Date of Adoption: July 3, 2003.

     Purpose: Adopting amended WAC 388-105-0005, 388-105-0030, and 388-105-0040 and new WAC 388-105-0045, to implement SSB 5579 (chapter 231, Laws of 2003). SSB 5579 requires the department to change its current bed hold process to the process described in the bill.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-105-0005, 388-105-0030, and 388-105-0040.

     Statutory Authority for Adoption: Chapter 231, Laws of 2003.

     Other Authority: Chapter 18.20 RCW.

     Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

     Reasons for this Finding: Section 11 of SSB 5579 requires the department to adopt rules concerning the bed-hold process and applicable rates. And the legislature made the finding in section 12 of SSB 5579 that "this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately."

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 3, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 3, Repealed 0.
     Effective Date of Rule: Immediately.

July 3, 2003

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

Four level payment system rates for AFHs, ARCs, & EARCs
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((46.06)) 45.70		$ ((44.79)) 44.43		$ ((44.79)) 44.43
Level 2	$ ((49.28)) 48.65		$ ((51.52)) 50.89		$ ((56.97)) 56.34
Level 3	$ ((57.07)) 56.32		$ ((59.51)) 58.76		$ ((65.76)) 65.01
Level 4	$ ((68.15)) 67.75		$ ((72.07)) 71.67		$ ((78.31)) 77.91

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0005, filed 10/31/02, effective 12/1/02. Statutory Authority: 2001 c 7 § 206. 01-21-077, § 388-105-0005, filed 10/18/01, effective 11/18/01. Statutory Authority: Chapter 74.39A RCW. 01-14-056, § 388-105-0005, filed 6/29/01, effective 7/30/01.]

COPES ALF Daily Payment Rates w/o Capital Add-on Rate
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((54.84)) 54.48		$ ((56.35)) 55.99		$ ((61.03)) 60.67
Level 2	$ ((61.14)) 60.51		$ ((62.92)) 62.29		$ ((68.52)) 67.89
Level 3	$ ((67.54)) 66.79		$ ((69.90)) 69.15		$ ((76.46)) 75.71

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0030, filed 10/31/02, effective 12/1/02.]

COPES ALF Add-on Rate July 1, 2002
Non- metropolitan		Metropolitan*		King Co.
$ 4.68		$ 4.39		$ 4.84

COPES ALF Daily Payment Rates with a Capital Add-on Rate
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((59.52)) 59.16		$ ((60.74)) 60.38		$ ((65.87)) 65.51
Level 2	$ ((65.82)) 65.19		$ ((67.31)) 66.68		$ ((73.36)) 72.73
Level 3	$ ((72.22)) 71.47		$ ((74.29)) 73.54		$ ((81.30)) 80.55

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0040, filed 10/31/02, effective 12/1/02.]

     (a) Short-term care is needed in a nursing home or hospital;

     (b) The resident is likely to return to the AFH, ARC, EARC, or AL; and

     (c) Payment is made under subsection (3) of this section.

     (2) When the department pays the provider to hold the Medicaid resident's bed or unit during the resident's short-term nursing home or hospital stay, the provider must hold the unit or bed for up to twenty days.

     (3) The department will compensate the provider for holding the bed or unit for the:

     (a) First through seventh day at seventy percent of the daily rate paid for care of the resident before the hospital or nursing home stay; and

     (b) Eighth through the twentieth day, at ten dollars and forty-three cents a day.

     (4) The AFH, ARC, EARC, and AL provider may seek third-party payment to hold a bed or unit for twenty-one days or longer. The provider may only collect from the third-party a payment not exceeding eighty-five percent of the average daily rate paid to the facility.

     (5) If third-party payment is not available and the returning Medicaid resident continues to meet the admission criteria under chapter 388-71-WAC, the Medicaid resident may return to the first available and appropriate bed or unit.

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