PREPROPOSAL STATEMENT OF INQUIRY
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Subject of Possible Rule Making: The department will amend chapter 388-105 WAC to:
| • | Update the home and community residential rates from the four level payment system to the comprehensive assessment reporting evaluation (CARE) payment levels and to reflect the vendor rate increases of July 1, 2005; |
| • | Amend the bed hold section to clarify the requirements for third-party payment and no payment for an absence less than twenty-four hours; |
| • | Amend the capital add-on section to specify that licensed boarding homes with assisted living contracts must have units available for Medicaid clients that meet specific construction requirements; and |
| • | Implement a policy on when an adult family home or boarding home with a contract to provide assisted living (AL), adult residential care (ARC), or enhanced adult residential care (EARC) services may accept: An additional payment from the client, the client's friend or family for a unit/bedroom amenity; or an item or service that is not covered by the Medicaid payment rate. |
Statutes Authorizing the Agency to Adopt Rules on this Subject: Chapter 74.39A RCW.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The WAC sections that include rates need to reflect the current rates. The legislature limited third-party payments for bed holds to the rate that the Medicaid rate that the client received before discharge to the hospital or nursing home. When a Medicaid client leaves the facility for less than twenty-four hours for hospital or nursing home stay, clarify that the facility will receive the client's daily payment rate rather than the bed hold rate. To limit a capital add-on rate only to AL contractors that make available to Medicaid clients units that meet specific structural requirements. Presently, home and community residential care contractors request payments from the client, family or friends for items not covered by the Medicaid rate. The policy will clarify the contractor's responsibilities and when requesting a supplements payment.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: None.
Process for Developing New Rule: By publishing in the Washington State Register this CR-101 Preproposal statement of inquiry, the Aging and Disability Services Administration (ADSA) welcomes public participation in developing its rule(s). Anyone interested in reviewing draft rules should contact the staff person indicated below. After review of the draft rules, ADSA will file proposed rules with the Office of the Code Reviser using a CR-102 Notice of proposed rule making and will send a copy of the proposed rules to everyone currently on the home and community services and residential care services mailing list.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication. If you would like to receive a copy of the draft rules for review before the Notice of Proposed Rule Making is published or receive a copy of the proposed rules, please contact Patricia Hague, Home and Community Rates, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2447, fax (360) 728-2641, e-mail HaguePE@dshs.wa.gov.
June 14, 2005
Andy Fernando, Manager
Rules and Policies Assistance Unit