WSR 23-13-087
PERMANENT RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Developmental Disabilities Administration)
[Filed June 16, 2023, 2:11 p.m., effective July 17, 2023]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The purpose of these rules is to regulate the emergency transitional support services provided at Rainier, a Washington state residential habilitation center. These permanent rules supersede emergency rules currently enacted on these sections under WSR 23-08-030.
Citation of Rules Affected by this Order: New WAC 388-829Z-005, 388-829Z-010, 388-829Z-015, 388-829Z-020, 388-829Z-025, 388-829Z-030, 388-829Z-035, 388-829Z-040, 388-829Z-045, 388-829Z-050, 388-829Z-055, 388-829Z-060, 388-829Z-065, 388-829Z-070, 388-829Z-075, 388-829Z-080, 388-829Z-085, and 388-829Z-090.
Statutory Authority for Adoption: RCW 71A.12.030.
Other Authority: Chapter 71A.20 RCW.
Adopted under notice filed as WSR 23-09-041 on April 14, 2023.
Changes Other than Editing from Proposed to Adopted Version: The developmental disabilities administration (DDA) added provider decertification as a reason for terminating a client's emergency transitional support services and also as a type of termination for which a client does not have an appeal right. DDA made these changes to clarify a client's hearing rights due to the provider being unqualified.
DDA corrected a cross-reference in WAC 388-829Z-070(1). This inaccuracy was a scrivener's error.
A final cost-benefit analysis is available by contacting Chantelle Diaz, P.O. Box 45310, Olympia, WA 98504-5310, fax 360-407-0955, TTY 1-800-833-6388, email Chantelle.Diaz@dshs.wa.gov.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 16, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 16, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 16, Amended 0, Repealed 0.
Date Adopted: June 16, 2023.
Lisa N. H. Yanagida
Chief of Staff
SHS-4953.8
Chapter 388-829Z WAC
EMERGENCY TRANSITIONAL SUPPORT SERVICES
NEW SECTION
WAC 388-829Z-005What definitions apply to this chapter?
The following definitions apply to this chapter.
"Client" means a person who has a developmental disability as defined in RCW 71A.10.020(5) and who DDA has determined eligible to receive services under chapter 71A.16 RCW. For purposes of notification, informed consent, and decision-making requirements, the term "client" includes the client's legal representative to the extent of the representative's legal authority.
"DDA" means the developmental disabilities administration, an administration of the department of social and health services, its employees, and authorized agents.
"Direct support professional" means a person who interacts directly with a client while the client receives emergency transitional support services.
"DSHS" or "the department" means the state of Washington department of social and health services, its employees, and authorized agents.
"Legal representative" means a person's legal guardian, limited guardian when the subject matter is within the scope of the limited guardianship, attorney-at-law, attorney-in-fact, or any other person who is authorized by law to act for another person.
"Provider" means the state-operated entity on the Rainier School campus providing emergency transitional support services.
"State of emergency" means an emergency proclaimed as such by the governor pursuant to RCW 43.06.010.
NEW SECTION
WAC 388-829Z-010What is the purpose of this chapter?
This chapter establishes rules for emergency transitional support services. These state-funded services, administered by DDA at Rainier School, were created in direct response to a state of emergency declared by the governor.
ELIGIBILITY
NEW SECTION
WAC 388-829Z-015Who may receive emergency transitional support services?
(1) To receive emergency transitional support services, a person must:
(a) Have been admitted to Rainier School to receive emergency transitional support services on or before March 31, 2023; or
(b) Meet the following criteria:
(i) The person is eligible for DDA services under chapter 388-823 WAC;
(ii) The person is age 18 or older; and
(iii) The person is:
(A) At risk of being hospitalized without medical need; or
(B) Hospitalized without medical need and there are no safe discharge options immediately available to the person.
(2) Emergency transitional support services are limited to specific legislative appropriations and program capacity.
PROVIDER QUALIFICATIONS
NEW SECTION
WAC 388-829Z-020What are the minimum requirements for direct support professionals providing emergency transitional support services?
To provide emergency transitional support services, a direct support professional must:
(1) Have a high school diploma or GED equivalent, unless hired before September 1, 1991;
(2) Be age 18 older;
(3) Have a current background check as required by WAC 388-829Z-025; and
(4) Successfully complete residential habilitation center new employee training, which includes at a minimum:
(a) Client rights;
(b) Mandatory reporting;
(c) Blood-borne pathogens;
(d) First aid and CPR;
(e) Crisis prevention and deescalation;
(f) Skills training for activities of daily living; and
(g) Person-centered thinking.
NEW SECTION
WAC 388-829Z-025Who must have a background check?
(1) A direct support professional, volunteer, and any other employee who may have unsupervised access to a DDA client must have a background check.
(2) Any person required to have a background check under this section must have a nondisqualifying background check result as required by DSHS.
NEW SECTION
WAC 388-829Z-030What will disqualify a direct support professional or a volunteer from working in a capacity that may involve access to DDA clients?
(1) Criminal convictions and pending charges that disqualify a direct support professional or a volunteer from working with DDA clients are listed in chapter 388-113 WAC.
(2) A volunteer or person employed by an emergency transitional support services provider who receives a DSHS background check with a disqualifying result is prohibited from any unsupervised access to DDA clients.
SERVICE DELIVERY
NEW SECTION
WAC 388-829Z-035What services and activities must be a part of emergency transitional support services?
The provider must provide the following services and activities at no cost to the client:
(1) A furnished home environment, including a private bedroom;
(2) Access to a safe outdoor area for recreation and leisure;
(3) Support accessing social and recreational opportunities in the community;
(4) Access to physical and behavioral health services prescribed by the client's treating professional;
(5) Three nutritious meals and two snacks per day;
(6) Bedding and towels;
(7) Access to laundry facilities; and
(8) Access to a telephone and a place to make private calls.
NEW SECTION
WAC 388-829Z-040What policies and procedures must the provider have?
(1) The provider must implement policies and procedures that address:
(a) Client rights, including a client's right to file a complaint or suggestion without interference;
(b) Reporting requirements for suspected abuse, neglect, financial exploitation, and abandonment;
(c) Client protections when there have been allegations of abuse, neglect, financial exploitation, or abandonment;
(d) Emergent situations that may pose a danger or risk to the client or others;
(e) Response to a missing person and other client emergencies;
(f) Emergency response plans for natural and other disasters;
(g) Client access to medical, mental health, and law enforcement resources;
(h) Notifications to client's primary caregiver, legal representative, or relatives in case of emergency;
(i) Client grievances, including timelines, possible remedies, and information about how to submit unresolved grievances to the department; and
(j) Aspects of medication management, including:
(i) Supervision of medication; and
(ii) Client refusal.
(2) The provider must train employees on its policies and procedures, maintain current written policies and procedures, and make them available upon request to all employees, clients, client legal representatives, and DDA.
NEW SECTION
WAC 388-829Z-045What requirements must be met before a provider transports a client?
Before transporting a client, a provider or direct support professional must have:
(1) Automobile insurance coverage under chapter 46.30 RCW; and
(2) A valid driver's license under chapter 46.20 RCW.
NEW SECTION
WAC 388-829Z-050How must the provider regulate the water temperature at Rainier School?
(1) The provider must regulate the water temperature at Rainier School as follows:
(a) Maintain the water temperature in the household between 105 degrees and 120 degrees Fahrenheit; and
(b) Check the water temperature at least once every six months.
(2) The provider must document compliance with these requirements.
NEW SECTION
WAC 388-829Z-055What records must the provider keep?
(1) For each client, the provider must keep the following information:
(a) The client's name and address;
(b) The name, address, and telephone number of the client's primary guardian or legal representative;
(c) A copy of the client's most recent person-centered service plan;
(d) Nurse delegation records, if applicable;
(e) Progress notes;
(f) Incident reports, if applicable;
(g) Medication documentation, including a medication intake form and medication administration records, if applicable;
(h) A list of the client's personal property upon arrival, acquisition of new property – other than consumables, and property at departure; and
(i) A record of money or gift cards managed by the provider on behalf of the client, if applicable.
(2) An emergency transitional support services provider must also keep the following:
(a) Water temperature monitoring records;
(b) Direct support professional training records; and
(c) Direct support professional time sheets specific to locations worked.
NEW SECTION
WAC 388-829Z-060How must a provider report suspected abuse and neglect?
A provider must immediately report suspected abandonment, abuse, financial exploitation, or neglect of vulnerable adults to:
(1) Adult protective services using the DSHS online reporting tool or by calling 1-877-734-6277 (TTY: 1-800-977-5456); and
(2) Law enforcement agencies as required under chapter 74.34 RCW, including when there is reason to suspect sexual or physical abuse.
TERMINATION
NEW SECTION
WAC 388-829Z-065When may DDA terminate a client's emergency transitional support services?
(1) DDA must terminate a client's emergency transitional support services if:
(a) Requested by the client; or
(b) The provider is decertified.
(2) DDA may terminate a client's emergency transitional support services if:
(a) DDA determines and documents that the client cannot be supported safely in the program's environment or poses a danger to other clients in the program; or
(b) The service is not funded by the legislature.
(3) DDA must provide 30 days' advance notice for termination of emergency transitional support services.
NEW SECTION
WAC 388-829Z-070What are a client's notice and appeal rights?
(1) A client has a right to appeal a termination under WAC 388-829Z-065 (2)(a).
(2) A client does not have a right to appeal termination of emergency transitional support services if the basis for termination is a lack of funding or provider decertification.
CERTIFICATION
NEW SECTION
WAC 388-829Z-075Must the provider of emergency transitional support services be certified?
(1) The provider of emergency transitional support services must be certified by DDA no more than 90 days after the first date of service delivery.
(2) DDA certifies the provider through a certification evaluation to monitor compliance with this chapter and other relevant DDA policies.
(3) DSHS-contracted evaluators conduct the certification evaluations.
(4) The provider must participate in a certification evaluation at least once every 12 months.
NEW SECTION
WAC 388-829Z-080What if the emergency transitional support services provider disagrees with a certification evaluation or certification decision?
If an emergency transitional support services provider disagrees with a certification evaluation or certification decision under this chapter, the provider may request an informal dispute resolution meeting with DDA by:
(1) Submitting a written request to DDA no more than 10 days after receiving the final certification letter and report; and
(2) Including a written statement that identifies the challenged action, describes the provider's concerns, and lists regulations and contract standards cited.
NEW SECTION
WAC 388-829Z-085What happens if the provider is found to be out of compliance?
(1) If DDA finds in its evaluation that the emergency transitional support services provider is out of compliance with any part of this chapter, the provider and DDA must develop a plan of correction.
(2) The plan of correction must:
(a) Outline methods for the provider to comply with the required corrections; and
(b) Provide a time frame for the provider to complete the corrective actions.
NEW SECTION
WAC 388-829Z-090When may DDA stop admission authorization for emergency transitional support services?
DDA may stop admission authorization for emergency transitional support services if:
(1) The provider demonstrates inadequate performance or inability to deliver quality care that jeopardizes the client's health, safety, or well-being;
(2) The provider does not complete the corrective actions within the agreed upon time frame;
(3) The provider fails to comply with the requirements of this chapter; or
(4) DDA has substantial evidence that a client's health, safety, or well-being is at risk.