WSR 16-13-107

[Filed June 20, 2016, 10:02 a.m.]

Title or Subject: Medicaid State Plan Amendment (SPA) 16-0024.

Effective Date: August 1, 2016.

Description: The health care authority (the agency) in conjunction with the aging and long-term services administration (ALTSA) within the department of social and health services (DSHS) intend to submit medicaid SPA 16-0024 regarding intermediate care facilities for individuals with developmental disabilities (ICF/IID).

Facilities must meet the conditions of participation described in Title 42 C.F.R. 442 in order to be certified as an ICF/IID. ICFs/IID that do not meet the applicable conditions of participation are subject to termination or nonrenewal of their provider contract. Under 42 C.F.R. 442.118, the state medicaid agency may deny payment for new admissions as an alternate remedy.

SPA 16-0022 will establish alternative sanctions for ICF/IID that have deficiencies in meeting the applicable conditions of participation, but those deficiencies do not pose immediate jeopardy to residents' health and safety. The alternative will sanctions [will] include:

1. Directed plan of correction.

2. Directed in-service training.

3. State monitoring.

SPA 16-0022 is anticipated to have no effect on annual aggregate expenditures; the alternative sanctions do not include financial penalties.

The SPA is in the development process; therefore a copy is not yet available for review. To contact DSHS for additional information and a copy of the SPA when it becomes available, please contact Loida Baniqued, ALTSA Residential Care Services, 4500 10th Avenue S.E., Olympia, WA 98504, phone (360) 725-2405, TDD/TTY 1-800-833-6388, fax 800-725-8208, e-mail baniqlc@dshs.wa.gov.