SOCIAL AND HEALTH SERVICES

(Developmental Disabilities Administration)

[Filed May 17, 2019, 9:25 a.m.]

Preproposal statement of inquiry was filed as WSR 19-04-068.

Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-823-0770 What evidence do I need of developmental delays?, 388-823-1010 When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA?, and 388-823-1015 What is the definition of "DDA paid services" in WAC 388-823-1010(2)?

Hearing Location(s): On June 25, 2019, at 10:00 a.m., at Office Building 2, Department of Social and Health Services (DSHS) Headquarters, 1115 Washington, Olympia, WA 98504. Public parking at 11th and Jefferson. A map is available at https://www.dshs.wa.gov/sesa/rules-and-policies-assistance-unit/driving-directions-office-bldg-2.

Date of Intended Adoption: Not earlier than June 26, 2019.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, email DSHSRPAURulesCoordinator@dshs.wa.gov, fax 360-664-6185, by 5:00 p.m., June 25, 2019.

Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, phone 360-664-6092, fax 360-664-6185, TTY 711 relay service, email Kildaja@dshs.wa.gov, by June 11, 2019.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed amendments to these rules increase the amount of time an assessment may be used as evidence of developmental delays, clarify for internal DDA eligibility workers when an eligibility review is required for clients who are nineteen years old, and clarify the definition of a "DDA-paid service."

Reasons Supporting Proposal: Increasing the amount of time an assessment may be used as evidence will simplify the eligibility determination process for many clients who may no longer be required to obtain a new assessment before receiving an eligibility determination. Amendments to WAC 388-823-1010 were requested by eligibility workers; the change is a clarification and is not a substantive change. Replacing terminology in WAC 388-823-1015 aligns with how the term has been updated in other parts of Title 388 WAC.

Statutory Authority for Adoption: RCW 71A.12.030, 71A.12.120.

Statute Being Implemented: RCW 71A.12.030.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: DSHS, governmental.

Name of Agency Personnel Responsible for Drafting: Chantelle Diaz, P.O. Box 45310, Olympia, WA 98504-5310, 360-407-1589; Implementation and Enforcement: Will Nichol, P.O. Box 45310, Olympia, WA 98504-5310, 360-407-1510.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is not required under RCW 34.05.328. Under RCW 34.05.328 (5)(b)(vii), the department is exempt from preparing a cost-benefit analysis if the rules relate to client medical or financial eligibility.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(4) because the rules do not affect small businesses.

Explanation of exemptions: The proposed amendments impose no new or disproportionate costs on small businesses so a small business economic impact statement is not required.

Katherine I. Vasquez

AMENDATORY SECTION(Amending WSR 14-12-046, filed 5/29/14, effective 7/1/14)

WAC 388-823-0770What evidence do I need of developmental delays?

(1) Evidence of substantial functional limitations requires developmental delays of at least 1.5 standard deviations or twenty-five percent or more of the chronological age in one or more of the following developmental areas based on an assessment current within the past ((12))eighteen months:

(a) Physical skills (fine or gross motor);

(b) Self help/adaptive skills;

(d) Social/emotional skills; and

(e) Cognitive, academic, or problem solving skills.

(2) The number of areas in which you are required to have delays to meet the evidence is specific to your age.

(3) Tools used to determine developmental delays must be diagnostic assessments that are designed to measure the developmental areas in subsection (1) of this section and are appropriate to the age of the child being tested.

(4) The assessment must be administered by one of the following professionals qualified to administer the assessment of developmental areas:

(a) Licensed physician;

(b) Licensed psychologist or certified school psychologist;

(d) Audiologist;

(e) Registered occupational therapist;

(f) Licensed physical therapist;

(g) Registered nurse;

(h) Certified teacher;

(i) Masters level social worker; or

(j) Orientation and mobility specialist.

AMENDATORY SECTION(Amending WSR 18-15-046, filed 7/13/18, effective 8/13/18)

WAC 388-823-1010When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA?

(1) DDA will review your eligibility:

(a) If you are age nineteen and ((you have not received an))your most recent eligibility determination ((since on or))was completed before your sixteenth birthday;

(b) If you are age nineteen and were determined eligible under another neurological or other condition similar to intellectual disability and have used academic delays as evidence of your substantial functional limitations;

(c) Before authorization of any DDA-paid service if you are not currently receiving paid services and your most current eligibility determination was made before June 1, 2005;

(d) If the evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;

(e) If new information becomes available that does not support your current eligibility determination; or

(f) If you were determined eligible due solely to your eligibility for fee-for-service (FFS) medically intensive children's program (MICP) services and you are no longer eligible for FFS MICP services.

(2) If DDA requires additional information to make a determination of eligibility during a review and you do not provide sufficient information, DDA will terminate your eligibility:

(a) On your twentieth birthday if the review is because you are age nineteen; or

(b) Ninety days after DDA requests the information if the review is because:

(i) You have requested a paid service;

(ii) The evidence used to make your most recent eligibility determination is insufficient, contains an error, or appears fraudulent;

(iii) New information is available that does not support your current eligibility determination; or

(iv) You are no longer eligible for FFS MICP services under chapter 182-551 WAC.

AMENDATORY SECTION(Amending WSR 14-12-046, filed 5/29/14, effective 7/1/14)

WAC 388-823-1015What is the definition of "DDA-paid services" in WAC ((388-823-1010(2)))388-823-1010?

"DDA-paid services" means a service or program administered by DDA as evidenced by:

(1) A DDA social services authorization ((of a paid service)) within the last ninety days ((as evidenced by a social services authorization)) in ((the))a DSHS payment system((,));

(2) A county authorization ((for day program services,));

(3) A DDA ((individual)) service plan approving a DDA service or program((,));

(4) Residence in a ((SOLA, RHC, or ICF/ID,))residential habilitation center; or

(5) Documentation of DDA approval of your absence from DDA paid services for more than ninety days with available funding for your planned return to services.