Community Health Plan of Washington is reaching out to all Mental Health Providers to inform you of recent legislative requirements to ensure children and youth seeking mental health care receive appropriate services.
RCW 74.09.340 requires all Managed Care Organizations (MCOs) to:
- Ensure that children with mental health needs secure an appointment with an appropriate Mental Health Provider when they or their parent/guardian make a request for mental health services.
- Follow up with members to ensure an appointment has been secured with an appropriate Mental Health Provider.
- Ensure that the Mental Health Provider(s) and Primary Care Provider are coordinating on individual treatment plans and medication management, in accordance with patient confidentiality laws.
If you are a Mental Health Care Provider outside of the IMC region, you are expected to:
- Conduct an initial assessment with first-time patients (both children and adults) to determine their mental health treatment needs and whether they meet Washington’s Access to Care Standards.
- Work with the patient to secure them an appointment for follow-up treatment with an appropriate Behavioral Health Provider based on the results of their assessment. This provider can be you, another MCO contracted provider, or a BHO contracted provider.
If you are a Mental Health Care Provider in the IMC region, you are expected to:
- Conducting an initial assessment with first-time patients (both children and adults) to assess their level of need.
- Secure an appointment for follow-up treatment with an appropriate Behavioral Health Provider for the patient based on the results of their initial assessment.
- Coordinate care with your patient’s Primary Care Provider.
If you are a Primary Care Provider or a Pediatrician in any region, you are expected to:
- Coordinate care with your patient’s Mental Health Provider(s).
- You do not have to submit a referral for your patient’s mental health or substance use treatment.
If you have any questions, please contact Provider Relations
For a full list of our covered services, please refer to the appropriate Member Benefit Grid.
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