PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 04-13-106.
Title of Rule and Other Identifying Information: Chapter 388-820 WAC, Community residential services and support, and other related sections.
Hearing Location(s): Blake Office Park East (behind Goodyear Courtesy Tire), Rose Room, 4500 10th Avenue S.E., Lacey, WA, on October 26, 2004, at 10:00 a.m.
Date of Intended Adoption: Not earlier than October 27, 2004.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., October 26, 2004.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by October 22, 2004, TTY (360) 664-6178 or (360) 664-6097.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of amending these rules is to reflect the correct administrative names as well as correct language changes due to the new HCBS waiver. In addition, the proposed rules will clarify procedures and requirements.
| WAC # | Subject of Amendment |
| 388-820-020 | Adds definitions of ADSA, HCBS, POC and RCS; updates correct administrative names; deletes the definition of community alternatives program. |
| 388-820-030 | Adds minimal rights guaranteed to residents of CRS. |
| 388-820-040, 388-820-090, 388-820-140, 388-820-180, 388-820-200, 388-820-240, 388-820-290, 388-820-360, 388-820-880, 388-820-890, 388-820-900, 388-820-910, and 388-820-920 | Updates correct administrative names. |
| 388-820-150 | Updates correct administrative names and clarifies DDD's role of initial certification. |
| 388-820-160 | Updates correct administrative names and clarifies the roles of DDD/RCS and the application procedures of initial certification. |
| 388-820-190 | Updates correct administrative names and adds principles and procedures of RCS. |
| 388-820-210 | Updates correct administrative names; clarifies intent of review and evaluation, deletion of needed draft copy of the report (subsection (5)(e)) and clarifies procedures and requirements. |
| 388-820-220 | Updates correct administrative names and deletion of receipt of the draft (subsection (1)(b)). |
| 388-820-230 | Updates correct administrative names and adds "must" in subsection (3)(b). |
| 388-820-250 | Updates correct administrative names and adds "client health and safety." |
| 388-820-260 | Addition of health and safety policies and procedures; deletes DDD required approval of administrative documents and adds subsection (4) other requirements. |
| 388-820-310 | Change "directly" to " continuously;" new subsection (5) states an existing requirement for boarding homes and adult family homes. |
| 388-820-330 | Updates correct administrative names; correct language changes due to the new HCBS waiver; and adds staff training with regards to ISP/POC. |
| 388-820-400, 388-820-520, 388-820-530, 388-820-540, 388-820-550, 388-820-560, 388-820-630, and 388-820-720 | Correct language changes due to the new HCBS waiver. |
| 388-820-405 | Corrects grammatical error. |
| 388-820-430 | Deletes reference to the contract. |
| 388-820-440 | Deletion of "DSHS approved" and adds "state law." |
| 388-820-650 | Clarifies previous intent of the WAC. |
| 388-820-930 | Updates correct administrative names and clarifies new procedure to the ETR (exception to rule) process. |
Reasons Supporting Proposal: See above.
Statutory Authority for Adoption: RCW 71A.12.030 and 71A.12.080.
Statute Being Implemented: Chapter 71A.12 RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of Social and Health Services, ADSA, RCS, governmental.
Name of Agency Personnel Responsible for Drafting: Jill Young, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-3210; Implementation and Enforcement: Pat Lashway, Director, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2401.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the proposed rules and determined that they will not result in more than minor costs to small businesses or nonprofits required to comply with the rules. A comprehensive small business economic impact statement is not required.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rules do not meet the definition of a significant legislative rule under RCW 34.05.328 (5)(c)(iii). A cost benefit is not required. The proposed rule clarify existing requirements, update names of DSHS units responsible for administering these rules, update names of DSHS programs and WAC cross references, and correct grammatical errors.
September 1, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
3459.5"ADSA" refers to aging and disability services administration at DSHS. Residential care services and the division of developmental disabilities are divisions under aging and disability services.
"Certification" ((means)) refers to the determination by
((DSHS)) RCS that an agency or service provider has
satisfactorily complied with the requirements outlined in this
chapter and in the department contract.
"Client" ((means)) refers to a person who has a
developmental disability and is eligible under RCW 71A.10.020.
(For eligibility criteria, see chapter 388-825 WAC and WAC 388-820-060.)
"Client services" ((means)) refers to instruction and
support activities that benefit clients, as specified under
WAC 388-820-450 through 388-820-510.
(("Community alternatives program (CAP)" means a Title
XIX Medicaid waiver program that serves a specific number of
individuals. This waiver is for particular home- and
community-based services not covered under the Medicaid state
plan. (See WAC 388-825-170 for more details.)))
"Community protection services" (Community Protection
Intensive Supported Living Services, or CP-ISLS) ((means))
refers to intensive supported living services provided to
clients who meet the criteria of "Individual with Community
Protection Issues."
"Crisis diversion services (CDS)" ((means)) refers to
DDD-authorized crisis residential services and supports
offered to clients on a temporary basis. These clients show a
serious decline in mental functioning, making the client at
risk for psychiatric hospitalization (see WAC 388-820-050 and
388-820-085 for details).
"Crisis service plan" refers to a document that identifies needs and services a client will receive while placed in crisis diversion services.
"DDD" refers to the division of developmental
disabilities ((at DSHS)) of aging and disability services
administration (ADSA).
"DSHS" refers to the department of social and health services of Washington state.
"Exceptions" ((means DSHS')) refers to residential care
services' (RCS) approval of a written request for an exception
to a rule in this chapter. (There are no exceptions to RCWs.)
"Group home" ((means)) refers to residential services
provided in a dwelling that is:
(1) Owned, leased, or rented by an entity other than the client;
(2) Licensed by the applicable state authority; and
(3) Operated by a provider.
(See WAC 388-820-090 for further details.)
"Group training home" ((means)) refers to a certified
nonprofit residential facility that provides full-time care,
treatment, training, and maintenance for clients, as defined
under RCW 71A.22.020(2).
"HCBS" refers to home and community based services waivers. This is a Title XIX Medicaid waiver program that serves a specific number of individuals. This waiver is for particular home and community based services not covered under the Medicaid state plan. (See WAC 388-825-170 for more details.)
"IFP" refers to individual financial plan. (See WAC 388-820-620.)
"IISP" refers to the individual instruction and support plan for clients. (See WAC 388-820-560 through 388-820-580.)
"Individual with community protection issues" ((means))
refers to a client identified by DDD as needing one or more of
the following criteria:
(1) The person has been convicted of or charged with a crime of sexual violence as defined in chapter 71.09 RCW, including, but not limited to, rape, statutory rape, rape of a child, and child molestation;
(2) The person has been convicted of or charged with acts directed towards strangers or individuals with whom a relationship has been established or promoted for the primary purpose of victimization;
(3) The person has been convicted of or charged with a sexually violent offense and/or predatory act, and may constitute a future danger;
(4) The person has not been convicted and/or charged, but has a history of stalking, sexually violent, predatory, and/or opportunistic behavior which demonstrates a likelihood to commit a sexually violent and/or predatory act based on current behaviors that may escalate to violence;
(5) The person has committed one or more violent crimes, such as murder, attempted murder, arson, first degree assault, kidnapping, or use of a weapon to commit a crime.
"Initial assessment" ((means)) refers to a written
evaluation that identifies a client's needs upon entry into
crisis diversion services.
"Instruction" ((means)) refers to goal-oriented teaching
that is designed for acquiring and enhancing skills.
"ISP" refers to the individual service plan for clients. (See WAC 388-820-520 through 388-820-550.)
"Nursing assistant" ((means)) refers to a person who is
registered or certified by department of health under chapter 18.88A RCW. A nursing assistant performs certain nursing care
tasks that are delegated by a registered nurse for a specific
client in authorized settings. (See chapter 246-841 WAC for
more details.)
"POC" refers to the plan of care for clients based on the criteria of the home and community based waivers. (See WAC 388-820-520 through 388-820-550.)
"RCS" refers to residential care services of aging and disability services (ADSA).
"Regional support network (RSN)" ((means)) refers to a
county, combination of counties or other member entities under
contract with DSHS mental health division (MHD). These RSNs
administer all mental health service activities within their
jurisdiction, using available resources. (See WAC 388-865-200
for details.)
"Reprisal" ((means)) refers to any negative action taken
as retaliation against an employee.
"Residential service" ((means)) refers to client services
offered by certified service providers.
"Secretary" ((means)) refers to the secretary of the
department of social and health services or the secretary's
designee.
"Service provider" ((means)) refers to an agency RCS has
certified ((by)) and DDD has contracted ((with DDD)) to
provide residential services to clients. Also refers to state
operated living alternative (SOLA) program.
"Severity" ((means)) refers to the seriousness of an
incident. This is determined by the extent to which a
client's physical, mental, or psychosocial well-being is or
may be compromised or threatened.
"SSP" (state supplemental payment) ((means)) refers to
DDD administered state paid cash assistance program for
certain clients of DDD. (See chapter 388-827 WAC for
details.)
"Support" ((means)) refers to assistance as requested or
needed by a client, based on their abilities, needs, and
goals.
"Supported living" ((means)) refers to residential
services provided to clients living in their own homes, which
are owned, rented, or leased by the clients or their legal
representatives. (See WAC 388-820-080 for more details.)
"Trust account" ((means)) refers to a bank account
containing two or more clients' funds where the service
provider has the authority to make deposits and withdrawals.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-020, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-020, filed 10/26/01, effective 1/1/02; 99-19-104, recodified as § 388-820-020, filed 9/20/99, effective 9/20/99. Statutory Authority: RCW 71A.12.080. 91-17-005 (Order 3230), § 275-26-020, filed 8/9/91, effective 9/9/91. Statutory Authority: Chapter 72.33 RCW. 86-08-003 (Order 2349), § 275-26-020, filed 3/20/86; 83-05-017 (Order 1945), § 275-26-020, filed 2/9/83.]
(1) Supported living services;
(2) Group home services; or
(3) Services provided in the group training home.
Residential services must follow the requirements outlined in this chapter. The client rights set forth in this chapter are the minimal rights guaranteed to all clients of certified residential services, and are not intended to diminish rights set forth in other state or federal laws that may contain additional rights.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-030, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-030, filed 10/26/01, effective 1/1/02; 99-19-104, recodified as § 388-820-030, filed 9/20/99, effective 9/20/99. Statutory Authority: RCW 71A.12.080. 91-17-005 (Order 3230), § 275-26-022, filed 8/9/91, effective 9/9/91. Statutory Authority: RCW 34.05.220 (1)(a) and 71.12.030 [71A.12.030]. 90-04-074 (Order 2997), § 275-26-022, filed 2/5/90, effective 3/1/90. Statutory Authority: Chapter 72.33 RCW. 83-05-017 (Order 1945), § 275-26-022, filed 2/9/83.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-040, filed 10/26/01, effective 1/1/02; 99-19-104, recodified as § 388-820-040, filed 9/20/99, effective 9/20/99. Statutory Authority: RCW 71A.12.080. 91-17-005 (Order 3230), § 275-26-050, filed 8/9/91, effective 9/9/91. Statutory Authority: Chapter 72.33 RCW. 83-05-017 (Order 1945), § 275-26-050, filed 2/9/83.]
(2) Group homes must have a contract with DDD.
(3) The service provider must ensure that group homes comply with all applicable licensing regulations.
(4) Group homes provide residential services to two or more clients who are unrelated to the provider.
(5) Clients who live in group homes pay costs of room and board from their own financial resources. (See WAC 388-820-120 for additional information.)
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-090, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-090, filed 10/26/01, effective 1/1/02; 99-19-104, recodified as § 388-820-090, filed 9/20/99, effective 9/20/99. Statutory Authority: Chapters 18.88A and 71A.12 RCW. 96-10-076 (Order 3978), § 275-26-076, filed 5/1/96, effective 6/1/96.]
(1) Initial certification;
(2) Regular certification; and
(3) Provisional certification.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-140, filed 10/26/01, effective 1/1/02.]
(2) An interested agency must apply to ((DDD)) RCS to be
certified.
(((2) DDD))
(3) RCS may grant initial certifications to agencies that meet the requirements outlined in this chapter.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-150, filed 10/26/01, effective 1/1/02.]
(1) An agency's completed application must be submitted to the regional DDD office for initial certification in that region. The application must include:
(a) A letter of intent;
(b) A mission statement;
(c) A statement of assurance stating that the service provider will not discriminate against a client or employee (see WAC 388-820-280);
(d) Verification of financial stability;
(e) A budget forecast;
(f) A staff-coverage schedule;
(g) A staff in-service training plan;
(h) The agency's policies and procedures;
(i) Relevant experience and qualifications of the agency;
(j) A minimum of two professional references;
(k) A copy of the license if applying for a group home;
(l) The administrator's resume; and
(m) A list of the agency board of directors and affiliations, if applicable.
(2) DSHS must provide the county with a copy of the agency's application.
(3) The county may submit written recommendations about the application to DSHS within thirty calendar days after receiving the application. DSHS reviews the county's recommendations.
(4) An agency must comply within one hundred and eighty days of the certification's effective date with:
(a) Relevant federal, state, and local laws and ordinances; and
(b) Department-established requirements.
(5) DDD notifies the agency in writing that all documentation has been received and approves or denies initial certification)) procedures.
(1) DDD will review:
(a) Verification of financial stability;
(b) A budget forecast; and
(c) A staff-coverage schedule.
(2) After reviewing, DDD will send a letter of suggestion to RCS.
(3) The interested agency will submit to RCS:
(a) A letter of intent;
(b) Relevant experience and qualifications of the agency;
(c) A minimum of two professional references;
(d) The administrator's resume;
(e) A list of the agency board of directors and affiliations, if applicable;
(f) Policies, principles and procedures regarding health and safety and;
(g) Methods on the prevention and reporting of abuse, neglect, exploitation and mistreatment to clients according to state law.
RCS may request additional information as needed to complete the application process.
(4) Before applying to RCS, the interested agency will keep in their records the following:
(a) A letter of intent;
(b) A mission statement;
(c) A statement of assurance stating that the service provider will not discriminate against a client or employee (see WAC 388-820-280);
(d) Verification of financial stability;
(e) A budget forecast;
(f) A staff coverage;
(g) A staff in-service training plan;
(h) The agency's policies and procedures;
(i) Relevant experience and qualifications of the agency;
(j) A minimum of two professional references;
(k) A copy of the license if applying for a group home;
(l) The administrator's resume; and
(m) A list of the agency board of directors and affiliations, if applicable.
(5) RCS must provide the county with a copy of the agency's letter of intent.
(6) The county may submit written recommendations about the application to RCS within thirty calendar days after receiving the letter of intent. RCS reviews the county's recommendations.
(7) An agency must comply within one hundred and eighty days of the certification's effective date with:
(a) Relevant federal, state, and local laws and ordinances; and
(b) RCS/DDD established requirements.
(8) After receiving all materials requested, a determination will be made on initial certification based on the information received. RCS notifies the agency in writing that all documentation has been received and determines if the agency meets the minimal requirements for initial certification.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-160, filed 10/26/01, effective 1/1/02.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-180, filed 10/26/01, effective 1/1/02.]
(2) The county may submit recommendations about a service
provider to ((DSHS)) RCS.
(3) After determining that a service provider has
complied with requirements, ((DSHS)) RCS may approve a service
provider for regular certification.
(a) This certification allows a service provider to continue to receive referrals and provide instruction and support to clients.
(b) Regular certification may be granted to service providers for up to two years.
(4) Regular certification may be extended for a period up to one hundred and eighty days.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-190, filed 10/26/01, effective 1/1/02.]
(2) ((DSHS)) RCS may review a client's records and
activities at any time to see if the service provider
continues to address the clients' needs for instruction and
support activities.
(3) DSHS may conduct additional evaluations or audits of any service provider at its discretion.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-200, filed 10/26/01, effective 1/1/02.]
(2) To gather information, evaluators use a sample of clients that the service provider supports. Ways to gather information for evaluation must include:
(a) ((Review of records)) Observation of staff and client
interactions;
(b) Interview of clients, legal representatives, and others with the client's consent; and
(c) ((Observation of staff and client interactions))
Review of records.
(3) Information may also be gathered by conducting:
(a) Interviews with other entities contracted with DSHS; and
(b) Interviews with DSHS staff.
(4) The state-contracted evaluators ((conduct meetings))
discuss with the service provider ((and DDD to discuss)) their
preliminary findings and request additional information and
clarification.
(5) Evaluators conduct an exit conference to present the
((evaluation)) draft report to the service providers and
((DSHS)) DDD. The service provider's administrator or
designee must be present at this exit conference. A copy of
the draft report with preliminary findings are sent to RCS.
(a) The evaluation report will include the service provider's operation history.
(b) If the service provider has not complied with certification requirements or with its contract with DSHS/DDD, the evaluator will note the findings in the draft report.
(c) The ((report)) service provider must ((specify the))
draft a corrective action ((plan. The corrective action plan
and)) plan(s) with specific time frames ((are negotiated
between the service provider and DSHS)) and submit it to RCS
for approval.
(d) At the conclusion of the exit conference, the service
provider ((may request a copy of part or all of the)) will
receive a draft copy of the report ((from the evaluator))
including the corrective action plan(s) and the evaluator(s)
will submit the draft copy to RCS.
(e) The final report, including corrective action
plan(s), will be finalized by RCS and sent to the service
provider ((may also submit a letter requesting a draft copy of
the report to DDD headquarters within fourteen days of the
exit conference)).
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-210, filed 10/26/01, effective 1/1/02.]
(a))) the exit conference((; or
(b) Receipt of the draft of the evaluation report)).
(2) After receiving the service provider's documentation,
((DDD)) RCS must send written notification of its decision to
the service provider within ((fourteen calendar)) ten working
days.
(3) The service provider's documentation and ((DDD's))
RCS' decision must become part of the final evaluation report.
(4) ((DDD)) RCS must file a final report of the
evaluation results and send a copy to the service provider. At this time, the evaluation report is considered to be a
public document.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-220, filed 10/26/01, effective 1/1/02.]
(2) Provisional certification may not exceed one hundred eighty days.
(3) At the end of provisional certification:
(a) If the service provider has complied with
certification requirements, ((DSHS)) RCS may approve the
service provider for regular certification.
(b) If the service provider has not complied with all
certification requirements, ((DSHS)) RCS must revoke the
service provider's certification and DSHS/DDD must terminate
the contract.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-230, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-230, filed 10/26/01, effective 1/1/02.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-240, filed 10/26/01, effective 1/1/02.]
(1) Overseeing all aspects of staff development, such as recruitment and staff training;
(2) Preparing and maintaining policies and procedures related to client services, personnel, and financial records; and
(3) Securely storing client, personnel, and financial records.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-250, filed 10/26/01, effective 1/1/02.]
(1) Service providers must have these written statements
((approved by DDD)):
(a) A mission statement;
(b) Program description ((and admission criteria));
(c) An organizational chart and description showing all supervisory relationships; and
(d) Definition of staff roles and responsibilities, including the person designated to act in the absence of the administrator.
(2) Service providers must also have these policies and
procedures ((approved by DDD)):
(a) Admission criteria;
(b) Client rights, including a client's right to file a complaint or suggestion without interference;
(((b))) (c) Client grievance procedures;
(((c))) and
(d) Methods used for soliciting client input and feedback on services and support received.
(3) Service providers must have health and safety policies and procedures including:
(a) Information on how to report suspected abuse, neglect, exploitation, and mistreatment;
(((d))) (b) Plans for responding to missing persons;
client emergencies, including access to medical, mental
health, and law enforcement resources; and natural or other
disasters;
(((e))) and
(c) Notification of client's guardian and/or relatives in
case of emergency((; and
(f) Methods used for soliciting client input and feedback on services and support received)).
(4) In addition to other required documents, service providers must keep all documents, policies and procedures as required by the Centers for Medicare and Medicaid Services and any other applicable state or federal laws and have them readily available to DSHS.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-260, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-260, filed 10/26/01, effective 1/1/02.]
(2) Clients must have immediate access to staff, or the means to contact staff, at all times: Twenty-four hours a day, seven days a week.
(3) A service provider must provide adequate staff within contracted hours to administer the program and meet the needs of the clients.
(4) ((A service provider must have other staff available,
as specified by the service provider's contract with DSHS.
(5))) Each group home must maintain staffing that complies with:
(a) Boarding home or adult family home licensing requirements under chapter 388-78A or 388-76 WAC, respectively; and
(b) Contract requirements with the division of developmental disabilities.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-290, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-290, filed 10/26/01, effective 1/1/02.]
(2) Before administrators, employees, volunteers or subcontractors may have unsupervised access to clients, the service provider must have a background check report from DSHS. This report must indicate that the individual has no disqualifying records that prevent him or her from working with clients.
(3) In certain situations, administrators, employees,
volunteers, or subcontractors ((must not)) can only work
((alone)) with clients ((unless)) when they are directly
observed by staff authorized to have unsupervised access to
clients. These situations are:
(a) The service provider has not yet received a DSHS response for a background check request;
(b) DSHS has disqualified the individual based on background check information; or
(c) The individual is awaiting FBI clearance and does not have provisional clearance from their employer under WAC 388-06-0500 through 388-06-0540.
(4) Background checks must be renewed at least every thirty-six months for each administrator, employee, volunteer or subcontractor of a contracted service provider.
(5) Licensed boarding homes or licensed adult family homes must adhere to the current regulations set forth in this chapter and in the applicable licensing laws.
(6) Service providers must follow the requirements of RCW 43.43.830 and 74.15.030.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-310, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-310, filed 10/26/01, effective 1/1/02.]
(1) Before the employee works alone with clients, the service provider must explain the following to the employee:
(a) The current instruction and support plans of the clients with whom the employee works;
(b) Emergency procedures for clients;
(c) The ((DSHS-approved policy)) state law on abuse and
neglect; and
(d) Client confidentiality.
(2) Within the first four weeks of employing a staff person, the service provider must provide training that includes:
(a) The service provider's mission statement;
(b) Policies and procedures; and
(c) On-the-job training.
(3) Additional training within the first six months must include:
(a) First aid/CPR;
(b) Bloodborne pathogens with HIV/AIDS information; and
(c) Client services.
(4) Each employee must keep first aid/CPR certification and bloodborne pathogens training current.
(5) The service provider must document orientation and training activities.
(6) Group homes must also meet the training requirements mandated by the licensing requirements specified in chapter 388-78A WAC.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-330, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-330, filed 10/26/01, effective 1/1/02.]
(2) On the effective date of a change of ownership,
((DSHS)) RCS must terminate the department's certification and
DSHS/DDD must terminate the contract with the previous service
provider.
(3) ((DSHS)) DDD must withhold final payment to the
previous service provider until that service provider submits
and DSHS accepts all reports and required documents.
(4) ((DSHS)) DDD is under no obligation to contract with
the new owner entity.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-360, filed 10/26/01, effective 1/1/02.]
(2) Service providers must keep certain information in client records to fulfill DSHS requirements. The client's records must include, but not be limited to, the following:
(a) The client's name, address, and Social Security number.
(b) The name, address, and telephone number of the client's relative, guardian or legal representative.
(c) Copies of legal guardianship papers, if any.
(d) Client health records, including:
(i) The name, address, and telephone number of the client's physician, dentist, mental health service provider, and any other health care service provider;
(ii) Health care service providers' instructions about health care needed, including appointment dates and date of next appointment if appropriate;
(iii) Written documentation that the health care service providers' instructions have been followed; and
(iv) A record of major health events and surgeries when known.
(e) A copy of the client's most recent individual service plan or plan of care (ISP/POC).
(f) The client's individual instruction and support plan (IISP), including:
(i) Instruction and support activities for each client as a basis for review and evaluation of client's progress;
(ii) Semiannual review of the IISP;
(iii) Consultation with other service providers and other interested persons;
(iv) IISP revisions and changes; and
(v) Other activities relevant to the client that the client wants included.
(g) Progress notes and incident reports on clients.
(h) The client's financial records for funds managed by the service provider, including:
(i) Receipts, ledgers and records of the client's financial transactions; and
(ii) Client's related bankbooks, checkbooks, bank registers, tax records and bank statements.
(i) Burial plans and wills.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-400, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-400, filed 10/26/01, effective 1/1/02.]
(a) The client's name, address, and Social Security number.
(b) The name, address, and telephone number of the client's relative, guardian or legal representative.
(c) Progress notes and incident reports on clients.
(2) Crisis diversion service providers other than those offering services in a client's own home have additional requirements. These service providers also must keep the following information in client records:
(a) An initial assessment;
(b) ((An)) A crisis service plan;
(c) Copies of legal guardianship papers, if any;
(d) Client health records, including:
(i) The name, address, and telephone number of the client's physician, dentist, mental health service provider, and any other health care service provider;
(ii) Health care service providers' instructions about health care needed, including appointment dates and date of next appointment if appropriate;
(iii) Written documentation that the health care service providers' instructions have been followed; and
(iv) A record of major health events and surgeries when known.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-405, filed 1/29/04, effective 2/29/04.]
(1) Notify the client's guardian or legal representative as soon as possible;
(2) Immediately report to DSHS about a serious incident
or emergency((, as specified in the contract)); and
(3) Submit a written incident report to DSHS, as required by law or policy.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-430, filed 10/26/01, effective 1/1/02.]
(2) Reports must be made to one of two different areas at DSHS:
(a) Service providers giving supported living services must report to adult protective services (APS); and
(b) Service providers giving services through group homes must report to residential care services (RCS).
(3) Reports must be made to law enforcement agencies, when appropriate.
(4) Service providers must have ((DSHS-approved))
policies and procedures complying with state law that specify
reporting requirements for client abuse, neglect,
exploitation, or mistreatment.
(5) Each administrator, owner, staff person, and
volunteer must read and sign ((this)) the policy about
reporting requirements. The service provider must ((place))
retain the signed policy ((in the personnel file)) for staff
((or)) and volunteers.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-440, filed 10/26/01, effective 1/1/02.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-520, filed 10/26/01, effective 1/1/02.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-530, filed 10/26/01, effective 1/1/02.]
(2) The case resource manager must also involve the client's guardian or legal representative and the service provider.
(3) In creating a client's individual service plan or plan of care (ISP/POC), under RCW 71A.18.010, the client and DDD case resource manager may involve:
(a) Department staff; and
(b) Other interested persons invited by the client.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-540, filed 10/26/01, effective 1/1/02.]
(2) In addition,)) An ISP/POC meeting must be held and a
new ISP/POC developed with the client at least every ((two
years)) twelve months, under RCW 71A.18.010. The meeting must
be held in the client's home unless requested otherwise by the
client.
(((3))) (2) A client may request a review of the ISP/POC
at any time.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-550, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-550, filed 10/26/01, effective 1/1/02.]
(2) The IISP must be based on the goals of the individual service plan or plan of care (ISP/POC), reflect the client's preferences, and have the client's agreement.
(3) The IISP identifies activities and opportunities that promote one or more of the following client services:
(a) Health and safety;
(b) Personal power and choice;
(c) Positive recognition by self and others;
(d) Integration in the physical and social life of the community;
(e) Positive relationships; and
(f) Competence and self-reliance.
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-560, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-560, filed 10/26/01, effective 1/1/02.]
(1) The part of the client's funds and income that will be managed by the service provider;
(2) The part of client funds and income that will be managed by the client or legal representative;
(3) The type of accounts used;
(4) A budget process;
(5) Asset management, such as personal property, burial plan, retirement funds, stock, and vehicles;
(6) Cash management;
(7) Money management instruction and/or support;
(8) An explanation of which purchases require receipts;
(9) Contingency plan for expenditures if a client's
resources exceed the ((CAP)) home and community based services
(HCBS) wavier limit; and
(10) A signature of the client and the client's guardian, if any.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-630, filed 10/26/01, effective 1/1/02.]
(1) Documentation for bank and cash accounts must include
a monthly reconciliation ((of bank and cash accounts that are
verified and initialed by a second party)) and verification of
the reconciliation. The reconciliation and/or verification
must be completed by a person who did not make or assist in
((the)) any financial transaction.
(2) Other documentation that a service provider must keep for client financial transactions include:
(a) Monthly bank statements and reconciliation;
(b) Checkbook registers and bankbooks;
(c) Deposit receipts;
(d) Receipts for purchases over twenty-five dollars;
(e) Any itemized subsidiary ledgers showing deposits, withdrawals, and interest payments to individual clients; and
(f) A control journal for trust accounts.
(3) Other documentation that a service provider must keep for client cash transactions include:
(a) A detailed ledger signed by the person who withdrew any of the client's money;
(b) Monthly reconciliation to the cash amount;
(c) Detailed accounting of the money received on behalf of the client, such as cash received from writing checks over the purchase amount, and a list of where the money was spent; and
(d) Receipts for purchases over twenty-five dollars where service provider staff withdrew the money.
(4) Service providers must notify DSHS when the client:
(a) Receives services under a ((CAP (community
alternative program))) home and community based services
(HCBS) waiver; and
(b) Has an account that reaches three hundred dollars less than the maximum amount allowed by federal or state law.
| Note: | CAP-waiver is defined under WAC 388-825-170. |
[Statutory Authority: RCW 71A.12.030 and chapter 71A.12 RCW. 04-04-043, § 388-820-650, filed 1/29/04, effective 2/29/04. Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-650, filed 10/26/01, effective 1/1/02.]
(a) Emergency medical care;
(b) Medical appointments; and
(c) Therapies.
(2) Within available resources, the service provider must provide necessary assistance with transportation to and from:
(a) Work, school or other publicly funded services;
(b) Leisure or recreation activities;
(c) Client-requested activities; and
(d) ISP/POC- or IISP-related activities.
(3) A vehicle that the service provider uses to transport clients must be:
(a) In safe operating condition; and
(b) Properly insured for its usage.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-720, filed 10/26/01, effective 1/1/02.]
(2) Within this twenty-eight day period, the agency or
service provider must request in writing that the ((DDD)) RCS
director or designee review the decision. The agency or
service provider must:
(a) Sign the request;
(b) Identify the challenged decision and the date it was made;
(c) State specifically the issues and regulations involved and the grounds for the service provider's disagreement; and
(d) Include with the request copies of any supporting documentation for the service provider's position.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-880, filed 10/26/01, effective 1/1/02.]
(2) Exception: The agency or service provider and
((DSHS)) RCS may agree in writing to a specific later date for
the conference.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-890, filed 10/26/01, effective 1/1/02.]
(2) Exception: If either ((the department)) RCS, or the
agency or service provider requests in writing that the
conference be held in person, the conference may not be
conducted by telephone.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-900, filed 10/26/01, effective 1/1/02.]
(2) The agency or service provider must bring to the
conference, or give to ((DSHS)) RCS before the conference, any
supporting documentation for the service provider's position.
(3) The parties must clarify and attempt to resolve the issues at the conference.
(4) If additional documentation is needed to resolve issues, a second session of the conference must be scheduled. The second conference must be scheduled no later than twenty-eight days after the initial session unless both parties agree in writing to a specific later date.
(5) The director ((of the division of developmental
disabilities)) or designee of RCS must give a written decision
to the service provider after the end of the conference.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-910, filed 10/26/01, effective 1/1/02.]
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-920, filed 10/26/01, effective 1/1/02.]
(1) The service provider must submit a written request for an exception to the DDD regional administrator of the region where the contract is held.
(2) ((DSHS)) DDD must evaluate requests for exceptions,
considering:
(a) The health and safety of the clients;
(b) The quality of the services;
(c) Supervision; and
(d) The impact on client services.
(3) ((DSHS)) DDD will send their recommendations of the
exceptions of the requirements to RCS.
(4) RCS must send a copy of ((those)) the requests that
have significant impacts on client services to the client(s)
involved. ((DSHS)) RCS must then give the client an
opportunity to comment before granting an exception.
(((4) The DDD))
(5) The RCS director or designee must approve or deny the request in writing within sixty calendar days after receiving the request from the service provider.
(((5))) (6) Any exception granted must be in line with
the legislative intent of Title 71A RCW.
(((6))) (7) Service providers must retain a copy of each
((DSHS)) RCS-approved exception.
(((7))) (8) Service providers do not have hearing rights
when they receive a denial from ((DSHS)) RCS for an exception
to the rules in this chapter.
[Statutory Authority: Title 71A RCW. 01-22-020, § 388-820-930, filed 10/26/01, effective 1/1/02.]