Behavioral Health and Service Integration

Type: 
Proposed Rulemaking (CR 102)
Rule Title/Subject Contact Person Washington State Register Citations

Chapter 388-875 WAC

The department intends to update outdated terms such as “mental health division”, revise the rules to more clearly reflect the changes that have occurred since the implementation of 2E2SSB 5177 (Chapter 7, Laws of 2015) including clarification of maximum payment for forensic evaluation in WAC 388-875-0040, and clarify the role and function of the Office of Forensic Mental Health Services.    

Jason Karpen
(360) 725-3529
Preproposal notice filed as WSR 18-06-102
Proposed rules filed as WSR 19-05-087
Hearing Date: March 26, 2019

Chapter 388-810, 865, 877, 877A, 877B, 877C WAC

The department is proposing to amend existing rules and create new rules in chapter 388-877 WAC regarding behavioral health services to provide a single set of regulations for behavioral health agencies to follow in order to provide mental health, substance use disorder, co-occurring, and pathological and problem gambling services. The department is also proposing to repeal chapters 388-810, 388-877A, 388-877B, 388-877C WAC, and repeal specific sections of chapters 388-865 and 388-877 WAC. The department has created a crosswalk table of existing and new WAC sections for reference purposes.

Stephanie Vaughn
(360) 725-1342
Preproposal notice filed as WSR 17-16-156
Proposed rules filed as WSR 17-24-079
Hearing Date: February 6, 2018

Chapter 388-877B WAC

The Division of Behavioral Health and Recovery is proposing new rules in chapter 388-877B WAC to enable behavioral health agencies to become certified to deliver Secure Withdrawal Management and Stabilization services. RCW 71.05.760(2) directs the department to ensure that at least one sixteen-bed secure detoxification facility is operational by April 1, 2018 and that at least two sixteen-bed secure detoxification facilities are operational by April 1, 2019. RCW 71.05.760, effective 4/1/18, directs DSHS & BHOs to develop a transition process & training for crisis responders to carry out functions in chapters 71.05 & 71.34 RCW.

Stephanie Vaughn
(360) 725-1342
Preproposal notice filed as WSR 17-11-091
Proposed rules filed as WSR 17-21-014
Hearing Date: November 21, 2017

Chapter 388-877A, 877B WAC

RCW 71.24.385 authorizes a supportive housing services program and a supported employment services program to be developed to serve individuals receiving behavioral health services. Programs for supportive housing services and supported employment services are included as part of Washington state’s Medicaid Transformation Waiver, which was approved on January 9, 2017. These proposed rules will allow the department to certify these services when a licensed behavioral health agency applies and qualifies for certification.

Stephanie Vaughn
(360) 725-1342
Preproposal notice filed as WSR 16-24-079
Proposed rules filed as WSR 17-11-073
Hearing Date: July 11, 2017

Chapter 388-877 WAC

The department is proposing to amend rules about grievances, appeals, and hearings in chapter 388-877 WAC to align with the Centers for Medicare and Medicaid Services (CMS) revised federal statutes in 42 CFR that govern the grievance and appeals system for Medicaid managed care. The federal statutes have updated definitions and appeal timeframes, and aligned certain processes for appeals and grievances in order to provide individuals with a more streamlined and manageable grievance and appeals process. Because the amended federal statutes are clear that an enrollee does not have a right to an administrative hearing regarding the resolution of a grievance, the department is clarifying in rule the due process rights for non-medicaid clients that currently exist in policy and contracts. This clarification to rule is being made by adding mention of a “Notice of Determination” which communicates the denial or limited authorization of a non-Medicaid service, and includes a right to request a fair hearing. The department is limiting the scope of these proposed amendments in order to bring these rules into compliance with federal statutes, make necessary updates to names and terms, and clarify rule language without changing the effect of the rules.

Stephanie Vaughn
(360) 725-1342
Preproposal notice filed as WSR 16-24-075
Proposed rules filed as WSR 17-11-068
Hearing Date: June 27, 2017

Chapter 388-865, 875, 877, 877A, 877B, 877C WAC

The department determined while in the permanent rule adoption process, that the rules would be significant rules requiring a Small Business Economic Impact Statement and Cost Benefit analysis. Because of that, the department is filing this supplemental CR-102 and completed the Cost Benefit Analysis and Small Business Economic Impact Statement. The permanent rule filed as part of this supplemental process will replace the emergency rule filed to be effective April 1, 2016. These rules support the requirements in 2SSB 6312, Chapter 225, Laws of 2014 which requires the renaming of Regional Support Networks (RSN) to Behavioral Health Organizations (BHO) effective April 1, 2016. The anticipated effect is to ensure BHOs provide or contract with behavioral health agencies to provide both substance use disorder treatment services and mental health services to individuals who need these services. An RSN currently provides only mental health services. Changes include updating definitions of "mental health professional" and "peer counselor", moving grievance system rules from chapter 388-877A WAC to chapter 388-877 WAC, and changing a grievance system rule concerning when a "notice of action" should be sent. Finally, processes and editing changes are made to provide clarification and consistency within the rules.

Kathy Sayre
(360) 725-1342
Preproposal notice filed as WSR 15-18-035
Proposed rules filed as WSR 16-07-152
Hearing Date: May 24, 2016

Chapter 388-865 WAC

The proposed new sections in chapter 388-865 WAC comply with Second Engrossed Second Substitute Senate Bill (2E2SSB) 5177 (Chapter 7, Laws of 2015) which requires, in part, the department to develop alternative locations and increased access to competency evaluation and restoration treatment services under chapter 10.77 RCW.

Kathy Sayre
(360) 725-1342
Preproposal notice filed as WSR 15-18-070
Proposed rules filed as WSR 16-01-124
Hearing Date: January 26, 2016

Chapter 388-865 WAC

The Department is adopting rules to comply with Second Substitute Senate Bill (2SSB) 6312, Chapter 225, Laws of 2014, that requires the Regional Support Networks (RSNs) to be renamed Behavioral Health Organizations (BHOs) effective April 1, 2016, and authorizes the Department to establish regional service areas within the state and integrate substance use disorder treatment with mental health services. The rules also update the verbiage "chemical dependency" to "substance use disorders", amend and add new definitions, move the grievance system rules from chapter 388-877A WAC to chapter 388-877 WAC, and make updates to provide clarifications.

Kathy Sayre
(360) 725-1342
Preproposal notice filed as WSR 15-18-035
Proposed rules filed as WSR 16-01-026
Hearing Date: February 9, 2016

WAC 388-865-0526

The proposed rule implements Washington Supreme Court decision in In re the Detention of D.W., et.al, No. 90110-4. WAC 388-865-0526 contains the department's rules for single bed certification which allows for the inpatient treatment of adults and children in facilities that are not certified as inpatient evaluation and treatment facilities. The amendment: (1) allows residential treatment facilities, psychiatric hospitals, hospitals with a psychiatric unit, and hospitals that can provide timely and appropriate mental health treatment to be recognized for single bed certification; (2) requires that any facility which is the site of a proposed single bed certification confirm that it is willing to provide treatment services; (3) articulates standards that facilities must meet while operating under a single bed certification; and (4) clarifies that the regional support networks retain responsibility for ensuring that the rights of patients are protected while in single bed certifications. The permanent rule will replace the current emergency rule filed under WSR 15-09-122 and effective April 21, 2015.

Kathy Sayre
(360) 725-1342
Preproposal notice filed as WSR 14-22-016
Proposed rules filed as WSR 15-11-085
Hearing Date: June 23, 2015

Chapters 388-865, 877, and 877A WAC

The proposed new rules inform individuals applying for, eligible for, or receiving mental health services of their right to express dissatisfaction regarding a mental health service and how to use the Regional Support Network's (RSN's) grievance system. The rules inform consumers of behavioral health services how to use the Division of Behavioral Health and Recovery's (DBHR's) complaint process, and update and clarify individual rights specific to the Medicaid program. The department is repealing WAC 388-865-0255 that is outdated due to these new rules.

Kathy Sayre
(360) 725-1342

Preproposal notice filed as WSR 14-16-111
Proposed rules filed as WSR 15-03-057
Hearing Date: March 10, 2015