WSR 23-24-012
PERMANENT RULES
HEALTH CARE AUTHORITY
[Filed November 27, 2023, 2:56 p.m., effective December 28, 2023]
Effective Date of Rule: Thirty-one days after filing.
Purpose: This rule lowers the minimum eligibility age for community support services from age 18 to age 16.
Citation of Rules Affected by this Order: Amending WAC 182-559-300.
Adopted under notice filed as WSR 23-21-068 on October 12, 2023.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: November 27, 2023.
Wendy Barcus
Rules Coordinator
OTS-4866.1
AMENDATORY SECTION(Amending WSR 21-23-052, filed 11/10/21, effective 12/11/21)
WAC 182-559-300Eligibility for community support services.
To be eligible for community support services, a client must:
(1) Be age ((eighteen))16 or older;
(2) Be eligible for Washington apple health (medicaid);
(3) Meet at least one of the following health criteria and be expected to benefit from community support services:
(a) Clients assessed by a licensed behavioral health agency, under chapter 246-341 WAC, to have a behavioral health need, which is defined as one or both of the following criteria:
(i) Mental health needs, including a need for improvement, stabilization, or prevention of deterioration of functioning (including the ability to live independently without support) resulting from the presence of a mental illness; or
(ii) Substance use needs determined by an assessment using the American Society of Addiction Medicine (ASAM) criteria indicates that the client meets at least ASAM level 1.0, indicating the need for outpatient substance use disorder (SUD) treatment. The ASAM is a multi-dimensional assessment approach for determining a client's need for SUD treatment.
(b) Clients assessed via a CARE assessment, per WAC 388-106-0050, to have a need for assistance demonstrated by:
(i) The need for assistance with at least three activities of daily living (ADLs) defined in WAC 388-106-0010, one of which may be body care; or
(ii) The need for hands-on assistance with at least one ADL which may include body care.
(c) Clients assessed to be a homeless person with a disability, according to 24 C.F.R. 578.3, which is defined as a long continuing or indefinite physical condition requiring improvement, stabilization, or prevention of deterioration of functioning (including ability to live independently without support).
(4) Exhibit at least one of the following risk factors:
(a) Homeless clients who:
(i) Have been homeless for at least ((twelve))12 months; or
(ii) Have been homeless on at least four separate occasions in the last three years, as long as the combined occasions equal at least ((twelve))12 months.
Homeless is defined as living in a safe haven, an emergency shelter, or a place not meant for human habitation. See 24 C.F.R. 578.3.
(b) A history of frequent or lengthy institutional contact.
(i) Institutional care facilities include jails, substance use disorder or mental health treatment facilities, hospitals, or other similar facilities, as defined in 24 C.F.R. 578.3, or skilled nursing facilities as defined in WAC 388-97-0001.
(ii) Frequent means more than one contact in the past ((twelve))12 months.
(iii) Lengthy means ((ninety))90 or more consecutive days within an institutional setting in the past ((twelve))12 months.
(c) A history of frequent stays at adult residential care facilities as defined by WAC 388-110-020 or residential treatment facilities as defined by WAC 246-337-005. Frequent means more than one contact in the past ((twelve))12 months.
(d) Have frequent turnover of in-home caregivers as defined by WAC 388-106-0040, where within the last ((twelve))12 months the client utilized three or more different in-home caregiver providers and the current placement is not appropriate for the client.
(e) Have a predictive risk score of 1.5 or above. See WAC 182-557-0225.