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Section 1.8 Formulary - means the Department Pharmaceutical Management and Formulary <br />Manual, The Formulary can be viewed at: <br />http://doc.wa.gov/business/healthcareproviders/def,;itilt.asp <br />Section 1.8.1 Formulary medication(s) - means the medication(s) medically necessary <br />according to the Offender Health Plan, <br />Section 1.8.2 Restricted Formulary medication(s) means the medication(s) is medically <br />necessary but the use is restricted to cases where there has been a documented failure of a <br />Formulary medication(s) or to certain populations or disease states. <br />Section 1.8.3 Non-Forinulary medication(s) — means the medication(s) is not a part of the <br />Formulary. Non -Formulary medication(s) is not generally prescribed in the Department, <br />Section 1.9 In -Facility care - means medical, mental health and dental care provided as part <br />of the per diem to include all over-the-counter medication, which is any medication that does <br />not require a prescription, and routine medical supplies, routine medical/psychiatric/dental <br />care, regular health screenings, and emergent medical treatment provided on-site at the Facility <br />that is undistinguishable from services provided to Contractor inmates. <br />Section 1.10 Licensed practitioner - means any licensed health care practitioner performing <br />services within the person's authorized scope of practice following RCW Title 18. <br />Section 1.11 Medicaid —means Title XIX of the Social Secu� enacted by the social <br />security amendments of 1965 (42 U.S.C. Sec. 1396; 79 Stat. 343), as amended. <br />Section 1.12 Medically necessary care - means medical care that meets one or more of the <br />following criteria for a given patient at a given time: <br />Section 1,12,1 Is essential to life or preservation of limb, OR <br />Section 1,12.2 Reduces intractable pain, OR <br />Section 1,12.3 Prevents significant deterioration of activities of daily living OR <br />Section 1.12.4 Is of proven value to significantly reduce the risk of one of the three outcomes <br />above (e.g. certain immunizations), OR <br />Section 1.12.5 Immediate intervention is not medically necessary, but delay of care would <br />make future care or intervention for intractable pain or preservation of activities <br />of daily living, significantly more dangerous, complicated, or significantly less <br />likely to succeed, OR <br />Section 1,12.6 Reduces severe psychiatric symptoms to a degree that permits engagement in <br />programming that advances correctional interests, OR <br />Section 1.12.7 Is described as part of a Departmental policy or health care protocol or guideline <br />and delivered according to such policy, protocol, or guideline, OR <br />Section 1.12.8 From a public health perspective, is necessary for the health and safety of a <br />State of Washington K9561 (4) Page 2 of 25 <br />Department of Corrections 158362 <br />