SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Effective Date of Rule: Immediately.
Purpose: The purpose of the amended sections is to expand the population eligible to receive the state supplementary payment (SSP) to include certain individuals in residential settings; to clarify the amount of SSP certain individuals who were previously on traditional family support are eligible to receive; and to establish rules allowing one-time payments to certain individuals.
Citation of Existing Rules Affected by this Order: Amending WAC 388-827-0115 and 388-827-0145.
Statutory Authority for Adoption: RCW 71A.12.030, 74.04.057.
Under RCW 34.05.350 the agency for good cause finds that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.
Reasons for this Finding: In order to receive federal funding for Title XIX Medicaid, the state is required to expend a certain amount of state supplementary payments (SSP) to meet a yearly maintenance of effort established by the federal Social Security Administration as specified in 20 C.F.R. 416.2099. By expanding the population eligible to receive SSP, clarifying the amount of SSP to certain individuals, and allowing the authorization of one-time payments, the state will achieve this maintenance of effort.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.
Date Adopted: June 29, 2006.
Andy Fernando, Manager
Rules and Policies Assistance Unit3779.1
(a) Certain voluntary placement program services, which include:
(i) Foster care basic maintenance,
(ii) Foster care specialized support,
(iii) Agency specialized support,
(iv) Staffed residential home,
(v) Out-of-home respite care,
(vi) Agency in-home specialized support,
(vii) Group care basic maintenance,
(viii) Group care specialized support,
(x) Agency attendant care,
(xi) Child care,
(xii) Professional services,
(xiii) Nursing services,
(xiv) Interpreter services,
(b) Family support;
(c) One or more of the following residential services:
(i) Adult family home,
(ii) Adult residential care facility,
(iii) Alternative living,
(iv) Group home,
(v) Supported living,
(vi) Agency attendant care,
(vii) Supported living or other residential service allowance,
(viii) Intensive individual supported living support (companion homes).
(2) For individuals with community protection issues as defined in WAC 388-820-020, the department will determine eligibility for SSP on a case-by-case basis.
(3) For new authorizations of family support opportunity:
(a) You were on the family support opportunity waiting list prior to January 1, 2003; and
(b) You are on the home and community based services (HCBS) waiver administered by DDD; and
(c) You continue to meet the eligibility requirements for the family support opportunity program contained in WAC 388-825-200 through 388-825-242; and
(d) You must have been eligible for or received SSI prior to July 1, 2003; or you received Social Security Title II benefits as a disabled adult child prior to July 1, 2003 and would have been eligible for SSI if you did not receive these benefits.
(4) For individuals on one of the HCBS waivers administered by DDD (Basic, Basic Plus, Core or community protection):
(a) You must have been eligible for or received SSI prior to April 1, 2004; and
(b) You were determined eligible for SSP prior to April 1, 2004.
(5) You received Medicaid personal care (MPC) between September 2003 and August 2004; and
(a) You are under age eighteen at the time of your initial comprehensive assessment and reporting evaluation (CARE) assessment;
(b) You received or were eligible to receive SSI at the time of your initial CARE assessment;
(c) You are not on a home and community based services waiver administered by DDD; and
(d) You live with your family, as defined in WAC 388-825-020.
(6) If you meet all of the requirements listed in (5) above, your SSP will continue.
(7) You received one or more of the following state-only funded residential services between July 1, 2003 and June 30, 2006 and continue to demonstrate a need for and meet the DDD program eligibility requirements for these services:
(a) Adult residential care facility;
(b) Alternative living;
(c) Group home;
(d) Supported living;
(e) Agency attendant care;
(f) Supported living or other residential allowance.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, and chapter 71A.12 RCW. 05-10-039, § 388-827-0115, filed 4/28/05, effective 5/29/05. Statutory Authority: RCW 71A.12.030 and 71A.12.120. 04-15-094, § 388-827-0115, filed 7/16/04, effective 8/16/04. Statutory Authority: RCW 71A.12.030, 71A.10.020, 2002 c 371. 04-02-015, § 388-827-0115, filed 12/29/03, effective 1/29/04.]
(1) For residential and voluntary placement program services, the amount of your SSP will be based on the amount of state-only dollars spent on certain services at the time the funding source was converted to SSP. If the type of your residential living arrangement changes, your need will be reassessed and your payment adjusted based on your new living arrangement and assessed need.
(2) For family support services, refer to WAC 388-825-200 through 388-825-284.
(a) If you are on the home and community based services (HCBS) waiver administered by DDD:
(i) You will receive nine hundred dollars DDD/SSP money per year to use as you determine.
(ii) The remainder up to the maximum allowed may be authorized by DDD to purchase HCBS waiver services and will be paid directly to the provider.
(b) If you are not on the HCBS waiver administered by DDD, the amount of your SSP will be based on the yearly maximum allowed at the time the funding source was converted to SSP unless your need changes.
(i) Need is based on your Service Need Level and whether you receive Medicaid Personal Care as specified in WAC 388-825-254.
(ii) If your need changes, the amount of your SSP will be adjusted accordingly.
(c) The yearly amount of DDD/SSP money will be prorated into monthly amounts. You will receive one twelfth of the yearly amount each month.
(3) If you are eligible for SSP because you meet the criteria in WAC 388-827-0115(5), you will receive one hundred dollars per month.
(a) For individuals whose initial CARE assessment was
completed prior to January 1, 2005, January 2005 is the first
month for which payment is made.
(b) For individuals whose initial CARE assessment is completed after December 31, 2004, the first month for which payment is made is the month in which the results of the initial CARE assessment are effective.))
(4) DDD may authorize additional payments to certain individuals if the SSP budget has sufficient funds to allow this payment.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, and chapter 71A.12 RCW. 05-10-039, § 388-827-0145, filed 4/28/05, effective 5/29/05. Statutory Authority: RCW 71A.12.030, 71A.10.020, 2002 c 371. 04-02-015, § 388-827-0145, filed 12/29/03, effective 1/29/04.]