Daniel R. Humphrey
President, Washington Center
for Comprehensive Rehabilitation
2821 South Walden
Seattle, WA 98144
Re: RCW 34.05.330(3) appeal of the June 30, 2000 denial by
the Department of Social and Health Services ("DSHS") of
that certain petition ("Petition") to amend WAC 388-97-005,
originally filed on April 29, 2000, regarding the definition
of "reasonable accommodation"
Dear Mr. Humphrey:
Thank you for your letter dated July 24, 2000 and received by my
office on July 27, 2000, appealing DSHS's decision to deny the
Petition.
Pursuant to RCW 34.05.330(3), I have fully reviewed your appeal
of the Petition and the relevant statutes and regulations, and
have affirmed DSHS's decision.
It is my policy to intervene in matters presented to me under RCW 34.05.330(3) only when I believe the agency whose decision is at
issue has abused its discretion or acted arbitrarily or
capriciously. It is also my policy not to second-guess the
thoughtful and deliberate decisions of a state agency, so long as
those decisions are well founded and proper under the law.
DSHS had a proper basis for its decision to deny the Petition
because the proposed amendment is outside of the scope of WAC
Chapter 388-97 and the authority granted to DSHS under RCW
Chapter 18.51. Those chapters contain requirements for the
provision of resident rights, care and related services; the
physical environment of the licensed nursing home; and obtaining
and maintaining a nursing home license. They do not address the
nursing facility payment system. That system is largely
statutory, and may be changed as you requested in the Petition
only by amending RCW Chapter 74.46 and regulations promulgated
under that chapter.
You stated in your letter that you believe the standard of care
and the necessary funding must be linked. That makes good sense,
and the current payment system provides such a link between care
standards and funding. As of October 1, 1998, each facility
receives a daily rate for Medicaid residents based on its costs
and the care needs of its residents. The rate structure includes
a component for therapy care. On July 1, 2001, a new rate will
go into effect based on 1999 costs adjusted for inflation.
DSHS is required by statute to contract for an evaluation of the
impacts of this linked payment system on access to nursing home
care, the wage and benefit levels of nursing home employees, and
the quality of care and quality of life for nursing home
residents. The study is due on December 1, 2001, and we look
forward to its conclusions.
Your letter also describes the importance of rehabilitation
services to younger people who have experienced a major trauma,
and who can most benefit from therapy. I agree that such
services are very important and, in the 1999 session, the
legislature authorized additional payments of $66.50 per day for
these types of residents. DSHS implemented the program on
January 1, 2000, and a report to the legislature on the
effectiveness of the program is due on December 12, 2002.
While some argue that the enhanced funding is still inadequate,
DSHS has implemented all of the statutory provisions for
rehabilitation services authorized by the legislature. It will
be necessary for the legislature to act for funding to be
increased again.
Thank you for your extensive efforts and profound commitment to
the care of Washington citizens with disabling injuries.
Sincerely,
Gary Locke
Governor
| cc: | Dennis W. Cooper, Code Reviser |
| Tim Martin, Co-Chief Clerk, House of Representatives | |
| Cindy Zehnder, Co-Chief Clerk, House of Representatives | |
| Tony Cook, Secretary of Senate | |
| Dennis Braddock, Secretary of DSHS | |
| Patricia Lashway, Director, Residential Care Services |