Substance Use Disorder (SUD) Treatment Services

The CSHCD SCRBH strives to provide a behavioral health system of care which offers timely access to medical necessary recovery-focused behavioral health services, supports, and care coordination.

Authorized services must meet the Washington State Health Care Authority’s (HCA) definition of medical necessity, which means a requested service which is reasonably calculated to prevent, diagnose, correct, cure, alleviate, or prevent worsening of conditions in an Individual that endangers life, or cause suffering of pain, or result in an illness or infirmity, or threaten to cause or aggravate a handicap, or cause physical deformity, or malfunction. There is no other equally effective, more conservative, or substantially less costly course of treatment available or suitable for the Individual requesting the service. For the purpose of this section, "course of treatment" may include mere observation or, where appropriate, no medical treatment at all per Washington Administrative Code (WAC) WAC 182-500-0070

The CSHCD SCRBH is responsible for contracting and funding the following services for Individuals in Adams, Ferry, Lincoln, Pend Oreille, Spokane, and Stevens counties:

  • Substance use disorder (SUD) crisis services and involuntary treatment evaluations for Individuals within the Spokane Regional Service Area (RSA);
  • Involuntary detentions to secure withdrawal management and stabilization services for non-Medicaid Individuals within the Spokane RSA;
  • Treatment and monitoring of non-Medicaid individuals within the Spokane RSA who have active Less Restrictive Alternative (LRA) court orders or Conditional Release orders; and
  • Non-crisis behavioral health services for non-Medicaid Individuals in the Spokane RSA who are at or below the two hundred twenty percent (220%) Federal Poverty Level utilizing General Fund State (GFS) or Federal Block Grants (FBG).

Priority Populations

Substance Abuse Block Grant (SABG) funded services shall be provided to financially eligible Individuals in the following order of priority:

  • Pregnant injecting drug users
  • Pregnant substance abusers
  • Women with dependent Children
  • Injecting drug users

The following are additional priority populations, in no particular order, for SABG services:

  • Postpartum women up to one (1) year, regardless of pregnancy outcome
  • Patients transitioning from residential care to outpatient care
  • Youth
  • Offenders as defined in RCW 70.96.350

Within Available Resources, the CSHCD SCRBH ensures the provision of non-crisis behavioral health services via state general funds, to Individuals who meet financial eligibility standards and meet one of the following criteria:

  • Are uninsured;
  • Have insurance, but are unable to pay the co-pay or deductible for services;
  • Are using excessive crisis services due to inability to access non-crisis behavioral health services; and
  • Have more than five (5) visits over six (6) months to the emergency department, a withdrawal management/detox facility, or sobering center due to a SUD disorder.

The CSHCS SCRBH does not have a centralized triage and referral process. Individuals may obtain behavioral health services in numerous ways based on the county in which they are accessing services and/or the behavioral health provider the Individual has selected.

Individuals may directly call or self-present for services at a CSHCD SCRBH contracted behavioral health provider agency. Physicians, schools, family, natural supports, and/or other referral sources may refer Individuals to behavioral health services. The CSHCD SCRBH provider directory and contact information may be found on line here. Individuals have the right to choose a qualified behavioral health service provider, including Indian Health Care Providers, when available and medically necessary.

The CSHCD SCRBH applies medical necessity criteria for the provision or denial of the following services:

  • Assessment
  • Case Management
  • Interim Services
  • Opiate Dependency/HIV Services Outreach
  • Group Therapy
  • Outpatient Treatment
  • Intensive Outpatient Treatment
  • Intensive Inpatient Residential Treatment Services
  • Long-Term Care Residential
  • Opioid Treatment Programs (OTPs)
  • Recovery House Residential Treatment
  • TB Counseling, Screening, Testing and Referral
  • TB Screening/Skin Test
  • Urinalysis/Screening Test
  • Withdrawal Management - Acute
  • Withdrawal Management -Sub-Acute

The CSHCD SCRBH may provide funding for the following services where medical necessity does not apply:

  • Sobering
  • Childcare
  • Community Outreach
  • Pregnant, Post-Partum, or Parenting Women (PPW) Housing Support Services
  • Sobering Services
  • Therapeutic Interventions for Children in Specialized (PPW) SUD Treatment Programs

Substance Use Disorder Fee-For-Service Rates: