Chemical Dependency Treatment - Detoxification Services
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Chemical Dependency Treatment - Detoxification Services

Revised December 15, 2011

Purpose: This chapter describes the Alcoholism and Drug Detoxification Program and identifies the counties where it operates through CSOs.
WAC 182-508-0305Detoxification--Covered services (Emergency rule effective 11/1/11.)

WAC 182-508-0305
WAC 182-508-0305

Effective October 14, 2012

WAC 182-508-0305 Detoxification--Covered services.

(1)  The agency or the agency's designee only pays for services that are:

(a)  Provided to eligible individuals as described in subsection (5) of this section;

(b)  Directly related to detoxification; and

(c)  Performed by a certified detoxification center or by a general hospital that has a contract with the department of social and health services to provide detoxification services.

(2)  The agency limits on paying for detoxification services are:

(a)  Three days for an acute alcoholic condition; or

(b)  Five days for acute drug addiction.

(3)  The agency only pays for detoxification services when notified within ten working days of the date detoxification began and all eligibility factors are met.

(4)  To apply for detoxification services, an individual must complete an application for benefits.  An interview is not required when applying for medical assistance.  However, additional documentation may be needed to prove or confirm the information provided in the application form.

(5)  An individual is eligible for detoxification services if the individual receives benefits under one of the following programs:

(a)  Temporary assistance for needy families (TANF);

(b)  Aged, blind, or disabled cash assistance program (ABD);

(c)  Supplemental Security Income (SSI);

(d)  Medical care services program (MCS);

(e)  Alcohol and Drug Addiction Treatment and Support Act (ADATSA); or

(f)  A medical assistance program.

(6)  An individual who is not eligible for one of the programs listed in subsection (5) of this section is eligible for the detoxification program if they meet the following criteria:

(a)  Nonexempt countable income does not exceed the eligibility standards for MCS and ADATSA as described in WAC 182-508-0230; and 

(b)  Nonexempt countable resources do not exceed one thousand dollars.

(7)  The following expenses are deducted from income when determining countable income:

(a)  Mandatory expenses of employment;

(b)  Support payments paid under a court order; and

(c)  Payments to a wage earner specified by a court in bankruptcy proceedings, or previously contracted major household repairs, when failure to make such payments will result in garnishment of wages or loss of employment.

(8)  The following resources are not counted when determining countable resources:

(a)  A home;

(b)  Household furnishings and personal clothing essential for daily living;

(c)  Other personal property used to reduce need for assistance or for rehabilitation;

(d)  A used and useful automobile; and

(e)  All income and resources of a noninstitutionalized SSI beneficiary.

(9)  The following resources are counted when determining countable resources:

(a)  Cash and other liquid assets;

(b)  Marketable securities; and

(c)  Any other resource not specifically exempted that can be converted to cash.

(10)  If an individual receives detoxification services, the individual will not incur a deductible as a factor of eligibility for the covered period of detoxification.

(11)  Once an individual has been determined eligible for detoxification services, the individual is eligible from the date detoxification begins through the end of the month in which the detoxification is completed.

 

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.

CLARIFYING INFORMATION

  1. This section does not apply to CSOs in counties that have a direct detox contract with the Division of Behavioral Health and Recovery (DBHR). The CSOs in the following counties do not have detox contracts with DBHR and are involved in providing access to detox services.
Columbia Cowlitz Ferry
Garfield Klickitat Lincoln
Okanogan Pend Oreille Skamania
Stevens Wahkiakum Whitman

  1. Hospitals assist clients complete the DSHS 14-001(X) and route the form to the appropriate CSO for determination of eligibility.

  2. The rules and procedures in VERIFICATION do not apply to the Detoxification (DETOX) Program.

  3. If the person is already eligible under another medical program, the medical coverage will cover the detoxification services and no further action is required to establish eligibility. If the person is not on a medical program eligibility for medical must be established.

WORKER RESPONSIBILITIES

DETOX Categorical Eligibility

  1. If the client is not open in ACES, determine eligibility for DETOX based on the information shown on the DSHS 14-001(X).

  2. To be eligible for DETOX:

    1. The client's combined income and resources can be no more than the Medical Care Services (MCS) payment standard in WAC 182-508-0230.

    2. The client's age, citizenship or residence in the state are not relevant factors.

  3. Accept the client's statement as verification of all factors.


DETOX Authorization

  1. When a person who is receiving neither a grant nor medical assistance applies for DETOX, determine eligibility for CN and MN before considering the person for DETOX program.

  2. Authorize DETOX for the period from the date treatment began to the end of the month in which the 3- or 5-day treatment was completed.


EXAMPLE

Treatment 11-4 through 11-6: authorization 11-4 through 11-30.
Treatment 11-30 through 12-2: authorization 11-30 through 12-31

ACES PROCEDURES

See Alcoholism and Drug Detoxification Program (DETOX)
Modification Date: December 15, 2011