SOCIAL AND HEALTH SERVICES

(Aging and Long-Term Support Administration)

[Filed February 19, 2019, 12:32 p.m.]

Preproposal statement of inquiry was filed as WSR 18-20-106.

Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-106-1920 What is the maximum amount of step three services I may receive a month? and 388-106-1933 How is the GetCare screening scored to determine if I am eligible for a GetCare assessment and related step three services?

Hearing Location(s): On March 26, 2019, at 10:00 a.m., at Office Building 2, Department of Social and Health Services (DSHS) Headquarters, 1115 Washington, Olympia, WA 98504. Public parking at 11th and Jefferson. A map is available at https://www.dshs.wa.gov/sesa/rules-and-policies-assistance-unit/driving-directions-office-bldg-2.

Date of Intended Adoption: Not earlier than March 27, 2019.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, email DSHSRPAURulesCoordinator@dshs.wa.gov, fax 360-664-6185, by 5:00 p.m., March 26, 2019.

Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, phone 360-664-6092, fax 360-664-6185, TTY 711 relay service, email Kildaja@dshs.wa.gov, by March 12, 2019.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is amending WAC 388-106-1920 to increase the step three benefit level for medicaid alternative care (MAC) and tailored supports for older adults (TSOA) participants. This benefit level is tied to the home care agency rate that typically increases every six months. The department recently received notice of the new rate for home care agencies effective January 1, 2019.

The department is also amending WAC 388-106-1933 to describe modifications to the GetCare screening tool questions and risk level scores. A statewide area agencies on aging and home and community services division workgroup made revisions to the tool and the related risk scores in order to track and trend outcomes for program recipients enrolled in this five year demonstration waiver.

Reasons Supporting Proposal: See purpose statement above.

Statutory Authority for Adoption: RCW 74.39A.030, 74.08.090.

Statute Being Implemented: RCW 74.39A.030.

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

Name of Proponent: DSHS, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Debbie Johnson, P.O. Box 45600, Olympia, WA 98504-5600, 360-725-2531.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is not required under RCW 34.05.328. Rules are exempt per RCW 34.05.328 (5)(b)(vii).

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(3).

Is exempt under RCW 34.05.328 (5)(b)(vii).

Katherine I. Vasquez

AMENDATORY SECTION(Amending WSR 18-20-001, filed 9/19/18, effective 10/20/18)

WAC 388-106-1920What is the maximum amount of step three services I may receive a month?

(1) Unless the department authorizes additional funds through an exception to rule under WAC 388-440-0001, beginning January 1, 2019, the maximum amount of step three services you and your caregiver may receive in MAC and TSOA will be published on the ALTSA/HCS rates website found on the MAC and TSOA tab at:

(((a) From January 1, 2018 through June 30, 2018 is an average of five hundred fifty-eight dollars per month not to exceed three thousand three hundred forty-eight dollars in a six month period.

(b) Beginning July 1, 2018 is an average of five hundred seventy-three dollars per month not to exceed three thousand four hundred thirty-eight dollars in a six month period))https://www.dshs.wa.gov/sites/default/files/ALTSA/msd/documents/All_HCS_Rates.xls.

(2) If you are a care receiver who does not have an available unpaid caregiver, you are receiving TSOA personal assistance services, and the department has not authorized additional funds through an exception to rule under WAC 388-440-0001, beginning January 1, 2019, the maximum amount of step three services you may receive will be published on the ALTSA/HCS rates website found on the MAC and TSOA tab at:

(((a) From January 1, 2018 through June 30, 2018 is five hundred fifty-eight dollars per month.

(b) Beginning July 1, 2018 is five hundred seventy-three dollars per month))https://www.dshs.wa.gov/sites/default/files/ALTSA/msd/documents/All_HCS_Rates.xls.

AMENDATORY SECTION(Amending WSR 18-08-033, filed 3/27/18, effective 4/27/18)

WAC 388-106-1933How is the GetCare screening scored to determine if I am eligible for a GetCare assessment and related step three services?

(1) ((For TSOA individuals who do not have an unpaid caregiver to support and are seeking step three TSOA services, the))To be eligible for a GetCare assessment, care plan, and associated step three services as described in WAC 388-106-1915 (3)(b)(ii), a TSOA individual without a caregiver ((screening)) must ((result in a risk score of moderate or high to be eligible for a GetCare assessment, care plan, and associated step three services as described in WAC 388-106-1915 (3)(b)(ii).

(2) There are eight TSOA individual without a caregiver screening questions. The following table indicates the risk score allocated to each potential response to the eight))have a moderate or high risk score resulting from the thirteen screening questions listed in the following table:

No.	Question	Scoring
No.	Question	Response	Score	Response	Score	Response	Score	Response	Score
1	Do you need help to do the following? Bathing Bed mobility Medication management Transferring Ambulating Eating Toileting Dressing Personal hygiene	Zero to two selected	Zero	Three or more selected	Two
2	((During the last six months, have you had a fall that caused injuries))Do you need help turning and repositioning?	No	Zero	Yes	Two
3	((Do you have a family member/friend to give you help when you need it))Who helps you with daily activities?	No one	((Zero))One	((Yes))Family/friend/other/paid help	((Two))Zero
4	((Have you thought about moving to other housing))During the last six months, have you had a fall that caused injuries?	No	Zero	Yes	Two
5	((Do you live alone))Have you had a hospitalization, or been admitted to a nursing facility, or both, in the past six months?	No	Zero	Yes	Two
6	((Do you or your family have concerns about your memory, thinking, ability to make decisions, or remembering to pay your bills))Have you received rehabilitation in the past six months?	No	Zero	Yes((, somewhat concerned))	((One))Two	((Yes, very concerned))	((Two))
7	((Do you need help turning and repositioning))Have you been treated in an emergency room, called 911 in the past six months, or both?	No	Zero	Yes, one to two times	((Two))One	Yes, three or more times	Two
8	((Do you or your family have concerns about your mental or emotional well-being))Do you live alone?	No	Zero	Yes((, somewhat concerned))	((One))Two	((Yes, very concerned))	((Two))
	If yes, do you feel safe living alone?	No	One	Yes	Zero
9	Do you plan on moving to other housing in the near future?	No	Zero	Yes	Two
10	Do you or your family have concerns about your memory, thinking, ability to make decisions, or remembering to pay your bills?	No, not concerned	Zero	Yes, somewhat concerned	One	Yes, very concerned	Two
11	Are you content with your social life?	No	Two	Somewhat	One	Yes	Zero
12	Over the last two weeks, have you been bothered by, or have little interest in doing things?	Not at all	Zero	Several days	One	More than half the days	Two	Nearly every day	Three
13	Over the last two weeks, have you been bothered by feeling down, depressed, or hopeless?	Not at all	Zero	Several days	One	More than half the days	Two	Nearly every day	Three

(((3)))(2) The risk level is calculated by totaling the ((eight point scores))points assigned to each question as determined by responses to the screening questions in subsection (((2)))(1) of this section ((to determine))and matching the total points to the risk level in the following ((risk categories))table:

Risk level	Point totals
No risk	0
Low risk	1-((5))8
Moderate risk	((6-10))9-16
High risk	((11-16))17 and up