WSR 14-01-057 EMERGENCY RULES DEPARTMENT OF SOCIAL AND HEALTH SERVICES (Developmental Disabilities Administration) [Filed December 12, 2013, 3:43 p.m., effective December 12, 2013, 3:43 p.m.] Effective Date of Rule: Immediately upon filing.
Purpose: Amending WAC 388-823-1010, 388-832-0085, 388-827-0145 and 388-828-9140, the purpose for these emergency rules is to allow the developmental disabilities administration (DDA) to continue enrollment of individuals onto the individual and family services (IFS) program, who have been waiting for services and supports. These changes have enabled families to continue caring for their family members in their own homes and help stabilize families and individuals who are experiencing increased caregiving stress and crisis by providing respite from their caregiving duties. The department filed the CR-101 on August 26, 2013, and is in the process of filing the CR-102 to make these changes permanent.
Citation of Existing Rules Affected by this Order: Amending WAC 388-823-1010, 388-832-0085, 388-827-0115, 388-827-0145, and 388-828-9140.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.
Other Authority: Washington state budget (3ESSB 5034, section 205(d)).
Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and 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: There are approximately 2,500 individuals who do not receive any paid services from DDA who have asked for help and have been put on a waitlist until funding becomes available to provide them with services and supports. These changes will provide immediate funding and eligibility to enable families to continue caring for family members in their own homes and help stabilize families who are experiencing increased caregiving stress and crisis by providing respite and support for families and individuals. The legislature has directed DDA to use historical data about award amounts and utilization to determine new award amounts for each service priority level so that DDA can help more individuals and families with the funds allocated in the budget.
In 3ESSB 5034, section 205(d): $6,244,000 of the general fund—state appropriation for fiscal year 2014 and $6,244,000 of the general fund—state appropriation for fiscal year 2015 are appropriated solely for the individual and family support program. Within these amounts, the department shall expand the current number of clients receiving services and focus on extending services to individuals with developmental disabilities who are not otherwise receiving paid services from the department.
Budget notes in SC3 IFS Expansion describe legislative intent on how DDA is to implement 3ESSB 5034, section 205(d): In order to increase the number of clients served by the IFS program, DDA must utilize past experience about award utilization to guide the number of authorized awards, and must change the maximum dollar amount awarded to each service priority level. Clients who are not receiving paid services from DDA may be added to the IFS program during the 2013-2015 biennium. Corresponding changes must be made to the state supplementary payment (SSP) program to ensure that award levels are consistent for clients in the IFS program and clients receiving SSP in lieu of IFS.
Fulfilling the intent of the legislative [legislature]: DDD is fulfilling the legislative intent by making these changes:
1. Reducing IFS award amounts to sixty percent of the current (old) amount in rule:
2. Expand the current number of clients receiving IFS or SSP in lieu of IFS:
3. Provide support as expediently as possible:
4. State supplementary payment amounts:
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 0, 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 0, Repealed 0.
Date Adopted: December 12, 2013.
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1010 When will DDD review my eligibility to determine if I continue to have a developmental disability?
(1) Your eligibility can be reviewed at any time if your eligibility effective date is prior to July 2005 and you are age ten or older and were eligible under a condition of developmental delay or Down syndrome. (2) Your eligibility will be reviewed at age seventeen with termination occurring no sooner than your eighteenth birthday if your most current eligibility determination was at sixteen or younger under mental retardation, cerebral palsy, epilepsy, autism, another neurological condition, or other condition similar to mental retardation. (3) DDD will review your eligibility prior to the initial authorization of any paid service from DDD when you are not currently receiving paid services and: (a) You are age eighteen or older and your most current eligibility determination ((is more than twenty-four months old)) was made prior to June 1, 2005; or (b) You are age four but under age eighteen and your eligibility was established under the eligible conditions of developmental delay or Down syndrome and your eligibility effective date is prior to July 2005. (4) DDD will review your eligibility if DDD discovers: (a) The evidence used to make your most recent eligibility determination completed in 1992 or later appears to be insufficient, in error, or fraudulent; or (b) New diagnostic information becomes available that does not support your current eligibility and you are under the age of eighteen.
AMENDATORY SECTION (Amending WSR 11-17-068, filed 8/16/11, effective 9/16/11)
WAC 388-827-0115 What are the programmatic eligibility requirements for DDD/SSP?
Following are the programmatic eligibility requirements to receive DDD/SSP: (1) You received one or more of the following services from DDD with state-only funding between March 1, 2001 and June 30, 2003 and continue to demonstrate a need for and meet the DDD program eligibility requirements for these services. Additionally, you must have been eligible for or received SSI prior to July 1, 2006; or you received Social Security Title II benefits as a disabled adult child prior to July 1, 2006 and would have been eligible for SSI if you did not receive these benefits. (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, (ix) Transportation, (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. (8) You received one or more of the following residential services between July 1, 2003 and June 30, 2013 and demonstrate an ongoing need for a residential allowance request on a periodic, or routine basis of at least once a quarter. You must also receive SSI or would receive SSI if it were not for the receipt of DAC as well as continue to meet the program eligibility requirements for these services: (a) Alternative living; (b) Supported living; or (c) Companion homes. (9) ((As of December 31, 2010, you met)) You meet the eligibility requirements listed in WAC 388-832-0015 for the individual and family services program (IFS)((, you had an IFS service level of three or four, and your individual service plan included IFS services. Additionally, you must have been eligible for or received SSI prior to January 1, 2011, or you received)) and you are currently receiving SSI payments or you would receive SSI payments if you did not receive Social Security Title II benefits as a disabled adult child ((prior to January 1, 2011 and would have been eligible for SSI if you did not receive these benefits)). (10) As of March 31, 2011, you met the eligibility requirements listed in WAC 388-832-0015 for the individual and family services program (IFS), you had an IFS service level of one or two, and your individual service plan included IFS services. Additionally, you must have been eligible for or received SSI prior to April 1, 2011, or you received social security title II benefits as a disabled adult child prior to April 1, 2011 and would have been eligible for SSI if you did not receive these benefits.
AMENDATORY SECTION (Amending WSR 06-24-074, filed 12/4/06, effective 1/4/07)
WAC 388-827-0145 How much money will I receive?
The purpose of the SSP is to increase the amount of income to meet your needs. The department will determine your payment amount based on your living arrangement and your assessed needs. (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 388-825-256.)) If you receive SSP in lieu of individual and family services you will receive the following amounts based on your DDA assessment:
(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 yearly award for traditional family support or family support opportunities 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, and you received state-only funding for the traditional family support program between March 1, 2001 and June 30, 2003 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) If you are not on the HCBS waiver administered by DDD, and you received state-only funding for the family support opportunity program between March 1, 2001 and June 30, 2003 the amount of your SSP will be fifteen hundred dollars per year. (d) 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. (4) DDD may authorize additional payments to certain individuals if the SSP budget has sufficient funds to allow this payment.
AMENDATORY SECTION (Amending WSR 08-16-121, filed 8/5/08, effective 9/5/08)
WAC 388-828-9140 How does DDD determine the amount of your individual and family service award?
DDD uses the following table to determine the amount of your individual and family services award:
AMENDATORY SECTION (Amending WSR 09-11-054, filed 5/13/09, effective 6/13/09)
WAC 388-832-0085 When there is state funding available to enroll additional clients ((in)) on the IFS program, how will DDD select from the clients on the IFS program request list?
When there is state funding available for additional IFS participants, DDD ((may)) will enroll participants based on ((the following considerations: (1) Clients who have requested residential habilitation center (RHC) respite, emergency services, or residential placement, prior to June 30, 2007. (2) Clients with the highest scores in caregiver and behavior status on the mini assessment. (3) Clients who have been on the IFS program request list the longest)) priorities established by the legislature or from the date the client was placed on the IFS request list.
AMENDATORY SECTION (Amending WSR 08-16-121, filed 8/5/08, effective 9/5/08)
WAC 388-832-0130 What is the amount of the IFS program allocation my family is going to receive?
The DDD assessment, described in chapter 388-828 WAC, will determine your level of need. The IFS program annual allocations are ((as follows: (1) Level 1 - Up to $2,000; (2) Level 2 - Up to $3,000; (3) Level 3 - Up to $4,000; and (4) Level 4 - Up to $6,000)) identified in 388-828-9140.
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