WSR 10-06-114

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed March 3, 2010, 9:10 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 09-14-042.

Title of Rule and Other Identifying Information: Chapter 388-106 WAC, Long-term care services.

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on April 6, 2010, at 10:00 a.m.

Date of Intended Adoption: Not earlier than April 7, 2010.

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 April 6, 2010.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by March 23, 2010, at TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Amending WAC 388-106-0125 If I am age twenty-one or older, how does CARE use criteria to place me in a classification group for in-home care? and adopting new WAC 388-106-0126 If I am under age twenty-one, how does CARE use criteria to place me in a classification group for in-home care?

The department is revising WAC 388-106-0125 to amend the in-home classifications to allow for the reduction of in-home base hours for each of the seventeen classification groups, as directed by the Washington state 2009-11 budget (ESHB 1244, section 206(5)). As instructed by the legislature, classification groups with greater care needs receive a smaller percentage reduction than classification groups with lesser care needs.

The department is adopting new WAC to maintain base hours for children and youth under the age of twenty-one from the rules.

Reasons Supporting Proposal: See above.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, Washington state 2009-11 budget (ESHB 1244, section 206(5)).

Statute Being Implemented: RCW 74.08.090, 74.09.520, Washington state 2009-11 budget (ESHB 1244, section 206(5)).

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, Implementation and Enforcement: Bea Rector, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2527.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The preparation of a small business economic impact statement is not required, as no new costs will be imposed on small businesses or nonprofits.

A cost-benefit analysis is not required under RCW 34.05.328. Rules are exempt, per RCW 34.05.328 (5)(b)(vii), relating only to client medical or financial eligibility.

February 24, 2010

Don Goldsby, Manager

Rules and Policies Assistance Unit

4113.4
AMENDATORY SECTION(Amending WSR 08-10-022, filed 4/25/08, effective 5/26/08)

WAC 388-106-0125   If I am age twenty-one or older, how does CARE use criteria to place me in a classification group for in-home care?   CARE uses the criteria of cognitive performance score as determined under WAC 388-106-0090, clinical complexity as determined under WAC 388-106-0095, mood/behavior and behavior point score as determined under WAC 388-106-0100, ADLS as determined under WAC 388-106-0105, and exceptional care as determined under WAC 388-106-0110 to place you into one of the following seventeen in-home groups. CARE classification is determined first by meeting criteria to be placed into a group, then you are further classified based on ADL score or behavior point score into a classification sub-group following a classification path of highest possible base hours to lowest qualifying base hours.

(1) If you meet the criteria for exceptional care, then CARE will place you in Group E. CARE then further classifies you into:

(a) Group E High with ((420)) 416 base hours if you have an ADL score of 26-28; or

(b) Group E Medium with ((350)) 346 base hours if you have an ADL score of 22-25.

(2) If you meet the criteria for clinical complexity and have cognitive performance score of 4-6 or you have cognitive performance score of 5-6, then you are classified in Group D regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group D High with ((280)) 277 base hours if you have an ADL score of 25-28; or

(b) Group D Medium-High with ((240)) 234 base hours if you have an ADL score of 18-24; or

(c) Group D Medium with ((190)) 185 base hours if you have an ADL score of 13-17; or

(d) Group D Low with ((145)) 138 base hours if you have an ADL score of 2-12.

(3) If you meet the criteria for clinical complexity and have a CPS score of less than 4, then you are classified in Group C regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group C High with ((200)) 194 base hours if you have an ADL score of 25-28; or

(b) Group C Medium-High with ((180)) 174 base hours if you have an ADL score of 18-24; or

(c) Group C Medium with ((140)) 132 base hours if you have an ADL score of 9-17; or

(d) Group C Low with ((95)) 87 base hours if you have an ADL score of 2-8.

(4) If you meet the criteria for mood and behavior qualification and do not meet the classification for C, D, or E groups, then you are classified into Group B. CARE further classifies you into:

(a) Group B High with ((155)) 147 base hours if you have an ADL score of 15-28; or

(b) Group B Medium with ((90)) 82 base hours if you have an ADL score of 5-14; or

(c) Group B Low with ((52)) 47 base hours if you have an ADL score of 0-4; or

(5) If you meet the criteria for behavior points and have a CPS score of greater than 2 and your ADL score is greater than 1, and do not meet the classification for C, D, or E groups, then you are classified in Group B. CARE further classifies you into:

(a) Group B High with ((155)) 147 base hours if you have a behavior point score 12 or greater; or

(b) Group B Medium-High with ((110)) 101 base hours if you have a behavior point score greater than 6; or

(c) Group B Medium with ((90)) 82 base hours if you have a behavior point score greater than 4; or

(d) Group B Low with ((52)) 47 base hours if you have a behavior point score greater than 1.

(6) If you are not clinically complex and your CPS score is less than 5 and you do not qualify under either mood and behavior criteria, then you are classified in Group A. CARE further classifies you into:

(a) Group A High with ((78)) 71 base hours if you have an ADL score of 10-28; or

(b) Group A Medium with ((62)) 56 base hours if you have an ADL score of 5-9; or

(c) Group A Low with ((29)) 26 base hours if you have an ADL score of 0-4.

[Statutory Authority: RCW 74.08.090, 74.09.520, and 2007 c 522. 08-10-022, 388-106-0125, filed 4/25/08, effective 5/26/08. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-106-0125, filed 5/17/05, effective 6/17/05.]


NEW SECTION
WAC 388-106-0126   If I am under age twenty-one, how does CARE use criteria to place me in a classification group for in-home care?   CARE uses the criteria of cognitive performance score as determined under WAC 388-106-0090, clinical complexity as determined under WAC 388-106-0095, mood/behavior and behavior point score as determined under WAC 388-106-0100, ADLS as determined under WAC 388-106-0105, and exceptional care as determined under WAC 388-106-0110 to place you into one of the following seventeen in-home groups. CARE classification is determined first by meeting criteria to be placed into a group, then you are further classified based on ADL score or behavior point score into a classification sub-group following a classification path of highest possible base hours to lowest qualifying base hours.

(1) If you meet the criteria for exceptional care, then CARE will place you in Group E. CARE then further classifies you into:

(a) Group E High with 420 base hours if you have an ADL score of 26-28; or

(b) Group E Medium with 350 base hours if you have an ADL score of 22-25.

(2) If you meet the criteria for clinical complexity and have cognitive performance score of 4-6 or you have cognitive performance score of 5-6, then you are classified in Group D regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group D High with 280 base hours if you have an ADL score of 25-28; or

(b) Group D Medium-High with 240 base hours if you have an ADL score of 18-24; or

(c) Group D Medium with 190 base hours if you have an ADL score of 13-17; or

(d) Group D Low with 145 base hours if you have an ADL score of 2-12.

(3) If you meet the criteria for clinical complexity and have a CPS score of less than 4, then you are classified in Group C regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group C High with 200 base hours if you have an ADL score of 25-28; or

(b) Group C Medium-High with 180 base hours if you have an ADL score of 18-24; or

(c) Group C Medium with 140 base hours if you have an ADL score of 9-17; or

(d) Group C Low with 95 base hours if you have an ADL score of 2-8.

(4) If you meet the criteria for mood and behavior qualification and do not meet the classification for C, D, or E groups, then you are classified into Group B. CARE further classifies you into:

(a) Group B High with 155 base hours if you have an ADL score of 15-28; or

(b) Group B Medium with 90 base hours if you have an ADL score of 5-14; or

(c) Group B Low with 52 base hours if you have an ADL score of 0-4; or

(5) If you meet the criteria for behavior points and have a CPS score of greater than 2 and your ADL score is greater than 1, and do not meet the classification for C, D, or E groups, then you are classified in Group B. CARE further classifies you into:

(a) Group B High with 155 base hours if you have a behavior point score 12 or greater; or

(b) Group B Medium-High with 110 base hours if you have a behavior point score greater than 6; or

(c) Group B Medium with 90 base hours if you have a behavior point score greater than 4; or

(d) Group B Low with 52 base hours if you have a behavior point score greater than 1.

(6) If you are not clinically complex and your CPS score is less than 5 and you do not qualify under either mood and behavior criteria, then you are classified in Group A. CARE further classifies you into:

(a) Group A High with 78 base hours if you have an ADL score of 10-28; or

(b) Group A Medium with 62 base hours if you have an ADL score of 5-9; or

(c) Group A Low with 29 base hours if you have an ADL score of 0-4.

[]

Washington State Code Reviser's Office