12-16-103

WSR 12-16-103

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed August 1, 2012, 9:46 a.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 12-09-093.

     Title of Rule and Other Identifying Information: Amending WAC 388-865-0536 Standards for administration and 388-865-0755 Standards for administration.

     Hearing Location(s): Office Building 2, Lookout Room, DSHS Headquarters, 1115 Washington, Olympia, WA 98504, (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), on September 4, 2012, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than September 5, 2012.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail [e-mail], fax [phone], by 5 p.m. on September 4, 2012.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by August 24, 2012, TTY [phone] or [phone] or by e-mail at [e-mail].

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: These rules meet the requirements of SSB 5452 that requires, in part, procedures to ensure a facility documents in an individual's clinical record that the mental health provider informed the arresting officer of the individual's release from the facility by agreement to voluntarily participate in outpatient treatment when the arresting officer specifically requested notification and provided contact information.

     Reasons Supporting Proposal: See Purpose above.

     Statutory Authority for Adoption: RCW 10.31.110, 71.05.153, 71.05.190 and chapter 74.09 RCW, SSB 5452.

     Statute Being Implemented: RCW 10.31.110, 71.05.153, 71.05.190 and chapter 74.09 RCW.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of social and health services, governmental.

     Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45330, Olympia, WA 98504-5330, [phone]; Implementation and Enforcement: Pete Marburger, P.O. Box 45330, Olympia, WA 98504-5330, [phone].

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The preparation of a small business economic impact statement is not required, as no new costs will be imposed on small businesses or nonprofits.

     A cost-benefit analysis is not required under RCW 34.05.328. These rules are exempt under RCW 34.05.328 (5)(b)(v) as they are explicitly and specifically dictated by statute.

July 26, 2012

Katherine I. Vasquez

Rules Coordinator

4354.3
AMENDATORY SECTION(Amending WSR 04-07-014, filed 3/4/04, effective 4/4/04)

WAC 388-865-0536   Standards for administration--Inpatient evaluation and treatment facilities.   ((The)) An inpatient evaluation and treatment facility must develop a policy to implement the following administrative requirements:

     (1) A description of the program, including age of consumers to be served, length of stay and services to be provided.

     (2) An organizational structure including clear lines of authority for management and clinical supervision.

     (3) Designation of a physician or other mental health professional as the professional person in charge of clinical services at that facility.

     (4) A quality management plan to monitor, collect data and develop improvements to meet the requirements of this chapter.

     (5) A policy management structure that establishes:

     (a) Procedures for maintaining and protecting resident medical/clinical records consistent with chapter 70.02 ((WAC)) RCW, "Medical Records Health Care Information Access and Disclosure Act" and Health Insurance Portability and Accountability Act (HIPAA);

     (b) Procedures for maintaining adequate fiscal accounting records consistent with generally accepted accounting principles (GAAP);

     (c) Procedures for management of human resources to ensure that residents receive individualized treatment or care by adequate numbers of staff who are qualified and competent to carry out their assigned responsibilities;

     (d) Procedures for admitting consumers needing inpatient evaluation and treatment services seven days a week, twenty-four hours a day, except that child long-term inpatient treatment facilities are exempted from this requirement;

     (e) Procedures to assure appropriate and safe transportation for persons who are not approved for admission to his or her residence or other appropriate place;

     (f) Procedures to detain arrested persons who are not approved for admission for up to eight hours ((in order)) so that reasonable attempts can be made to ((enable)) notify law enforcement to return to the facility and take the person back into custody;

     (g) Procedures to assure access to necessary medical treatment, emergency life-sustaining treatment, and medication;

     (h) Procedures to assure the protection of consumer and family rights as described in this chapter and chapters 71.05 and 71.34 RCW;

     (i) Procedures to inventory and safeguard the personal property of the consumer being detained, including a process to limit inspection of the inventory list by responsible relatives or other persons designated by the detained consumer;

     (j) Procedures to assure that a mental health professional and licensed physician are available for consultation and communication with both the consumer and the direct patient care staff twenty-four hours a day, seven days a week;

     (k) Procedures to provide warning to an identified person and law enforcement when an adult has made a threat against an identified victim;

     (l) Procedures to ensure that consumers detained for up to fourteen or ninety additional days of treatment are evaluated by the professional staff of the facility in order to be prepared to testify that the consumer's condition is caused by a mental disorder and either results in likelihood of serious harm or the consumer being gravely disabled;

     (m) Procedures to assure the rights of consumers to make mental health advance directives, and facility protocols for responding to consumer and agent requests consistent with RCW 71.32.150;

     (n) Procedures to ensure that the following requirements are met when an individual is brought to the facility by a peace officer under RCW 71.05.153:

     (i) The individual must be examined by a mental health professional (MHP) within three hours of arrival;

     (ii) Within twelve hours of arrival, a designated mental health professional (DMHP) must determine if the individual meets detention criteria under chapter 71.05 RCW; and

     (iii) If the facility releases the individual to the community, the facility must inform the peace officer of the release within a reasonable period of time after the release if the peace officer has specifically requested notification and has provided contact information to the facility.

[Statutory Authority: RCW 71.05.560, 71.34.800, and chapters 71.05 and 71.34 RCW. 04-07-014, § 388-865-0536, filed 3/4/04, effective 4/4/04.]

AMENDATORY SECTION(Amending WSR 08-14-079, filed 6/26/08, effective 7/27/08)

WAC 388-865-0755   Standards for administration--Crisis stabilization units.   ((The)) A crisis stabilization unit must ensure that the following standards for administration are met:

     (1) A description of the program, including age of persons to be served, length of stay, and services to be provided.

     (2) An organizational structure that demonstrates clear lines of authority for administrative oversight and clinical supervision.

     (3) The professional person in charge of administration of the unit is a mental health professional.

     (4) A management plan to monitor, collect data and develop improvements to meet the requirements of this chapter.

     (5) A policy management structure that establishes:

     (a) Procedures for maintaining and protecting personal medical/clinical records consistent with chapter 70.02 ((WAC)) RCW, "Medical records -- Health care information access and disclosure," and the Health Insurance Portability and Accountability Act (HIPAA)((;)).

     (b) Procedures for managing human resources to ensure that persons receive individualized evaluation and crisis stabilization services by adequate numbers of staff who are qualified and competent to carry out their assigned responsibilities((;)).

     (c) Procedures for ensuring a secure environment appropriate to the legal status of the person(s), and necessary to protect the public safety. "Secure" means having:

     (i) All doors and windows leading to the outside locked at all times;

     (ii) Visual monitoring, either by line-of-sight or camera as appropriate to the individual;

     (iii) Adequate space to segregate violent or potentially violent persons from others;

     (iv) The means to contact law enforcement immediately in the event of an elopement from the facility; and

     (v) Adequate numbers of staff present at all times that are trained in facility security measures.

     (d) Procedures for admitting persons needing crisis stabilization services seven days a week, twenty-four hours a day((;)).

     (e) Procedures to ensure that for persons who have been brought to the unit involuntarily by police, the stay is limited to twelve hours unless the individual has signed voluntarily into treatment.

     (f) Procedures to ensure that within twelve hours of the time of arrival to the crisis stabilization unit, individuals who have been detained by a designated mental health professional or designated crisis responder under chapter 71.05 or 70.96B RCW are transferred to a certified evaluation and treatment facility.

     (g) Procedures to assure appropriate and safe transportation of persons who are not approved for admission or detained for transfer to an evaluation and treatment facility, and if not in police custody, to their respective residence or other appropriate place((;)).

     (h) Procedures to detain arrested persons who are not ((otherwise detained and transferred to an evaluation and treatment facility for a period of up to eight hours in order to enable law enforcement to return to the facility and take the person back into custody;)) approved for admission for up to eight hours so that reasonable attempts can be made to notify law enforcement to return to the facility and take the person back into custody.

     (i) Procedures to ensure access to emergency life-sustaining treatment, necessary medical treatment, and medication((;)).

     (j) Procedures to ensure the protection of personal and familial rights as described in WAC 388-865-0561 and chapter 71.05 RCW((;)).

     (k) Procedures to inventory and safeguard the personal property of the persons being detained((;)).

     (l) Procedures to ensure that a mental health professional (as defined in chapter 388-865 WAC) is on-site twenty-four hours a day, seven days a week((;)).

     (m) Procedures to ensure that a licensed physician is available for consultation to direct care staff and patients twenty-four hours a day, seven days a week((;)).

     (n) Procedures to provide warning to an identified individual and law enforcement when an individual has made a threat against an identified victim, in accordance with RCW 71.05.390(10)((;)).

     (o) Procedures to ensure the rights of persons to make mental health advance directives((; and)).

     (p) Procedures to establish unit protocols for responding to the provisions of the advanced directives consistent with RCW 71.32.150.

     (q) Procedures to ensure that the following requirements are met when an individual is brought to the facility by a peace officer under RCW 71.05.153:

     (i) The individual must be examined by a mental health professional (MHP) within three hours of arrival;

     (ii) Within twelve hours of arrival, a designated mental health professional (DMHP) must determine if the individual meets detention criteria under chapter 71.05 RCW; and

     (iii) If the facility releases the individual to the community, the facility must inform the peace officer of the release within a reasonable period of time after the release if the peace officer has specifically requested notification and has provided contact information to the facility.

[Statutory Authority: RCW 71.05.020, 71.24.035, and 2007 c 375. 08-14-079, § 388-865-0755, filed 6/26/08, effective 7/27/08.]