WAC 182-546-4600 Ambulance transportation—Involuntary substance use disorder treatment—Ricky Garcia Act.

Effective November 8, 2018

  1. Definitions. For the purposes of this section, the following definitions and those found in chapter 182-500 WAC apply:
    1. "Behavioral health organization (BHO)" - See WAC 182-500-0015.
    2. "Chemical dependency professional" means a person certified as a chemical dependency professional by the department of health (DOH) under chapter 18.205 RCW.
    3. "Designated crisis responder (DCR)" means a mental health professional appointed by the behavioral health organization (BHO) to perform the duties described in chapter 71.05 RCW.
    4. "Detention" or "detain" means the lawful confinement of a person, under chapter 71.05 RCW.
    5. "Gravely disabled" means a condition in which a person, as a result of a mental disorder, or as the result of the use of alcohol or other psychoactive chemicals:
      1. Is in danger of serious physical harm as a result of being unable to provide for personal health or safety; or
      2. Shows repeated and escalating loss of cognitive control over personal actions and is not receiving care essential for personal health or safety.
    6. "Less restrictive alternative treatment" means a program of individualized treatment in a less restrictive setting than inpatient treatment and that includes the services described in RCW 71.05.585.
    7. "Nearest and most appropriate destination" means the nearest facility able and willing to accept the involuntarily detained person for treatment, not the closest facility based solely on driving dis­tance.​
    8. "Secure detoxification facility" means a facility operated by either a public or private agency that:
      1. Provides for intoxicated people:
        1. Evaluation and assessment by certified chemical dependency professionals;
        2. Acute or subacute detoxification services;
        3. Discharge assistance by certified chemical dependency profes­sionals, including assistance with transitions to appropriate volunta­ry or involuntary inpatient services, or to less-restrictive alterna­tives appropriate for the client;
      2. Includes security measures sufficient to protect the pa­tients, staff, and community; and
      3. Is certified as a secure withdrawal management and stabili­zation facility by the department of health (DOH).
  2. For a client involuntarily detained for substance use disor­der (SUD) treatment, the agency covers transportation services under the ITA when the client has been assessed by a DCR and found to be one of the following:
    1. A danger to self;
    2. A danger to others;
    3. At substantial risk of inflicting physical harm upon the property of others; or
    4. Gravely disabled as a result of SUD.
  3. The agency pays for transportation under this section only when the transportation is:
    1. From one of the following locations:
      1. The site of the initial detention;
      2. A local emergency room department;
      3. A court hearing; or
      4. A secure detoxification facility or crisis response center.
    2. To one of the following locations:
      1. A less restrictive alternative setting, except when ambulance transportation to a client's home is not covered;
      2. A local emergency room department;
      3. A court hearing; or
      4. A secure detoxification facility or crisis response center.
    3. Provided by an ambulance transportation provider or law en­forcement. The ambulance transportation provider must have an active core provider agreement (CPA) with the agency.
    4. To the nearest and most appropriate destination. The reason for a diversion to a more distant facility must be clearly documented in the client's file.
  4. The DCR authorizes the treatment destination based on the client's legal status.
  5. A copy of the agency's authorization of ambulance/secure transportation services under the Involuntary Treatment Act (ITA) form (HCA 42-0003) must be completed and signed by the DCR and kept in the client's file.
  6. The agency establishes payment for SUD-related transportation services when the transportation provider complies with the agency's requirements for drivers, driver training, vehicle and equipment standards and maintenance. Providers must clearly identify ITA trans­portation on the claim when billing the agency.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.