WSR 08-07-061

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed March 17, 2008, 10:09 a.m. ]

     Continuance of WSR 07-15-076 and 07-18-088.

     Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

     Title of Rule and Other Identifying Information: Continuance, WAC 246-310-990 Certificate of need, 246-329-990 Child birth centers, 246-335-990 In-home services agencies, 246-337-990 Residential treatment facilities, and 246-380-990 State institutional survey.

     Hearing Location(s): Department of Health, Town Center 2, Room 158, 111 Israel Road S.E., Tumwater, WA 98501, on April 22, 2008, at 10:00 a.m.

     Date of Intended Adoption: May 1, 2008.

     Submit Written Comments to: Alisa Harris, P.O. Box 47852, Olympia, WA 98504-7852, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2901, by April 18, 2008.

     Assistance for Persons with Disabilities: Contact Alisa Harris by April 18, 2008, TTY (800) 833-6388 or 711.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Due to the passage of Initiative 960, the department needed approval from the legislature to increase fees. The department is extending the deadline for submitting written comments and conducting a continuance to the August 22, 2007, hearing. The new hearing will be held April 22, 2008. The proposed rules increase fees in the certificate of need, child birth centers, in-home services agencies, residential treatment facilities and state institutional survey program in excess of the fiscal growth factor. This exemption was given to meet the actual cost of conducting business as approved by the legislature in section 222, chapter 522, Laws of 2007 (SHB 1128).

     This proposal also adds to WAC 246-335-990(5), in-home services agencies on how the department of health will process refunds.

     Reasons Supporting Proposal: RCW 43.70.250 requires the department to charge fees sufficient to cover the full cost program operations. These additional resources are necessary to maintain current program operations and the assure public health and safety in facilities statewide.

     Statutory Authority for Adoption: RCW 43.70.250, 70.38.105, 18.46.030, 70.127.090, 71.12.470, 43.70.040.

     Statute Being Implemented: RCW 43.70.250.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of health, office of facilities and services licensing, governmental.

     Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Steven Saxe, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-2905.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. This proposal is exempt under RCW 19.85.025(3) and does not require a small business economic impact statement. However, the department prepared fee analyses which provides documentation of the need for fee increases. To obtain a copy of a fee analysis, contact Alisa Harris at the address above.

     A cost-benefit analysis is not required under RCW 34.05.328. The department did not complete a cost-benefit analysis. This proposal is exempt from this requirement under RCW 34.05.328 [(5)(b)](ii).

March 17, 2008

Mary C. Selecky

Secretary

OTS-9796.1


AMENDATORY SECTION(Amending WSR 03-22-020, filed 10/27/03, effective 11/27/03)

WAC 246-310-990   Certificate of need review fees.   (1) An application for a certificate of need under chapter 246-310 WAC must include payment of a fee consisting of the following:

     (a) A review fee based on the facility/project type;

     (b) If more than one facility/project type applies to an application, the review fee for each type of facility/project must be included.


Facility/Project Type Review Fee
Ambulatory Surgical Centers/Facilities $((13,379.00)) 17,392.00
Amendments to Issued Certificates of Need $((8,432.00)) 10,961.00
Emergency Review $((5,427.00)) 7,055.00
Exemption Requests
• Continuing Care Retirement Communities (CCRCs)/Health Maintenance Organization (HMOs) $((5,427.00)) 7,055.00
• Bed Banking/Conversions $((883.00)) 1,147.00
• Determinations of Nonreviewability $((1,261.00)) 1,639.00
• Hospice Care Center $((1,136.00)) 1,476.00
• Nursing Home Replacement/Renovation Authorizations $((1,136.00)) 1,476.00
• Nursing Home Capital Threshold under RCW 70.38.105 (4)(e) (Excluding Replacement/Renovation Authorizations) $((1,136.00)) 1,476.00
• Rural Hospital/Rural Health Care Facility $((1,136.00)) 1,476.00
Extensions
• Bed Banking $((505.00)) 656.00
• Certificate of Need/Replacement Renovation Authorization Validity Period $((505.00)) 656.00
Home Health Agency $((16,155.00)) 21,001.00
Hospice Agency $((14,388.00)) 18,704.00
Hospice Care Centers $((8,432.00)) 10,961.00
Hospital (Excluding Transitional Care Units-TCUs, Ambulatory Surgical Center/Facilities, Home Health, Hospice, and Kidney Disease Treatment Centers) $((26,506.00)) 34,457.00
Kidney Disease Treatment Centers $((16,409.00)) 21,331.00
Nursing Homes (Including CCRCs and TCUs) $((30,293.00)) 39,380.00

     (2) The fee for amending a pending certificate of need application is determined as follows:

     (a) If an amendment to a pending certificate of need application results in the addition of one or more facility/project types, the review fee for each additional facility/project type must accompany the amendment application;

     (b) If an amendment to a pending certificate of need application results in the removal of one or more facility/project types, the department shall refund to the applicant the difference between the review fee previously paid and the review fee applicable to the new facility/project type; or

     (c) If an amendment to a pending certificate of need application results in any other change as identified in WAC 246-310-100, a fee of one thousand ((three)) seven hundred ((fifty-one)) fifty-six dollars must accompany the amendment application.

     (3) If a certificate of need application is returned by the department under WAC 246-310-090 (2)(b) or (e), the department shall refund seventy-five percent of the review fees paid.

     (4) If an applicant submits a written request to withdraw a certificate of need application before the beginning of review, the department shall refund seventy-five percent of the review fees paid by the applicant.

     (5) If an applicant submits a written request to withdraw a certificate of need application after the beginning of review, but before the beginning of the ex parte period, the department shall refund one-half of all review fees paid.

     (6) If an applicant submits a written request to withdraw a certificate of need application after the beginning of the ex parte period the department shall not refund any of the review fees paid.

     (7) Review fees for exemptions and extensions are nonrefundable.

[Statutory Authority: RCW 43.70.250 and 70.38.105(5). 03-22-020, § 246-310-990, filed 10/27/03, effective 11/27/03. Statutory Authority: Chapters 70.127 and 70.38 RCW. 03-07-096, § 246-310-990, filed 3/19/03, effective 4/19/03. Statutory Authority: RCW 70.38.105 and 2002 c 371. 02-14-051, § 246-310-990, filed 6/27/02, effective 7/28/02. Statutory Authority: RCW 70.38.105(5) and 43.70.110. 01-15-094, § 246-310-990, filed 7/18/01, effective 8/18/01. Statutory Authority: RCW 70.38.105(5). 99-23-089, § 246-310-990, filed 11/16/99, effective 12/17/99. Statutory Authority: Chapter 70.38 RCW. 96-24-052, § 246-310-990, filed 11/27/96, effective 12/28/96. Statutory Authority: RCW 70.38.135, 43.70.250 and 70.38.919. 92-02-018 (Order 224), § 246-310-990, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-310-990, filed 12/27/90, effective 1/31/91. Statutory Authority: Chapter 70.38 RCW. 90-15-001 (Order 070), § 440-44-030, filed 7/6/90, effective 8/6/90. Statutory Authority: RCW 43.20A.055. 89-21-042 (Order 2), § 440-44-030, filed 10/13/89, effective 11/13/89; 87-16-084 (Order 2519), § 440-44-030, filed 8/5/87; 87-12-049 (Order 2494), § 440-44-030, filed 6/1/87; 84-13-006 (Order 2109), § 440-44-030, filed 6/7/84; 83-21-015 (Order 2037), § 440-44-030, filed 10/6/83. Statutory Authority: 1982 c 201. 82-13-011 (Order 1825), § 440-44-030, filed 6/4/82.]

OTS-9797.1


AMENDATORY SECTION(Amending WSR 07-07-075, filed 3/16/07, effective 4/16/07)

WAC 246-329-990   Fees.   The purpose of the fees section is to describe the fees associated with licensing, renewal and other charges assessed by the department.

     (1) Childbirth centers licensed under chapter 18.46 RCW shall submit an annual fee of ((five)) seven hundred ((ninety-nine)) thirteen dollars and ((ninety)) zero cents to the department unless a center is a charitable, nonprofit, or government-operated institution under RCW 18.46.030.

     (2) A change of ownership fee of one hundred ((fifty)) seventy-eight dollars. A new license will be issued and valid for the remainder of the current license period.

     (3) The department may charge and collect from a licensee a fee of ((seven)) eight hundred ((fifty)) ninety-two dollars for:

     (a) A second on-site visit resulting from failure of the licensee to adequately respond to a statement of deficiencies;

     (b) A complete on-site survey resulting from a substantiated complaint; or

     (c) A follow-up compliance survey.

     (4) A licensee shall submit an additional late fee in the amount of ((twenty-five)) twenty-nine dollars per day, not to exceed five hundred ninety-five dollars, from the renewal date (which is thirty days before the current license expiration date) until the date of mailing the fee, as evidenced by the postmark.

     (5) Refunds. The department shall refund fees paid by the applicant for initial licensure as follows:

     (a) If an application has been received but no on-site survey or technical assistance has been performed by the department, two-thirds of the fees paid, less a fifty dollar processing fee; or

     (b) If an application has been received and an on-site survey or technical assistance has been performed by the department, one-third of the fees paid, less a fifty dollar processing fee.

     (c) The department may not refund applicant fees if:

     (i) The department has performed more than one on-site visit for any purpose;

     (ii) One year has elapsed since an initial licensure application is received by the department, but no license is issued because applicant failed to complete requirements for licensure; or

     (iii) The amount to be refunded as calculated by (a) or (b) of this subsection is ten dollars or less.

[Statutory Authority: Chapter 18.46 RCW and RCW 43.70.040. 07-07-075, § 246-329-990, filed 3/16/07, effective 4/16/07. Statutory Authority: RCW 43.70.250. 06-21-108, § 246-329-990, filed 10/17/06, effective 11/17/06; 05-13-189, § 246-329-990, filed 6/22/05, effective 7/23/05. Statutory Authority: RCW 43.70.250, 18.46.030, 43.70.110, 71.12.470. 04-19-141, § 246-329-990, filed 9/22/04, effective 10/23/04. Statutory Authority: RCW 43.70.250 and 70.38.105(5). 03-22-020, § 246-329-990, filed 10/27/03, effective 11/27/03. Statutory Authority: RCW 43.70.250. 02-13-061, § 246-329-990, filed 6/14/02, effective 7/15/02. Statutory Authority: RCW 18.46.030, 43.70.110 and 43.70.250. 01-15-090, § 246-329-990, filed 7/18/01, effective 8/18/01. Statutory Authority: RCW 43.70.040. 91-02-050 (Order 122), § 246-329-990, filed 12/27/90, effective 1/31/91.]

OTS-9798.2


AMENDATORY SECTION(Amending WSR 04-19-142, filed 9/22/04, effective 10/23/04)

WAC 246-335-990   Fees.   (1) A licensee or applicant shall submit to the department:

     (a) An initial twelve-month license fee of ((one thousand nine hundred sixty-six)) two thousand one hundred sixty-two dollars for each service category for new persons not currently licensed in that category to provide in-home services in Washington state, or currently licensed businesses which have had statement of charges filed against them;

     (b) A twenty-four month renewal fee based on the number of full-time equivalents (FTEs), which is a measurement based on a forty-hour week and is applicable to paid agency personnel or contractors, or the number of beds, as follows:

     (c) For single service category licenses:

# of FTEs Home Health Hospice Home Care # of Beds Hospice Care Center
5 or less $((1,966.00)) 2,162.00 $((983.00)) 1,081.00 $((590.00)) 649.00 5 or less $((655.00)) 720.00
6 to 15 $((2,765.00)) 3,041.00 $((1,035.00)) 1,138.00 $((1,068.00)) 1,174.00 6 to 10 $((1,311.00)) 1,442.00
16 to 50 $((3,146.00)) 3,460.00 $((1,540.00)) 1,694.00 $((1,147.00)) 1,261.00 11 to 15 $((1,966.00)) 2,162.00
51 to 100 $((3,965.00)) 4,361.00 $((2,467.00)) 2,713.00 $((1,343.00)) 1,477.00 16 to 20 $((2,621.00)) 2,883.00
101 or more $((4,083.00)) 4,491.00 $((2,595.00)) 2,854.00 $((1,442.00)) 1,586.00

     (d) For multiple service category licenses:

     (i) One hundred percent of the home health category fee and seventy-five percent of the appropriate service category fee for each additional service category (hospice, home care, hospice care center); or

     (ii) One hundred percent of the hospice category fee and seventy-five percent of the appropriate service category fee for each additional service category (home care, hospice care center); and

     (e) A change of ownership fee of ((one hundred ninety-seven)) two hundred sixteen dollars for each licensed service category. A new license will be issued and valid for the remainder of the current license period.

     (2) The department may charge and collect from a licensee a fee of ((nine hundred eighty-three)) one thousand eighty-one dollars for:

     (a) A second on-site visit resulting from failure of the licensee to adequately respond to a statement of deficiencies:

     (b) A complete on-site survey resulting from a substantiated complaint; or

     (c) A follow-up compliance survey.

     (3) A licensee with deemed status shall pay fees according to this section.

     (4) A licensee shall submit an additional late fee in the amount of ((thirty-three)) thirty-six dollars per day, not to exceed five hundred fifty dollars, from the renewal date (which is thirty days before the current license expiration date) until the date of mailing the fee, as evidenced by the postmark.

     (5) Refunds. The department shall refund fees paid by the applicant for initial licensure as follows:

     (a) If an application has been received but no on-site survey or technical assistance has been performed by the department, two-thirds of the fees paid, less a fifty dollar processing fee; or

     (b) If an application has been received and an on-site survey or technical assistance has been performed by the department, one-third of the fees paid, less a fifty dollar processing fee.

     (6) The department may not refund applicant fees if:

     (a) The department has performed more than one on-site visit for any purpose;

     (b) One year has elapsed since an initial licensure application is received by the department, but no license is issued because applicant failed to complete requirements for licensure; or

     (c) The amount to be refunded as calculated by subsection (5)(a) or (b) of this section is ten dollars or less.

[Statutory Authority: RCW 43.70.250 and 70.127.090. 04-19-142, § 246-335-990, filed 9/22/04, effective 10/23/04. Statutory Authority: RCW 43.70.250 and 70.38.105(5). 03-22-020, § 246-335-990, filed 10/27/03, effective 11/27/03. Statutory Authority: Chapter 70.127 RCW. 02-18-026, § 246-335-990, filed 8/23/02, effective 10/1/02.]

OTS-9799.1


AMENDATORY SECTION(Amending WSR 06-21-108, filed 10/17/06, effective 11/17/06)

WAC 246-337-990   Licensing fees.   A licensee must submit the following fees to the department:


FEE TYPE AMOUNT
Administrative processing/

initial application fee

 $((155.00)) 204.00
License bed fee (per bed) $((144.60)) 190.00
Annual renewal fee (per bed) $((144.60)) 190.00
Late fee (per bed) $((25.00)) 33.00 (up to $((500.00)) 660.00)
Follow-up compliance survey fee or a complete on-site survey fee resulting from a substantiated complaint $((1000.00)) 1,320.00

     (1) The department shall refund fees paid by the applicant for initial licensure if:

     (a) The department has received an application but has not conducted an on-site survey or provided technical assistance. The department shall refund two-thirds of the fees paid, less a fifty dollar processing fee;

     (b) The department has received an application and has conducted an on-site survey or provided technical assistance. The department shall refund one-third of the fees paid, less a fifty dollar processing fee.

     (2) The department will not refund fees paid by the applicant if:

     (a) The department has conducted more than one on-site visit for any purpose;

     (b) One year has elapsed since the department received an initial licensure application, and the department has not issued a license because the applicant failed to complete requirements for licensure; or

     (c) The amount to be refunded as calculated by subsection (1)(a) or (b) of this section is ten dollars or less.

[Statutory Authority: RCW 43.70.250. 06-21-108, § 246-337-990, filed 10/17/06, effective 11/17/06; 05-23-099, § 246-337-990, filed 11/17/05, effective 12/18/05. Statutory Authority: Chapter 71.12 RCW. 05-15-157, § 246-337-990, filed 7/20/05, effective 8/20/05.]

OTS-9800.1


AMENDATORY SECTION(Amending WSR 06-21-108, filed 10/17/06, effective 11/17/06)

WAC 246-380-990   Fees.   An annual health and sanitation survey fee for community colleges, ferries, and other state of Washington institutions and facilities shall be assessed as follows:


Fee
(1) Food Service
(a) As defined in WAC 246-215-011(12) food service establishments or concessions in community colleges, ferries, or any other state of Washington facility preparing potentially hazardous foods. This shall include dockside food establishments directly providing food for the Washington state ferry system. $((603.30)) 796.00
(b) Food service establishments or concessions that do not prepare potentially hazardous foods. $((302.60)) 399.00
(c) The health and sanitation survey fee referenced in subsection (a) and (b) of this section may be waived provided there is an agreement between the department of health and the local jurisdictional health agency for the local health agency to conduct the food service establishments surveys.
(2) State institutions or facilities.
(a) Institutions or facilities operating a food service: The annual fee shall be ((nine)) twelve dollars and fifty cents times the population count plus ((six)) seven hundred ((three)) ninety-six dollars and ((thirty)) zero cents per food service establishment. The population count shall mean the average daily population for the past twelve months (January through December).
(b) Institutions or facilities that do not operate a food service: The annual fee shall be ((nine)) twelve dollars and fifty cents times the population count.
(c) The population count for a new institution shall mean the average projected daily population for the first twelve months of operation.

[Statutory Authority: RCW 43.70.250. 06-21-108, § 246-380-990, filed 10/17/06, effective 11/17/06; 05-13-189, § 246-380-990, filed 6/22/05, effective 7/23/05. Statutory Authority: RCW 43.70.250 and 70.38.105(5). 03-22-020, § 246-380-990, filed 10/27/03, effective 11/27/03. Statutory Authority: RCW 43.70.250 and 2002 c 371. 02-20-040, § 246-380-990, filed 9/24/02, effective 11/1/02. Statutory Authority: RCW 43.20B.020. 91-21-075 (Order 204), § 246-380-990, filed 10/18/91, effective 11/18/91. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-380-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20A.055. 87-14-066 (Order 2493), § 440-44-076, filed 7/1/87; 85-13-007 (Order 2238), § 440-44-076, filed 6/7/85.]

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