SOCIAL AND HEALTH SERVICES

(Developmental Disabilities Administration)

[Filed July 3, 2019, 8:49 a.m., effective August 3, 2019]

Effective Date of Rule: Thirty-one days after filing.

Purpose: These amendments increase the amount of time an assessment may be used as evidence of developmental delay, clarifies for internal developmental disabilities administration (DDA) eligibility workers when an eligibility review is required for clients who are nineteen years old, and clarifies the definition of a DDA-paid service.

Citation of Rules Affected by this Order: Amending WAC 388-823-0770, 388-823-1010, and 388-823-1015.

Statutory Authority for Adoption: RCW 71A.12.030.

Adopted under notice filed as WSR 19-11-081 on May 17, 2019.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 3, Repealed 0.

Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 3, Repealed 0.

Date Adopted: July 2, 2019.

Katherine I. Vasquez

AMENDATORY SECTION(Amending WSR 14-12-046, filed 5/29/14, effective 7/1/14)

WAC 388-823-0770What evidence do I need of developmental delays?

(1) Evidence of substantial functional limitations requires developmental delays of at least 1.5 standard deviations or twenty-five percent or more of the chronological age in one or more of the following developmental areas based on an assessment current within the past ((12))eighteen months:

(a) Physical skills (fine or gross motor);

(b) Self help/adaptive skills;

(d) Social/emotional skills; and

(e) Cognitive, academic, or problem solving skills.

(2) The number of areas in which you are required to have delays to meet the evidence is specific to your age.

(3) Tools used to determine developmental delays must be diagnostic assessments that are designed to measure the developmental areas in subsection (1) of this section and are appropriate to the age of the child being tested.

(4) The assessment must be administered by one of the following professionals qualified to administer the assessment of developmental areas:

(a) Licensed physician;

(b) Licensed psychologist or certified school psychologist;

(d) Audiologist;

(e) Registered occupational therapist;

(f) Licensed physical therapist;

(g) Registered nurse;

(h) Certified teacher;

(i) Masters level social worker; or

(j) Orientation and mobility specialist.

AMENDATORY SECTION(Amending WSR 18-15-046, filed 7/13/18, effective 8/13/18)

WAC 388-823-1010When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA?

(1) DDA will review your eligibility:

(a) If you are age nineteen and ((you have not received an))your most recent eligibility determination ((since on or))was completed before your sixteenth birthday;

(b) If you are age nineteen and were determined eligible under another neurological or other condition similar to intellectual disability and have used academic delays as evidence of your substantial functional limitations;

(c) Before authorization of any DDA-paid service if you are not currently receiving paid services and your most current eligibility determination was made before June 1, 2005;

(d) If the evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;

(e) If new information becomes available that does not support your current eligibility determination; or

(f) If you were determined eligible due solely to your eligibility for fee-for-service (FFS) medically intensive children's program (MICP) services and you are no longer eligible for FFS MICP services.

(2) If DDA requires additional information to make a determination of eligibility during a review and you do not provide sufficient information, DDA will terminate your eligibility:

(a) On your twentieth birthday if the review is because you are age nineteen; or

(b) Ninety days after DDA requests the information if the review is because:

(i) You have requested a paid service;

(ii) The evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;

(iii) New information is available that does not support your current eligibility determination; or

(iv) You are no longer eligible for FFS MICP services under chapter 182-551 WAC.

AMENDATORY SECTION(Amending WSR 14-12-046, filed 5/29/14, effective 7/1/14)

WAC 388-823-1015What is the definition of "DDA-paid services" in WAC ((388-823-1010(2)))388-823-1010?

"DDA-paid services" means a service or program administered by DDA as evidenced by:

(1) A DDA social services authorization ((of a paid service)) within the last ninety days ((as evidenced by a social services authorization)) in ((the))a DSHS payment system((,));

(2) A county authorization ((for day program services,));

(3) A DDA ((individual)) service plan approving a DDA service or program((,));

(4) Residence in a ((SOLA, RHC, or ICF/ID,))residential habilitation center; or

(5) Documentation of DDA approval of your absence from DDA paid services for more than ninety days with available funding for your planned return to services.