Washington Administrative Code › Title 182 - Health Care Authority › WASHINGTON APPLE HEALTH › Chapter 182-546 - Transportation services › Section 182-546-0125 - Ambulance transportation-Definitions

Current through Register Vol. 24-14, July 15, 2024
The following definitions and those found in chapter 182-500
				  WAC apply to ambulance transportation services.
"Advanced life support (ALS)"
- See
				  RCW
				  18.73.030.
"Advanced life support (ALS) assessment"
- Means
				  an assessment performed by ALS trained personnel as part of an emergency
				  response that was necessary because the client's reported conditions at the
				  time of dispatch was such that only an ALS crew was qualified to perform the
				  assessment. An ALS assessment does not necessarily result in an ambulance
				  transport or determination that the client requires an ALS level of service or
				  that the transport will be reimbursed at the ALS rate.
"Advanced life support, Level 1 (ALS1)"
- Means
				  the transportation by ground ambulance vehicle and the provision of medically
				  necessary supplies and services including the provision of an ALS assessment or
				  at least one ALS intervention.
"Advanced life support, Level 1 (ALS1)
				  emergency"
- Means medically necessary ALS1 services, as previously
				  specified, in the context of an emergency response. An emergency response is
				  one that, at the time the ambulance provider is called, it responds
				  immediately.
"Advanced life support, Level 2 (ALS2)"
- Means
				  transportation by ground ambulance vehicle and the provision of medically
				  necessary supplies and services including at least three separate
				  administrations of one or more medications by intravenous push/bolus or by
				  continuous infusion (excluding crystalloid fluids) or ground ambulance
				  transport, medically necessary supplies and services, and the provision of at
				  least one of the ALS2 procedures listed below:
(a) Endotracheal intubation;
(b) Cardiac pacing;
(c) Chest decompression;
(d) Creation of a surgical airway;
(e) Manual defibrillation/cardioversion;
(f) Placement of central venous line; or
(g) Placement of intraosseous line.
(a) Get up from bed without assistance;
(b) Unable to bear weight or ambulate;
(c) Sit in a chair or wheelchair.
(a) Is in danger of serious physical harm as a result of
				  being unable to provide for personal health or safety; or
(b) Shows repeated and escalating loss of cognitive control
				  over personal actions and is not receiving care essential for personal health
				  or safety.
"Ground ambulance"
- Means a ground vehicle
				  designed and used to transport the ill and injured and to provide personnel,
				  facilities, and equipment to treat clients before and during
				  transportation.
"Indirect costs"
- Means the costs for a common
				  or joint purpose benefiting more than one cost objective and allocated to each
				  objective using an agency-approved indirect rate or an allocation
				  methodology.
"Initial detention"
- Means the period, up to
				  seventy-two hours, in which a person is involuntarily placed in an evaluation
				  and treatment facility under
				  RCW
				  71.05.150 or
				  71.05.153
				  (see
				  RCW
				  71.05.160 ). This period begins on the date
				  and time the evaluation and treatment facility provisionally accepts the client
				  for admission. See definition for "petition for initial detention."
"Interfacility"
- Means transportation services
				  between hospitals.
"Invasive procedure"
- Means a medically
				  necessary operative procedure in which skin or mucous membranes and connective
				  tissues are cut or an instrument is introduced through a natural body orifice,
				  e.g., an intubation tube. Invasive procedures include a range of procedures
				  from minimally invasive (biopsy, excision) to extensive (organ
				  transplantation). This does not include use of instruments for examinations or
				  very minor procedures such as drawing blood.
"Involuntary Treatment Act (ITA)"
- See chapters
				  71.05 and 71.34 RCW.
"Less restrictive alternative treatment"
- Means
				  a program of individualized treatment in a less restrictive setting than
				  inpatient treatment and that includes the services described in
				  RCW
				  71.05.585.
"Lift-off fee"
- Means either of the two base
				  rates the agency pays to air ambulance providers for transporting a client. The
				  agency establishes separate lift-off fees for helicopters and airplanes.
"Loaded mileage"
- Means the distance the client
				  is transported in the ambulance.
"Medical attestation"
- Means the medical
				  professional is attesting to the fact that the client has a condition that
				  justifies medical transportation and the level of care that is specified by BLS
				  or ALS services and supplies. The condition must also be such that other means
				  of transportation (such as taxi, bus, car, or other means) would be harmful to
				  the client. (See WAC
				  182-500-0070 for
				  additional information - Medically necessary definition.)
"Medical control"
- Means the medical authority
				  upon which an ambulance provider relies to coordinate prehospital emergency
				  services, triage, and trauma center assign-ment/destination for the person
				  being transported. The medical control is designated in the trauma care plan,
				  by the department of health's (DOH) contracted medical program director, of the
				  region in which the ambulance service is provided.
"Nonemergency ambulance transportation"
- Means
				  the use of a ground ambulance to carry a client who may be confined to a
				  stretcher but typically does not require the provision of emergency medical
				  services in transit, or the use of an air ambulance to or from an out-of-state
				  health care service when the out-of-state health care service and air ambulance
				  transportation are prior authorized by the agency. Nonemergency ambulance
				  transportation is usually scheduled or prearranged. See definitions for "prone
				  or supine transportation."
"Parent"
- For the purpose of family initiated
				  treatment under
				  RCW
				  71.34.600 through
				  71.34.670,
				  means a legal guardian, a person that has been given authorization to make
				  health care decisions for the adolescent, a kinship caregiver who is involved
				  in caring for the adolescent, or another relative who is responsible for the
				  health care of the adolescent who may be required to provide a declaration
				  under penalty of perjury stating that they are a relative responsible for the
				  health care of the adolescent under
				  RCW
				  9A.72.085.
"Petition for initial detention"
- A document
				  required by the superior court of Washington for admission of the client by the
				  evaluation and treatment facility. This form is available on the Washington
				  state superior court mental proceedings rules web page.
"Petition for revocation of a conditional release or
				  less restrictive treatment"
- Means a document completed by a designated
				  crisis responder (DCR).
"Point of destination"
- Means a health care
				  facility generally equipped to provide the necessary medical, nursing, or
				  behavioral health care necessary to treat the client's injury, illness,
				  symptoms, or complaint.
"Point of pickup"
- Means the location of the
				  client at the time the client is placed on board the ambulance or transport
				  vehicle.
"Prehospital care"
- Means an assessment,
				  stabilization, and emergency medical care of an ill or injured client by an
				  emergency medical technician, paramedic, or other person before the client
				  reaches the hospital.
"Prone or supine transportation"
- Means
				  transporting a client confined to a stretcher or gurney, with or without
				  emergency medical services being provided in transit.
"Public institution"
- Means a facility that is
				  either an organizational part of a government entity or over which a
				  governmental unit exercises final administrative control, (e.g., city/county
				  jails and state correctional facilities).
"Publicly owned or operated"
- Means an entity
				  that is owned or operated by a unit of government. The unit of government is a
				  state, city, county, special purpose district, or other governmental unit in
				  the state that has taxing authority, has direct access to tax revenues, or is
				  an Indian tribe as defined in the Indian Self-Determination and Education
				  Assistance Act, Section 4.
"Qualifying expenditure"
- Means an expenditure
				  for covered services provided to an eligible beneficiary.
"Secure withdrawal management and stabilization
				  facility"
- Means a facility operated by either a public or private
				  agency or by the program of an agency which provides care to voluntary
				  individuals involuntarily detained and committed under this chapter for whom
				  there is a likelihood of serious harm or who are gravely disabled due to the
				  presence of a substance use disorder.
"Service period"
- Means July 1st through June
				  30th of each Washington state fiscal year.
"Shift"
- Means a standard period of time
				  assigned for a complete cycle of work as set by each participating
				  provider.
"Specialty care transport (SCT)"
- Means
				  interfacility (hospital-to-hospital or hospital-to-skilled nursing facility)
				  transportation of a critically injured or ill client by a ground ambulance
				  vehicle under the command of ALS-trained personnel with additional training
				  above the level of a paramedic.
"Standing order"
- Means an order remaining in
				  effect indefinitely until canceled or modified by an approved medical program
				  director (regional trauma system) or attending physician.
"Substance use disorder professional (SUDP)"
-Means a person certified as a substance use disorder professional by the
				  department of health (DOH) under chapter 18.205 RCW.
"Transfer-down"
- Means a transfer from a higher
				  level facility to a facility of lower or equivalent level of care, or back to
				  the original point of pickup (e.g., referring hospital or skilled nursing
				  facility).
"Transfer-up"
- Means a transfer from one
				  hospital to a hospital of higher level care when the transfer and discharging
				  hospital has inadequate facilities or care, or appropriate personnel to provide
				  the necessary medical services required by the client.
"Trip"
- Means a transportation one-way from the
				  point of pickup to the point of destination by an authorized transportation
				  provider.