WSR 22-21-088
EMERGENCY RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Aging and Long-Term Support Administration)
[Filed October 14, 2022, 12:48 p.m., effective October 20, 2022]
Effective Date of Rule: October 20, 2022.
Purpose: The department is extending the amendment of the rules listed below. Because of the ongoing COVID-19 public health emergency, on January 18, 2022, home and community services (HCS) temporarily suspended conducting ongoing assessments for HCS clients living in adult family homes, assisted living facilities, and enhanced services facilities. This suspension allows HCS staff to focus on conducting assessments for patients staying in hospitals to facilitate their discharge to long-term care facilities and improve the current surge capacity in hospitals. This emergency rule suspends the regulatory requirement for these facilities to complete assessments for HCS clients while the HCS assessors are not available. The Centers for Medicare and Medicaid Services (CMS) approved this flexibility for medicaid beneficiaries needing specific long-term care services and supports whose assessments meet the requirements under 42 C.F.R. 441.720. The department filed a CR-101 under WSR 22-13-121 to begin the permanent rule-making process.
Citation of Rules Affected by this Order: Amending WAC 388-76-10350, 388-78A-2100, and 388-107-0080.
Statutory Authority for Adoption: RCW 18.20.090, 70.97.230, and 70.128.040(1).
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.
Reasons for this Finding: This emergency rule was put in place at a time when many hospitals in this state were at or over capacity, leading them to redirect patients who were in need of emergency care and delay procedures that were necessary but nonemergent. This put the health of all residents of Washington at risk if they were not able to get the care they needed at their local hospital. By temporarily suspending assessment requirements for residents living in adult family homes, assisted living facilities, and enhanced services facilities, HCS was able to focus personnel resources on assessing patients in hospitals, which facilitated admissions to long-term care facilities and increased the bed availability in hospitals. HCS is continuing to use the extended timelines in this rule to address hospital capacity surges as they arise and to focus on significant change assessments.
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 3, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, 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: October 14, 2022.
Katherine I. Vasquez
Rules Coordinator
SHS-4914.2
AMENDATORY SECTION(Amending WSR 07-21-080, filed 10/16/07, effective 1/1/08)
WAC 388-76-10350Assessment—Updates required.
The adult family home must ensure each resident's assessment is reviewed and updated to document the resident's ongoing needs and preferences as follows:
(1) When there is a significant change in the resident's physical or mental condition;
(2) When the resident's negotiated care plan no longer reflects the resident's current status, needs, and preferences;
(3) At the resident's request or at the request of the resident's representative; or
(4) At least every ((twelve))12 months, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency.
AMENDATORY SECTION(Amending WSR 13-13-063, filed 6/18/13, effective 7/19/13)
WAC 388-78A-2100On-going assessments.
The assisted living facility must:
(1) Complete a full assessment addressing the elements set forth in WAC 388-78A-2090 for each resident at least annually, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency;
(2) Complete an assessment specifically focused on a resident's identified problems and related issues:
(a) Consistent with the resident's change of condition as specified in WAC 388-78A-2120;
(b) When the resident's negotiated service agreement no longer addresses the resident's current needs and preferences;
(c) When the resident has an injury requiring the intervention of a practitioner.
(3) Ensure the staff person performing the on-going assessments is qualified to perform them.
AMENDATORY SECTION(Amending WSR 16-14-078, filed 7/1/16, effective 8/1/16)
WAC 388-107-0080Ongoing comprehensive assessments.
The enhanced services facility must:
(1) Complete a comprehensive assessment, addressing the elements set forth in WAC 388-107-0070((,))on the following timelines:
(a) Upon a significant change in the resident's condition; or
(b)((or))At least every 180 days if there is no significant change in condition, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency.
(2) Complete an assessment specifically focused on a resident's identified strengths, preferences, limitations, and related issues:
(a) Consistent with the resident's change of condition as specified in WAC 388-107-0060;
(b) When the resident's person-centered service plan no longer addresses the resident's current needs and preferences; and
(c) When the resident has an injury requiring the intervention of a practitioner((;)).
(3) Review each resident's needs to evaluate discharge or transfer options when the resident:
(a) No longer needs the level of behavioral support provided by the facility; or
(b) Expresses the desire to move to a different type of community based setting((;)).
(4) Ensure that the person-centered service planning team discusses all available placement options; and
(5) Ensure the staff person performing the ongoing assessments is a qualified assessor.