WSR 97-15-083

PREPROPOSAL STATEMENT OF INQUIRY

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

[Filed July 17, 1997, 10:45 a.m.]

Subject of Possible Rule Making: Adjusting functional eligibility standards or service levels for the chore, COPES, and Medicaid personal care services programs.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.09.520, 74.09.530, 74.39A.110, 74.39A.120, and 74.39A.030.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The 1997-99 operating budget (SSB 6062, section 207(3)) authorized the department to adjust functional eligibility standards or service levels sufficiently to maintain expenditures within appropriated levels for chore, COPES, and Medicaid personal care services.

The 1997-99 budget provided funding for a caseload growth level of 157 clients per year for fiscal year 1998 and 237 clients per year for fiscal year 1999 for home and community programs. Home and community caseloads have grown by an average of 220 cases per month in fiscal year 1997. The department does not anticipate a sudden decrease in caseloads to the fiscal year 1998 funded level of 157 beginning July 1997.

The 1997-99 budget allows the department to offset projected over-expenditures for chore, COPES, and Medicaid personal care with under-expenditures resulting from lower than budgeted nursing home caseloads. However, the nursing home caseload growth is currently growing at higher than budgeted levels. As a result, the department is required to adjust functional eligibility standards or service levels for chore, COPES, and Medicaid personal care programs to stay within appropriated levels.

The department will be meeting with clients, advocates and provider groups for suggested amendments to eligibility requirements.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Health Care Financing Administration. The Department of Social and Health Services will notify the Health Care Financing Administration of required amendments to the state Medicaid plan or home and community-based waiver (i.e. COPES) regarding eligibility or service levels.

Aging and adult services will be coordinating this proposal on behalf of the department and will coordinate with the Medical Assistance Administration, Health and Rehabilitation Administration, and other affected administrations.

Process for Developing New Rule: Interested parties may submit verbal or written comments, concerns, and recommendations to AASA at any time prior to filing the notice of proposed rule making. Public meetings will be widely publicized in advance in order to promote maximum attendance and participation in the rule development process by interested parties. Interested parties (see attached proposed mailing list of interested parties) [no information was supplied by agency] will be invited to attend informal meetings, and/or provide oral or written suggestions to the department. At the time the notice of proposed rule making is filed, interested parties will be notified of the scheduled hearing to adopt rules and how to submit comments.

July 15, 1997

Merry A. Kogut, Manager