Original Notice.

     Preproposal statement of inquiry was filed as WSR 07-09-046.

     Title of Rule and Other Identifying Information: The department is amending and creating new sections in chapter 388-825 WAC, Division of developmental disabilities service rules.

Washington Administrative Code	Effect of Rule	Impact Small Business?
388-825-020 Definitions
"Abandonment" - repealed	Definition is no longer used in this chapter.	No
"Adolescent" - repealed	Definition is no longer used in this chapter.	No
"Attendant care" - repealed	Definition is now contained in WAC 388-825-074.	No
"Best interest" - repealed	Definition is no longer used in this chapter.	No
"Client or person" - amended	Revises definition to correspond with other chapters.	No
"Community support services" - repealed	Definition is no longer used in this chapter.	No
"Companion Home" - repealed	Definition is now contained in chapter 388-829C WAC.	No
"Division or DDD" - amended	Adds the aging and disability services administration to the definition.	No
"Emergency" - repealed	Definition is no longer used in this chapter.	No
"Exemption" - repealed	Definition is no longer used in this chapter.	No
"Family" - amended	Revises definition of "family" to correspond with other chapters.	No
"Family resource coordinator" - repealed	Definition is no longer used in this chapter.	No
"ICF/MR" - amended	Clarifies the definition of ICF/MR.	No
"Individual Support Plan (ISP)" - new	Adds the definition of ISP.	No
"Individual" - repealed	Definition is no longer used in this chapter.	No
"Individual alternative living" - repealed	Definition is no longer used in this chapter.	No
"Intelligence quotient score" - repealed	Definition is no longer used in this chapter.	No
"Intensive individual supported living support" - repealed	Definition is no longer used in this chapter.	No
"Medicaid personal care" - amended	Corrects the cross-reference to chapter 388-106 WAC.	No
"Nonresidential programs" - repealed	Definition is no longer used in this chapter.	No
"Nursing facility eligible" - repealed	Definition is no longer used in this chapter.	No
"Other resources" - repealed	Definition is no longer used in this chapter.	No
"Part C" - repealed	Definition is no longer used in this chapter.	No
"RHC capacity" - repealed	Definition is no longer used in this chapter.	No
"Residential programs - amended	Corrects the types of programs considered to be residential and adds cross references.	No
"Respite care" - amended	Amends definition for consistency with other programs.	No
"Vacancy" - repealed	Definition is no longer used in this chapter.	No
"Vulnerable adult" - repealed	Definition is no longer used in this chapter.	No
388-825-025 - repealed	Exemptions are no longer valid.	No
388-825-045 - repealed	Section is broken down into more manageable sections later in this chapter.	No
388-825-050 - repealed	Individual service plans are no longer in use.	No
388-825-055 - repealed	Section is broken down into more manageable sections later in this chapter.	No
388-825-056 - new	Describes how DDD services benefit persons with developmental disabilities.	No
388-825-057 - new	Describes how eligibility for paid services is determined.	No
388-825-0571 - new	Describes the services available to persons under eighteen who are in a dependency guardianship or foster care with children's administration.	No
388-825-058 - new	Lists services that DDD may authorize.	No
388-825-059 - new	Clarifies that the individual support plan identifies the services and the amount to be received.	No
388-825-061 - new	Describes services for persons under the age of three.	No
388-825-062 - new	Defines the infant toddler early intervention program (ITEIP).	No
388-825-063 - new	Defines services available under ITEIP.	No
388-825-065 - repealed	Section is no longer applicable.	No
388-825-066 - new	Describes where program eligibility rules and service definitions for ITEIP can be found.	No
388-825-067 - new	Defines medicaid state plan services.	No
388-825-068 - new	Describes what medicaid state plan service that DDD can authorize.	No
388-825-069 - new	Describes service available under the DDD home and community based services (HCBS) waiver.	No
388-825-071 - new	Describes eligibility criteria for services for persons enrolled in a DDD HCBS waiver.	No
388-825-072 - new	Describes where information on DDD's HCBS waivers can be found.	No
388-825-073 - new	Defines "state-only funded" services.	No
388-825-074 - new	Describes eligibility for state-only funded services.	No
388-825-079 - new	Defines which HCBS waiver services that DDD can authorize with state-only funding for persons not on an HCBS waiver.	No
388-825-080 - repealed	Section is moved to WAC 388-825-098 and reworded.	No
388-825-081 - new	Defines which state-only funded services not available in a HCBS waiver that DDD can authorize.	No
388-825-082 - new	Lists and defines other state-only funded services that are not contained in other DDD rules.	No
388-825-083 - new	Lists all of the services available through DDD.	No
388-825-084 - new	Lists limitations of state-only services and programs.	No
388-825-087 - new	Lists out-of-home residential services that address the special needs of persons with developmental disabilities.	No
388-825-088 - new	Lists where additional information can be found about DDD contracted residential services.	No
388-825-089 - new	Defines residential habilitation centers (RHCs) and lists the RHCs' locations in the state.	No
388-825-091 - new	Defines the eligibility for RHC services.	No
388-825-093 - new	Defines when a person can receive a short-term stay at an RHC.	No
388-825-094 - new	Describes when a person can request to live in an RHC and how the request is processed.	No
388-825-096 - new	Describes what a person must pay toward the cost of DDD services.	No
388-825-097 - new	Describes what expenses can be deducted from income in determining participation.	No
388-825-098 - new	Moved from WAC 388-825-080 and reworded for clarity.	No

     Hearing Location(s): Office Building 2, Auditorium, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html

or by calling (360) 664-6094), on May 6, 2008, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than May 7, 2008.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by

5 p.m. on May 6, 2008.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by April 29, 2008, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at johnsjl4@dshs.wa.gov.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: These amendments and new sections define and reorganize the rules governing the delivery of services to individuals with developmental disabilities.

     Reasons Supporting Proposal: The definitions reorganization of the rules allow stakeholders to easily find the rules pertaining to specific programs and services.

     Statutory Authority for Adoption: RCW 71A.12.030.

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

     Name of Proponent: Department of social and health services, governmental.

     Name of Agency Personnel Responsible for Drafting: Steve Brink, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail brinksc@dshs.wa.gov, (360) 725-3416, fax (360) 404-0955; Implementation: Shannon Manion, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail maniosk@dshs.wa.gov, (360) 725-3454, fax (360) 404-0955; and Enforcement: Don Clintsman, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail clintdl@dshs.wa.gov, (360) 725-3421, fax (360) 404-0955.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. DDD has determined that these rules do not impact small businesses. See Title of Rule above.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Steve Brink, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, phone (360) 725-3416, fax (360) 404-0955, e-mail brinksc@dshs.wa.gov.

March 12, 2008

Stephanie E. Schiller

Rules Coordinator

     (6) Provide the least-restrictive setting that will meet the person's medical and personal needs.))

     "Client or person" means a person ((the division determines under RCW 71A.16.040 and WAC 388-825-030 eligible for division-funded services)) who has a developmental disability as defined in RCW 71A.10.020(3) who also has been determined eligible to receive services by the division under chapter 71A.16 RCW.

     (("Community support services" means one or more of the services listed in RCW 71A.12.040 including, but not limited to the following services: Architectural, case management, early childhood intervention, employment, counseling, family support, respite care, information and referral, health services and equipment, therapy services, and residential support.

     "Companion home" means the same as "intensive individual supported living support."))

     "Department" means the department of social and health services of the state of Washington.

     "Director" means the director of the division of developmental disabilities.

     "Division or DDD" means the division of developmental disabilities within the aging and disability services administration of the department of social and health services.

     (("Emergency" means a sudden, unexpected occurrence demanding immediate action.

     "Exemption" means the department's approval of a written request for an exception to a rule in this chapter.))

     "Family" means ((individuals, of any age, living together in the same household and related by blood, marriage, adoption or as a result of sharing legal custody of a minor child)) relatives who live in the same home with the eligible client. Relatives include spouse; natural, adoptive or step parents; grandparents; brother; sister; stepbrother; stepsister; uncle; aunt; first cousin; niece; or nephew.

     (("Family resources coordinator" means the person who is:

     (1) Recognized by the IDEA Part C lead agency; and

     (2) Responsible for:

     (a) Providing family resources coordination;

     (b) Coordinating services across agencies; and

     (c) Serving as a single contact to help families receiving assistance and services for their eligible children who are under three years of age.))

     "ICF/MR" means a facility certified as an intermediate care facility for the mentally retarded by Title XIX to provide diagnosis, treatment and rehabilitation services to the mentally retarded or persons with related conditions.

     "ICF/MR eligible" for admission to an ICF/MR means a person is determined by DDD as needing active treatment as defined in CFR 483.440. Active treatment requires:

     (1) Twenty-four hour supervision; and

     (2) Continuous training and physical assistance in order to function on a daily basis due to deficits in the following areas: Toilet training, personal hygiene, dental hygiene, self-feeding, bathing, dressing, grooming, and communication.

     "Individual Support Plan (ISP)" is a document that authorizes and identifies the DDD paid services to meet a client's assessed needs.

     (("Individual" means a person applying for services from the division.

     "Individual alternative living" means provision of community-based individualized client training, assistance and/or ongoing support to enable a client to live as independently as possible with minimal services.

     "Intelligence quotient score" means a full scale score on the Wechsler, or the intelligence quotient score on the Stanford-Binet or the Leiter International Performance Scale.

     "Intensive individual supported living support" (also known as companion home) means provision of twenty-four hour residential support in a nonlicensed home for no more than one adult person with developmental disabilities in a regular family residence approved and contracted by the department ensuring client health, safety and well-being.))

     "Medicaid personal care" is the provision of medically necessary personal care tasks as defined in chapter ((388-15)) 388-106 WAC.

     (("Nonresidential programs" means programs including, but not limited to, county-funded habilitation services.

     "Nursing facility eligible" means a person is assessed by DDD as meeting the requirements for admission to a licensed nursing home as defined in WAC 388-71-0700 (3) through (5). The person must require twenty-four hour care provided by or under the supervision of a licensed nurse.

     "Other resources" means resources that may be available to the client, including but not limited to:

     (1) Private insurance;

     (2) Medicaid;

     (3) Indian health care;

     (4) Public school services through the office of the superintendent of public instruction; and

     (5) Services through the department of health.

     "Part C" means early intervention for children from birth through thirty-five months of age as defined in the Individuals with Disabilities Education Act (IDEA), Part C and 34 CFR, Part 303 and Washington's federally approved grant.))

     "Residential habilitation center" or "RHC" means a state-operated facility certified to provide ICF/MR and/or nursing facility level of care for persons with developmental disabilities.

     (("RHC capacity" means the maximum number of eligible persons that can reside in a residential habilitation center without exceeding its 1997 legislated budgeted capacity.))

     "Residential programs" means provision of support for persons in community living situations. Residential programs include DDD certified community residential services and support, both facility-based such as((,)) licensed group homes, and nonfacility based, ((i.e., supportive)) such as supported living((, intensive tenant support,)) and state-operated living alternatives (SOLA). Other residential programs include ((individual)) alternative living (as described in chapter 388-829A WAC, companion homes (as described in chapter 388-829C WAC), ((intensive individual supportive living services,)) adult family homes, adult residential care services, ((nursing homes, and)) children's foster homes, group care and staffed residential homes.

     "Respite care" means ((temporary residential services provided to a person and/or the person's family on an emergency or planned basis)) short-term intermittent relief for persons normally providing care for the individuals.

     "Secretary" means the secretary of the department of social and health services or the secretary's designee.

     "State supplementary payment (SSP)" is the state paid cash assistance program for certain DDD eligible SSI clients.

     (("Vacancy" means an opening at a RHC, which when filled, would not require the RHC to exceed its 1997 biannually budgeted capacity, minus:

     (1) Twenty-six beds designated for respite care use; and

     (2) Any downsizing related to negotiations with the Department of Justice regarding community placements.

     "Vulnerable adult" means a person who has a developmental disability as defined under RCW 71A.10.020.))

[Statutory Authority: RCW 71A.12.030, 71A.10.020 and 2002 c 371. 04-02-014, § 388-825-020, filed 12/29/03, effective 1/29/04. Statutory Authority: RCW 71A.16.010, 71A.16.030, 71A.12.030, chapter 71A.20 RCW, RCW 72.01.090, and 72.33.125. 02-16-014, § 388-825-020, filed 7/25/02, effective 8/25/02. Statutory Authority: RCW 71A.12.030 and 71A.12.040. 99-23-021, amended and recodified as § 388-825-020, filed 11/9/99, effective 12/10/99. Statutory Authority: RCW 71A.12.030. 99-04-071, § 275-27-020, filed 2/1/99, effective 3/4/99. Statutory Authority: RCW 74.12A.030 and 71A.16.030. 98-20-044, § 275-27-020, filed 9/30/98, effective 10/7/98. Statutory Authority: RCW 71A.14.030 and 71A.16.020. 92-09-115 (Order 3373), § 275-27-020, filed 4/21/92, effective 5/22/92. Statutory Authority: RCW 71A.16.020. 91-17-005 (Order 3230), § 275-27-020, filed 8/9/91, effective 9/9/91. Statutory Authority: RCW 71.20.070. 89-06-049 (Order 2767), § 275-27-020, filed 2/28/89; 84-15-058 (Order 2124), § 275-27-020, filed 7/18/84. Statutory Authority: RCW 72.01.090, 72.33.040, 72.33.125 and 72.33.165. 78-04-033 (Order 1280), § 275-27-020, filed 3/16/78; Order 1143, § 275-27-020, filed 8/11/76.]

     (1) An opportunity to learn, improve or retain social and adaptive skills necessary for living in the community;

     (2) Health and safety;

     (3) Personal power and choice;

     (4) Competence and self reliance;

     (5) Positive recognition by self and others;

     (6) Positive relationships; and

     (7) Integration into the physical and social life of the community.

[]

     (1) You are under the age of three and meet the eligibility requirements contained in WAC 388-825-061 through 388-825-066; or

     (2) You are a recipient of Washington State medicaid under the categorically needy program (CNP) and meet the eligibility requirements contained in chapters 388-474, 388-475 and 388-513 WAC; or

     (3) You are enrolled in a DDD home and community based services waiver and meet the eligibility requirements contained in chapter 388-845 WAC; or

     (4) You have been enrolled in the individual and family services program and meet the eligibility requirements contained in chapter 388-832 WAC; or

     (5) You have been approved to receive a state-only funded service.

[]

     (1) You are under the age of eighteen;

     (2) You have been determined to meet DDD eligibility requirements; and

     (3) You are in a dependency guardianship or foster care with children's administration.

[]

     (1) Medicaid state plan services;

     (2) Infant toddler early intervention program (ITEIP) services;

     (3) Home and community based services (HCBS) waiver services; and

     (4) State-only funded services.

[]

[]

     (2) Infants and toddlers eligible for DDD may receive DDD state-only funded child development services if funding is available.

[]

[]

[]

[]

     (2) To receive the service, you must be assessed by DSHS to have an unmet need for the service and meet the eligibility criteria for the program. See WAC 388-825-068 for services authorized by DDD.

[]

     (1) Medicaid personal care, per chapter 388-106 WAC;

     (2) Private duty nursing for adults age eighteen and older; per chapter 388-106 WAC;

     (3) Private duty nursing for children under the age of eighteen, per WAC 388-551-3000;

     (4) Adult day health for adults, per WAC 388-106-0810 and 388-106-0815; and

     (5) ICF/MR services, per chapters 388-835 and 388-837 WAC.

Medicaid State Plan Services
Adult day health ICF/MR services Medically intensive home care program for children Private duty nursing for adults	Medicaid personal care • In-home • Adult family home • Adult residential care

[]

     (2) Certain federal regulations governing ICF/MRs are "waived" enabling the provision of services in the home and community to persons who would otherwise require the services provided in an ICF/MR as defined in chapters 388-835 and 388-837 WAC.

[]

     (1) Your waiver services are limited to the services available in your specific waiver based on an assessment of your health and welfare needs.

     (2) The services available through each of DDD's HCBS waivers are described in chapter 388-845 WAC.

[]

[]

[]

     (1) You have a current DDD assessment that identifies the need for the service;

     (2) You meet the programmatic and financial eligibility requirements for the specific service or program;

     (3) Your need cannot be met through medicaid state plan services;

     (4) You are not enrolled in a DDD home and community based services (HCBS) waiver;

     (5) You do not receive SSP as a replacement for the requested service;

     (6) The program or service is funded by the legislature.

[]

     (2) Services that are available through the DDD HCBS waivers and authorized with state-only funding:

     (a) Are subject to the definitions, limitations and provider qualifications contained in chapter 388-845 WAC; and

     (b) Require prior approval by the director of DDD or designee.

[]

     (1) Adult day care (WAC 388-106-0800);

     (2) Attendant care (WAC 388-825- 082);

     (3) Childcare for foster children (chapter 388-826 WAC);

     (4) Chore services (chapter 388-106 WAC);

     (5) Supported living allowance (chapter 388-101 WAC);

     (6) Individual and family assistance by the county (WAC 388-825-082);

     (7) Information and education by the county (WAC 388-825-082);

     (8) Medical and dental services (WAC 388-825-082);

     (9) Psychological counseling (WAC 388-825-082);

     (10) Reimbursement through a family support program to families for the purchase of approved items or service (WAC 388-825-242);

     (11) State supplementary payments (chapter 388-827 WAC); and

     (12) Transportation reimbursement for an escort (WAC 388-825-082).

[]

     (1) "Adult day care" not covered by Medicaid is a DDD county service providing a structured social program for adults and is limited to persons receiving the service prior to June 2005.

     (2) "Attendant care" provides respite care or personal care and is limited to persons who:

     (a) Are not eligible for other DDD services to meet their need; and

     (b) Were receiving attendant care in March 2004.

     (3) "Individual and family assistance" is a time limited county service available to individuals and families.

     (a) Supports are provided to additional families and persons with developmental disabilities in need of services within existing resources;

     (b) Individuals and families receiving services have more control and flexibility with the use of the resources; and

     (c) The individual and family are assisted in connecting to and using natural and informal community supports.

     (4) "Information and education" is a county service that provides a variety of activities and strategies to assure that individuals with developmental disabilities and families have full access to current information about services and support that will assist them in becoming full participants in their communities.

     (5) "Medical and dental services" means those services which are necessary for the health of the client and are not covered by medicaid or private insurance.

     (6) "Psychological counseling" may provide specialized cognitive counseling, strategies for effectively relating to people or coping with situations and problems.

     (7) "Transportation reimbursement for an escort" is the payment for someone other than the driver to provide one-on-one attention to the client being transported.

[]

     (1) Waiver personal care services that are not available with state-only funds include:

     (a) In-home services;

     (b) Adult family home; and

     (c) Adult residential care.

     (2) Waiver services that can be funded as state-only services:

     (a) Behavior management and consultation;

     (b) Community transition;

     (c) Environmental accessibility adaptations;

     (d) Medical equipment and supplies;

     (e) Occupational therapy;

     (f) Physical therapy;

     (g) Respite care;

     (h) Sexual deviancy evaluation;

     (i) Skilled nursing;

     (j) Specialized medical equipment or supplies;

     (k) Specialized psychiatric services;

     (l) Speech, hearing and language therapy;

     (m) Staff/family consultation and training;

     (n) Transportation/mileage;

     (o) Residential habilitation services (RHS), including:

     (i) Alternative living;

     (ii) Companion homes;

     (iii) Supported living;

     (iv) Group home;

     (v) Child foster care;

     (vi) Child group care;

     (vii) Staffed residential; and

     (viii) State operated SL;

     (p) Employment/day programs, including:

     (i) Community access;

     (ii) Community guide;

     (iii) Person-to-person;

     (iv) Prevocational services; and

     (v) Supported employment;

     (q) ITEIP/County programs, including child development services;

     (r) Mental health stabilization services, including:

     (i) Behavior management and consultation;

     (ii) Mental health crisis; and

     (iii) Skilled nursing; and

     (s) Specialized psychiatric services.

     (3) State-only services that are not available as a waiver service:

     (a) Adult day care;

     (b) Architectural and vehicle modification;

     (c) Attendant care;

     (d) Child care for foster children;

     (e) Chore services;

     (f) Community services grant;

     (g) Individual and family assistance;

     (h) Information/education;

     (i) Medical and dental services;

     (j) Medical insurance co-pays and costs exceeding other coverage;

     (k) Parent and sibling education;

     (l) Parent training and counseling;

     (m) Psychological counseling;

     (n) Recreational opportunities;

     (o) State supplementary payments;

     (p) Specialized clothing;

     (q) Specialized nutrition;

     (r) Supported living;

     (s) Training of the client;

     (t) Transportation - cost of escort service or travel time; and

     (u) Reimbursement to families for the purchase of approved items or services.

[]

     (1) All state-only funded services are limited by available funding.

     (2) The following programs are closed to new admissions:

     (a) Adult day care; and

     (b) Attendant care.

     (3) Chore services are limited to persons who were receiving the service in 1998 and who have continued to receive this service monthly.

     (4) Traditional family support (TFS) is limited to persons enrolled in the program as of May 31, 1996. This program ends on June 30, 2008.

     (5) Family support opportunity (FSO) is limited to persons enrolled in the program from June 1, 1996 through March 27, 2006. This program ends on June 30, 2008.

     (6) Family support pilot (FSP) is limited to persons enrolled in the program March 28, 2006 or later. This program ends on June 30, 2008.

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     (1) Contracted and DDD-certified community based residential services for adults;

     (2) Contracted community based services for children; and

     (3) Residential habilitation centers (RHC) for a person of any age who requires ICF/MR or nursing facility care.

[]

     (1) Certified community residential services and supports are contained in chapter 388-101 WAC and include information regarding:

     (a) Group homes (GH);

     (b) Group training home;

     (c) Supported living (SL); and

     (d) State operated living alternative (SOLA).

     (2) Alternative living services are contained in chapter 388-829A WAC;

     (3) Companion home services are contained in chapter 388-829C WAC;

     (4) Voluntary placement program services for children are contained in chapter 388-826 WAC and include information regarding:

     (a) Foster homes;

     (b) Group homes;

     (c) Group training homes;

     (d) Child placing agencies; and

     (e) Staffed residential homes.

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     (1) Rainier School in Buckley, Washington;

     (2) Francis Hadden Morgan Center in Bremerton, Washington;

     (3) Fircrest School in Shoreline, Washington;

     (4) Yakima Valley School in Selah, Washington; and

     (5) Lakeland Village in Medical Lake, Washington.

[]

     (1) You are currently DDD eligible;

     (2) You choose to receive services in the RHC;

     (3) You need the level of care provided at the RHC; and

     (4) DDD has determined that you can be supported safely in an RHC environment and will not pose a danger to other residents of the RHC.

[]

     (1) Short term stays are limited by available vacancies;

     (2) Short term stays must be included in your individual support plan; and

     (3) Short term stays in excess of thirty days in a calendar year require approval by the director of the division of developmental disabilities.

[]

     (1) Your case/resource manager will update your DDD assessment and gather other information.

     (2) Admission to an RHC requires approval by the director of the division of developmental disabilities or designee.

[]

     (2) If DDD authorizes you to live in a licensed community residential facility you must pay your room and board costs from your earned and unearned income. You may also be responsible for a portion of the cost of your care.

     (a) If you are eligible for and receiving SSI or have SSI related eligibility per WAC 388-475-0100 (2)(a) or (b), you are not required to pay toward the cost of your care if you are living at home or in a community setting.

     (b) If you are enrolled in a DDD HCBS waiver you must pay toward the cost of your services as described in WAC 388-515-1510.

     (c) If you are not enrolled in a DDD HCBS waiver you must pay toward the cost of your services as described in WAC 388-106-0225.

     (3) If you live in a medical institution you must pay toward the cost of your care as described in WAC 388-513-1380. See WAC 388-500-0005 for the definition of a medical institution.

[]

     (1) If you have SSI related eligibility the cost of your payee or guardianship service may be deducted as described in chapter 388-79 WAC and WAC 388-475-0800(5).

     (2) If you are enrolled in a DDD HCBS waiver refer to WAC 388-515-1510 for rules used to determine allowable deductions.

     (3) If you are not enrolled in a DDD HCBS waiver refer to WAC 388-106-0225 for rules used to determine allowable deductions.

[]

[]

     The following sections of the Washington Administrative Code are repealed:

WAC 388-825-025	Exemptions.
WAC 388-825-045	Determination for necessary services.
WAC 388-825-050	Individual service plan.
WAC 388-825-055	Authorization of services.
WAC 388-825-065	Financial services.
WAC 388-825-080	Guardianship services.

© Washington State Code Reviser's Office