The rule-making agenda represents activity that can be forecast at this time. There may be additional DSHS rule-making activity, or some activity in this report may not occur during this period, as DSHS responds to new state laws, to meet federal requirements, or to meet unforeseen circumstances.

     If you have questions about this rule-making agenda or the DSHS rule-making process, please contact Andy Fernando, DSHS Rules Coordinator, at P.O. Box 45850, Olympia, WA 98504-5850, by phone at (360) 664-6094, or by e-mail at FernaAX@dshs.wa.gov. If you are interested in receiving DSHS rule-making notices, please contact Fred Swenson at the DSHS Rules and Policies Assistance Unit by phone at (360) 664-6097 or by e-mail at SwensFH@dshs.wa.gov. This document is also available from the Department of Social and Health Services public website, at http://www1.dshs.wa.gov/msa/rpau/.

     Following the tables are explanations of the terms CR-101, CR-102, CR-103 and CR-105, and other selected terms.

AGING AND DISABILITY SERVICES ADMINISTRATION (ADSA)
ADSA - Division of Developmental Disabilities (DDD)
WAC Chapter or WAC Section #	Chapter, Subpart Caption	Subject Matter or Section Caption	Anticipated Rule-Making Actions      in the Period July 1 through December 31, 2003
Chapter 388-820 WAC	Community residential services and support.	Same.	CR-101, CR-102, CR-103 Amending and clarifying language.
Chapter 388-820 WAC Chapter 388-825 WAC Chapter 388-850 WAC	Community residential services and support. DDD service rules. County plan for developmental disabilities.	State supplemental payment program.	CR-102, CR-103 Amending and adopting new rules to implement legislation (SSB 6387) on DDD state supplemental payment program; and revising eligibility rules.
Chapter 388-825 WAC	DDD service rules.	Eligibility for services.	CR-101, CR-102, CR-103 Amending and clarifying language regarding appeal processes.
New chapter 388-827 WAC	State supplemental payment program.	DDD state supplemental payment program.	CR-102, CR-103 Creating a new WAC chapter to replace new WAC 388-825-500 through 388-825-600 adopted by emergency rule. Adopting new rules to implement legislation (ESSB 6387) on DDD state supplemental payment program; and revising eligibility rules.
Chapter 388-830 WAC	DDD program option rules.	Same.	CR-101, CR-102, CR-103 Possible repeal of this WAC chapter.
Chapter 388-835 WAC	ICF/MR program and reimbursement system.	Same.	CR-101, CR-102, CR-103 Amending language to reflect new rates.
Chapter 388-850 WAC	County plan for DDD.	Same.	CR-101, CR-102, CR-103 Rewriting rules in clear rule format and clarifying language.
WAC 388-513-1301, 388-513-1315, and 388-513-1510	Client not in own home -- Institutional medical.	Implementing new DDD federal waivers.	CR-101 Amending and adopting new rule to implement waivers to maintain federal funding.
ASDA - Home and Community Services Division (HCS)
Chapter 388-71 WAC Chapter 388-515 WAC	Social services for adults. Alternate living -- Institutional medical.	Medically-needy (MN) waiver and community options program entry system (COPES).	CR-103 Permanent rules effective July 13, 2003, adopted to establish the medically-needy waiver program; and amending COPES rules to reflect changes in the program requirements and/or options; and complying with Executive Order 97-02.
WAC 388-71-0194, 388-71-0415, and 388-71-0440 WAC 388-72A-0060	Social services for adults. Comprehensive assessment reporting and evaluation tool.	Medicaid personal care (MPC).	CR-102, CR-103 Amending MPC rules to comply with new legislative and budget requirements adopted by the 2003 legislature.
WAC 388-71-0400 through 388-71-0480	Social services for adults, home and community programs.	Home and community programs.	CR-102, CR-103 To establish and clarify (1) what constitutes "living with others" for clients who receive in-home services from Medicaid personal care, COPES or Chore; (2) what services may be authorized when a client lives with another person(s); and (3) the amount of services a person can receive when they live with another person(s).
WAC 388-71-0460	Social services for adults, home and community programs.	Shared living.	CR-103 Permanent rule effective August 3, 2003, clarifying what services DSHS will not pay for when a client and individual provider share a household.
WAC 388-71-0465	Social services for adults, home and community programs.	Are there waiting lists for HCP?	CR-101, CR-102 Amending the rules is required by legislative mandate to control caseload growth.
WAC 388-71-0805, 388-71-0810, 388-71-0815, 388-71-0820, and 388-71-0840	Social services for adults -- Program for all-inclusive care for the elderly (PACE).	PACE.	CR-103 Permanent rules effective July 17, 2003, clarifying PACE requirements and additional options under PACE, and to make other amendments.
WAC 388-71-1065 through 388-71-1095	Social services for adults -- Respite care.	Respite care -- Family caregiver support program.	CR-101 Amending the respite care subchapter to include the family caregiver support program per state legislation.
WAC 388-71-05923	Social services for adults.	Caregiver training.	CR-102, CR-103 Revising language to make the rule easier to implement. Public hearing scheduled for August 26, 2003.
WAC 388-79-010, 388-79-020, 388-79-030, 388-79-040, and 388-79-050	Guardianship fees for clients of the department.	Same.	CR-103 Permanent rules filed July 28, 2003. To provide for a total of thirty days for proceedings; prohibit deductions from participation for fees an [and] costs incurred prior to Medicaid eligibility; limit, to the extent possible, the court's ability to advance fees at one accounting and to award higher fees at a later accounting. Second public hearing was held April 22, 2003.
Chapter 388-112 WAC Chapter 388-71 WAC	Residential long-term care services. Social services for adults.	Same.	CR-102, CR-103 Amending rules adopted in 2002 to correct typographical errors without changing the effect of the rules.
WAC 388-513-1350 and 388-513-1380	Client not in own home -- Institutional medical.	Maximum resources allowed and client participation for long-term care services.	CR-101, CR-102, CR-103 Amending the rules to comply with new state statute (ESHB 2257) to reduce the maximum resource allocation for the community spouse effective August 1, 2003; and increase the community spouse standards for long-term care program to be consistent with federal standards effective April 1, 2003.
WAC 388-513-1365 WAC 388-561-0100	Client not in own home -- Institutional medical. Trusts, annuities, and life estates -- Effect on medical programs.	Evaluating the transfer of an asset made on or after March 1, 1997, for long-term care services.	CR-103 Permanent rules effective August 1, 2003, clarifying rules on lifetime care contracts and sole benefit trusts as they relate to financial eligibility for department long-term care.
ADSA - Residential Care Services Division (RCS)
WAC 388-76-650, 388-76-76500 series	Adult family homes.	Same.	CR-102, CR-103 To incorporate changes consistent with food worker rules of the Department of Health and to clarify emergency evacuation and safety requirements.
WAC 388-76-655	Adult family homes.	Same.	CR-103 Permanent rule effective July 20, 2003, to address provider access to liability insurance.
WAC 388-76-675 WAC 388-97-076	Adult family homes. Nursing homes.	Reporting requirements/prevention of abuse.	CR-101, CR-102, CR-103 To comply with the recently passed legislation ESHB 1904, relating to the reporting of incidents by mandated reporters.
Chapter 388-78A WAC	Boarding homes.	Same.	CR-103 Permanent rule to be filed by August 1, 2003, effective September 1, 2004. To review and update rules to be consistent with current practices in residential care and to make it more applicable to today's boarding home residents. Current rules will be repealed and replaced with new rules in chapter 388-78A WAC. Public hearing held March 11, 2003.
Chapter 388-110 WAC	Contracted residential care services.	Same.	CR-102, CR-103 To incorporate dementia care pilot project standards into rule for contracting with boarding homes to provide dementia care to department clients, and to make revisions necessary as a result of amendments to chapter 388-78A WAC.
ADSA - Rates Management Division
Chapter 388-96 WAC	Nursing facility payment system.	Same.	CR-102, CR-103 Codifying current policies and practices; editing previous codifications for substance and form.
WAC 388-105-0005, 388-105-0030, 388-105-0040, and new 388-105-0045	Medicaid rates for contracted home and community residential care services.	Bed hold process, rates.	CR-101, CR-102, CR-103 Implementing SSB 5579 (chapter 231, Laws of 2003), requiring a change to the current bed hold process for residential care settings and implementing new rates.
CHILDREN'S ADMINISTRATION
WAC 388-25-0018	Child welfare services -- Foster care.	What is the agency's goal as to the maximum number of children who remain in foster care in excess of twenty-four hours?	CR-103 Permanent rule effective July 26, 2003. Expedited rule making - adopting a policy rule required by federal and state law. The rule language was repealed in error previously.
WAC 388-27-0120, 388-27-0130, 388-27-0135, 388-27-0155, 388-27-0160, 388-27-0165, 388-27-0175, 388-27-0190, 388-27-0195, 388-27-0200, 388-27-0210, 388-27-0215, 388-27-0220, 388-27-0225, 388-27-0235, 388-27-0240, 388-27-0245, 388-27-0270 and related sections	Child welfare services -- Adoption services and adoption support.	Adopting special needs children.	CR-101, CR-102, CR-103 Amending rules to comply with legislative directives to control rate and reimbursement decisions with families adopting special needs children by maximizing use of federal funds.
WAC 388-32-0020 and 388-32-0030	Child welfare services to prevent out-of-home placement and achieve family reconciliation.	Family reconciliation services.	CR-102, CR-103 Amending rules to implement recent legislation and implement a new twenty-four hour intake service. Public hearing scheduled for August 5, 2003.
New chapter 388-140 WAC	Licensing standards for group receiving centers.	Same.	CR-102, CR-103 To establish under a new WAC chapter licensing procedures and standards for group receiving center currently approved under waivers.
Chapter 388-148 WAC	Foster homes and facility licensing requirements.	Same.	CR-102, CR-103 Workgroup convened to develop amendments and additions to licensing chapter identified as problematic.
ECONOMIC SERVICES ADMINISTRATION (ESA)
ESA- Community Services Division (CSD)
WAC 388-273-0025, 388-273-0030, and 388-273-0035	Washington telephone assistance program.	Same.	CR-102, CR-103 Clarifying the payment limits for reimbursable services, and streamlining the billing process. The amendment also adds community service voice mail as a WTAP benefit as provided for by chapter 134, Laws of 2003.
ESA - Division of Child Care and Early Learning (DCCEL)
Chapter 388-290 WAC	Working connections child care (WCCC).	Activity fees; copays and mandatory cooperation.	CR-102, CR-103 Changing and clarifying the rules including but not limited to activity fees, change in co-payments during the authorization period and mandatory cooperation with quality assurance reviews.
WAC 388-290-0075, 388-290-0085, 388-290-0190, and 388-290-0210	Working connections child care (WCCC).	Copayments.	CR-102, CR-103 Increasing participant family copayment levels; eliminating unfunded portions of WCCC program to meet budget reductions.
WAC 388-290-0130	Working connections child care (WCCC).	Same.	CR-101, CR-102, CR-103 Clarifying that an in-home/relative child care provider may be an eligible provider following results of a criminal background check.
New chapter 388-292 WAC, repeal WAC 388-165-130	Seasonal child care program.	Same.	CR-103 Permanent rules, chapter 388-292 WAC, filed June 30, 2003, effective August 1, 2003.
New chapter 388-295 WAC, repeal all rules in chapter 388-150 WAC	Minimum licensing requirements for child care centers.	Same.	CR-103 Permanent rules, chapter 388-295 WAC, filed June 30, 2003, effective August 1, 2003.
New chapter 388-296 WAC Repealing all rules in chapter 388-155 WAC	New chapter name. Minimum licensing requirements for family child care homes.	Licensing requirements for family child care homes.	CR-102, CR-103 Revising this chapter to meet the governor's clear rule-writing mandate. Revisions will result in adopting new chapter(s) of Title 388 WAC.
ESA - Division of Child Support (DCS)
WAC 388-14A-1030, 388-14A-2040, 388-14A-2075, 388-14A-2135, 388-14A-3125, 388-14A-3300, 388-14A-3315, 388-14A-3350, 388-14A-3375, 388-14A-3800, 388-14A-3865, 388-14A-3875, 388-14A-4605, 388-14A-5000, and 388-14A-5008	Division of child support rules.	Correcting erroneous cross references.	CR-102, CR-103 Amending the rules to correct erroneous or obsolete WAC or RCW cross references without changing the effect of the rules. Public hearing scheduled for September 2, 2003.
WAC 388-14A-2000, 388-14A-2025, 388-14A-2080, 388-14A-3800, 388-14A-3810, 388-14A-4000, 388-14A-4300, and 388-14A-4304	Division of child support rules.	Modifying support obligations.	CR-102, CR-103 Amending the rules to allow the Division of Child Support (DCS) to modify support obligations when both parties make informal arrangements and are unable to return to court to officially change the support order.
WAC 388-14A-3100, 388-14A-3102, 388-14A-3110, 388-14A-3115, 388-14A-3120, 388-14A-3370, and 388-14A-3810	Division of child support rules.	Uniform Parentage Act.	CR-102, CR-103 Bringing DCS rules into compliance with new legislation (chapter 302, Laws of 2002). Public hearing scheduled for August 5, 2003.
WAC 388-14A-3900 to 388-14A-3925	Division of child support rules.	Modification of a support order.	CR-102 Allowing for modification of a support order when it will not change by more than the current standard.
WAC 388-14A-4100, 388-14A-4110, 388-14A-4120, and 388-14A-4130	Division of child support rules.	Medical child support obligations.	CR-102, CR-103 Developing new rules and procedures for enforcing medical child support obligations using the national medical support notice.
WAC 388-14A-4500 though 388-14A-4530	Division of child support rules.	DCS license suspension program.	CR-102, CR-103 Clarifying who is subject to license suspension. Public hearing scheduled for August 26, 2003.
New WAC 388-14A-6105, 388-14A-6110, 388-14A-6115, 388-14A-6120, and 388-14A-6125	Division of child support rules.	Hearing procedures.	CR-102, CR-103 Clarify hearing, reconsideration and review rights for individuals affected by DCS rules consistent with amendments to chapter 388-02 WAC, DSHS Hearing rules. Public hearing scheduled for August 5, 2003.
ESA - Division of Employment and Assistance Programs (DEAP)
WAC 388-61-001	Family violence.	Family violence amendment -- TANF.	CR-102, CR-103 Amending rules to align their intent with current practice.
WAC 388-310-0800, 388-310-1800	WorkFirst.	WorkFirst support services.	CR-102, CR-103 Amending the rule to eliminate the transitional work expense from authorized support services, and to keep WorkFirst support services within budget allocations.
WAC 388-310-1600	WorkFirst.	WorkFirst sanctions.	CR-102, CR-103 Proposing changes to the sanction process for WorkFirst participants.
WAC 388-406-0005, 388-406-0010, 388-406-0015, 388-406-0021, 388-406-0035, 388-406-0040, 388-406-0055, 388-406-0060, and 388-406-0065 WAC 388-416-0005	Applications. Certification periods.	Washington basic food program.	CR-101, CR-102, CR-103 Amending rules to update program language and clarify program requirements for the application process, expedited service, and certification periods for the Washington basic food program.
WAC 388-408-0005	Assistance units.	Correction.	CR-102, CR-103 Correcting an incorrect WAC cross reference. Public hearing scheduled for July 22, 2003.
WAC 388-408-0034, 388-408-0035, 388-408-0040, 388-408-0045, 388-408-0050	Assistance units.	Same.	CR-102, CR-103 This chapter will be revised to simplify the rules regarding inclusion in the assistance unit. Public hearing scheduled for September 9, 2003.
WAC 388-410-0030	Benefit error.	How does the department calculate and set up my food assistance overpayment?	CR-102, CR-103 Correcting an incorrect WAC cross reference.
WAC 388-412-0015, 388-412-0020, 388-412-0025, and 388-412-0040 WAC 388-460-0001, 388-460-0005, 388-460-0010, and 388-460-0015	Benefit issuances. Payees for benefit issuances.	Washington basic food program.	CR-101, CR-102, CR-103 Amending rules to update and clarify program language and requirements for payees, allotments, and benefit issuances for the Washington basic food program.
WAC 388-414-0001	Categorical eligibility for food assistance.	Some food assistance units do not have to meet all eligibility requirements.	CR-102, CR-103 Amendment will reflect changes in WorkFirst support services that impact which clients are categorically eligible for food assistance and do not have to meet certain requirements to get food assistance benefits.
Chapter 388-418 WAC Chapter 388-444 WAC Chapter 388-450 WAC other chapters as appropriate	Change of circumstances. Employment and training. Income.	Same.	CR-102, CR-103 Amending all necessary sections of Title 388 WAC to implement changes related to change-reporting requirements that affect client's eligibility and benefit level for food stamps and the state-funded food assistance program for legal immigrants.
WAC 388-424-0005, 388-424-0010, and 388-424-0015	Citizenship, alien status.	Same.	CR-102, CR-103 Amending the rules to incorporate changes from federal law; and to revise the rule for clarity.
WAC 388-436-0002	Emergency cash assistance.	Additional requirements for emergent needs (ARENS).	CR-102, CR-103 Reducing the maximum allowable payment to prevent overspending of state funds.
Chapter 388-444 WAC	Food stamp employment and training.	Same.	CR-101 Simplifying and updating language so that the rules are easier to read and use.
Chapter 388-448 WAC	Incapacity.	Individual responsibility plan requirements -- General assistance	CR-102, CR-103 Developing new individual responsibility plan requirements for general assistance recipients enrolled in WorkPlus.
Chapter 388-448 WAC	Incapacity.	General assistance -- Unemployable.	CR-102, CR-103 Anticipating legislation governing eligibility for the GAU program that may require changes in administrative rules.
WAC 388-448-0130 and 388-448-0140	Incapacity.	General assistance -- Unemployable.	CR-103 Clarifying optional employment services and participation; clarifying what is good cause for refusing medical treatment or agency referrals. Public hearing was held May 6, 2003.
WAC 388-448-0180	Incapacity.	How and when we redetermine your eligibility if we decide you are eligible for GAX.	CR-102, CR-103 Amending the rule to make reference to the correct type of hearing. "Administrative hearing" needs to be replaced by "appeals court review."
WAC 388-450-0080 and 388-450-0085	Income.	What is self-employment income?	CR-103 Permanent rules effective August 1, 2003. Clarifying the treatment of self-employment income to assure consistent application of the rule.
WAC 388-450-0135	Income.	Allocating income of an ineligible spouse to a GA-U client.	CR-102, CR-103 Simplifying how the department allocates income from an ineligible spouse to a general assistance recipient.
WAC 388-450-0185, 388-450-0190, and 388-450-0195; WAC 388-478-0060; and WAC 388-492-0040 and 388-492-0070	Income. Standards for payments. Washington combined application project.	Same.	CR-102, CR-103 Standards are required by federal regulations and approved department waivers. These standards must be adjusted annually in order to determine a client's eligibility and benefit level for WASHCAP or the Washington basic food program.
WAC 388-452-0005	Interview requirements.	Do I have to be interviewed in order to get benefits?	CR-102, CR-103 Clarifying when an in person or a telephone interview is appropriate to receive basic food benefits. Public hearing scheduled for August 26, 2003.
WAC 388-454-0006, and 388-454-0025	Living with a relative.	Background checks.	CR-102, CR-103 Revising rules on background checks on adults who are acting in loco parentis (in place of another) without court ordered custody.
Chapter 388-460 WAC	Payees on benefit issuances.	Protective payee policies.	CR-102 Proposing changes to protective payee policies.
WAC 388-468-0005	Residency.	Same.	CR-102, CR-103 Amending rules to prohibit the receipt of benefits from Washington state while receiving comparable benefits from another state. Public hearing scheduled for September 9, 2003.
Chapter 388-474 WAC	Supplemental security income.	State supplemental payment program.	CR-101, CR-102, CR-103 Amending rules to add certain persons who receive federal supplemental security income (SSI) to the population who receive state supplemental payments.
WAC 388-480-0001 and WAC 388-482-0005	Strikers. Student status.	Washington basic food program.	CR-101, CR-102, CR-103 Amending rules to update and clarify language and program requirements for strikers and students for the Washington basic food program.
Chapter 388-490 WAC	Verification.	Proof of eligibility.	CR-102, CR-103 Streamlining the application process by standardizing how the department requests proof of eligibility.
Chapter 388-492 WAC	Washington combined application program (WASHCAP).	Same.	CR-102, CR-103 Clarifying language and updating WASHCAP standards.
WAC chapter not yet specified		Client reporting requirements.	CR-101 Implementing quarterly reporting for clients.
WAC chapter not yet specified		Overpayments to clients.	CR-101 Eliminating overpayments caused by agency error and amending all related rules.
HEALTH AND REHABILITATIVE SERVICES ADMINISTRATION (HRSA)
HRSA - Division of Alcohol and Substance Abuse (DASA)
Chapter 388-805 WAC	Certification requirements for chemical dependency treatment providers.	Opiate substitution treatment programs, and certification requirements for service providers.	CR-102, CR-103 Amending and adopting new rules implementing SSB 5417 (chapter 242, Laws of 2001) on certifying opiate substitution treatment programs. Reviewing and revising rules using governor's criteria for regulatory improvement. Public hearing scheduled for August 5, 2003.
HRSA - Division of Vocational Rehabilitation (DVR)
Chapter 251-25 WAC	Washington state internship program.	Eligibility -- Duration of internship.	CR-101 Adopting rules to extend duration of internship to twelve months.
Chapter 388-06 WAC	Background checks.	Background checks for DVR service providers.	CR-101 Adopting rules to clarify background check requirements for providers supplying services to vocational rehabilitation clients.
Chapter 388-891 WAC	Rehabilitation services for individuals with disabilities.	Making direct payments to customers.	CR-101 Adopting new rules to comply with federal and state laws, and with requirements of the department.
New chapter 388-892 WAC Repeal WAC 490-500-520	Purchase of services -- Selection. Criteria -- Community rehabilitation programs.	Change standards for community rehabilitation programs.	CR-102 Amending rules to comply with changes in federal and state laws, and with requirements of the department. Subject matter will be adopted as a new chapter of Title 388 WAC. Public hearing scheduled for August 26, 2003.
HRSA - Mental Health Division (MHD)
WAC 388-865-0100 through 388-865-0484	Community mental health and involuntary treatment programs.	Community support service providers.	CR-102, CR-103 Revising rules to be consistent with the federal Balanced Budget Act, and for quality improvement.
New WAC 388-865-0217	Community mental health and involuntary treatment programs.	Psychiatric indigent inpatient program.	CR-101, CR-102, CR-103 New program to replace medically indigent program eliminated in the 2003-05 budget.
WAC 388-865-0500 through 388-865-0565	Community mental health and involuntary treatment programs.	Inpatient evaluation and treatment.	CR-102, CR-103 Revising rules to be consistent with Department of Health rules on residential treatment facilities.
HRSA - Office of Deaf and Hard of Hearing Services (ODHHS) No ODHHS rule-making activity anticipated in this period.
HRSA - Special Commitment Center
Chapter 388-880 WAC	Sexual predator program -- Special commitment -- Escorted leave.	Evaluations.	CR-102, CR-103 Amending the evaluation sections of this chapter in accordance with RCW 71.09.040(4).
JUVENILE REHABILITATION ADMINISTRATION (JRA)
Chapter 388-700 WAC	Juvenile rehabilitation administration -- Practices and procedures.	Background checks.	CR-101, CR-102, CR-103 Potential revisions due to changes in background check procedures.
Chapter 388-720 WAC	Collection of costs of support, treatment, and confinement of juveniles.	Establishing criteria for determination of ability to pay and providing scope clarity for ALJs.	CR-101, CR-102, CR-103 Changes based on court ruling and to provide clarification for ALJs.
Chapter 388-745 WAC	Transfer of juvenile offenders to the Department of Corrections (DOC).	Transfers to DOC.	CR-101, CR-102, CR-103 Potential revisions due to changes in transfer procedures.
Chapter 388-750 WAC	Impact account -- Criminal justice cost reimbursement.	Reimbursement rates and procedures for criminal justice impact.	CR-101, CR-102, CR-103 Potential rule changes to clarify reimbursement rates.
MANAGEMENT SERVICES ADMINISTRATION
WAC 388-02-0215	DSHS hearing rules.	What is the authority of the ALJ?	CR-103 Permanent rule effective July 12, 2003. Clarifying cases where an initial decision by an administrative law judge may be reviewed by the DSHS Board of Appeals.
MEDICAL ASSISTANCE ADMINISTRATION (MAA)
WAC 388-416-0005 WAC 388-418-0005, and 388-418-0025 WAC 388-418-0005	Certification periods. Change of circumstance. Eligibility review and recertifications.	Children and family medical programs -- Eligibility.	CR-102, CR-103 Implementing legislation initiating a six-month eligibility review and eliminating continuous eligibility for children.
Chapter 388-438 WAC Chapter 388-475 WAC Chapter 388-505 WAC Chapter 388-535 WAC Chapter 388-544 WAC other chapters as appropriate	Emergency assistance for medical needs. Healthcare workers with disabilities (HWD) program. Family medical. Dental-related services. Vision and hearing aid services.	2003-05 state operating budget bill (ESSB 5404).	CR-102, CR-103 Amending rules as required by the 2003-05 state operating budget bill, ESSB 5404, adopted by the 2003 legislature.
WAC 388-438-0100, and 388-438-0110 WAC 388-503-0505	Emergency assistance for medical needs. Family medical.	Medically indigent program.	CR-102, CR-103 Medically indigent program funding was eliminated effective July 1, 2003, in the state's 2003-2005 omnibus operating budget.
WAC 388-468-0005	Residency.	Same.	CR-102, CR-103 Clarifying portions of the rule subject to misinterpretation. Public hearing scheduled for September 9, 2003.
WAC 388-476-0005	Social Security number.	Same.	CR-102, CR-103 Deleting references to the children's health program that has been eliminated. Public hearing scheduled for September 9, 2003.
WAC 388-478-0075	Standards for payments.	Federal poverty level standards.	CR-103 Permanent rule effective July 17, 2003. Amending the rule to adopt new federal poverty level standards effective April 1, 2003.
WAC 388-478-0080	Standards for payments.	Supplemental security income (SSI) -- Categorically needy income level and countable resource standards.	CR-102, CR-103 Revising the rule to qualify for continued federal financial participation.
WAC 388-478-0085	Standards for payments.	Medicare savings program.	CR-102, CR-103 Permanent rule effective July 17, 2003. Amending the rule to adopt new federal poverty level standards effective April 1, 2003.
Chapters 388-500 through 388-561 WAC	All medical assistance chapters.	Federal Health Insurance Portability and Accountability Act.	CR-102, CR-103 Revising all appropriate MAA rules to be compliant with federal law protecting the privacy of DSHS client health information.
WAC 388-500-0005	Medical definitions.	Same.	CR-102, CR-103 Updating the general definitions used throughout MAA rules.
WAC 388-500-0005 WAC 388-501-0165	Medical definitions. Administration of medical programs -- General.	"Medically necessary" definition.	CR-102, CR-103 Amending the definition of "medically necessary" to incorporate the use of medical information that is supported by scientific evidence in its determination of services. Amending WAC 388-501-0165 to be consistent with the medically necessary definition.
WAC 388-501-0135	Administration of medical programs.	Patients requiring regulation.	CR-102, CR-103 Amending policy to improve medical supervision of patients who inappropriately overuse medical and pharmaceutical services.
WAC 388-502-0010	Administration of medical programs -- Providers.	Payment -- Eligible providers defined.	CR-103 Permanent rule effective July 30, 2003. Amending the rule to add "hold harmless" language omitted from MAA core provider agreements.
WAC 388-502-0220, 388-502-0230, and 388-502-0260	Administration of medical programs -- Providers.	Vendor dispute resolution.	CR-102, CR-103 Updating the vendor dispute resolution process.
Chapter 388-505 WAC	Premiums -- Children's medical.	Same.	CR-102, CR-103 Adopting language required to implement the premium requirement for optional children as allowed by HB 2285 (chapter 14, Laws of 2003).
WAC 388-505-0210	Premiums -- Children's medical.	Expedited rule-making.	CR-103 Permanent rule effective July 31, 2003. Expedited rule making to correct a WAC cross reference.
WAC 388-510-1005	Definitions -- Aliens.	Expedited rule-making.	CR-105, CR-103 Expedited repeal a duplicative rule. The language of this rule was incorporated into the rules contained in WAC 388-424-0005 and 388-424-0010.
WAC 388-513-1325	Client not in own home -- Institutional medical.	Income of single client for long-term care services.	CR-102, CR-103 Adding income requirements currently found in other rules; correcting incorrect WAC cross references.
WAC 388-513-1340 WAC 388-450-0020	Client not in own home -- Institutional medical. Income.	Income exclusions.	CR-102, CR-103 Clarifying that veterans aid and attendance and unusual medical expense can be considered third-party resources.
WAC 388-513-1350, and 388-513-1380	Client not in own home -- Institutional medical.	Maximum resources allowed and client participation for long-term care services.	CR-101, CR-102, CR-103 Amending the rules to reduce the maximum resource allocation for the community spouse; and increase the community spouse standards for long-term care program to be consistent with federal standards effective April 1, 2003.
WAC 388-513-1364	Client not in own home -- Institutional medical.	Evaluating the transfer of an asset made on or after April 1, 2003, for long-term care (LTC) services.	CR-105, CR-103 Expedited rule making. Changing an obsolete WAC cross reference and renumbering subsections without changing the effect of the rule. Public review period and deadline to object to expedited rule making ends August 19, 2003.
WAC 388-513-1365 WAC 388-561-0100	Client not in own home -- Institutional medical. Trusts, annuities, and life estates -- Effect on medical programs.	Evaluating the transfer of an asset made on or after March 1, 1997, for long-term care services.	CR-103 Permanent rules effective August 1, 2003. Clarifying rules on lifetime care contracts and sole benefit trusts as they relate to financial eligibility for department long-term care.
WAC 388-527-2700	Estate recovery.	Same.	CR-102, CR-103 Implementing changes from new federal guidelines and chapter 7, Laws of 2001 on estate recovery.
WAC 388-530-1300	Prescription drugs.	Same.	CR-102, CR-103 Amending rules requiring pharmacies to dispense the most "cost-effective" form of a drug.
WAC 388-530-1850	Prescription drugs.	Drug utilization and education (DUE) council.	CR-102, CR-103 Renaming the drug utilization and education council to the Pharmacy and Therapeutics Committee.
Chapter 388-531 WAC	Physician-related services.	Same.	CR-102, CR-103 Revising rules to remain current with medical teaching and residency programs.
Chapter 388-532 WAC	Family planning services.	Same.	CR-103 Revising rules to better identify persons eligible for family planning services. Public hearing scheduled for July 8, 2003.
Chapter 388-533 WAC	Maternity-related services.	Maternity services and first steps.	CR-101 Changing eligibility criteria for infant case management, defining core services, changing codes and time limits for billing, integrating maternity case management with maternity support services, and creating a separate rule for childbirth education.
Chapter 388-533 WAC	Maternity-related services.	Same.	CR-102, CR-103 Adopting rules on the chemical-using pregnant (CUP) women program, which assists pregnant women in maintaining sobriety to ensure healthier birth outcomes.
WAC 388-533-1000	Maternity-related services.	First steps childcare program.	CR-102, CR-103 Revisions to clarify and update language pertaining to background check requirements, and to mirror background check requirements of other agencies.
WAC 388-535-1050, 388-535-1070, 388-535-1080, 388-535-1100, 388-535-1200, 388-535-130, 388-535-1240, and 388-535-1450; other rules as appropriate	Dental related services.	Same.	CR-102, CR-103 Clarifying existing policy on dental related services; reducing adult dental services by 25% effective August 1, 2003; and amending rules to be compliant with the federal Health Insurance Portability and Accountability Act by October 16, 2003. Public hearing scheduled for August 26, 2003.
Chapter 388-536 WAC	Federally qualified health centers and rural health centers.	Same.	CR-102 Adopting a new WAC chapter will comply with federal financial changes, section 702 of BIPA 2000, and legislative directive to implement prospective payment system.
Chapter 388-538 WAC	Managed care.	Same.	CR-103 Amending rules to bring the program into compliance with the federal Balanced Budget Act and the patient bill of rights; and modifying the criteria for exemptions and ending enrollment in managed care. Public hearing scheduled for August 5, 2003.
WAC 388-538-060	Managed care.	Managed care and choice.	CR-101, CR-102 Amending the rule to make the process of enrolling for Medicaid managed care more efficient and to simplify the administrative process.
Chapter 388-540 WAC	Kidney disease program and kidney center services.	Freestanding kidney centers.	CR-103 Adopting rules to comply with requirements for Medicaid dialysis reimbursements. Public hearing scheduled August 26, 2003.
Chapter 388-544 WAC	Vision services.	Same.	CR-102, CR-103 Updating coverage policies, clarify policy, and add coverage for disposable contact lenses.
Chapter 388-545 WAC	Infusion, parenteral and interal therapies.	Same.	CR-102, CR-103 Adopting rules to provide medically necessary nutrition services to Medicaid and medical assistance clients who are unable to feed or be fed orally.
Chapter 388-545 WAC	Medical nutrition therapy program.	Same, formerly known as nutritional counseling services.	CR-102, CR-103 Adopting rules to provide medically necessary nutritional counseling for DSHS clients.
Chapter 388-546 WAC	Nonemergency medical transportation.	Same.	CR-102, CR-103 Clarifying language and current policy for nonemergent medical transportation services.
Chapter 388-547 WAC	Ambulatory surgery centers.	Same.	CR-102, CR-103 Consolidating these rules into the new WAC chapter; codifying department policy and practice.
Chapter 388-550 WAC	Hospital services.	Federally qualified health centers and rural health clinics.	CR-102, CR-103 Amending rules to comply with federal payment methodology.
WAC 388-550-1300, 388-550-1400, 388-550-1500, 388-550-6000, and related sections	Hospital services.	Federal Health Insurance Portability and Accountability Act.	CR-102, CR-103 Amending rules to comply with the federal Health Insurance Portability and Accountability Act by October 16, 2003. Public hearing scheduled for August 26, 2003.
WAC 388-550-1900	Hospital services.	Interns, residents, teaching physicians and physician preceptorships.	CR-102, CR-103 Amending rules to be consistent with industry standards; to establish MAA standards for supervising interns and residents in nonhospital settings; and expanding definition of "under primary care exception."
WAC 388-550-2800, 388-550-4800, 388-550-5450 and 388-550-6000	Hospital services.	Trauma services network.	CR-102, CR-103 Adopting rules to encourage participation in the trauma services network.
WAC 388-550-3700	Hospital services.	Diagnosis-related group payment (DRG) methodology.	CR-103 Permanent rule effective July 14, 2003. Clarifying how DSHS pays hospitals for Medicaid claims that qualify as DRG high-cost outliers.
WAC 388-550-4500, 388-550-4900, 388-550-5000, 388-550-5150, 388-550-5200, 388-550-5400, 388-550-5600, 388-550-6800, and 388-550-6900	Hospital services.	Payment methods -- Disproportionate share payments.	CR-103 Permanent rules effective July 14, 2003. Updating the rule to reflect current department policy.
WAC 388-550-4800	Hospital services.	Diagnosis-related group (DRG) high-cost outliers; medically indigent program; general assistance -- Unemployable program.	CR-103 To clarify how MAA determines payments for state-administered program claims that qualify as diagnosis-related group (DRG) high-cost outliers. To remove language regarding enhanced payments for trauma care provided to a client eligible under the medically indigent (MI) program or general assistance-unemployable (GAU) program. To add a table that shows high-cost outlier calculations for qualifying claims for state-administered programs.
WAC 388-550-6000	Hospital services.	Outpatient hospital services.	CR-102, CR-103 Implementing a new Medicaid payments method for outpatient services provided to Medicaid clients.
WAC 388-551-1000, 388-551-1010, 388-551-1200, 388-551-1210, 388-551-1300, 388-551-1310, 388-551-1315, 388-551-1320, 388-551-1330, 388-551-1340, 388-551-1350, 388-551-1360, 388-551-1400, 388-551-1410, 388-551-1500, 388-551-1510, 388-551-1520, and 388-551-1530	Alternatives to hospital services.	Hospice care program.	CR-102, CR-103 Incorporating language from current agreements with hospice care centers into rule, and to update and clarify language.
Chapter 388-555 WAC	Interpreter services.	Same.	CR-102, CR-103 Changing how interpreter services are purchased and delivered. Implements legislative directives in SB 6832.
New chapter 388-557 WAC	Medical care -- Other services provided.	Disease management.	CR-103 Permanent rules effective July 14, 2003. Establishing a new supplemental service for individuals who are not institutionalized, not enrolled in managed care, and who suffer from certain diseases.
Chapter not specified	Home infusion therapy.	Same.	CR-102, CR-103 Adopting new rules to establish limitations, restrictions, and requirements of MAA's home infusion therapy program.
OFFICE OF THE SECRETARY
Chapter 388-01 WAC	DSHS organization/disclosure of public records.	Same.	CR-102 Update and clarify current rules to reflect changes and improvements in procedures for responding to public requests for disclosure of records.
WAC 388-01-030	DSHS organization/disclosure of public records.	What DSHS records are public.	CR-102, CR-103 Clarifying which DSHS records are available to the public by law; which confidential records are not available; how an individual may have access to a confidential record about him/herself. Public hearing scheduled for August 5, 2003.
Chapter 388-06 WAC	Background checks.	Same.	CR-101 Revising background check rules to incorporate additional DSHS programs.

     Explanation of terms used in these tables:

     "CR-101" is a Preproposal Statement of Inquiry, filed per RCW 34.05.310. A CR-101 is a preliminary notice to the public that the agency is in the planning stages to adopt, amend or repeal rules on a particular subject, and the laws authorizing the agency's action. The notice also lets the public know how to participate in the development of the agency rule, and identifies the agency's contact person.

     "CR-102" is a Proposed Rule-Making notice, filed per RCW 34.05.320. A CR-102 is an announcement that includes: (1) A general description of the rules that the agency proposes to adopt, amend or repeal; (2) the laws authorizing the agency action; (3) the complete text of proposed rules; (4) if applicable, a small business economic impact statement; and (5) agency staff whom the public may contact about the rules. A CR-102 notice also includes the date and location of a public hearing to take formal comments about the proposed rules, the deadline for written comments, and where written comments may be sent. Except for expedited rules, an agency must file and distribute a CR-102 notice, invite public comments and conduct a public hearing before adopting proposed rules as permanent.

     "CR-103" is a Rule-Making Order, filed per RCW 34.05.360 and 34.05.380. A CR-103 is the official action and notice that an agency is adopting new, amended or repealed rules. A permanent CR-103 order includes the purpose of the rule-making order, the laws authorizing the agency's action, the date the permanent rules will take effect, and the complete text of the rules being adopted or the citation and caption of rules being repealed. Agencies also may use a CR-103 notice to adopt temporary emergency rules that become effective without the regular rule-making steps. Emergency rules may not become permanent unless the agency files a CR-101 and/or CR-102 notice as applicable, invites public comment on the proposed rules, conducts a public hearing, and complies with other applicable rule-making statutes.

     "CR-105" is an Expedited Rule-Making notice, filed per RCW 34.05.353. An agency may use this process to notify the public that it intends to adopt, amend or repeal limited types of rules without accepting public comment or conducting a public hearing. A CR-105 notice contains a description of the rule, the laws authorizing the agency's action, and the complete text of the rule being adopted or amended, or the citation and caption of rules being repealed. Within forty-five days after the CR-105 is published in the State Register, anyone may file a written objection to the agency using the expedited rule-making process to adopt the rule. If a written objection is received, the agency must file a CR-102 notice, invite public comments and hold a public hearing on the proposed rule before adopting it as permanent. If no objection is received by the deadline, the agency may adopt the rule as permanent by filing a CR-103 Rule-Making Order.

     "Rules" as used generally in this document are Washington Administrative Code, also known as WAC or regulations. References to "federal rules" are United States government regulations, also known as the Code of Federal Regulations, or C.F.R.

     State "statutes" are laws adopted by the legislature and signed by the governor, or may be initiatives adopted by public vote, and are codified as the Revised Code of Washington (RCW). Federal statutes are laws adopted by congress and signed by the president.

     All DSHS rule-making notices and adoption orders are filed with the state Office of the Code Reviser for legal publication in the Washington State Register. Interested persons, businesses, organizations and agencies can receive copies of DSHS rule-making notices by postal mail or e-mail by contacting Fred Swenson at the DSHS Rules and Policies Assistance Unit, (360) 664-6097, or at SwensFH@dshs.wa.gov. This document is also available from the DSHS public website, at http://www1.dshs.wa.gov/msa/rpau/.

Andy Fernando

Rules Coordinator

© Washington State Code Reviser's Office