The following limits apply to your receipt of specialized evaluation and consultation:

1. (1) You must be enrolled on the community protection waiver.
2. (2) Specialized evaluation and consultation support needs must be identified in your DDA assessment and must be documented in your person-centered service plan.

3. (3) Specialized evaluation and consultation is limited to services that are:

   1. (a) Consistent with waiver objectives of avoiding institutionalization; and
   2. (b) Not a covered benefit under the medicaid state plan, including mental health treatment.
4. (4) This service must not replace one-on-one, group, or other treatments to address a mental health condition which are covered by the medicaid state plan.
5. (5) One-on-one and group skill building that is a component of behavioral health treatment is not covered under specialized evaluation and consultation.

[Statutory Authority: RCW 71A.12.030, 71A.12.380, 71A.12.380(1), and 42 C.F.R. 441.301. WSR 26-01-057, s 388-845-2143, filed 12/11/25, effective 1/11/26. Statutory Authority: RCW 71A.12.030, 71A.12.120, and 42 C.F.R. 441.301 (c)(6). WSR 23-18-035, § 388-845-2143, filed 8/29/23, effective 9/29/23.]