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Behavioral Health A Washington State Register, Issue 15-04 WSR 15-03-057 WSR 15-03-057 A small business economic impact statement has been PROPOSED RULES prepared under chapter 19.85 RCW. DEPARTMENT OF SOCIAL AND HEALTH SERVICES Small Business Economic Impact Statement (Behavioral Health and Service Integration Administration) SUMMARY OF PROPOSED RULES: The DBHR of the (Division of Behavioral Health and Recovery) department of social and health services (the department) is [Filed January 15, 2015, 9:09 a.m.] adopting new sections in chapters 388-877 and 388-877A Original Notice. WAC that clarify how individuals can express concern about Preproposal statement of inquiry was filed as WSR 14- their rights, services, or treatment regarding mental health 16-111. services received from an agency contracted through an RSN. Title of Rule and Other Identifying Information: New The rules also inform consumers of behavioral health ser- WAC 388-877A-0400 How individuals can express concern vices how to use the DBHR's complaint system. WAC 388- about their rights, services, or treatment, 388-877A-0410 865-0255 Consumer grievance process, is being repealed. Grievance system—Definitions, 388-877A-0420 Grievance These rules: process, 388-877A-0430 Notice of action, 388-877A-0440 • Explain DBHR's complaint process and the grievance Appeal process, 388-877A-0450 Administrative hearings, process, the appeal process, and access to administrative 388-877A-0460 Individual rights specific to medicaid recipi- hearings. ents and 388-877-0605 DBHR complaint process; and • Describe how an individual who receives mental health repealing WAC 388-865-0255 Consumer grievance process. services can express dissatisfaction about a service, Hearing Location(s): Office Building 2, DSHS Head- define words and phrases used in the grievance system, quarters, 1115 Washington, Olympia, WA 98504 (public and update specific individual rights for medicaid recip- parking at 11th and Jefferson. A map is available at http:// ients. www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), • Repeal a section that has been updated and incorporated on March 10, 2015, at 10:00 a.m. in the new rules. Date of Intended Adoption: Not earlier than March 11, 2015. INVOLVEMENT OF STAKEHOLDERS AND SMALL BUSI- Submit Written Comments to: DSHS Rules Coordinator, NESSES: The department recently adopted new chapters 388- P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAU 877, 388-877A, 388-877B, and 388-877C WAC regarding [email protected], fax (360) 664-6185, by behavioral health services and subsequently provided stake- 5:00 p.m., March 10, 2015. holder and provider trainings throughout the state in eight Assistance for Persons with Disabilities: Contact Jeff community locations. It was determined that there was a need Kildahl, DSHS rules consultant, TTY (360) 664-6178 or to adopt rules to inform individuals of their right to express (360) 664-6094 or e-mail [email protected]. dissatisfaction regarding a behavioral health service and how Purpose of the Proposal and Its Anticipated Effects, to use the complaint process and grievance system. The Including Any Changes in Existing Rules: The proposed new department is also adopting a rule that identifies individual rules inform individuals applying for, eligible for, or receiv- rights specific to medicaid recipients. ing mental health services of their right to express dissatisfac- The department filed a CR-101 (preproposal statement tion regarding a mental health service and how to use the of inquiry) under WSR 14-16-111 on August 6, 2014. Copies regional support network's (RSN) grievance system. The of the CR-101 were sent to tribal leaders and all stakeholders rules inform consumers of behavioral health services how to and providers listed in DBHR's mailing list for rule notifica- use the division of behavioral health and recovery's (DBHR) tions. In October 2014, the department sent a draft of the complaint process, and update and clarify individual rights rules to all interested parties who contacted the department specific to the medicaid program. The department is repeal- with an interest to participate in reviewing the proposed rule. ing WAC 388-865-0255 that is outdated due to these new The department provides a response to each comment rules. received. Statutory Authority for Adoption: Chapter 49.60 RCW, SMALL BUSINESS ECONOMIC IMPACT STATEMENT RCW 71.05.560, 71.24.035 (5)(c), and 71.34.380; 42 C.F.R. (SBEIS) – DETERMINATION OF NEED: Chapter 19.85 RCW, §438.400. the Regulatory Fairness Act, requires that the economic Statute Being Implemented: Chapter 49.60 RCW, RCW impact of proposed regulations be analyzed in relation to 71.05.560, 71.24.035 (5)(c), and 71.34.380; 42 C.F.R. small businesses and outlines the information that must be §438.400. included in an SBEIS. An SBEIS is required when a pro- Rule is not necessitated by federal law, federal or state posed rule has the potential of placing a disproportionate eco- court decision. nomic impact on small businesses which employ fifty or Name of Proponent: Department of social and health ser- fewer people and are independently owned and operated. vices, governmental. The rules in chapter 388-877A WAC apply specifically Name of Agency Personnel Responsible for Drafting: to behavioral health agencies that provide mental health treat- Kathy Sayre, P.O. Box 45330, Olympia, WA 98504-5330, ment services to individuals. The department determined (360) 725-1342; Implementation and Enforcement: Dennis there are about one hundred eighty business entities that pro- Malmer, P.O. Box 45330, Olympia, WA 98504-5330, (360) vide mental health services at more than four hundred spe- 725-3747. cific locations. Of the estimated one thousand services sites [ 1 ] Proposed WSR 15-03-057 Washington State Register, Issue 15-04 providing behavioral health services, about one hundred sixty (a) A grievance process; agencies provide both certified chemical dependency ser- (b) An appeal process; and vices and mental health services. (c) Access to administrative hearings. EVALUATION OF PROBABLE COSTS AND PROBABLE (2) Before requesting an administrative hearing, the indi- BENEFITS: The department has determined these rules meet vidual must exhaust: the definition of significant legislative rules under RCW (a) The grievance process, subject to the rules in WAC 34.05.328 (5)(c)(iii) because they make "significant amend- 388-877A-0420; or ments to, a policy or regulatory program." (b) The appeal process, subject to the rules in WAC 388- RCW 34.05.328 (1)(d) requires the department to ana- 877A-0440. lyze the probable costs and probable benefits of the rules, tak- (3) Individuals may also use the free and confidential ing into account both the qualitative and quantitative costs ombuds services through the RSN that contracts with the and benefits. Impacted groups include behavioral health behavioral health agency in which they receive mental health agencies owned by nonprofit businesses, for-profit busi- services. Ombuds services are provided independent of RSNs nesses, public nonprofit providers, and tribal programs that and agency services providers, and are offered to individuals provide DBHR-certified chemical dependency services and/ at any time to help them with resolving issues or problems at or DBHR-certified outpatient mental health services. the lowest possible level during the grievance, appeal, or Costs and Benefits: Under chapter 19.85 RCW, the administrative hearing process. department has considered annual costs to small businesses (4) See WAC 388-865-0250 for more information on that are fifty dollars or more per consumer and believes there ombuds services. are no costs or minimal costs for the rules that will affect ser- vices provided at service sites that meet the definition of a small business. Individuals who apply for, are eligible for, or NEW SECTION receive behavioral health services will be informed of their WAC 388-877A-0410 Grievance system—Defini- rights to express dissatisfaction regarding a behavioral health tions. The terms and definitions in this section and WAC service, and how to use the complaint process and grievance 388-877-0200 apply to the grievance system rules. system. RSNs, agencies that with the RSN, and ombuds ser- vices staff will use the rules to apply the grievance system (1) "Action" means, in the case of a regional support net- processes uniformly. work (RSN): CONCLUSION: The department has given careful consid- (a) The denial or limited authorization of a requested ser- eration to the impact of the proposed rules on small busi- vice, including the type or level of service; nesses. To comply with the Regulatory Fairness Act (chapter (b) The reduction, suspension, or termination of a previ- 19.85 RCW), the department has analyzed impacts on small ously authorized service; businesses and determined the costs to be minor and that the (c) The denial in whole or in part, of payment for a ser- probable benefits outweigh the probable costs. vice; Please contact Kathy Sayre if you have any questions at (d) The failure to provide services in a timely manner, as (360) 725-1342, toll free 1-877-301-4557, or e-mail kathy. defined by the state; or [email protected]. (e) The failure of an RSN or its contracted behavioral A copy of the statement may be obtained by contacting health agency to act within the timeframes provided in sec- Kathy Sayre, Rules Manager, P.O. Box 45330, Olympia, WA tion 42 CFR 438.408(b). 98504-5330, phone (360) 725-1342, fax (360) 725-2280, e- (2) "Administrative hearing" means a proceeding before mail [email protected]. an administrative law judge that gives an individual an A cost-benefit analysis is required under RCW 34.05.- opportunity to be heard in disputes about DSHS programs 328. A preliminary cost-benefit analysis may be obtained by and services.
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