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Section 1.8 Formulary -means the Department Pharmaceutical Management and Formulary Manual. The Formulary can be viewed at: http://doc.wa.gov!business!healthcareproviders/default.asp Section 1.8. 1 Formulary medication{s) -means the medication(s) medically necessary according to the Offender Health Plan. Section 1.8.2 Restricted Formulary medication{s) means the medication(s) is medically necessary but the use is restricted to cases where there has been a documented failure of a Formulary medication(s) or to certain populations or disease states. Section 1.8.3 Non-Formulary medication{s) -means the medication(s) is not a part of the Formularv. Non-Formulary medication(s) is not generally prescribed in the Department. Section 1.9 In-Facility care -means medical, mental health and dental care provided as part of the per diem to include all over-the-counter medication, which is any medication that does not require a prescription, and routine medical supplies, routine medical/psychiatric/dental care, regular health screenings, and emergent medical treatment provided on-site at the Facility that is undistinguishable from services provided to Contractor inmates. Section 1.10 Licensed practitioner -means any licensed health care practitioner performing services within the person's authorized scope of practice following RCW Title 18 . Section 1.11 Medicaid -means Title XIX of the Social Securitv Act enacted by the social security amendments of 1965 (42 U.s.c. Sec. 1396; 79 Stat. 343), as amended. Section 1.12 Medically necessary care -means medical care that meets one or more of the following criteria for a given patient at a given time: Section 1.12.1 Is essential to life or preservation of limb, OR Section 1.12.2 Reduces intractable pain, OR Section 1.12.3 Prevents significant deterioration of activities of daily living OR Section 1.12.4 Is of proven value to significantly reduce the risk of one of the three outcomes above (e.g. certain immunizations), OR Section 1.12.5 Immediate intervention is not medically necessary, but delay of care would make future care or intervention for intractable pain or preservation of activities of daily living, significantly more dangerous, complicated, or significantly less likely to succeed, OR Section 1.12.6 Reduces severe psychiatric symptoms to a degree that permits engagement in programming that advances correctional interests, OR Section 1.12.7 Is described as part of a Departmental policy or health care protocol or guideline and delivered according to such policy, protocol, or guideline, OR Section 1.12.8 From a public health perspective, is necessary for the health and safety of a State of Washington Department of Corrections K9561 (4) Page 2 of 25 158362