WSR 11-17-133

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed August 24, 2011, 8:53 a.m. , effective August 25, 2011 ]


Effective Date of Rule: August 25, 2011.

Purpose: The department is amending WAC 388-106-0125 to reduce personal care hours in order to implement the 2011-2013 operating budget (2ESHB 1087). An average of ten percent acuity-based reduction is made to personal care service hours for adult clients receiving in-home personal care under Medicaid programs. The actual reduction will range between six and eighteen percent per client depending on acuity.

Citation of Existing Rules Affected by this Order: Amending WAC 388-106-0125.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.

Other Authority: Governor's Executive Order 10-04.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

Reasons for this Finding: The department held a CR-102 hearing under WSR 11-12-088 on July 5, 2011. This CR-103E continues emergency rules filed under WSR 11-10-035 while the department completes the process for permanent adoption. The initial public notice (CR-101) was filed January 18, 2011, under WSR 11-03-081. Additionally, in M.R. v. Dreyfus, the plaintiffs asked the United States District Court for a preliminary injunction that would prevent the department from implementing the reduction in the personal care hours. The United States District Court denied the plaintiff's request, but the plaintiffs appealed that decision to the Ninth Circuit Court of Appeals. The court has not issued a decision yet. The department is proceeding with the adoption of the rules to the extent possible.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.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 1, Repealed 0.

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 1, Repealed 0.

Date Adopted: August 18, 2011.

Katherine I. Vasquez

Rules Coordinator

4262.2
AMENDATORY SECTION(Amending WSR 10-11-050, filed 5/12/10, effective 6/12/10)

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 ((416)) 393 base hours if you have an ADL score of 26-28; or

(b) Group E Medium with ((346)) 327 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 ((277)) 260 base hours if you have an ADL score of 25-28; or

(b) Group D Medium-High with ((234)) 215 base hours if you have an ADL score of 18-24; or

(c) Group D Medium with ((185)) 168 base hours if you have an ADL score of 13-17; or

(d) Group D Low with ((138)) 120 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 ((194)) 176 base hours if you have an ADL score of 25-28; or

(b) Group C Medium-High with ((174)) 158 base hours if you have an ADL score of 18-24; or

(c) Group C Medium with ((132)) 115 base hours if you have an ADL score of 9-17; or

(d) Group C Low with ((87)) 73 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 ((147)) 129 base hours if you have an ADL score of 15-28; or

(b) Group B Medium with ((82)) 69 base hours if you have an ADL score of 5-14; or

(c) Group B Low with ((47)) 39 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 ((147)) 129 base hours if you have a behavior point score 12 or greater; or

(b) Group B Medium-High with ((101)) 84 base hours if you have a behavior point score greater than 6; or

(c) Group B Medium with ((82)) 69 base hours if you have a behavior point score greater than 4; or

(d) Group B Low with ((47)) 39 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 ((71)) 59 base hours if you have an ADL score of 10-28; or

(b) Group A Medium with ((56)) 47 base hours if you have an ADL score of 5-9; or

(c) Group A Low with ((26)) 22 base hours if you have an ADL score of 0-4.

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 564 206(5). 10-11-050, 388-106-0125, filed 5/12/10, effective 6/12/10. 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.]

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.

Washington State Code Reviser's Office