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approval for use. The DOC Pharmaceutical Management and Formulary Manual can be <br />viewed at: http://doc.wa.gov/business/healtheareproviders/default.asp <br />Section 1.9 In -Facility care - means medical, mental health and dental care provided <br />as part of the per diem to include all over-the-counter medication, which is any medication <br />that does not require a prescription, and routine medical supplies, routine <br />medical/psychiatric/dental care, regular health screenings, and emergent medical <br />treatment provided on-site at the Facility that is undistinguishable from services provided <br />to Contractor inmates. <br />Section 1.10 Licensed practitioner - means any licensed health care practitioner <br />performing services within the person's authorized scope of practice following RCW Title <br />18. <br />Section 1.11 Medicaid — means Title XIX of the Social Security Act 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 <br />the 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 <br />(ADLs), OR <br />Section 1.12.4 Is of proven value to significantly reduce the risk of one of the <br />three outcomes above (e.g. certain immunizations), OR <br />Section 1.12.5 Immediate intervention is not medically necessary, but delay of <br />care would make future care or intervention for intractable pain or preservation <br />of ADLs significantly more dangerous, complicated, or significantly less likely to <br />succeed, OR <br />Section 1.12.6 Reduces severe psychiatric symptoms to a degree that permits <br />engagement in programming that advances correctional interests, OR <br />Section 1.12.7 Is described as part of a Departmental policy or health care <br />protocol or guideline and delivered according to such policy, protocol, or <br />guideline, OR <br />Section 1.12.8 From a public health perspective, is necessary for the health and <br />safety of a community of individuals and is medically appropriate, but may not be <br />medically necessary for the individual (for example, treatment for head lice); <br />Section 1.12.9 Not considered experimental or to be lacking in medically <br />recognized professional documentation of efficacy; and, <br />State of Washington K9561(6) Page 2 of 9 <br />Department of Corrections 208362 <br />