Emergency mental health practitioner accessibility

Contracted mental health practitioners are expected to be available at any time to assess and stabilize members in their care. If you plan to be unavailable, you must arrange for coverage.

If you are unable to meet the following initial access standards or the member's requested time frame, refer the member to the Mental Health Access Center for referral to another practitioner.

• For members needing routine, non-urgent care, meet with the member within two weeks of member contact.
• For urgent care, you must meet with the member within 48 hours.
• For emergent care, you must meet with the member within six hours.

When you have reason to believe that a member requires a higher level of service than you can provide, contact the Mental Health Access Center (MHAC) at 206-630-1680 or toll-free at 1-888-287-2680, Monday through Friday, 8 a.m. to 5 p.m. to determine the course of action. MHAC staff will assist in determining the need for urgent or emergent care and will work with the member and practitioner to assure adequate stabilization appointments are available.

If after-hours, on holidays, or weekends, contact EPRO for notification. Authorizations are not provided after-hours, on holidays, or on weekends. In these cases, contact EPRO (Emergency Patient Resources and Options) at 1-800-337-3197 to inform Kaiser Permanente of admission. The MHAC will review on the next business day.

If the member is at immediate risk of harm to self or others, follow appropriate clinical protocol and, if necessary, call 911.

As of July 2022, anyone experiencing a mental health or suicidal crisis can call, text, or chat the new 988 Suicide and Crisis Lifeline to be connected with a trained crisis counselor. The 988 line is confidential, free, and available 24/7/365. If you are worried about a loved one who may need crisis support, you can also contact the 988 line. 988 line services are available in Spanish, along with interpretation services in over 250 languages. For people who are deaf, hard of hearing, and TTY users, please use your preferred relay service or dial 711 then 988.

Kaiser Permanente complies with WA E2SHB 1688 (“Protecting consumers from charges for out-of-network health care services, by aligning state law and the federal no surprises act and addressing coverage of treatment for emergency conditions”) related to coverage of emergency services and alignment of state and federal balance billing laws. This Washington state law requires health plans to cover emergency behavioral health services provided by any in-network or out-of-network emergency behavioral health services provider, without any prior authorization requirement. Covered emergency behavioral health service providers include:

• Mobile rapid response crisis teams: a team that provides professional on-site community-based intervention such as outreach, de-escalation, stabilization, resource connection, and follow-up support for individuals who are experiencing a behavioral health crisis.
• Crisis stabilization units: a short-term facility or a portion of a facility licensed or certified by the Washington State Department of Health, such as an evaluation and treatment facility or a hospital, which has been designed to assess, diagnose, and treat individuals experiencing an acute crisis without the use of long-term hospitalization.
• Evaluation and treatment facilities: any facility which can provide directly, or by direct arrangement with other public or private agencies, emergency evaluation and treatment, outpatient care, and timely and appropriate inpatient care to persons suffering from a mental disorder, and which is licensed or certified as such by the Washington State Department of Health.
• Outpatient crisis services agencies: a provider that offers services in an outpatient setting for individuals who are in behavioral health crisis.
• Triage facilities: a short-term facility or a portion of a facility licensed or certified by the Washington State Department of Health, which is designed as a facility to assess and stabilize an individual or determine the need for involuntary commitment of an individual. A triage facility may be structured as a voluntary or involuntary placement facility.
• Medically-managed or medically-monitored withdrawal management: a facility operated by either a public or private agency or by the program of an agency which provides care to voluntary individuals and individuals involuntarily detained and committed for whom there is a likelihood of serious harm or who are gravely disabled due to the presence of a substance use disorder.