WSR 21-07-112
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed March 23, 2021, 8:28 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 21-01-199.
Title of Rule and Other Identifying Information: WAC 182-513-1620 Tailored supports for older adults (TSOA)—Presumptive eligibility (PE).
Hearing Location(s): On April 27, 2021, at 10:00 a.m. In response to the coronavirus disease 2019 (COVID-19) public health emergency, the agency will not provide a physical location for this hearing. This promotes social distancing and the safety of the citizens of Washington state. A virtual public hearing, without a physical meeting space, will be held instead. To attend the virtual public hearing, you must register at the following link https://attendee.gotowebinar.com/register/181514389970288398, Webinar ID 554-761-747. After registering, you will receive a confirmation email containing the information about joining the webinar.
Date of Intended Adoption: Not sooner than April 28, 2021.
Submit Written Comments to: Health Care Authority (HCA) Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, by April 27, 2021.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication[s] relay service 711, email amber.lougheed@hca.wa.gov, by April 9, 2021.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is revising this section to mirror language in WAC 388-106-1910 to alleviate confusion caused by the discrepancies in the language between the two sections.
Reasons Supporting Proposal: See purpose.
Rule is not necessitated by federal law, federal or state court decision.
Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: Not applicable.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Jason Crabbe, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-9563; Implementation and Enforcement: Mark Westenhaver, P.O. Box 45534, Olympia, WA 98504-5534, 360-725-1324.
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. RCW
34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The proposed rule pertains to client program eligibility and does not impose any costs on businesses.
March 23, 2021
Wendy Barcus
Rules Coordinator
OTS-2940.1
AMENDATORY SECTION(Amending WSR 19-11-123, filed 5/22/19, effective 6/22/19)
WAC 182-513-1620Tailored supports for older adults (TSOA)—Presumptive eligibility (PE).
(1) A person may be determined presumptively eligible for tailored supports for older adults (TSOA) services upon completion of a prescreening interview.
(2) The prescreening interview may be conducted by either:
(a) The area agency on aging (AAA); or
(b) A home and community services intake case manager or social worker.
(3) To receive services under presumptive eligibility (PE), the person must meet:
(a) Nursing facility level of care under WAC 388-106-0355;
(b) TSOA income limits under WAC 182-513-1635; and
(c) TSOA resource limits under WAC 182-513-1640.
(4) The PE period begins on the date the determination is made and:
(a) Ends on the last day of the month following the month of the PE determination if a full TSOA application is not completed and submitted by that date; or
(b) Continues through the date the final TSOA eligibility determination is made if a full TSOA application is submitted before the last day of the month following the month of the PE determination.
(5) If the person applies and is not determined financially eligible for TSOA, there is no overpayment or liability on the part of the applicant for services received during the PE period.
(6) The medicaid agency or the agency's designee sends written notice as described in WAC 182-518-0010 when PE for TSOA is approved or denied.
(7) A person may receive ((only one PE period))services under presumptive eligibility only once within a ((consecutive)) twenty-four-month period.
(8) If the department of social and health services establishes a waitlist for TSOA services under WAC 388-106-1975, then PE does not apply.