Wash. Admin. Code § 388-865-0266

Current through Register Vol. 24-23, December 1, 2024
Section 388-865-0266 - Behavioral health organizations-Quality review teams

A behavioral health organization (BHO) must establish and maintain unencumbered access to and maintain the independence of a quality review team as described in this section and in the contract between the BHO and the division of behavioral health and recovery (DBHR). The quality review team must include individuals who currently receive or have in the past received behavioral health services, and may also include the family members of such individuals. The BHO must assure that quality review teams:

(1) Fairly and independently review the performance of the BHO and service providers in order to evaluate systemic issues as measured by objective indicators of individual outcomes in rehabilitation and recovery, including all of the following:
(a) Quality of care;
(b) The degree to which services are focused on the individual and are age and culturally appropriate;
(c) The availability of alternatives to hospitalization, cross-system coordination and range of treatment options; and
(d) The effectiveness of the BHO's coordination with allied systems including, but not limited to, schools, state and local hospitals, jails and shelters.
(2) Have the authority to enter and monitor any behavioral health agency contracted with a BHO.
(3) Meet with interested individuals and family members, allied service providers, including state or community psychiatric hospitals, BHO contracted service providers, and persons that represent the age and ethnic diversity of the BHO's service area to:
(a) Determine if services are accessible and address the needs of individuals based on sampled individual recipient's perception of services using a standard interview protocol. The protocol will query the sampled individuals regarding ease of accessing services, the degree to which services address medically necessary needs, and the benefit of the service received; and
(b) Work with interested individuals and other persons, if requested by the individual, service providers, the BHO, and DBHR to resolve identified problems.
(4) Provide reports and formalized recommendations at least biennially to DBHR, the behavioral health advisory committee and the BHO advisory and governing boards and ensure that input from the quality review team is integrated into the overall BHO quality strategy, behavioral health ombuds office services, local consumer and family advocacy groups, and provider network.
(5) Receive training in and adhere to applicable confidentiality standards.

Wash. Admin. Code § 388-865-0266

Adopted by WSR 16-13-087, Filed 6/15/2016, effective 7/16/2016