WSR 07-11-140

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed May 22, 2007, 10:51 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 07-04-065.

Title of Rule and Other Identifying Information: Division of developmental disabilities (DDD) voluntary placement program rules: Amending WAC 388-826-0085 and 388-826-0130; and new sections WAC 388-826-0129 What are the residential settings that DDD uses to provide voluntary placement program services?, 388-826-0135 When does DDD administer the foster care rate assessment?, 388-826-0136 How often does DDD administer the foster care rate assessment tool?, 388-826-0138 What questions are asked in the foster care rate assessment tool and how are the licensed foster home provider's answers scored?, 388-826-0145 How does DDD determine the foster care level from the raw score?, and 388-826-0175 How does DDD determine the rate that is paid to support a child in a licensed group facility?

Hearing Location(s): Blake Office Park East, Rose Room,

4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on June 26, 2007, at 10:00 a.m.

Date of Intended Adoption: Not earlier than June 27, 2007.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail schilse@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. on June 26, 2007.

Assistance for Persons with Disabilities: Contact Stephanie Schiller, DSHS Rules Consultant, by June 22, 2007, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at schilse@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This rule change describes how rates are set for foster homes and other settings in the DDD voluntary placement program (VPP). The foster care rate assessment (FCRA) is used in the DDD VPP. The FCRA has been used for the last five years to set specialized rates for foster homes that accept children with developmental disabilities in the VPP for placement. The assessment and the algorithms underlying the assessment are described in this rule.

Reasons Supporting Proposal: The rule describes the method currently used by DDD to set specialized rates for licensed child foster homes.

Statutory Authority for Adoption: RCW 74.13.750.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of social and health services, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Rita Dickey, P.O. Box 45310, Olympia, WA 98504, (360) 725-3403.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This rule does not impact small businesses.

A cost-benefit analysis is not required under RCW 34.05.328. This rule does not meet the definition of a significant rule, as defined in RCW 34.05.328 (5)(c)(iii).

May 14, 2007

Stephanie E. Schiller

Rules Coordinator

3845.4
AMENDATORY SECTION(Amending WSR 06-04-088, filed 1/31/06, effective 3/2/06)

WAC 388-826-0085   What other DDD services are available for a child through the voluntary placement program?   (1) When a parent signs a voluntary placement agreement and the child is placed ((in the VPP)) outside the parental home, the child will no longer be eligible for services from the state-funded family support ((opportunity)) program((, or the Medicaid personal care program)).

(2) Children living with their parents may receive personal care services provided under chapter 388-71 WAC.

(3) If the child is covered under the DDD core waiver as described in chapter 388-845 WAC, the child will receive the services identified on the plan of care.

[Statutory Authority: RCW 71A.12.030, 74.13.350, and Title 71A RCW. 06-04-088, 388-826-0085, filed 1/31/06, effective 3/2/06. Statutory Authority: RCW 74.13.350. 02-22-057, 388-826-0085, filed 10/31/02, effective 12/1/02.]


NEW SECTION
WAC 388-826-0129   What are the residential settings that DDD uses to provide voluntary placement program services?   DDD voluntary placement program services may be provided in a:

(1) Licensed foster home;

(2) Licensed group care facility;

(3) Licensed staffed residential home; or

(4) Licensed child placing agency.

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AMENDATORY SECTION(Amending WSR 06-04-088, filed 1/31/06, effective 3/3/06)

WAC 388-826-0130   How ((is the foster care rate determined in VPP)) does DDD determine the rate that is paid to support a child in a licensed foster home?   DDD determines the rate that is paid to support a child in a licensed foster home by adding:

(1) The basic foster care room and board rate ((is)) published annually by children's administration ((each year. See)) per WAC 388-25-0120.

(2) ((The foster care assessment is completed annually by DDD to determine the amount of any specialized rate that will be paid to the foster parent in addition to the basic rate.

(3) The department administers the assessment with the foster parent. Based on information given by the foster parent and information gathered by the department, the standardized assessment will determine a score and assign a level.

(4) Algorithms determine the score corresponding to the care needs for each child. Each level is assigned a rate. The rate will be paid to the foster parent caring for the child)) The specialized rate identified after administering the foster care rate assessment (FCRA) tool.

[Statutory Authority: RCW 71A.12.030, 74.13.350, and Title 71A RCW. 06-04-088, 388-826-0130, filed 1/31/06, effective 3/3/06.]


NEW SECTION
WAC 388-826-0135   When does DDD administer the foster care rate assessment tool?   DDD administers the foster care rate assessment tool within thirty days from the date of the child's admission to a licensed foster home.

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NEW SECTION
WAC 388-826-0136   How often does DDD administer the foster care rate assessment tool?   (1) DDD administers the foster care rate assessment tool on an annual basis, between the months of November and February so rates can be updated by April 1 of each year.

(2) DDD does not have to re-administer the foster care rate assessment if it was administered within ninety days of February 1.

(3) The FCRA may be re-administered if a significant change is reported that affects the child's need for support (e.g., changes in medical condition, behavior, caregiver status, etc.).

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NEW SECTION
WAC 388-826-0138   What questions are asked in the foster care rate assessment tool and how are the licensed foster home provider's answers scored?   The foster care rate assessment tool consists of thirteen questions that are scored by DDD based on discussion between the DSHS representative and the licensed foster home provider.

(1) Daily Living: Include the average number of hours per day spent caring for this child beyond what is expected for his/her age on daily living tasks including dressing, grooming, toileting, feeding and providing specialized body care.


Answers Score
0 to 1 30
2 to 5 91
6 to 9 213
10 to 20 396
Over 20 609

(2) Physical Needs: What is the average number of hours per day beyond what is expected for his/her age providing assistance not included in the "daily living" category above? (e.g., wheelchairs, prosthetics, and other assistive devices, dental/orthodontic, communication (speech, hearing, sight), airway management (monitors, ventilators), pressure sores and/or intravenous nutrition.)


Answers Score
0 to 1 30
2 to 5 91
6 to 20 274
Over 20 609

(3) Behavioral Needs: What is the average number of hours per day the foster parent(s) will need to spend supporting and supervising the child due to behaviors disorders, emotional disorders, and mental disorders?


Answers Score
0 to 1 30
2 to 5 91
6 to 13 335
14 to 24 578
Over 24 731

(4) Participation in Child's Therapeutic Plan: Include the average number of hours per week implementing a plan prescribed by a professional related to the child's physical, behavioral, emotional or mental therapy.

(a) Physical therapeutic plan (e.g., meeting with providers, attending therapy or directly giving physical, occupational or post-surgical therapy.)


Answers Score
0 to 1 4
2 to 3 13
4 to 9 30
10 to 46 65

(b) Participation in emotional/behavioral support plan (e.g., meeting with providers, attending therapy or directly supporting therapeutic plan.)


Answers Score
0 to 1 4
2 to 3 13
4 to 19 48
20 to 60 104
Over 60 hours/week 390

(5) Arranging, Scheduling and Supervising Activities: Indicate the average number of hours per week scheduling appointments and accompanying the child.

(a) Medical/Dental (e.g., transporting and waiting for medical services including doctor visits, dental visits, rehabilitation, and therapy visits.)


Answers Score
0 to 1 4
2 to 5 13
6 to 14 39
Over 14 hours/week 82

(b) Community activities (e.g., transporting and waiting during events including recreation, leisure, sports or extra-curricular activities.)


Answers Score
0 to 1 4
2 to 3 13
4 to 7 30
8 to 20 48
Over 20 hours/week 130

(6) House Care: Indicate the average number of times per week to repair, clean or replace household items, including medical equipment, over and above normal wear and tear, due to:

(a) Chronic conditions (e.g., lack of personal control resulting in bed-wetting or incontinence, lack of muscle control or unawareness of the consequences of physical actions.)


Answers Score
0 to 1 6
2 to 7 24
8 to 19 58
20 to 38 91
Over 38 times per week 238

(b) Destructive behavior (e.g., lack of emotional control resulting in damage or destruction of property.)


Answers Score
0 to 1 6
2 to 3 15
4 to 9 28
10 to 22 58
Over 22 times per week 162

(7) Development and Socialization: Indicate the average number of hours per week to provide guidance and assistance.

(a) Direct developmental assistance (e.g., helping with homework and readiness to learn activities.)


Answers Score
0 to 1 4
2 to 3 13
4 to 11 30
12 to 30 87
Over 30 hours/week 249

(b) Professional interaction (e.g., meeting with teachers, visiting the school either planned or in crisis, speaking on the phone with school personnel, participating in individual education plan development and review.)


Answers Score
0 to 1 4
2 to 3 13
4 to 5 22
6 to 12 30
Over 12 hours/week 82

(c) Socialization and functional life skills (e.g., helping the child build skills, make choices and take responsibility, learn about the use of money, relate to peers, adults and family members and explore the community.)


Answers Score
0 to 1 4
2 to 7 22
8 to 19 56
20 to 60 173
Over 60 hours/week 403

(8) Shared Parenting: Indicate the average number of hours per week to work with the birth parents and/or siblings, including assisting in the care of the child during visits, demonstrating care techniques, planning and decision making.


Answers Score
0 to 1 4
2 to 3 13
4 to 12 30
Over 12 82

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NEW SECTION
WAC 388-826-0145   How does DDD determine the foster care level from the raw score?   The following are the foster care levels based on the range of aggregate scores:


Level Low Score High Score
1 0 320
2 321 616
3 617 1501
4 1502 2085
5 2086 2751
6 2752 9999999

A standardized rate for specialized services is assigned to each level one through six. The standardized rate is published by DDD. The rate is paid monthly to the foster parent in addition to the basic rate.

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NEW SECTION
WAC 388-826-0175   How does DDD determine the rate that is paid to support a child in a licensed group care facility?   A rate is negotiated by contract between DDD and the licensed group care facility.

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REPEALER

     The following section of the Washington Administrative Code is repealed:
WAC 388-826-0140 What areas are covered in the foster care assessment?

Washington State Code Reviser's Office