Current through Register Vol. 24-18, September 15, 2024
Center of excellence.
(1) For the purposes of this chapter, center
of excellence (COE) refers to an individual provider, not a facility.
(2) A center of excellence (COE) must be an
evaluating and prescribing provider.
(3) The COE provider must be:
(a) A person licensed under Title 18 RCW who
is experienced in the diagnosis and treatment of autism spectrum disorders and
is:
(i) A developmental
pediatrician;
(ii) A
neurologist;
(iii) A pediatric
neurologist;
(iv) A pediatric
psychiatrist;
(v) A psychiatrist;
or
(vi) A psychologist;
or
(b) A qualified
medical provider who meets qualifications in subsection (4) of this section and
who has been designated by the agency as a COE provider.
(4) With the exception of providers listed in
subsection (3)(a) of this section, ARNPs, physicians, physician assistants, and
naturopaths must complete the required COE training authorized by the agency.
The COE provider must be prequalified by the agency and meet the following
criteria:
(a) ARNPs, physicians, physician
assistants, and naturopaths must have demonstrated expertise in diagnosing an
autism spectrum disorder by:
(i) Using a
validated diagnostic tool;
(ii)
Confirming the diagnosis by observing the client's behavior and interviewing
family members; or
(iii) Reviewing
the documentation available from the client's primary care provider,
individualized education plan, or individualized family service plan;
(b) ARNPs, physicians, physician
assistants, and naturopaths must understand the medically necessary use of
applied behavior analysis (ABA); and
(c) ARNPs, physicians, physician assistants,
and naturopaths must be sufficiently qualified to conduct and document a
comprehensive diagnostic evaluation and develop a multidisciplinary clinical
treatment plan under WAC
182-531A-0500(2).
(5) To be recognized as a COE by
the agency, the provider, as listed in (4)(a) of this section, must submit a
signed COE Attestation form, HCA 13-0009, to the agency.
(6) To be reimbursed for fee-for-service or
agency-contracted managed care organization (MCO) services:
(a) All COE providers must be enrolled with
the agency.
(b) All COEs providing
services to clients enrolled with an agency-contracted MCO must also be
contracted with the MCO, per the MCO contract specifications in accordance with
42 C.F.R. §
438.14.
(7) All ABA providers must meet the specified
minimum qualifications and comply with applicable state laws.
Lead behavior analysis therapist.
(8) The lead behavior analysis therapist
(LBAT) must:
(a) Be licensed by the department
of health (DOH) to practice independently as a behavior analyst or an assistant
behavior analyst with supervision from a licensed behavior analyst or licensed
psychologist (see chapter 18.380 RCW) and be an eligible provider according to
chapter 182-502 WAC; or
(b) Be a
DOH-licensed mental health counselor, DOH-licensed marriage and family
therapist, DOH-licensed independent clinical social worker, DOH-licensed
advanced social worker, or DOH-licensed psychologist (see chapter 18.380 RCW).
Providers listed in this subsection must have a signed Applied Behavior
Analysis (ABA) Attestation form, HCA 13-0008, regarding certification as a
board-certified behavior analyst (BCBA) or a board-certified assistant behavior
analyst (BCaBA) on file with the agency.
(9) The LBAT must enroll as a servicing
provider under chapter 182-502 WAC, be authorized to supervise ancillary
providers, and be:
(a) A DOH-licensed behavior
analyst (LBA) (see chapter 18.380 RCW); or
(b) A DOH-licensed assistant behavior analyst
(LABA) (see chapter 18.380 RCW).
(10) If the LBAT's role is filled by a LABA,
the responsibilities below must be fulfilled by both the LABA and the
supervising LBA or licensed psychologist, as required by DOH under chapter
246-805 WAC. The LBAT must:
(a) Develop and
maintain an ABA therapy treatment plan that is comprehensive, incorporating
treatment provided by other health care professionals, and that states how all
treatment will be coordinated; and
(b) Supervise at least five percent of the
total direct care provided by the certified behavior technician per
week.
Certified behavior technician.
(11) The certified behavior technician (CBT)
must be certified by DOH as a CBT under chapter 18.380 RCW in good standing
with no license restrictions.
(12)
The CBT must enroll as a servicing provider under chapter 182-502
WAC.
(13) The CBT must:
(a) Deliver services according to the ABA
therapy treatment plan;
(b) Be
supervised by a DOH-licensed professional who meets the requirements under WAC
246-805-330; and
(c) Review the client's progress with the
supervisor at least every two weeks to confirm that the ABA therapy treatment
plan still meets the client's needs. If changes are clinically indicated, they
must be made by the supervisor.
Facility-based day program.
(14) All facility-based day program providers
must meet the requirements under WAC
182-531A-0600
(3)(a), and meet the following requirements:
(a) Outpatient hospital facilities must meet
the applicable DOH licensure requirements under chapter 246-320 WAC;
(b) Any provider rendering direct ABA
services in the facility-based day program must meet the qualifications and
applicable licensure or certification requirements as described in this
subsection, as applicable;
(c) Any
provider serving as a member of the multidisciplinary care team must be
licensed or certified under Title 18 RCW; and
(d) Have a signed ABA Day Program Capacity
Attestation form, HCA 13-0007, on file with the agency.
