Transportation coverage under the Involuntary Treatment Act (ITA).
(1) For purposes of this section, the following definitions apply:
(a) "Nearest and most appropriate destination" means the nearest facility able and willing to accept the involuntarily detained individual for treatment, not the closest facility based solely on driving distance.
(b) "County-designated mental health professional (CD-MHP)" means a person who, under the guidelines specified by the Involuntary Treatment Act (ITA):
(i) Assesses a client's level of need for transportation according to procedures established by the county in which the client being assessed resides; and
(ii) Decides, following the assessment, how a client should be transported to an inpatient psychiatric treatment facility.
(c) "Involuntary Treatment Act" means, for adults, chapter 71.05
RCW; for juveniles, chapter 71.34
RCW. See also chapter 388-865
(d) "Regional support network (RSN)" means a county authority or group of county authorities recognized by the secretary of the department of social and health services (DSHS) and which contracts with DSHS to implement a locally managed community mental health program.
(2) The medical assistance administration (MAA) covers transportation under ITA for an individual who is being involuntarily detained for mental health treatment, after that individual has been assessed by a CD-MHP and found to be:
(a) A danger to self;
(b) A danger to others; or
(c) Gravely disabled.
(3) Transportation under ITA may be provided to an eligible individual by an organization designated as an ITA provider by the local community mental health center and/or RSN. Designated ITA providers must comply with the department's requirements for drivers, driver training, vehicle and equipment standards and maintenance.
(4) Transportation under the ITA for an individual described in subsection (2) is covered from:
(a) The site of the initial detention;
(b) An evaluation and treatment facility designated by the department; or
(c) A court hearing.
(5) Transportation under the ITA for an individual described in subsection (2) is covered when provided to:
(a) An evaluation and treatment facility;
(b) A less restrictive alternative setting, except when ambulance transport to a client's home is not covered; or
(c) A court hearing.
(6) The CD-MHP authorizes the level of transportation provided under ITA to and from covered facilities based on the individual's need. A copy of the authorization by the CD-MHP must be kept in the individual's file.
(7) MAA pays for ITA transports to the nearest and most appropriate destination. The reason for the diversion to a more distant facility must be clearly documented in the individual's file.
(8) The department's mental health division (MHD) establishes payment for ITA transports. Providers must clearly identify ITA transports on the claim form when submitting claims to MAA.
[WSR 11-14-075, recodified as § 182-546-4000, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.057
, 74.08.090, and 74.09.510. WSR 04-17-118, § 388-546-4000, filed 8/17/04, effective 9/17/04.]