WSR 16-01-113
(Developmental Disabilities Administration)
[Filed December 17, 2015, 12:09 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 15-19-018.
Title of Rule and Other Identifying Information: The department plans to adopt new rules in chapter 388-845 WAC related to wellness education that the Centers for Medicare and Medicaid Services (CMS) has agreed to add to our Basic Plus waiver and Core waiver.
Hearing Location(s): Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at, on January 26, 2016, at 10:00 a.m.
Date of Intended Adoption: Not earlier than January 27, 2016.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail, fax (360) 664-6185, by 5:00 p.m., January 26, 2016.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by January 12, 2016, TTY (360) 664-6178, (360) 664-6092, or e-mail
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The Basic Plus waiver and Core waiver both provide home and community-based services to individuals as an alternative to placement in an intermediate care facility for individuals with intellectual disabilities. CMS approved an amendment that removes personal care services from those waivers, as those services are available through the state's 1915(k) Community First Choice option program in the medicaid state plan. The CMS amendments also added a new service, wellness education, to both the Basic and Core waivers which provides wellness information to participants designed to assist them in achieving goals identified during their person-centered planning process. These rules will support the CMS decision and be in compliance with C.F.R. 441.510(d).
Reasons Supporting Proposal: See Purpose above.
Statutory Authority for Adoption: RCW 71A.12.030 General authority of secretaryRule adoption.
Statute Being Implemented: C.F.R. 441.510 Eligibility (d).
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: [DSHS], governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Bob Beckman, DDA, P.O. Box 45310, Olympia, 98504-5310, (360) 725-3445.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The rules do not impact small businesses or nonprofits. They only impact DSHS clients.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rules do not meet the definition of a "significant legislative rule" under RCW 34.05.328 (5)(c)(iii) because they do not impose penalties or sanctions, affect a license or permit, or create or amend a policy or regulatory program.
December 16, 2016
Katherine I. Vasquez
Rules Coordinator
Wellness Education
WAC 388-845-2280 What is wellness education?
Wellness education provides you with monthly individualized printed educational materials designed to assist you in managing health related issues and achieving wellness goals identified in your person-centered service plan that address your health and safety issues. Individualized educational materials are developed by the state, other content providers and the contracted wellness education provider. This service is available on the Basic Plus and Core Waivers.
WAC 388-845-2283 How are my wellness educational materials selected?
Individualized educational materials are selected for you by the wellness education provider's algorithm and are based on your DDA assessment. Goals, diagnoses, treatments, conditions and other factors identified in your DDA assessment provide the basis for the algorithm to select educational materials for you. These goals, diagnoses, treatments, conditions and other factors may include, but are not limited to the following:
(1) Diabetes – IDDM;
(2) Diabetes – NIDDM;
(3) COPD;
(4) Cardiovascular disease;
(5) Rheumatoid arthritis;
(6) Traumatic brain injury;
(7) Cerebral palsy;
(8) Alzheimer's disease;
(9) Anxiety disorder;
(10) Asthma;
(11) Autism;
(12) Stroke;
(13) Congestive heart failure;
(14) Decubitus ulcer;
(15) Depression;
(16) Emphysema;
(17) GERD;
(18) Hypertension;
(19) Hypotension;
(20) Down's syndrome;
(21) Fragile X syndrome;
(22) Prader-Willi;
(23) ADD;
(24) ADHD;
(25) Post-traumatic stress disorder;
(26) Asperger's syndrome;
(27) Hepatitis;
(28) Paraplegia;
(29) Quadriplegia;
(30) Fetal alcohol syndrome/fetal alcohol effect;
(31) Epilepsy;
(32) Seizure disorder;
(33) Sleep apnea;
(34) Urinary tract infection;
(35) Multiple sclerosis;
(36) Falls;
(37) Smoking;
(38) Alcohol abuse;
(39) Substance abuse;
(40) Bowel incontinence;
(41) Bladder incontinence;
(42) Diabetic foot care;
(43) Pain daily;
(44) Sleep issues;
(45) BMI = or greater than 25;
(46) BMI less than 18.5;
(47) Skin care (pressure ulcers, abrasions, burns, rashes);
(48) Seasonal allergies;
(49) Edema;
(50) Poor balance;
(51) Recent loss/grieving;
(52) Conflict management;
(53) Importance of regular dental visits;
(54) ADA diet;
(55) Cardiac diet;
(56) Celiac diet;
(57) Low sodium diet;
(58) Goals; and
(59) Parkinson's Disease.
WAC 388-845-2285 Are there limits to wellness education?
Wellness education is a once a month service. In the basic plus waiver, you are limited to the aggregate service expenditure limits defined in WAC 388-845-0210.
WAC 388-845-2290 Who are qualified providers of wellness education?
The wellness education provider must have the ability and resources to:
1) Receive and manage client data in compliance with all applicable federal HIPPA regulations, state law and rules and ensure client confidentiality and privacy;
2) Translate materials into the preferred language of the participant;
3) Ensure that materials are targeted to the participant's assessment and person-centered service plan;
4) Manage content sent to participants to prevent duplication of materials;
5) Deliver newsletters and identify any undeliverable client/representative addresses prior to each monthly mailing and manage any returned mail in a manner that ensures participants receive the monthly information; and
6) Contract with ALTSA or DDA to provide this service.