School-based health care services for children in special education—Provider qualifications.
The medicaid agency pays school districts to provide certain health care-related services (see WAC 182-537-0400
). These services must be delivered by qualified health care providers who are enrolled with the medicaid agency and hold a current professional license:
(1) Audiology services must be delivered by a licensed audiologist.
(2) Counseling services must be delivered by:
(a) A licensed independent social worker (LiCSW);
(b) A licensed advanced social worker (LiACSW);
(c) A licensed mental health counselor (LMHC); or
(d) A licensed mental health counselor associate (LMHCA) under the supervision of a department of health-approved licensed supervisor.
(3) Nursing services must be delivered by:
(a) A licensed registered nurse (RN);
(b) A licensed practical nurse (LPN) who is supervised by an RN; or
(c) A noncredentialed school employee who is delegated certain limited health care tasks by an RN and is supervised according to professional practice standards (see RCW 18.79.260
(4) Occupational therapy services must be delivered by:
(a) A licensed occupational therapist (OT); or
(b) A licensed occupational therapist assistant (OTA) who is supervised by a licensed occupational therapist.
(5) Physical therapy services must be delivered by:
(a) A licensed physical therapist (PT); or
(b) A licensed physical therapist assistant (PTA) who is supervised by a licensed physical therapist.
(6) Psychological services must be delivered by a licensed psychologist.
(7) Speech therapy services must be delivered by:
(a) A licensed speech-language pathologist (SLP); or
(b) A speech-language pathology assistant (SLPA) who:
(i) Has graduated from a speech-language pathology assistant program at a board-approved institution; and
(ii) Is directly supervised by a speech-language pathologist with a current certificate of clinical competence (CCC).
(8) For services provided under the supervision of a physical therapist, occupational therapist or speech-language pathologist, nurse, or counselor/social worker, the following requirements apply:
(a) The nature, frequency, and length of the supervision must be provided in accordance with professional practice standards, and be sufficient to ensure a child receives quality therapy services;
(b) The supervising therapist must see the child face-to-face at the beginning of services and at least once more during the school year;
(c) At a minimum, supervision must be face-to-face communication between the supervisor and the supervisee once per month. Supervisors are responsible for approving and cosigning all treatment notes written by the supervisee before submitting claims for payment; and
(d) Documentation of supervisory activities must be recorded and available to the agency or its designee upon request.
(9) The school district must assure providers meet the professional licensing and certification requirements.
(10) Licensing exemptions found in the following regulations do not apply to federal medicaid reimbursement for the services indicated below:
(d) Speech therapy as found in RCW 18.35.195
[Statutory Authority: RCW 41.05.021
, 34 C.F.R. 300.154(d), and chapter 182-502 WAC. WSR 13-21-079, § 182-537-0350, filed 10/17/13, effective 11/17/13. Statutory Authority: RCW 41.05.021
. WSR 13-05-017, § 182-537-0350, filed 2/7/13, effective 3/10/13. WSR 11-14-075, recodified as § 182-537-0350, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090
, 74.09.500, and 42 C.F.R. 440.110. WSR 09-07-004, § 388-537-0350, filed 3/4/09, effective 4/4/09.]