WAC 388-865-0217 Psychiatric indigent inpatient program.

1. The psychiatric indigent inpatient (PII) program is a state-funded, limited casualty (LCP) program specifically for mental health clients identified in need of inpatient psychiatric care by the regional support network (RSN).

2. The psychiatric indigent inpatient (PII) program pays only for emergent voluntary inpatient psychiatric care in community hospitals within the state of Washington. Psychiatric indigent inpatient (PII) does not cover ancillary charges for physician, transportation, pharmacy, or other costs associated with a voluntary inpatient psychiatric hospitalization. 

3. To be eligible for the psychiatric indigent inpatient (PII) program, a client is subject to the following conditions and limitations:

1. The client must have a voluntary inpatient psychiatric admission authorized by a regional support network (RSN) in the month of application or within the three months immediately preceding the month of application.

2. Consumers applying for the psychiatric indigent inpatient (PII) program are subject to the income and resource rules for TANF and TANF-related clients in chapters 388-450 and 388-470  WAC.

3. If a client's income and/or resources exceed the standard for medically needy (MN), as described in WAC 388-478-0070, the client must spend down the excess amount as described in WAC 388-519-0100 for the client to be eligible for the psychiatric indigent inpatient (PII) program.  Spenddown is a client financial obligation for medical expenses.  The department deducts the spenddown from payments to providers (see WAC 388-502-0100 ).

4. A client who is voluntarily admitted must have incurred an emergency medical expense requirement (EMER) of two thousand dollars over a twelve-month period.  EMER is a client financial obligation.  The department deducts the EMER from payments to providers (see WAC 388-502-0100 ).

1. Qualifying emergency medical expense requirement (EMER) expenses are psychiatric inpatient services in a community hospital.

2. The emergency medical expense requirement (EMER) period lasts for twelve calendar months, beginning on the first day of the month of certification for psychiatric indigent inpatient (PII) and continuing through the last day of the twelfth month.

5. A client is limited to a single three-month period of psychiatric indigent inpatient (PII) eligibility per twelve-month emergency medical expense requirement (EMER) period.

4. Clients are not eligible for the psychiatric indigent inpatient (PII) program if they:

1. Are eligible for, or receiving, any other cash or medical program; or

2. Entered the Washington state specifically to obtain medical care; or

3. Are an inmate of a federal or state prison.

4. Are committed under the Involuntary Treatment Act (ITA).