WSR 00-10-033

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)

[ Filed April 24, 2000, 3:30 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 99-11-083.

Title of Rule: WAC 388-71-0430 Am I eligible for one of the HCP programs? and WAC 388-71-0435 Am I eligible for COPES-funded services?

Purpose: WAC 388-71-0435 is being adopted so that COPES eligibility requirements are identical to that of nursing facility care as required by federal regulations (42 C.F.R. 441.302(c)). WAC 388-71-0430 is being amended to update a WAC reference and to add general Medicaid-eligibility requirements.

Statutory Authority for Adoption: RCW 74.39A.030.

Statute Being Implemented: RCW 74.39A.030.

Summary: The rule will meet federal regulations, which require that individuals receiving COPES also be in need of the level of care provided in a nursing facility. The rule will meet clear rule-writing standards, per Governor's Executive Order 97-02.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Brooke Buckingham, P.O. Box 45600, Olympia, WA 98504, (360) 493-2544.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: This rule clarifies the general eligibility requirements for HCP services. It also clarifies the eligibility criteria for COPES so that it is consistent with nursing facility care eligibility. The department does not anticipate that the change in rule will have an impact on caseload.

Proposal Changes the Following Existing Rules: The proposal establishes a new rule under chapter 388-71 WAC, repeals WAC 388-15-610 COPES -- Eligibility and amends WAC 388-71-0430 Am I eligible for one of the HCP programs?

No small business economic impact statement has been prepared under chapter 19.85 RCW. A small business economic impact statement is not required because the rule does not impact small businesses.

RCW 34.05.328 does not apply to this rule adoption. Rules do meet the definition of "significant legislative rule," but the department is exempt from preparing a cost benefit analysis under RCW 34.05.328 (5)(b)(vii).

Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on June 6, 2000, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact DSHS Rules Coordinator by May 26, 2000, phone (360) 664-6094, TTY (360) 664-6178, e-mail myercme@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by June 6, 2000.

Date of Intended Adoption: June 13, 2000.

April 19, 2000

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

2735.1
AMENDATORY SECTION(Amending WSR 00-04-056, filed 1/28/00, effective 2/28/00)

WAC 388-71-0430
Am I eligible for one of the HCP programs?

You are eligible to receive HCP services if you meet the functional and financial eligibility requirements in WAC ((388-15-610)) 388-71-0435 for COPES, WAC 388-71-0440 for MPC, or WAC 388-71-0445 for Chore. You must also meet general eligibility requirements. This means you must reside in Washington state, be a U.S. citizen or have certain immigrant status, have a Social Security Number, agree to certain conditions and meet other requirements as stated in WAC 388-503-0505. Your eligibility begins upon the date of the department's service authorization.

[Statutory Authority: RCW 74.39.010, 74.08.090, 74.39A.110, 74.09.520. 00-04-056, 388-71-0430, filed 1/28/00, effective 2/28/00.]


NEW SECTION
WAC 388-71-0435
Am I eligible for COPES-funded services?

You are eligible for COPES-funded services if you meet all of the following criteria. The department or its designee must assess your needs and determine that:

(1) You are age:

(a) Eighteen or older and blind or disabled, as defined in WAC 388-511-1105; or

(b) Sixty-five or older.

(2) You meet financial eligibility requirements. This means the department will assess your finances and determine if your income and resources fall within the limits set in WAC 388-515-1505, Community options program entry system (COPES).

(3) You:

(a) Are not eligible for Medicaid personal care services; or

(b) Are eligible for Medicaid personal care services, but the department determines that the amount, duration, or scope of your needs is beyond what Medicaid personal care can provide.

(4) Your comprehensive assessment shows you need the level of care provided in a nursing facility (or will likely need the level of care within thirty days unless COPES services are provided) which means one of the following applies. You:

(a) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis due to your complex medical needs;

(b) Have an unmet need requiring substantial or total assistance with at least two or more of the following activities of daily living (ADLS):

(i) Eating,

(ii) Toileting,

(iii) Ambulation,

(iv) Transfer,

(v) Positioning,

(vi) Bathing, and

(vii) Self-medication.

(c) Have an unmet need requiring minimal, substantial or total assistance in three or more of the ADLS listed in subsection (4)(b)(i) through (vii) of this section; or

(d) Have:

(i) A cognitive impairment and require supervision due to one or more of the following: disorientation, memory impairment, impaired judgment, or wandering; and

(ii) An unmet need requiring substantial or total assistance with one or more of the ADLS listed in subsection (4)(b)(i) through (vii) of this section.

(5) You have an approved service plan, per WAC 388-15-205.

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REPEALER

     The following section of the Washington Administrative Code is repealed:
WAC 388-15-610 COPES -- Eligibility.

Washington State Code Reviser's Office