Washington Administrative Code › Title 388 - Social and Health Services, Department of › MENTAL HEALTH › Chapter 388-865 - Community mental health and involuntary treatment programs › BEHAVIORAL HEALTH ORGANIZATIONS › Section 388-865-0238 - Behavioral health organizations-Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section, WAC
					 388-877-0200, and WAC
					 388-877-0655 apply to behavioral health organizations (BHO) and the BHO managed
					 care plan.
"Behavioral health organization"
or
"BHO
" means any county authority or group of county authorities or
					 other entity recognized by the secretary in contract in a defined
					 region.
"Behavioral health organization (BHO) managed care
					 plan"
is the entity that operates the prepaid inpatient health plan
					 (PIHP) for medicaid behavioral health services
.
"Chemical dependency professional"
or
"CDP"
means a person credentialed by the department of health as a
					 chemical dependency professional (CDP) with primary responsibility for
					 implementing an individualized service plan for substance use disorder
					 services.
"Child"
means a person under the age of
					 eighteen years. For the purposes of the medicaid program, child means a person
					 who is under the age of twenty-one years.
"Community support services"
means services
					 authorized, planned, and coordinated through resource management services
					 including, at a minimum, assessment, diagnosis, emergency crisis intervention
					 available twenty-four hours, seven days a week; prescreening determinations for
					 persons who are mentally ill being considered for placement in nursing homes as
					 required by federal law; screening for patients being considered for admission
					 to residential services; diagnosis and treatment for children who are mentally
					 or severely emotionally disturbed discovered under screening through the
					 federal Title XIX early and periodic screening, diagnosis, and treatment
					 (EPSDT) program; investigation, legal, and other nonresidential services under
					 chapter
					 71.05 RCW; case management
					 services; psychiatric treatment including medication supervision; counseling;
					 psychotherapy; assuring transfer of relevant patient information between
					 service providers; recovery services; and other services determined by
					 behavioral health organizations.
"Consultation"
means the clinical review and
					 development of recommendations regarding activities, or decisions of, clinical
					 staff, contracted employees, volunteers, or students by persons with
					 appropriate knowledge and experience to make recommendations.
"County authority"
means the board of county
					 commissioners, county council, or county executive having authority to
					 establish a community mental health program, or two or more of the county
					 authorities specified in this subsection which have entered into an agreement
					 to provide a community mental health program.
"Designated chemical dependency specialist"
means a person designated by the behavioral health organization (BHO) or by the
					 county alcoholism and other drug addiction program coordinator designated by
					 the BHO to perform the commitment duties described in
					 RCW
					  70.96A.140 and qualified to do so by meeting
					 standards adopted by the department.
"Designated mental health professional"
or
"DMHP"
means a mental health professional designated by the
					 behavioral health organization (BHO) county or other authority authorized in
					 rule to perform duties under the involuntary treatment act as described in
					 RCW
					  10.77.010, 71.05.-020, 71.24.025 and
					 71.34.020.
"Ethnic minority"
or
"racial/ethnic
					 groups"
means, for the purposes of this chapter, any of the following
					 general population groups:
(1) African American;
(2) An American Indian or Alaskan native, which
					 includes:
(a) A person who is a member or considered to be a member
					 in a federally recognized tribe;
(b) A person determined eligible to be found Indian by the
					 secretary of interior;
(c) An Eskimo, Aleut, or other Alaskan native; and
(d) An unenrolled Indian meaning a person considered Indian
					 by a federally or nonfederally recognized Indian tribe or off-reservation
					 Indian/Alaskan native community organization;
(3) Asian/Pacific Islander; or
(4) Hispanic.
"Housing services"
means the active search and
					 promotion of individual access to, and choice in, safe and affordable housing
					 that is appropriate to the individual's age, culture, and needs.
"Medical necessity"
or
"medically
					 necessary"
is a term for describing a requested service which is
					 reasonably calculated to prevent, diagnose, correct, cure, alleviate or prevent
					 the worsening of conditions in the recipient that endanger life, or cause
					 suffering or pain, or result in illness or infirmity, or threaten to cause or
					 aggravate a handicap, or cause or physical deformity or malfunction, and there
					 is no other equally effective, more conservative or substantially less costly
					 course of treatment available or suitable for the person requesting service.
					 For the purpose of this chapter "course of treatment" may include mere
					 observation or, where appropriate, no treatment at all.
"Mental health professional"
means:
(1) A psychiatrist, psychologist, psychiatric nurse or
					 social worker as defined in
					 chapters
					 71.05 and
					 71.34 RCW;
(2) A person who is licensed by the department of health as
					 a mental health counselor, mental health counselor associate, marriage and
					 family therapist, or marriage and family therapist associate;
(3) A person with a master's degree or further advanced
					 degree in counseling or one of the behavioral sciences from an accredited
					 college or university. Such person shall have, in addition, at least two years
					 of experience in direct treatment of persons with mental illness or emotional
					 disturbance, such experience gained under the supervision of a mental health
					 professional;
(4) A person who meets the waiver criteria of
					 RCW
					  71.24.260, which was granted prior to
					 1986;
(5) A person who had an approved waiver to perform the
					 duties of a mental health professional that was requested by a regional support
					 network and granted by the mental health division prior to July 1, 2001;
					 or
(6) A person who has been granted a time-limited exception
					 of the minimum requirements of a mental health professional by the division of
					 behavioral health and recovery.
"Mental health specialist"
means:
(1) A
"child mental health specialist"
is
					 defined as a mental health professional with the following education and
					 experience:
(a) A minimum of one hundred actual hours (not quarter or
					 semester hours) of special training in child development and the treatment of
					 children and youth with serious emotional disturbance and their families;
					 and
(b) The equivalent of one year of full-time experience in
					 the treatment of seriously emotionally disturbed children and youth and their
					 families under the supervision of a child mental health specialist.
(2) A
"geriatric mental health specialist"
is
					 defined as a mental health professional who has the following education and
					 experience:
(a) A minimum of one hundred actual hours (not quarter or
					 semester hours) of specialized training devoted to the mental health problems
					 and treatment of persons sixty years of age and older; and
(b) The equivalent of one year of full-time experience in
					 the treatment of persons sixty years of age and older, under the supervision of
					 a geriatric mental health specialist.
(3) An
"ethnic minority mental health
					 specialist"
is defined as a mental health professional who has
					 demonstrated cultural competence attained through major commitment, ongoing
					 training, experience and/or specialization in serving ethnic minorities,
					 including evidence of one year of service specializing in serving the ethnic
					 minority group under the supervision of an ethnic minority mental health
					 specialist; and
(a) Evidence of support from the ethnic minority community
					 attesting to the person's commitment to that community; or
(b) A minimum of one hundred actual hours (not quarter or
					 semester hours) of specialized training devoted to ethnic minority issues and
					 treatment of ethnic minority individuals.
(4) A
"disability mental health specialist"
is
					 defined as a mental health professional with special expertise in working with
					 an identified disability group. For purposes of this chapter only, "disabled"
					 means an individual with a disability other than a mental illness, including a
					 developmental disability, serious physical handicap, or sensory impairment.
(a) If the consumer is deaf, the specialist must be a
					 mental health professional with:
(i) Knowledge about the deaf culture and psychosocial
					 problems faced by who are deaf; and
(ii) Ability to communicate fluently in the preferred
					 language system of the consumer.
(b) The specialist for individuals with developmental
					 disabilities must be a mental health professional who:
(i) Has at least one year's experience working with people
					 with developmental disabilities; or
(ii) Is a developmental disabilities professional as
					 defined in
					 RCW
					  71.05.020.
"Peer counselor"
means a person recognized by
					 the division of behavioral health and recovery (DBHR) as a person who:
(1) Is a self-identified consumer of mental health
					 services;
(2) Is a counselor credentialed under chapter 18.19
					 RCW;
(3) Has completed specialized training provided by or
					 contracted through DBHR. If the person was trained by trainers approved by the
					 mental health division (now DBHR) before October 1, 2004, and has met the
					 requirements in subsection (1), (2) and (4) of this section by January 31,
					 2005, the person is exempt from completing this specialized training;
(4) Has successfully passed an examination administered by
					 DBHR or an authorized contractor; and
(5) Has received a written notification letter from DBHR
					 stating that DBHR recognizes the person as a "peer counselor."
"Quality assurance and quality improvement"
means a focus on compliance to minimum requirements in rules and contracts, and
					 activities to perform above minimum standards and achieve reasonably expected
					 levels of performance, quality, and practice.
"Quality strategy"
means an overarching system
					 and/or process whereby quality assurance and quality improvement activities are
					 incorporated and infused into all aspects of a behavioral health organization's
					 (BHO)'s operations.
"Regional support network (RSN)"
no longer
					 exists as of March 31, 2016. See
"Behavioral health organization
					 (BHO)."
"Residential services"
means a complete range
					 of residences and supports authorized by resource management services and which
					 may involve a facility, a distinct part thereof, or services which support
					 community living, for persons who are acutely mentally ill, adults who are
					 chronically mentally ill, children who are severely emotionally disturbed, or
					 adults who are seriously disturbed and determined by the behavioral health
					 organization to be at risk of becoming acutely or chronically mentally
					 ill.
"Resource management services"
means the
					 planning, coordination, and authorization of residential services and community
					 support services for:
(1) Adults and children who are acutely mentally
					 ill;
(2) Adults who are chronically mentally ill;
(3) Children who are severely emotionally disturbed;
					 or
(4) Adults who are seriously disturbed and determined
					 solely by a behavioral health organization to be at risk of becoming acutely or
					 chronically mentally ill.
"Service area"
means the geographic area
					 covered by each behavioral health organization (BHO) for which it is
					 responsible
.
"State minimum standards"
means minimum
					 requirements established by rules adopted by the secretary and necessary to
					 implement this chapter for delivery of behavioral health services.
"Substance use disorder"
means a cluster of
					 cognitive, behavioral, and physiological symptoms indicating that an individual
					 continues using the substance despite significant substance-related problems.
					 The diagnosis of a substance use disorder is based on a pathological pattern of
					 behaviors related to the use of the substances.
"Tribal authority"
means, for the purposes of
					 behavioral health organizations and
					 RCW
					  71.24.300 only, the federally recognized
					 Indian tribes and the major Indian organizations recognized by the secretary as
					 long as these organizations do not have a financial relationship with any
					 behavioral health organization that would present a conflict of
					 interest.