Current through Register Vol. 24-18, September 15, 2024
(1) Agencies
certified for outpatient behavioral health crisis services provide face-to-face
and other means of services to stabilize an individual in crisis to prevent
further deterioration, provide immediate treatment or intervention in the least
restrictive environment at a location best suited to meet the needs of the
individual which may be in the community, a behavioral health agency, or other
setting.
(2) An agency certified
for outpatient behavioral health crisis services does not need to meet the
requirements in WAC
246-341-0640.
(3) An agency providing outpatient behavioral
health crisis services for substance use disorder must ensure a professional
appropriately credentialed to provide substance use disorder treatment is
available or on staff 24 hours a day, seven days a week.
(4) An agency providing any outpatient
behavioral health crisis services must:
(a)
Provide crisis telephone support in accordance with WAC
246-341-0670;
(b) For mental health crisis, ensure
face-to-face outreach services are provided by a mental health professional or
department-credentialed staff person with documented training in crisis
response;
(c) For a substance use
disorder crisis, ensure face-to-face outreach services are provided by a
professional appropriately credentialed to provide substance use disorder
treatment, or individual who has completed training that covers substance use
disorders;
(d) Develop and
implement policies and procedures for training staff to identify and assist
individuals in crisis before assigning the staff member unsupervised
duties;
(e) Resolve the crisis in
the least restrictive manner possible;
(f) Require that trained staff remain with
the individual in crisis in order to provide stabilization and support until
the crisis is resolved or referral to another service is
accomplished;
(g) Determine if an
individual has a crisis plan and request a copy if available;
(h) Assure communication and coordination
with the individual's mental health or substance use treatment provider, if
indicated and appropriate;
(i) As
appropriate, refer individuals to voluntary or involuntary treatment facilities
for admission on a seven day a week, 24 hour a day basis, including
arrangements for contacting the designated crisis responder;
(j) Maintain a current list of local
resources for referrals, legal, employment, education, interpreter and social
and health services;
(k) Transport
or arrange for transport of an individual in a safe and timely manner, when
necessary;
(l) Be available 24
hours a day, seven days a week; and
(m) Include family members, significant
others, and other relevant treatment providers, as necessary, to provide
support to the individual in crisis.
(5) Documentation of a crisis service must
include the following:
(a) A brief summary of
each crisis service encounter, including the:
(i) Date;
(ii) Time, including time elapsed from
initial contact to face-to-face contact, if applicable; and
(iii) Nature and duration of the
encounter.
(b) The names
of the participants;
(c) A
disposition including any referrals for services and individualized follow-up
plan;
(d) Whether the individual
has a crisis plan and any request to obtain the crisis plan; and
(e) The name and credential, if applicable,
of the staff person providing the service.
(6) An agency utilizing peers to provide
crisis outreach services must:
(a) Ensure
services are provided by a person recognized by the health care authority as a
peer, as defined in WAC
246-341-0200;
(b) Ensure services provided by a peer are
within the scope of the peer's training and credential;
(c) Ensure peers receive annual training that
is relevant to their unique working environment.
(7) When services are provided in a private
home or nonpublic setting, the agency must:
(a) Have a written plan for training, staff
back-up, information sharing, and communication for staff members who respond
to a crisis in an individual's personal residence or in a nonpublic
location;
(b) Ensure that a staff
member responding to a crisis is able to be accompanied by a second trained
individual when services are provided in the individual's personal residence or
other nonpublic location;
(c)
Ensure that any staff member who engages in home visits is provided access, by
their employer, to a wireless telephone or comparable device, for the purpose
of emergency communication;
(d)
Provide staff members who are sent to a personal residence or other nonpublic
location to evaluate an individual in crisis prompt access to information about
any history of dangerousness or potential dangerousness on the individual they
are being sent to evaluate, that is documented in a crisis plan(s) or
commitment record(s). This information must be made available without unduly
delaying the crisis response.
(8) If utilizing peers for crisis outreach
response:
(a) Ensure that a peer responding
to an initial crisis visit is accompanied by a mental health professional or
individual appropriately credentialed to provide substance use disorder
treatment as appropriate to the crisis;
(b) Develop and implement policies and
procedures for determining when peers may provide follow-up crisis outreach
services without being accompanied by a mental health professional or
individual appropriately credentialed to provide substance use disorder
treatment as appropriate to the crisis.
