WSR 05-11-082

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed May 17, 2005, 4:45 p.m. , effective June 17, 2005 ]


Purpose: Adopting new chapter 388-106 WAC, Long-term care services, and revision of other rules are required to phase out rules that no longer apply, due to the implementation of the comprehensive assessment reporting and evaluation (CARE) tool. In addition, ADSA is reorganizing, amending, and streamlining rules to ensure that all rules are current and clear.

WAC Conversion Chart

This chart indicates the new WAC number or location which will replace those WACs being repealed in chapters 388-71 and 388-72A WAC, and WAC sections that will remain in chapter 388-71 WAC.

PREVIOUS SECTIONS IN CHAPTER 388-71 WAC NEW WAC NUMBER, IF ANY
HOME AND COMMUNITY PROGRAMS
388-71-0194 Home and community services -- Nursing services. 388-106-0200, 388-106-0300, 388-106-0305, 388-106-0400, and 388-106-0500
388-71-0202 Long-term care services -- Definitions. 388-71-0215
388-71-0203 Long-term care services -- Assessment of task self-performance and determination of required assistance. 388-71-0230
388-71-0205 Long-term care services -- Service plan. 388-71-0235
388-71-0400 What is the intent of the department's home and community programs? Repealed - No new number.
388-71-0405 What are the home and community programs? 388-106-0015
388-71-0410 What services may I receive under HCP? 388-106-0300, 388-106-0305, 388-106-0400, 388-106-0500, and 388-106-0600
388-71-0415 What other services may I receive under the COPES program? 388-106-0300, 0305
388-71-0420 What services are not covered under HCP? 388-106-0020
388-71-0425 Who can provide HCP services? 388-106-0040
388-71-0430 Am I eligible for one of the HCP programs? 388-106-0210, 388-106-0310, 388-106-0410, 388-106-0510, and 388-106-0610
388-71-0435 Am I eligible for COPES-funded services? 388-106-0310
388-71-0440 Am I eligible for MPC-funded services? 388-106-0210
388-71-0442 Am I eligible for medically needy residential waiver services? 388-106-0410
388-71-0445 Am I eligible for Chore-funded services? 388-106-0610
388-71-0450 How do I remain eligible for services? 388-106-0220, 388-106-0320, 388-106-0420, 388-106-0520, and 388-106-0620
388-71-0455 Can my services be terminated if eligibility requirements for HCP change? 388-106-0220, 388-106-0320, 388-106-0420, 388-106-0520, and 388-106-0620
388-71-0460 Are there limitations to HCP services I can receive? 388-106-0130
388-71-0465 Are there waiting lists for HCP services? 388-106-0235, 388-106-0335, 388-106-0435, and 388-106-0535
388-71-0470 Who pays for HCP services? 388-106-0225, 388-106-0325, 388-106-0425, 388-106-0525, and 388-106-0625
388-71-0480 If I am employed, can I still receive HCP services? 388-106-0230, 388-106-0330, 388-106-0430, 388-106-0530, and 388-106-0630
INDIVIDUAL PROVIDER AND HOME CARE AGENCY PROVIDER QUALIFICATIONS Kept in chapter 388-71 WAC
RESIDENTIAL CARE SERVICES
388-71-0600 What are residential services? 388-106-0010
388-71-0605 Am I eligible for residential services? 388-106-0905
388-71-0610 Who pays for residential care? 388-106-0225, 388-106-0325, 388-106-0425, and 388-106-0525
388-71-0613 For what days will the department pay the residential care facility? 388-106-0225, 388-106-0325, 388-106-0425, and 388-106-0525
388-71-0615 If I leave a hospital, residential facility, or nursing facility, are there resources available to help me find a place to live? 388-106-0950
388-71-0620 Am I eligible for a residential discharge allowance? 388-106-0955
NURSING FACILITY CARE AND PAYMENT
388-71-0700 What are the requirements for nursing facility eligibility, assessment, and payment? 388-106-0350, 388-106-0355, and 388-106-0360
ADULT DAY SERVICES (KEPT IN CHAPTER 388-71 WAC EXCEPT FOR THE FOLLOWING)
388-71-0704 Adult day care -- Services. 388-106-0800
388-71-0706 Adult day health -- Services. 388-106-0805
388-71-0708 Adult day care -- Eligibility. 388-106-0810
388-71-0710 Adult day health -- Eligibility. 388-106-0815
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
388-71-0800 What is PACE? 388-106-0015
388-71-0805 What services does PACE cover? 388-106-0700
388-71-0810 Who provides these services? Repealed - No new number.
388-71-0815 Where are these services provided? Repealed - No new number.
388-71-0820 How do I qualify for Medicaid-funded PACE services? 388-106-0705
388-71-0825 What are my appeal rights? 388-106-1305
388-71-0830 Who pays the PACE provider? 388-106-0710
388-71-0835 How do I enroll into the PACE program? 388-106-0705
388-71-0840 How do I disenroll from the PACE program? 388-106-0715
388-71-0845 What are my rights as a PACE client? 388-106-1300
PRIVATE DUTY NURSING
388-71-0900 What is the intent of WAC 388-71-0900 through 388-71-0960? Kept in chapter 388-71 WAC
388-71-0905 What is private duty nursing (PDN) for adults? Kept in chapter 388-71 WAC
388-71-0910 Am I financially eligible for Medicaid-funded private duty nursing services? Kept in chapter 388-71 WAC
388-71-0915 Am I medically eligible to receive private duty nursing services? Kept in chapter 388-71 WAC
388-71-0920 How is my eligibility determined? Kept in chapter 388-71 WAC
388-71-0925 Am I required to pay participation toward PDN services? Kept in chapter 388-71 WAC
388-71-0930 Are PDN costs subject to estate recovery? Kept in chapter 388-71 WAC
388-71-0935 Who can provide my PDN services? Kept in chapter 388-71 WAC
388-71-0940 Are there limitations or other requirements for PDN? Kept in chapter 388-71 WAC
388-71-0945 What requirements must a home health agency meet in order to provide and get paid for my PDN? Kept in chapter 388-71 WAC
388-71-0950 What requirements must a private RN or LPN meet in order to provide and get paid for my PDN services? Kept in chapter 388-71 WAC
388-71-0955 Can I receive PDN in a licensed adult family home (AFH)? Kept in chapter 388-71 WAC
388-71-0960 Can I receive services in addition to PDN? Kept in chapter 388-71 WAC
388-71-0965 Can I choose to self-direct my care if I receive PDN? Kept in chapter 388-71 WAC
SENIOR CITIZEN'S SERVICES
388-71-1000 What is the Senior Citizens Services Act? 388-106-0015
388-71-1005 Who administers the Senior Citizens Services Act funds? Repealed - No new number.
388-71-1010 What services does the SCSA fund? 388-106-1100
388-71-1015 How do I apply for SCSA-funded services? 388-106-1105
388-71-1020 Am I eligible for SCSA-funded services at no cost? 388-106-1110
388-71-1025 What income and resources are exempt when determining eligibility? 388-106-1115
388-71-1030 What if I am not eligible to receive SCSA-funded services at no cost? 388-106-1120
388-71-1035 What are my rights under SCSA? 388-106-1300
RESPITE CARE SERVICES
388-71-1065 What is the purpose of the respite care program? 388-106-0015, 388-106-1205
388-71-1070 What definitions apply to respite care services? 388-106-1200
388-71-1075 Who is eligible to receive respite care services? 388-106-1210
388-71-1080 Who may provide respite care services? 388-106-1215
388-71-1085 How are respite care providers reimbursed for their services? 388-106-1220
388-71-1090 Are participants required to pay for the cost of their services? 388-106-1225
388-71-1095 Are respite care services always available? 388-106-1230
VOLUNTEER CHORE
388-71-1100 What is volunteer chore services (VCS)? 388-106-0015, 388-106-0650
388-71-1105 Am I eligible to receive volunteer chore services? 388-106-0655
388-71-1110 How do I receive information on applying for volunteer chore services? Repealed - No new number.

PREVIOUS SECTIONS IN CHAPTER 388-72A WAC NEW WAC NUMBER, IF ANY
APPLICATION
388-72A-0005 When do the rules in chapter 388-72A WAC apply to me? Repealed - No new number
388-72A-0010 Does chapter 388-71 WAC apply to me? Repealed - No new number.
388-72A-0015 If the department did not use the CARE tool for my last assessment, may I have my assessments done on the assessment form used for my last assessment? Repealed - No new number.
ASSESSMENT AND SERVICE PLANNING
388-72A-0020 What is an assessment? 388-106-005 [388-106-0005]
388-72A-0025 What is the process for conducting an assessment? 388-106-0065
388-72A-0030 What is the purpose of an assessment? 388-106-0055
388-72A-0035 What are personal care services? 388-106-0015
388-72A-0036 How are my needs for personal care services determined? 388-106-0075
388-72A-0037 How are self-performance and support provided for the activities of daily living (ADLs) scored? 388-106-0075
388-72A-0038 How are the ADLs bathing, body care, and medication management scored? 388-106-0075
388-72A-0039 How are self-performance and difficulty for the instrumental activities of daily living (IADLs) scored? 388-106-0075
388-72A-0042 How are ADLs and IADLs scored for children? 388-106-0213
388-72A-0043 How are other elements in CARE scored for children age seventeen and younger and foster care clients? 388-106-0213
388-72A-0045 How will the department plan to meet my care needs? Repealed - No new number.
388-72A-0050 What if I disagree with the result of the assessment or the decisions about what services I may receive? 388-106-1305
CARE ELIGIBILITY
388-72A-0053 Am I eligible for one of the HCP programs? 388-106-0210, 388-106-0310, 388-106-0410, 388-106-0510, and 388-106-0610
388-72A-0055 Am I eligible for COPES-funded services? 388-106-0310
388-72A-0057 Am I eligible for medically needy residential waiver (MNRW)-funded services? 388-106-0410
388-72A-0058 Am I eligible for medically needy in-home wavier (MNIW)-funded services? 388-106-0510
388-72A-0060 Am I eligible for MPC-funded services? 388-106-0210
388-72A-0065 Am I eligible for Chore-funded services? 388-106-0610
388-72A-0069 How does CARE use the information the assessor gathers? 388-106-0055
CLASSIFICATION FOR IN-HOME AND RESIDENTIAL CARE
388-72A-0070 What are the in-home hours and residential rate based on? 388-106-0080
388-72A-0080 What are the elements that the CARE tool evaluates for each of the criteria in WAC 388-72A-0075? 388-106-0085
388-72A-0081 How is cognitive performance measured in the CARE tool? 388-106-0090
388-72A-0082 How is clinical complexity measured within the CARE tool? 388-106-0095
388-72A-0083 How are mood and behaviors measured within the CARE tool? 388-106-0100
388-72A-0084 How are ADL scores measured within the CARE tool? 388-106-0105
388-72A-0085 How does the CARE tool evaluate for the two exceptional care classifications of in-home care? 388-106-0110
388-72A-0086 How is the information in WAC 388-72A-0081 through 388-72A-0084 used to determine the client's classification payment group for residential settings? 388-106-0115
388-72A-0087 How is the information in WAC 388-72A-0081 through 388-72A-0085 used to determine the classification payment group for in-home clients? 388-106-0125
PAYMENT METHODOLOGY FOR IN-HOME SERVICES
388-72A-0090 What are the maximum hours that I can receive for in-home services? 388-106-0135
388-72A-0092 How are my in-home hours determined? 388-106-0130
388-72A-0095 What additional criteria are considered to determine the number of hours I will receive for in-home services? 388-106-0130
388-72A-0100 Are there other in-home services I may be eligible to receive in addition to those described in WAC 388-72A-0095(3)? 388-106-0300
388-72A-0105 What would cause a change in the maximum hours authorized? 388-106-0140
HOME AND COMMUNITY PAYMENT RATES
388-72A-0110 How much will the department pay for my care? 388-106-0120
388-72A-0115 When the department adjusts an algorithm, when does the adjustment become effective? Repealed - No new number.
388-72A-0120 When a client requests a fair hearing to have the client's CARE tool assessment results reviewed and there is (are) a more recent CARE assessment(s), which CARE tool assessment does the administrative law judge review in the fair hearing? 388-106-1310

Citation of Existing Rules Affected by this Order: Repealing WAC 388-71-0194 Home and community services--Nursing services, 388-71-0202 Long-term care services--Definitions, 388-71-0203 Long-term care services--Assessment of task self-performance and determination of required assistance, 388-71-0205 Long-term care services--Service plan, 388-71-0400 What is the intent of the department's home and community programs?, 388-71-0405 What are the home and community programs?, 388-71-0410 What services may I receive under HCP?, 388-71-0415 What other services may I receive under the waiver-funded programs?, 388-71-0420 What services are not covered under HCP?, 388-71-0425 Who can provide HCP services?, 388-71-0430 Am I eligible for one of the HCP programs?, 388-71-0435 Am I eligible for COPES-funded services?, 388-71-0440 Am I eligible for MPC-funded services?, 388-71-0442 Am I eligible for medically needy residential waiver services?, 388-71-0445 Am I eligible for Chore-funded services?, 388-71-0450 How do I remain eligible for services?, 388-71-0455 Can my services be terminated if eligibility requirements for HCP change?, 388-71-0460 Are there limitations to HCP services I can receive?, 388-71-0465 Are there waiting lists for HCP services?, 388-71-0470 Who pays for HCP services?, 388-71-0480 If I am employed, can I still receive HCP services?, 388-71-0600 What are residential services?, 388-71-0605 Am I eligible for residential services?, 388-71-0610 Who pays for residential care?, 388-71-0613 For what days will the department pay the residential care facility?, 388-71-0615 If I leave a hospital, residential facility, or nursing facility, are there resources available to help me find a place to live?, 388-71-0620 Am I eligible for a residential discharge allowance?, 388-71-0700 What are the requirements for nursing facility eligibility, assessment, and payment?, 388-71-0800 What is PACE?, 388-71-0805 What services does PACE cover?, 388-71-0810 Who provides these services?, 388-71-0815 Where are these services provided?, 388-71-0820 How do I qualify for Medicaid-funded PACE services?, 388-71-0825 What are my appeal rights?, 388-71-0830 Who pays the PACE provider?, 388-71-0835 How do I enroll into the PACE program?, 388-71-0840 How do I disenroll from the PACE program?, 388-71-0845 What are my rights as a PACE client?, 388-71-1000 What is the Senior Citizens Services Act?, 388-71-1005 Who administers the Senior Citizens Services Act funds?, 388-71-1010 What services does the SCSA fund?, 388-71-1015 How do I apply for SCSA-funded services?, 388-71-1020 Am I eligible for SCSA-funded services at no cost?, 388-71-1025 What income and resources are exempt when determining eligibility?, 388-71-1030 What if I am not eligible to receive SCSA-funded services at no cost?, 388-71-1035 What are my rights under SCSA?, 388-71-1065 What is the purpose of the respite care program?, 388-71-1070 What definitions apply to respite care services?, 388-71-1075 Who is eligible to receive respite care services?, 388-71-1080 Who may provide respite care services?, 388-71-1085 How are respite care providers reimbursed for their services?, 388-71-1090 Are participants required to pay for the cost of their services?, 388-71-1095 Are respite care services always available?, 388-71-1100 What is volunteer chore services (VCS)?, 388-71-1105 Am I eligible to receive volunteer chore services?, 388-71-1110 How do I receive information on applying for volunteer chore services?, 388-72A-0005 When do the rules in chapter 388-72A WAC apply to me?, 388-72A-0010 Do chapter 388-71 WAC and WAC 388-845-1300 apply to me?, 388-72A-0015 If the department did not use the CARE tool for my last assessment, may I have my assessments done on the assessment form used for my last assessment?, 388-72A-0020 What is an assessment?, 388-72A-0025 What is the process for conducting an assessment?, 388-72A-0030 What is the purpose of an assessment?, 388-72A-0035 What are personal care services?, 388-72A-0036 How are my needs for personal care services determined?, 388-72A-0037 How are self-performance and support provided for the activities of daily living (ADLs) scored?, 388-72A-0038 How are the ADLs bathing, body care, and medication management scored?, 388-72A-0039 How are self-performance and difficulty for the instrumental activities of daily living (IADLs) scored?, 388-72A-0041 How are status and assistance available scored for ADLs and IADLs?, 388-72A-0042 How are ADLs and IADLs scored for children?, 388-72A-0043 How are other elements in CARE scored for children age seventeen and younger and foster care clients?, 388-72A-0045 How will the department plan to meet my care needs?, 388-72A-0050 What if I disagree with the result of the assessment or the decisions about what services I may receive?, 388-72A-0053 Am I eligible for one of the HCP programs?, 388-72A-0055 Am I eligible for COPES-funded services?, 388-72A-0057 Am I eligible for medically needy residential waiver (MNRW)-funded services?, 388-72A-0058 Am I eligible for medically needy in-home wavier (MNIW)-funded services?, 388-72A-0060 Am I eligible for MPC-funded services?, 388-72A-0065 Am I eligible for Chore-funded services?, 388-72A-0069 How does CARE use the information the assessor gathers?, 388-72A-0070 What are the in-home hours and residential rate based on?, 388-72A-0080 What criteria does the CARE tool use to place a client in one of the classification groups?, 388-72A-0081 How is cognitive performance measured in the CARE tool?, 388-72A-0082 How is clinical complexity measured within the CARE tool?, 388-72A-0083 How are mood and behaviors measured within the CARE tool?, 388-72A-0084 How are ADL scores measured within the CARE tool?, 388-72A-0085 How does the CARE tool evaluate for the two exceptional care classifications of in-home care?, 388-72A-0086 How is the information in WAC 388-72A-0081 through 388-72A-0084 used to determine the client's classification payment group for residential settings?, 388-72A-0087 How is the information in WAC 388-72A-0081 through 388-72A-0085 used to determine the classification payment group for in-home clients?, 388-72A-0090 What are the maximum hours that I can receive for in-home services?, 388-72A-0092 How are my in-home hours determined?, 388-72A-0095 What additional criteria are considered to determine the number of hours I will receive for in-home services?, 388-72A-0100 Are there other in-home services I may be eligible to receive in addition to those described in WAC 388-72A-0095(3)?, 388-72A-0105 What would cause a change in the maximum hours authorized?, 388-72A-0110 How much will the department pay for my care?, 388-72A-0115 When the department adjusts an algorithm, when does the adjustment become effective? and 388-72A-0120 When a client requests a fair hearing to have the client's CARE tool assessment results reviewed and there is (are) a more recent CARE assessment(s), which CARE tool assessment does the administrative law judge review in the fair hearing?; and amending WAC 388-515-1540, 388-515-1550, 388-71-0500, 388-71-0515, 388-71-0520, 388-71-0540, 388-71-0704, 388-71-0706, 388-71-0708, 388-71-0710, 388-71-0716, and 388-71-0720.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.

Other Authority: RCW 74.08.090, 74.09.520.

Adopted under notice filed as WSR 05-03-096 on January 18, 2005.

Changes Other than Editing from Proposed to Adopted Version: (1) The department has withdrawn proposed rules on private duty nursing, WAC 388-106-1000 through 388-106-1055. In addition, the private duty nursing sections in chapter 388-71 WAC will not be repealed (WAC 388-71-0900 through 388-71-0955).

(2) WAC 388-106-0010:

(a) The department has bolded all defined terms and used a consistent numbering format under each definition (i.e. a, b, c).

(b) The department has removed the sentence "In licensed boarding homes, this may include situations in which you cannot physically self-administer medications but can accurately direct others, per WAC 388-78A-0300" from the term "Assistance with medication management" (c). This WAC no longer exists.

(c) The department has clarified the "service summary" definition to more accurately describe its contents and to include relevant sections from WAC 388-71-0205: "CARE information which includes: contacts (e.g. emergency contact), services the client is eligible for, number of hours or residential rates, personal care needs, the list of formal and informal providers and what tasks they will provide, a provider schedule, referral needs/information, and dates and agreement to the services.

(3) WAC 388-106-0015:

(a) Language has been revised: "The department provides long-term care services through programs that are designed to help you remain in the community. These programs offer an alternative to nursing home care (which is described in WAC 388-106-0350 through 0360). You may receive services from any of the following:"

(b) Language has been removed from subsection (4), Medically Needy In-Home Waiver (MNIW): "Clients eligible for this program may receive personal care in their own home or in a residential facility."

(c) The WAC reference 388-820, cited in subsection (15), has been changed to 388-825.

(d) Nursing facility has been added to the list of services.

(4) WAC 388-106-0065: Replaced third party with third parties. "However, you have the right to request that third parties be present...."

(5) WAC 388-106-0305 and 388-106-0400, subsection (5)(c): The department has replaced the word "defined" with "described."

(6) WAC 388-106-1110(3) and 388-106-1225 (1). The language has been corrected to say "...income at or below forty percent of the state median income (SMI), based on family size."

(7) WAC 388-106-1210: To be consistent with (1)(b), the language in (3) has been updated to reinforce that the caregiver must provide 12 hours a day "...to become eligible for respite care services, as long as it is a minimum of twelve hours per day, as outlined in (1)(b) of this section."

(8) WAC 388-106-1305: The department has clarified that the decisions pertain to eligibility. "What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department? You have a right to contest the result of your CARE assessment and/or other eligibility decisions made by the department..."

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 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 107, Amended 12, Repealed 96.

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 107, Amended 12, Repealed 96.

Date Adopted: May 10, 2005.

Andy Fernando, Manager

Rules and Policies Assistance Unit

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 05-13 issue of the Register.

Washington State Code Reviser's Office