1. (1) Application. To apply for an endorsement, an eligible organization must submit an application for endorsement to the authority and all documentation required in subsection (3) of this section. Eligible organizations may apply:

   1. (a) Online through the authority's website; or
   2. (b) By completing the Crisis Team Endorsement Application form (HCA 82-0588) and mailing it to the authority.

2. (2) Submission periods for applications.

   1. (a) A team must submit its completed application by the deadline published on the authority's endorsement web page. (See https://www.hca.wa.gov/billers-providers-partners/program-information-providers/mobile-crisis-response-endorsement-program).
   2. (b) Providers must meet all application deadlines and endorsement criteria to be eligible for endorsement.
   3. (c) The authority defers submissions received after the deadlines in (a) of this subsection until the next contract cycle.

3. (3) Required documentation. An eligible organization applying for an endorsement must also submit:

   1. (a) A current contract with the behavioral health administrative services organization (BH-ASO) serving the region where the eligible organization will operate or a letter of intent to contract once the team is endorsed;
   2. (b) The eligible organization's policies and procedures and the authority's training verification tool, which outlines how the eligible organization currently complies with the training requirements in WAC 182-140-0090;
   3. (c) A copy of the transportation plan outlined in WAC 182-140-0100;
   4. (d) A copy of the eligible organization's Endorsement Staffing Plan form (HCA 82-0624) described in WAC 182-140-0080; and
   5. (e) A mobile crisis response information template (MCRIT) supplied by the authority.

4. (4) Community-based crisis teams (CBCT). A CBCT that intends to contract with a licensed and certified behavioral health agency (BHA) to provide staff must also submit:

   1. (a) The contracting BHA's active contract with the BH-ASO located in the region where the CBCT will operate; or
   2. (b) A letter of intent from the BH-ASO to establish a contractual relationship with the contracting BHA upon the CBCT receiving an endorsement; and
   3. (c) A letter of intent from the contracting BHA to establish a contractual relationship with the CBCT upon the CBCT receiving an endorsement.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 26-10-026, s 182-140-0030, filed 4/29/26, effective 6/1/26. Statutory Authority: RCW 41.05.021, 41.05.160, and 71.24.903. WSR 24-18-088, § 182-140-0030, filed 8/30/24, effective 9/30/24.]