To contest a decision by the mental health division, the service provider, regional support network, or mental health prepaid health plan must, within twenty-eight calendar days:
(1) File a written application for a hearing with a method that shows proof of receipt to: The Board of Appeals, P.O. Box 2465, Olympia, WA 98504; and
(2) Include in the appeal:
(a) The issue to be reviewed and the date the decision was made;
(b) A specific statement of the issue and law involved;
(c) The grounds for contesting a decision of the mental health division; and
(d) A copy of the mental health division decision that is being contested.
(3) The appeal must be signed by the director of the service provider and include the address of the service provider.
(4) The decision will be made following the requirements of the Administrative Procedure Act, chapter
34.05 RCW and chapter
388-02 WAC.
[Statutory Authority: RCW 71.05.560, 71.24.035 (5)(c),71.34.800 , 9.41.047, 43.20B.020, and 43.20B.335. 01-12-047, § 388-865-0482, filed 5/31/01, effective 7/1/01.]