see "spouse" in WAC
182-500-0100.
"Institution" means an entity that furnishes (in
single or multiple facilities) food, shelter, and some treatment or services to
four or more people unrelated to the proprietor. Eligibility for a Washington
apple health program may vary depending upon the type of institution in which
an individual resides. For the purposes of apple health programs, "institution"
includes all the following:
(1)
"Institution for mental diseases (IMD)" - A hospital, nursing
facility, or other institution of more than 16 beds that is primarily engaged
in providing diagnosis, treatment or care of people with mental diseases,
including medical attention, nursing care and related services. An IMD may
include inpatient substance use disorder (SUD) facilities of more than 16 beds
which provide residential treatment for SUD.
(2)
"Intermediate care facility for
individuals with intellectual disabilities (ICF/IID)" - An institution
or distinct part of an institution that is:
(b) Certified to provide ICF/IID services
under 42 C.F.R.
483, Subpart I; and
(c) Primarily for the diagnosis, treatment,
or rehabilitation for people with intellectual disabilities or a related
condition.
(3)
"Medical institution" - An entity that is organized to provide
medical care, including nursing and convalescent care. The terms "medical
facility" and "medical institution" are sometimes used interchangeably
throughout Title 182 WAC.
(a) To meet the
definition of medical institution, the entity must:
(i) Be licensed as a medical institution
under state law;
(ii) Provide
medical care, with the necessary professional personnel, equipment, and
facilities to manage the health needs of the patient on a continuing basis
under acceptable standards; and
(iii) Include adequate physician and nursing
care.
(b) Medical
institutions include:
(i) "Hospice care
center" - An entity licensed by the department of health (DOH) to provide
hospice services. Hospice care centers must be medicare-certified, and approved
by the agency or the agency's designee to be considered a medical
institution.
(iii) "Nursing facility (NF)" - An entity
certified to provide skilled nursing care and long-term care services to
medicaid recipients under Social Security Act Sec. 1919(a), 42 U.S.C. Sec.
1396r. Nursing facilities that may become certified include nursing homes
licensed under chapter 18.51 RCW, and nursing facility units within hospitals
licensed by DOH under chapter 70.41 RCW. This includes the nursing facility
section of a state veteran's facility.
(iv) "Psychiatric hospital" - An institution,
or a psychiatric unit located in a hospital, licensed as a hospital under
applicable Washington state laws and rules, that is primarily engaged to
provide psychiatric services for the diagnosis and treatment of mentally ill
people under the supervision of a physician.
(v) "Psychiatric residential treatment
facility (PRTF)" - A non-hospital residential treatment center licensed by DOH,
and certified by the agency or the agency's designee to provide psychiatric
inpatient services to medicaid-eligible people age 21 and younger. A PRTF must
be accredited by the Joint Commission on Accreditation of Health care
Organizations (JCAHO) or any other accrediting organization with comparable
standards recognized by Washington state. A PRTF must meet the requirements in
42 C.F.R.
483, Subpart G, regarding the use of
restraint and seclusion.
(vi)
"Residential habilitation center (RHC)" - A state-operated facility for persons
with developmental disabilities governed by chapter 71A.20 RCW.
(c) Medical institutions do not
include entities licensed by the agency or the agency's designee as adult
family homes (AFHs) and boarding homes. AFHs and boarding homes include
assisted living facilities, adult residential centers, enhanced adult
residential centers, and developmental disability group homes.
(4)
"Public
institution" means an entity that is the responsibility of a
governmental unit or over which a governmental unit exercises administrative
control.
(a) Public institutions include:
(i) Correctional facility - An entity such as
a state prison, or city, county, or tribal jail, or juvenile rehabilitation or
juvenile detention facility.
(ii)
Eastern and Western State mental hospitals. (Medicaid coverage for these
institutions is limited to people age 21 and younger, and people age 65 and
older.)
(iii) Certain facilities
administered by Washington state's department of veteran's affairs (see (b) of
this subsection for facilities that are not considered public
institutions).
(b)
Public institutions do not include intermediate care facilities, entities that
meet the definition of medical institution (such as Harborview Medical Center
and University of Washington Medical Center), or facilities in Retsil, Orting,
and Spokane that are administered by the department of veteran's affairs and
licensed as nursing facilities.
"Institution for mental diseases (IMD)" see
"institution" in this section.
"Institutional review board" - A board or
committee responsible for reviewing research protocols and determining
whether:
(1) Risks to subjects are
minimized;
(2) Risks to subjects
are reasonable in relation to anticipated benefits, if any, to subjects, and
the importance of the knowledge that may reasonably be expected to
result;
(3) Selection of subjects
is equitable;
(4) Informed consent
will be sought from each prospective subject or the subject's legally
authorized representative;
(5)
Informed consent will be appropriately documented;
(6) When appropriate, the research plan makes
adequate provision for monitoring the data collected to ensure the safety of
subjects;
(7) When appropriate,
there are adequate provisions to protect the privacy of subjects and to
maintain the confidentiality of data; and
(8) When some or all of the subjects are
likely to be vulnerable to coercion or undue influence, such as children,
prisoners, pregnant people, mentally disabled persons, or economically or
educationally disadvantaged persons, additional safeguards have been included
in the study to protect the rights and welfare of these subjects.
"Institutionalized spouse" see "spouse" in WAC
182-500-0100.
"Intermediate care facility for individuals with
intellectual disabilities (ICF/IID)" see "institution" in this
section.