WSR 08-20-033

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed September 22, 2008, 4:06 p.m. , effective October 23, 2008 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: These rules are necessary to amend the procedures for administering the home and community based services waivers. They incorporate changes reflected in the waivers approved by the federal Centers for Medicare and Medicaid Services under Section 1915(c) of the Social Security Act. They also clarify the existing rules. By amending these rules, the department is able to claim additional federal Title XIX funds.

Citation of Existing Rules Affected by this Order:
WAC SUMMARY and SBEIS/CBA WORKSHEET

June 2008

Washington Administrative Code Effect of Rule Impact Small Business?
388-845-0001 Definitions - Amended

"CAP Waiver" - Removed

"Gainful employment" - Added

"Integrated settings" - Added

"Living wage" - Added

This definition is obsolete.

Adds the definition of "gainful employment."

Adds the definition of "integrated settings."

Adds the definition of "living wage."

No

No

No

No

388-845-0045 - Amended Clarifies that needs refer to the identified health and welfare needs. No
388-845-0205 - Amended Increases the maximum allowable amount for employment/day program services. No
388-845-0210 - Amended Increases the maximum allowable amount for employment/day program services and that this amount may be exceeded by exception to rule. No
388-845-0600 - Amended Rewords the definition of community access services for clarity. No
388-845-0605 - Amended Rewords who can be providers of community access services for clarity. No
388-845-0610 - Amended Clarifies that community access is a service. No
388-845-0750 - Amended Clarifies that community transition services may be available when moving from an institutional setting or from a provider operated setting to a community setting in which you live in your own home or apartment and are responsible for your living expenses. No
388-845-0760 - Amended Clarifies that community transitional services may not be used for rent. No
388-845-1200 - Amended Clarifies the definition of person-to-person services. No
388-845-1205 - Amended Grammatical change only. No
388-845-1210 - Amended Clarifies the limitations of person-to-person services. No
388-845-1305 - Amended Clarifies that providers of personal care services must be contracted with ADSA rather than DDD. No
388-845-1310 - Amended Clarifies that homecare agencies must be contracted with ADSA rather than DDD and eliminates an erroneous cross-reference. No
388-845-1400 - Amended Expands the definition of prevocational services. No
388-845-1410 - Amended Expands the limitations of prevocational services to require prior approval, that these services are time-limited and when a review of these services may be required. No
388-845-1600 - Amended Clarifies the definition of respite care. No
388-845-1620 - Amended Expands the limitations on respite care regarding parent providers. No
388-845-1650 - Amended Changes the term deviation to deviancy and expands the definition for clarity. No
388-845-1655 - Amended Changes the term deviation to deviancy. No
388-845-1660 - Amended Changes the term deviation to deviancy. No
388-845-2100 - Amended Revises and expands the definition of supported employment services. No
388-845-2105 - Amended Rewords the grammar for clarity. No
388-845-2110 - Amended Clarifies the limitations on supported employment services. No
388-845-2210 - Amended Adds a limitation of sixty miles per month for transportation services provided by a personal care provider. Yes

Statutory Authority for Adoption: RCW 71A.12.030, 71A.12.120.

Other Authority: Title 71A RCW.

Adopted under notice filed as WSR 08-15-008 on July 3, 2008.

Changes Other than Editing from Proposed to Adopted Version: WAC 388-845-1310 has been changed to delete the cross reference to chapter 388-71 WAC.

A final cost-benefit analysis is available by contacting Steve Brink, P.O. Box 45310, Olympia, WA 98504-5310, phone (360) 725-3416, fax (360) 407-0955, e-mail brinksc@dshs.wa.gov.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 25, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 25, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 25, Repealed 0.

Date Adopted: September 22, 2008.

Robin Arnold-Williams

Secretary

3946.4
AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-0001   Definitions.   "ADSA" means the aging and disability services administration, an administration within the department of social and health services.

"Aggregate services" means a combination of services subject to the dollar limitations in the Basic and Basic Plus waivers.

(("CAP waiver" means the community alternatives program waiver.))

"CARE" means the comprehensive assessment and reporting evaluation.

"DDD" means the division of developmental disabilities, a division within the aging and disability services administration of the department of social and health services.

"DDD assessment" refers to the standardized assessment tool as defined in chapter 388-828 WAC, used by DDD to measure the support needs of persons with developmental disabilities.

"Department" means the department of social and health services.

"Employment/day program services" means community access, person-to-person, prevocational services or supported employment services subject to the dollar limitations in the Basic and Basic Plus waivers.

"Family" means relatives who live in the same home with the eligible client. Relatives include spouse, natural, adoptive or step parents; grandparents; brother; sister; stepbrother; stepsister; uncle; aunt; first cousin; niece; or nephew.

"Gainful employment" means employment that reflects achievement of or progress towards a living wage.

"HCBS waivers" means home and community based services waivers.

"Home" means your present or intended place of residence.

"ICF/MR" means an intermediate care facility for the mentally retarded.

"Individual support plan (ISP)" is a document that authorizes and identifies the DDD paid services to meet a client's assessed needs.

"Integrated settings" mean typical community settings not designed specifically for individuals with disabilities in which the majority of persons employed and participating are individuals without disabilities.

"Legal representative" means a parent of a person who is under eighteen years of age, a person's legal guardian, a person's limited guardian when the subject matter is within the scope of limited guardianship, a person's attorney at law, a person's attorney in fact, or any other person who is authorized by law to act for another person.

"Living wage" means the amount of earned wages needed to enable an individual to meet or exceed his/her living expenses.

"Necessary supplemental accommodation representative" means an individual who receives copies of DDD planned action notices (PANs) and other department correspondence in order to help a client understand the documents and exercise the client's rights. A necessary supplemental accommodation representative is identified by a client of DDD when the client does not have a legal guardian and the client is requesting or receiving DDD services.

"Plan of care (POC)" means the primary tool DDD uses to determine and document your needs and to identify services to meet those needs until the DDD assessment is administered and the individual support plan is developed.

"Providers" means an individual or agency who meets the provider qualifications and is contracted with ADSA to provide services to you.

"Respite assessment" means an algorithm within the DDD assessment that determines the number of hours of respite care you may receive per year if you are enrolled in the Basic, Basic Plus, or Core waiver.

"SSI" means Supplemental Security Income, an assistance program administered by the federal Social Security Administration for blind, disabled and aged individuals.

"SSP" means state supplementary payment, a benefit administered by the department intended to augment an individual's SSI.

"State funded services" means services that are funded entirely with state dollars.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-0001, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0001, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-0045   When there is capacity to add people to a waiver, how does DDD determine who will be enrolled?   When there is capacity on a waiver and available funding for new waiver participants, DDD may enroll people from the statewide data base in a waiver based on the following priority considerations:

(1) First priority will be given to current waiver participants assessed to require a different waiver because their identified health and welfare needs have increased and these needs cannot be met within the scope of their current waiver.

(2) DDD may also consider any of the following populations in any order:

(a) Priority populations as identified and funded by the legislature.

(b) Persons DDD has determined to be in immediate risk of ICF/MR admission due to unmet health and welfare needs.

(c) Persons identified as a risk to the safety of the community.

(d) Persons currently receiving services through state-only funds.

(e) Persons on an HCBS waiver that provides services in excess of what is needed to meet their identified health and welfare needs.

(f) Persons who were previously on an HCBS waiver since April 2004 and lost waiver eligibility per WAC 388-845-0060(9).

(3) For the Basic waiver only, DDD may consider persons who need the waiver services available in the Basic waiver to maintain them in their family's home or in their own home.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-0045, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0045, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-0205   Basic waiver services.  


BASIC WAIVER SERVICES YEARLY LIMIT
AGGREGATE SERVICES: May not exceed $1454 per year on any combination of these services

Behavior management and consultation
Community guide
Environmental accessibility adaptations
Occupational therapy
Physical therapy
Specialized medical equipment/supplies
Specialized psychiatric services
Speech, hearing and language services
Staff/family consultation and training
Transportation
EMPLOYMENT/DAY PROGRAM SERVICES:


Community access

May not exceed $((6631)) 6804 per year
Person-to-person
Prevocational services
Supported employment
Sexual deviancy evaluation Limits are determined by DDD
Respite care Limits are determined by the DDD assessment
Personal care Limits are determined by the CARE tool used as part of the DDD assessment
MENTAL HEALTH STABILIZATION SERVICES: Limits are determined by a mental health professional or DDD

Behavior management and consultation
Mental health crisis diversion bed services
Skilled nursing
Specialized psychiatric services
Emergency assistance is only for aggregate services and/or employment/day program services contained in the Basic waiver $6000 per year; Preauthorization required

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-0205, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120. 07-05-014, 388-845-0205, filed 2/9/07, effective 3/12/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0205, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-0210   Basic Plus waiver services.  


BASIC PLUS WAIVER SERVICES YEARLY LIMIT
AGGREGATE SERVICES: May not exceed $6192 per year on any combination of these services

Behavior management and consultation
Community guide
Environmental accessibility adaptations
Occupational therapy
Physical therapy
Skilled nursing
Specialized medical equipment/supplies
Specialized psychiatric services
Speech, hearing and language services
Staff/family consultation and training
Transportation
EMPLOYMENT/DAY PROGRAM SERVICES: May not exceed $((9691)) 9944 per year
Community access


Person-to-person


Prevocational services


Supported employment

This amount may be increased to a maximum of $19,888 per year by exception to rule based on client need
Adult foster care (adult family home) Determined per department rate structure
Adult residential care (boarding home)
MENTAL HEALTH STABILIZATION SERVICES: Limits determined by a mental health professional or DDD
Behavior management and consultation
Mental health crisis diversion bed services
Skilled nursing
Specialized psychiatric services
Personal care Limits determined by the CARE tool used as part of the DDD assessment
Respite care Limits are determined by the DDD assessment
Sexual deviancy evaluation Limits are determined by DDD
Emergency assistance is only for aggregate services and/or employment/day program services contained in the Basic Plus waiver $6000 per year; Preauthorization required

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-0210, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120. 07-05-014, 388-845-0210, filed 2/9/07, effective 3/12/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0210, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-0600   What ((is)) are community access services?   Community access ((is a)) services are provided in the community to enhance or maintain ((the person's competence,)) your community integration, physical or mental skills.

(1) If you are age sixty-two or older, ((this service is)) these services are available to assist you to participate in activities, events and organizations in the community in ways similar to others of retirement age.

(2) ((This service is)) These services are available ((to adults)) in the Basic, Basic Plus, and CORE waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0600, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-0605   Who ((is a)) are qualified providers of community access services?   ((The)) Providers of community access services must be a county or an individual or agency contracted with a county or DDD.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0605, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-0610   Are there limits to community access services I can receive?   The following limits apply to your receipt of community access services:

(1) You must be age sixty-two or older.

(2) You cannot be authorized to receive community access services if you receive prevocational services or supported employment services.

(3) The dollar limitations for employment/day program services in your Basic or Basic Plus waiver limit the amount of service you may receive.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0610, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-0750   What are community transition services?   (1) Community transition services are reasonable costs (necessary expenses in the judgment of the state for ((an individual)) you to establish ((his or her)) your basic living arrangement) associated with moving from:

(a) An institutional setting to a community setting in which you are living in your own home or apartment, responsible for your own living expenses and receiving services from a DDD certified residential habilitation services provider as defined in WAC 388-845-1505 and 388-845-1510; or

(b) A provider operated setting, such as a group home, staffed residential, or companion home in the community to a community setting in which you are living in your own home or apartment, responsible for your own living expenses, and receiving services from a DDD certified residential habilitation services provider as defined in WAC 388-845-1505 and 388-845-1510.

(2) Community transition services include:

(a) Security deposits (not to exceed the equivalent of two month's rent) that are required to obtain a lease on an apartment or home;

(b) Essential furnishings such as a bed, a table, chairs, window blinds, eating utensils and food preparation items;

(c) Moving expenses required to occupy ((and use a community domicile)) your own home or apartment;

(d) Set-up fees or deposits for utility or service access (e.g., telephone, electricity, heating); and

(e) Health and safety assurances, such as pest eradication, allergen control or one-time cleaning prior to occupancy.

(3) Community transition services are available in the CORE and community protection waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0750, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-0760   Are there limitations to community transition services I can receive?   (1) Community transition services do not include:

(a) Diversional or recreational items such as televisions, cable TV access, VCRs, MP3, CD or DVD players; and

(b) Computers ((whose use is)) if primarily ((diversional or recreational)) used as a diversional or for recreation.

(2) ((Community transition services are available only to individuals that are moving from an institution to a community setting and are enrolled in either the CORE or community protection waiver)) Rent assistance is not available as a community transition service.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-0760, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1200   What ((is a)) are "person-to-person" services?   (1) "Person-to-person" ((is a day program)) services are intended to assist ((participants)) you to ((progress toward)) achieve the outcome of gainful employment ((goals)) in an integrated setting through ((individualized planning, skill instruction, information and referral, and one to one relationship building)) a combination of services, which may include:

(a) Development and implementation of self-directed employment services;

(b) Development of a person centered employment plan;

(c) Preparation of an individualized budget; and

(d) Support to work and volunteer in the community, and/or access the generic community resources needed to achieve integration and employment.

(2) These ((This)) services may be provided in addition to community access, prevocational services, or supported employment.

(3) These ((This)) services ((is)) are available ((to adults)) in all four HCBS waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1200, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1205   Who ((is a)) are qualified providers of person-to-person services?   ((The)) Providers of "person-to-person" services must be a county or an individual or agency contracted with a county or DDD.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1205, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1210   Are there limits to the person-to-person service I can receive?   (1) You must be age twenty and graduating from high school prior to your July or August twenty-first birthday, age twenty-one and graduated from high school or age twenty-two or older to receive person-to-person services.

(2) The dollar limitations for employment/day program services in your Basic or Basic Plus waiver limit the amount of service you may receive.

(3) These services will be provided in an integrated environment.

(4) Your service hours are determined by the level of assistance you need to reach your employment outcomes and might not equal the number of hours you spend on the job or in job related activities.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1210, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1305   Who are the qualified providers of personal care services?   (1) Qualified providers of personal care services may be individuals or licensed homecare agencies contracted with ((DDD)) ADSA.

(2) All individual providers and homecare agency providers must meet provider qualifications for in-home caregivers in WAC 388-71-0500 through 388-71-0556.

(3) Providers of personal care services for adults must comply with the training requirements in these rules governing Medicaid personal care providers in WAC 388-71-05670 through 388-71-05799.

(4) Natural, step, or adoptive parents can be the personal care provider of their adult child age eighteen or older.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1305, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-1310   Are there limits to the personal care services I can receive?   (1) You must meet the programmatic eligibility for Medicaid personal care in chapter 388-106 WAC governing Medicaid personal care (MPC) using the current department approved assessment form: Comprehensive assessment reporting evaluation (CARE).

(2) The maximum hours of personal care you may receive are determined by the CARE tool used as part of the DDD assessment.

(a) Provider rates are limited to the department established hourly rates for in-home Medicaid personal care.

(b) Homecare agencies must be licensed through the department of health and contracted with ((DDD)) ADSA.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-1310, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1310, filed 12/13/05, effective 1/13/06.]

Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1400   What are prevocational services?   (1) Prevocational services occur in a segregated setting and are designed to prepare ((an adult)) you for ((paid or unpaid)) gainful employment in an integrated setting through ((the teaching of such concepts as compliance, attendance, task completion, problem solving and safety)) training and skill development.

(2) Prevocational ((These)) services are available in all four HCBS waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1400, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1410   Are there limits to the prevocational services I can receive?   The following limitations apply to your receipt of prevocational services:

(1) You must be age twenty and graduating from high school prior to your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive prevocational services.

(2) ((You are not expected to be competitively employed within one year (excluding supported employment programs))) New referrals for prevocational services require prior approval by the DDD regional administrator and county coordinator or their designees.

(3) Prevocational services are a time limited step on the pathway toward individual employment and are dependent on your demonstrating steady progress toward gainful employment over time. Your annual vocational assessment will include exploration of integrated settings within your next service year. Criteria that would trigger a review of your need for these services include, but are not limited to:

(a) Compensation at more than fifty percent of the prevailing wage;

(b) Significant progress made toward your defined goals;

(c) Your expressed interest in competitive employment; and/or

(d) Recommendation by your individual support plan team.

(((3))) (4) You ((cannot)) will not be authorized to receive prevocational services ((if you receive)) in addition to community access services or supported employment services.

(((4))) (5) The dollar limitations for employment/day program services in your Basic or Basic Plus waiver limit the amount of service you may receive.

(6) Your service hours are determined by the assistance you need to reach your employment outcomes.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1410, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1600   What is respite care?   Respite care is ((intended to provide)) short-term intermittent relief for persons normally providing care for waiver individuals. This service is available in the Basic, Basic Plus, and CORE waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1600, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-1620   Are there limits to the respite care I can receive?   The following limitations apply to the respite care you can receive:

(1) The DDD assessment will determine how much respite you can receive per chapter 388-828 WAC.

(2) Prior approval by the DDD regional administrator or designee is required:

(a) To exceed fourteen days of respite care per month; or

(b) To pay for more than eight hours in a twenty-four hour period of time for respite care in any setting other than your home or place of residence. This limitation does not prohibit your respite care provider from taking you into the community, per WAC 388-845-1610(2).

(3) Respite cannot replace:

(a) Daycare while ((a parent or guardian)) your parent or guardian is at work; and/or

(b) Personal care hours available to you. When determining your unmet need, DDD will first consider the personal care hours available to you.

(4) Respite providers have the following limitations and requirements:

(a) If respite is provided in a private home, the home must be licensed unless it is the client's home or the home of a relative of specified degree per WAC 388-825-345;

(b) The respite provider cannot be the spouse of the caregiver receiving respite if the spouse and the caregiver reside in the same residence; and

(c) If you receive respite from a provider who requires licensure, the respite services are limited to those age-specific services contained in the provider's license.

(5) ((Your caregiver cannot provide)) Your caregiver will not be paid to provide DDD services for you or other persons at the same time you receive respite services.

(6) If your personal care provider is your parent, your parent provider will not be paid to provide respite services ((for you or other persons during your respite care hours)) to any client in the same month that you receive respite services.

(((6))) (7) DDD cannot pay for any fees associated with the respite care; for example, membership fees at a recreational facility, or insurance fees.

(((7))) (8) If you require respite from a licensed practical nurse (LPN) or a registered nurse (RN), services may be authorized as skilled nursing services per WAC 388-845-1700 using an LPN or RN. If you are in the Basic Plus waiver, skilled nursing services are limited to the dollar limits of your aggregate services per WAC 388-845-0210.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-1620, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1620, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1650   What are sexual ((deviation)) deviancy evaluations?   (1) Sexual ((deviation)) deviancy evaluations:

(a) Are professional evaluations ((of sexual deviancy to determine the need for psychological, medical or therapeutic services)) that assess the person's needs and the person's level of risk of sexual offending or sexual recidivism;

(b) Determine the need for psychological, medical or therapeutic services; and

(c) Provide treatment recommendations to mitigate any assessed risk.

(2) Sexual deviancy evaluations are available in all four waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1650, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-1655   Who is a qualified provider of sexual ((deviation)) deviancy evaluations?   The provider of sexual deviancy evaluations must:

(1) Be a certified sexual offender treatment provider (SOTP); and

(2) Meet the standards contained in WAC 246-930-030 (education required prior to examination) and WAC 246-930-040 (professional experience required prior to examination).

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1655, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-1660   Are there limitations to the sexual ((deviation)) deviancy evaluations I can receive?   (1) ((The)) Sexual deviancy evaluations must meet the standards contained in WAC 246-930-320.

(2) Sexual ((deviation)) deviancy evaluations require prior approval by the DDD regional administrator or designee.

(3) The costs of sexual ((deviation)) deviancy evaluations do not count toward the dollar limits for aggregate services in the Basic or Basic Plus waivers.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-1660, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-1660, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-2100   What ((is)) are supported employment services?   Supported employment services provide((s)) you with intensive ongoing ((individual or group)) support ((in a work setting to adults with developmental disabilities)) if you need individualized assistance to gain and/or maintain employment. ((This service is)) These services are tailored to your individual needs, interests, abilities, and promote your career development. These services are provided in individual or group settings and are available in all four HCBS waivers.

(1) Individual supported employment services include((s)) activities needed to sustain ((paid work by individuals receiving waiver services, including supervision and training)) minimum wage pay or higher. These services are conducted in integrated business environments and include the following:

(a) Creation of work opportunities through job development;

(b) On-the-job training;

(c) Training for your supervisor and/or peer workers to enable them to serve as natural supports to you on the job;

(d) Modification of your work site tasks;

(e) Employment retention and follow along support; and

(f) Development of career and promotional opportunities.

(2) ((Supported employment is conducted in a variety of settings; particularly work sites in which persons without disabilities are employed)) Group supported employment services are a step on your pathway toward gainful employment in an integrated setting and include:

(a) The activities outlined in individual supported employment services;

(b) Daily supervision by a qualified employment provider; and

(c) Groupings of no more than eight workers with disabilities.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-2100, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-2105   Who ((is a)) are qualified providers of supported employment services?   ((A)) Supported employment services providers must be a county, or agencies or individuals contracted with a county or DDD.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-2105, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 06-01-024, filed 12/13/05, effective 1/13/06)

WAC 388-845-2110   Are there limits to the supported employment services I can receive?   The following limitations apply to your receipt of supported employment services:

(1) You must be age twenty and graduating from high school prior to your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive supported employment services.

(2) Payment will be made only for the ((adaptations, supervision, training, and)) employment support ((with the activities of daily living)) you require as a result of your disabilities.

(3) Payment ((is excluded for)) for individual supported employment excludes the supervisory activities rendered as a normal part of the business setting.

(4) You ((cannot)) will not be authorized to receive supported employment services ((if you receive)) in addition to community access ((services)) or prevocational services.

(5) The dollar limitations for employment/day program services in your Basic or Basic Plus waiver limit the amount of supported employment service you may receive.

(6) Your service hours are determined by the assistance you need to reach your employment outcomes and might not equal the number of hours you spend on the job or in job related activities.

[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-2110, filed 12/13/05, effective 1/13/06.]


AMENDATORY SECTION(Amending WSR 07-20-050, filed 9/26/07, effective 10/27/07)

WAC 388-845-2210   Are there limitations to the transportation services I can receive?   The following limitations apply to transportation services:

(1) Transportation to/from medical or medically related appointments is a Medicaid transportation service and is to be considered and used first.

(2) Transportation is offered in addition to medical transportation but cannot replace Medicaid transportation services.

(3) Transportation is limited to travel to and from a waiver service.

(4) Transportation does not include the purchase of a bus pass.

(5) Reimbursement for provider mileage requires prior approval by DDD and is paid according to contract.

(6) This service does not cover the purchase or lease of vehicles.

(7) Reimbursement for provider travel time is not included in this service.

(8) Reimbursement to the provider is limited to transportation that occurs when you are with the provider.

(9) You are not eligible for transportation services if the cost and responsibility for transportation is already included in your provider's contract and payment.

(10) The dollar limitations for aggregate services in your Basic or Basic Plus waiver limit the amount of service you may receive.

(11) Transportation services require prior approval by the DDD regional administrator or designee.

(12) If your individual personal care provider uses his/her own vehicle to provide transportation to you for essential shopping and medical appointments as a part of your personal care service, your provider may receive up to sixty miles per month in mileage reimbursement. If you work with more than one individual personal care provider, your limit is still a total of sixty miles per month. This cost is not counted toward the dollar limitation for aggregate services in the Basic or Basic Plus waiver.

[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. 07-20-050, 388-845-2210, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. 06-01-024, 388-845-2210, filed 12/13/05, effective 1/13/06.]

Washington State Code Reviser's Office