g) Physicians, in accordance with chapters 18.71 RCW and 246-919 WAC;
(h) Physician assistants, in accordance with chapters 18.71A RCW and 246-918 WAC;
(i) Psychologists, in accordance with chapters 18.83 RCW and 246-924 WAC;
(j) Registered nurses, in accordance with chapters 18.79 RCW and 246-840 WAC;
(k) Dentists, in accordance with chapters 18.260 and 246-817; and
(l) Dental hygienists, in accordance with chapters 18.29 and 246-815 WAC.
(4) To become a qualified SBIRT provider, eligible licensed health care professionals must:
(a) Complete ((a minimum of four hours of)) agency-approved SBIRT training((;)) and (((b))) mail or fax the SBIRT training certificate or other proof of this training completion to the agency; or
(b) Have an addiction specialist certification and mail or fax proof of this certification to the agency.
(5) The agency pays for SBIRT as follows:
(a) Screenings, which are included in the reimbursement for the evaluation and management code billed;
(b) Brief interventions, limited to four sessions per client, per provider, per calendar year; and
(c) When billed by one of the following qualified SBIRT health care professionals:
(i) Advanced registered nurse practitioners;
(ii) Mental health counselors;
(iii) Marriage and family therapists;
(iv) Independent and advanced social workers;
(v) Physicians;
(vi) Psychologists;
(vii) Dentists; and
(viii) Dental hygienists.
(6) The agency evaluates a request for additional sessions in excess of the limitations or restrictions according to WAC 182-501-0169.
(7) To be paid for providing alcohol and substance misuse counseling through SBIRT, providers must bill the agency using the agency's published billing instructions.