WSR 08-12-023

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed May 29, 2008, 8:35 a.m. , effective July 1, 2008 ]


Effective Date of Rule: July 1, 2008.

Purpose: The department is amending chapter 388-106 WAC, Long-term care services. The medicare/medicaid integration project (MMIP) that has been available to dual eligible clients living in King or Pierce County will be phased out during 2008. This rule making amends and repeals sections in chapter 388-106 WAC to remove references to MMIP.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-106-0720, 388-106-0725, 388-106-0730, 388-106-0735 and 388-106-0740; and amending WAC 388-106-0015 and 388-106-0070.

Statutory Authority for Adoption: RCW 74.08.090 and 74.09.520.

Adopted under notice filed as WSR 08-08-114 on April 2, 2008.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 5.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 5.

Date Adopted: May 22, 2008.

Stephanie E. Schiller

Rules Coordinator

3957.1
AMENDATORY SECTION(Amending WSR 06-16-035, filed 7/25/06, effective 8/25/06)

WAC 388-106-0015   What long-term care services does the department provide?   The department provides long-term care services through programs that are designed to help you remain in the community. These programs offer an alternative to nursing home care (which is described in WAC 388-106-0350 through 388-106-0360). You may receive services from any of the following:

(1) Medicaid personal care (MPC) is a Medicaid state plan program authorized under RCW 74.09.520. Clients eligible for this program may receive personal care in their own home or in a residential facility.

(2) Community options program entry system (COPES) is a Medicaid waiver program authorized under RCW 74.39A.030. Clients eligible for this program may receive personal care in their own home or in a residential facility.

(3) Medically needy residential waiver (MNRW) is a Medicaid waiver program authorized under RCW 74.39.041. Clients eligible for this program may receive personal care in a residential facility.

(4) Medically needy in-home waiver (MNIW) is a Medicaid waiver program authorized under RCW 74.09.700. Clients eligible for this program may receive personal care in their own home.

(5) Chore is a state-only funded program authorized under RCW 74.39A.110. Grandfathered clients may receive assistance with personal care in their own home.

(6) Volunteer chore is a state-funded program that provides volunteer assistance with household tasks to eligible clients.

(7) Program of all-inclusive care for the elderly (PACE) is a Medicaid/Medicare managed care program authorized under 42 CFR 460.2. Clients eligible for this program may receive personal care and medical services in their own home, in residential facilities, and in adult day health centers.

(8) Adult day health is a supervised daytime program providing skilled nursing and rehabilitative therapy services in addition to core services outlined in WAC 388-106-0800.

(9) Adult day care is a supervised daytime program providing core services, as defined under WAC 388-106-0800.

(10) GAU-funded residential care is a state-funded program authorized under WAC 388-400-0025. Clients eligible for this program may receive personal care services in an adult family home or an adult residential care facility.

(11) Residential care discharge allowance is a service that helps eligible clients to establish or resume living in their own home.

(12) Private duty nursing is a Medicaid service that provides an alternative to institutionalization in a hospital or nursing facility setting. Clients eligible for this program may receive at least four continuous hours of skilled nursing care on a day to day basis in their own home.

(13) Senior Citizens Services Act (SCSA) is a program authorized under chapter 74.38 RCW. Clients eligible for this program may receive community-based services as defined in RCW 74.38.040.

(14) Respite program is a program authorized under RCW 74.41.040 and WAC 388-106-1200. This program provides relief care for unpaid family or other caregivers of adults with a functional disability.

(15) Programs for persons with developmental disabilities are discussed in chapter 388-823 through 388-853 WAC.

(16) Nursing facility.

(17) ((Medicare/Medicaid integration project (MMIP) is a DSHS prepaid managed care program, authorized under 42 CFR Part 438, that integrates medical and long-term care services for clients who are sixty-five years of age or older and eligible for Medicare (Parts A and B) and Medicaid.

(18))) New Freedom consumer directed services (NFCDS) is a Medicaid waiver program authorized under RCW 74.39A.030.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. 06-16-035, 388-106-0015, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, 388-106-0015, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 42 C.F.R. 441.302(a), Social Security Act, Section 1915(c) waiver rules, 42 C.F.R. 438. 05-19-045, 388-106-0015, filed 9/15/05, effective 10/16/05. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-106-0015, filed 5/17/05, effective 6/17/05.]


AMENDATORY SECTION(Amending WSR 07-24-026, filed 11/28/07, effective 1/1/08)

WAC 388-106-0070   Will I be assessed in CARE?   You will be assessed in CARE if you are applying for or receiving DDD services, COPES, MNIW, MNRW, MPC, chore, respite, adult day health, GAU-funded residential care, PACE, private duty nursing, New Freedom or long-term care services within the ((MMIP or)) WMIP program((s)).

If you are under the age of eighteen and within thirty calendar days of your next birthday, CARE determines your assessment age to be that of your next birthday.

[Statutory Authority: RCW 74.08.090, 74.09.520. 07-24-026, 388-106-0070, filed 11/28/07, effective 1/1/08; 07-10-024, 388-106-0070, filed 4/23/07, effective 6/1/07; 05-11-082, 388-106-0070, filed 5/17/05, effective 6/17/05.]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-106-0720 What services may I receive under MMIP?
WAC 388-106-0725 Am I eligible for MMIP services?
WAC 388-106-0730 How do I pay for MMIP services?
WAC 388-106-0735 How do I disenroll from MMIP?
WAC 388-106-0740 What is the fair hearing process for enrollee appeals of managed care organization actions?

Washington State Code Reviser's Office