WASHINGTON STATE REGISTER

WSR 07-05-012

PREPROPOSAL STATEMENT OF INQUIRY

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed February 9, 2007, 2:36 p.m. ]

аааааSubject of Possible Rule Making: WAC 388-513-1315 Eligibility for long-term care (institutional, waiver, and hospice) services and 388-513-1395 Determining eligibility for institutional or hospice services and for facility care only under the medically needy (MN) program.

аааааStatutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, 74.39.010.

аааааReasons Why Rules on this Subject may be Needed and What They Might Accomplish:

Х Updating and clarifying language regarding when long-term care (LTC) rules are used and needed for the hospice program.

Х Adding language to WAC 388-513-1395 indicating LTC medically needy rules apply to clients residing in medical institutions, including hospice elections in medical institutions.

Х Clarifying language that hospice is paid as a service under noninstitutional categorically needy and medically needy programs when the client is residing in a home or residential setting. Institutional Medicaid rules are not used for hospice elections in noninstitutional settings unless beneficial to the client under WAC 388-515-1505. (Those with income over the medically needy income level (MNIL) and under 300% of the federal benefit rate (FBR), or with a community spouse.)

Х Amending language to be consistent with WAC 388-438-0110 regarding alien emergency medical (AEM); indicating nursing facility and hospice services under AEM must be preapproved, for clarification purposes.

Х Adding language limiting medical and remedial care expenses to zero if such expenses were incurred during a transfer of asset penalty, described in WAC 388-513-1363 through 388-513-1366.

Х Updating WAC references and clarifying language.

аааа Other policy changes on these subjects may be incorporated into this rule making. Other WAC chapters may need to be updated as a result of this rule-making.

аааааProcess for Developing New Rule: The department invites the interested public to review and provide input on the draft language of this rule. Draft material and information about how to participate may be obtained from the department representative listed below.

аааааInterested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Lori Rolley, Home and Community Services, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2271, fax (360) 407-7582, e-mail rollelj@dshs.wa.gov.

January 9, 2007

Jim Schnellman, Chief

Office of Administrative Resources

Х	Updating and clarifying language regarding when long-term care (LTC) rules are used and needed for the hospice program.
Х	Adding language to WAC 388-513-1395 indicating LTC medically needy rules apply to clients residing in medical institutions, including hospice elections in medical institutions.
Х	Clarifying language that hospice is paid as a service under noninstitutional categorically needy and medically needy programs when the client is residing in a home or residential setting. Institutional Medicaid rules are not used for hospice elections in noninstitutional settings unless beneficial to the client under WAC 388-515-1505. (Those with income over the medically needy income level (MNIL) and under 300% of the federal benefit rate (FBR), or with a community spouse.)
Х	Amending language to be consistent with WAC 388-438-0110 regarding alien emergency medical (AEM); indicating nursing facility and hospice services under AEM must be preapproved, for clarification purposes.
Х	Adding language limiting medical and remedial care expenses to zero if such expenses were incurred during a transfer of asset penalty, described in WAC 388-513-1363 through 388-513-1366.
Х	Updating WAC references and clarifying language.

й Washington State Code Reviser's Office