WSR 06-16-070

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed July 28, 2006, 2:41 p.m. , effective August 28, 2006 ]


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

Purpose: New WAC 388-106-0047 clarifies long-term care services eligibility, including denial and termination.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, 42 C.F.R. 441.302(a); Social Security Act Section 1915c waiver rules, 42 C.F.R. 440.180.

Adopted under notice filed as WSR 05-15-146 on July 19, 2005; WSR 05-20-080 on October 4, 2005; and WSR 06-09-091 on April 19, 2006.

Changes Other than Editing from Proposed to Adopted Version: WAC 388-106-0047: Subsection (2) adds language to clarify the challenging cases protocol is a department policy; and subsection (2)(a) adds the following clarifying language: "After a department representative reviews with you your rights and responsibilities as a client of the department, per WAC 388-106-1300 and 388-106-1303..."

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.

Date Adopted: July 28, 2006.

Andy Fernando, Manager

Rules and Policies Assistance Unit

3535.9
NEW SECTION
WAC 388-106-0047   When can the department terminate or deny long-term care services to me?   (1) The department will deny or terminate long-term care services if you are not eligible for long-term care services pursuant to WAC 388-106-0210, 388-106-0310, 388-106-0410, 388-106-0510, or 388-106-0610.

(2) The department may deny or terminate long-term care services to you if, after exhaustion of standard case management activities and the approaches delineated in the department's challenging cases protocol, which must include an attempt to reasonably accommodate your disability or disabilities, any of the following conditions exist:

(a) After a department representative reviews with you your rights and responsibilities as a client of the department, per WAC 388-106-1300 and WAC 388-106-1303, you refuse to accept those long-term care services identified in your plan of care that are vital to your health, welfare or safety;

(b) You choose to receive services in your own home and you or others in your home demonstrate behaviors that are substantially likely to cause serious harm to you or your care provider;

(c) You choose to receive services in your own home and hazardous conditions in or immediately around your home jeopardize the health, safety, or welfare of you or your provider. Hazardous conditions include but are not limited to the following:

(i) Threatening, uncontrolled animals (e.g., dogs);

(ii) The manufacture, sale, or use of illegal drugs;

(iii) The presence of hazardous materials (e.g., exposed sewage, evidence of a methamphetamine lab).

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Washington State Code Reviser's Office