WSR 10-02-072

PROPOSED RULES

HEALTH CARE AUTHORITY


(Community Health Services)

[ Order 09-04 -- Filed January 5, 2010, 8:01 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 09-23-113.

Title of Rule and Other Identifying Information: Community health service, administration, WAC 182-20-100 and eligibility, WAC 182-20-160. Amendments to include tribal governments.

Hearing Location(s): Health Care Authority, 676 Woodland Square Loop S.E., The Sue Crystal Center, Olympia, WA, on February 9, 2010, at 8:30 a.m.

Date of Intended Adoption: February 10, 2010.

Submit Written Comments to: Jan Ward Olmstead, Tribal Liaison, 676 Woodland Square Loop S.E., P.O. Box 42721, Olympia, WA 98504-2721, e-mail jan.olmstead@hca.wa.gov, fax (360) 923-2803, by February 9, 2010.

Assistance for Persons with Disabilities: Contact Nikki Johnson by February 1, 2010, TTY (888) 923-5622 or (360) 923-2805.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Amendment of the rules are needed to clarify the administration of the CHS grant program and to add tribal governments to the eligibility requirements.

Statutory Authority for Adoption: RCW 41.05.160, 41.05.220, and 41.05.230.

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

Name of Proponent: Washington state health care authority, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Jan Ward Olmstead, 676 Woodland Square Loop, Lacey, WA, (360) 923-2803.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The joint administrative rules review committee has not requested the filing of a small business economic impact statement, and there will be no costs to small businesses.

A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to the health care authority rules unless requested by the joint administrative rules [review] committee or applied voluntarily.

January 5, 2010

Jason Siems

Rules Coordinator

OTS-2907.2


AMENDATORY SECTION(Amending Order 00-06, filed 2/7/01, effective 3/10/01)

WAC 182-20-100   Administration.   The authority shall contract with community health clinics to provide primary health care in the state of Washington by:

(1) Developing criteria for the selection of community health clinics to receive funding;

(2) Establishing statewide standards governing the granting of awards and assistance to community health clinics;

(3) Disbursing funds appropriated for community health clinics only to those clinics meeting the criteria in WAC 182-20-160;

(4) Distributing available state funds to community health clinics ((according to the following priority in the order listed)), including:

(a) ((First, to)) Community health clinics that are private, nonprofit corporations classified exempt under Internal Revenue Service Rule 501 (c)(3) and governed by a board of directors including representatives from the populations served;

(b) ((Second, to)) Local health jurisdictions with an organized primary health clinic or division;

(c) ((Third, to)) Private nonprofit or public hospitals with an organized primary health clinic or department; and

(d) Tribal governments.

(5) Reviewing records and conducting on-site visits of contractors or applicants as necessary to assure compliance with these rules; and

(6) Withholding funding from a contractor or applicant until such time as satisfactory evidence of corrective action is received and approved by the authority, if the authority determines:

(a) Noncompliance with applicable state law or rule; or

(b) Noncompliance with the contract; or

(c) Failure to provide such records and data required by the authority to establish compliance with section 214(3), chapter 19, Laws of 1989 1st ex. sess., this chapter, and the contract; or

(d) The contractor or applicant provided inaccurate information in the application.

[Statutory Authority: RCW 41.05.160. 01-04-080 (Order 00-06), 182-20-100, filed 2/7/01, effective 3/10/01. Statutory Authority: RCW 43.70.040. 95-12-010, 182-20-100, filed 5/26/95, effective 6/26/95.]


AMENDATORY SECTION(Amending Order 00-06, filed 2/7/01, effective 3/10/01)

WAC 182-20-160   Eligibility.   Applicants shall:

(1) Demonstrate private, nonprofit, tax exempt status incorporated in Washington state or public agency status under the jurisdiction of a local or county government;

(2) Receive other funds from at least one of the following sources:

(a) Section 329 of the Public Health Services Act;

(b) Section 330 of the Public Health Services Act;

(c) Community development block grant funds;

(d) Title V Urban Indian Health Service funds; ((or))

(e) Tribal governments; or

(f) Other public or private funds providing the clinic demonstrates:

(i) Fifty-one percent of total clinic population are low income;

(ii) Fifty-one percent or greater of funds come from sources other than programs under WAC 182-20-160;

(3) Operate as a community health clinic providing primary health care for at least eighteen months prior to applying for funding;

(4) Provide primary health care services with:

(a) Twenty-four-hour coverage of the clinic including provision or arrangement for medical and/or dental services after clinic hours;

(b) Direct clinical services provided by one or more of the following:

(i) Physician licensed under chapters 18.57 and 18.71 RCW;

(ii) Physician's assistant licensed under chapters 18.71A and 18.57A RCW;

(iii) Advanced registered nurse practitioner under chapter 18.79 RCW;

(iv) Dentist under chapter 18.32 RCW;

(v) Dental hygienist under chapter 18.29 RCW;

(c) Provision or arrangement for services as follows:

(i) Preventive health services on-site or elsewhere including:

(A) Eye and ear examinations for children;

(B) Perinatal services;

(C) Well-child services; and

(D) Family planning services;

(ii) Diagnostic and treatment services of physicians and where feasible a physician's assistant and/or advanced registered nurse practitioner, on-site;

(iii) Services of a dental professional licensed under Title 18 RCW on-site or elsewhere;

(iv) Diagnostic laboratory and radiological services on-site or elsewhere;

(v) Emergency medical services on-site or elsewhere;

(vi) Arrangements for transportation services;

(vii) Preventive dental services on-site or elsewhere; and

(viii) Pharmaceutical services, as appropriate, on-site or elsewhere;

(5) Demonstrate eligibility to receive and receipt of reimbursement from:

(a) Public insurance programs; and

(b) Public assistant programs, where feasible and possible;

(6) Have established for at least eighteen months an operating sliding scale fee schedule for adjustment of charges, based upon the individual's ability to pay for low-income individuals;

(7) Provide health care regardless of the individual's ability to pay; and

(8) Establish policies and procedures reflecting sensitivity to cultural and linguistic differences of individuals served and provide sufficient staff with the ability to communicate with the individuals.

[Statutory Authority: RCW 41.05.160. 01-04-080 (Order 00-06), 182-20-160, filed 2/7/01, effective 3/10/01. Statutory Authority: RCW 43.70.040. 95-12-010, 182-20-160, filed 5/26/95, effective 6/26/95.]

Washington State Code Reviser's Office