SOCIAL AND HEALTH SERVICES

(Developmental Disabilities Administration)

[Filed December 3, 2019, 10:04 a.m.]

Preproposal statement of inquiry was filed as WSR 19-18-065.

Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-845-0030 Do I meet criteria for HCBS waiver-funded services?, 388-845-0055 How do I remain eligible for the waiver?, 388-845-0100 What determines which waiver I am assigned to?, 388-845-0230 What services are available under the individual and family services (IFS) waiver?, 388-845-0415 What is assistive technology?, 388-845-0425 Are there limits to the assistive technology you may receive?, 388-845-0600 What are community access services?, 388-845-0605 Who are qualified providers of community access services?, 388-845-0610 Are there limits to community access services you may receive?, 388-845-0900 What are environmental adaptations?, 388-845-0910 What limits apply to environmental adaptations?, 388-845-1100 What are behavioral health crisis diversion bed services?, 388-845-1110 What are the limits of behavioral health crisis diversion bed services?, 388-845-1150 What are behavioral health stabilization services?, 388-845-1190 What is peer mentoring?, 388-845-1191 Who are qualified providers of peer mentoring?, 388-845-1192 What limitations are there for peer mentoring?, 388-845-1800 What are specialized medical equipment and supplies?, 388-845-1805 Who are the qualified providers of specialized medical equipment and supplies?, 388-845-1810 Are there limits to the specialized medical equipment and supplies you may receive?, 388-845-2000 What is staff and family consultation and training?, 388-845-2005 Who is a qualified provider of staff/family consultation and training?, 388-845-2010 Are there limits to the staff and family consultation and training you may receive?, 388-845-2160 What is therapeutic equipment and supplies?, and 388-845-2170 Are there limits to your receipt of therapeutic equipment and supplies?

Hearing Location(s): On January 22, 2020, 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/office-of-the-secretary/driving-directions-office-bldg-2.

Date of Intended Adoption: January 23, 2020.

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., January 22, 2020.

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 January 8, 2020.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed major changes or new requirements to the chapter include the following: Remove the "three years old" limit from home and community based waiver services; remove therapeutic equipment and supplies from the individual and family services (IFS) waiver; update the service definition of assistive technology; Limit assistive technology to services not otherwise covered under the medicaid state plan, including early and periodic screening, diagnosis, and treatment (EPSDT), and consistent with waiver objectives of avoiding institutionalization; replace "community access" with the service's new name, "community inclusion"; update the service definition of environmental adaptations; add examples of environmental adaptations; replace "home" with "dwelling" to clarify that environmental adaptations can be made to all types of residences; add repairs for property destruction caused by a waiver participant's behavior to the environmental adaptations allowed under the IFS and children's intensive in-home behavioral support (CIIBS) waivers; clarify when an environmental adaptation is excluded; require evidence of required completed inspections be submitted to the developmental disabilities administration (DDA) prior to final payment for work; add deck construction, deck repair, jetted tubs, and saunas to list of items excluded from environmental adaptations; limit environmental adaptations to services not otherwise covered under the medicaid state plan, including EPSDT, and consistent with waiver objectives of avoiding institutionalization; update service definition for behavioral health crisis diversion bed services; add behavioral health crisis diversion bed services to the IFS waiver; replace "individual support plan" with "person-centered service plan"; clarify who determines a participant's need for crisis diversion bed services and who determines the duration and amount of the service the participant may receive; exempt the cost of behavioral health crisis diversion bed services from the annual allocation in the IFS waiver; add behavioral health stabilization services crisis diversion bed to the IFS waiver; clarify the service definition for peer mentoring services and who can provide them (nonsubstantive changes in wording); clarify the limits to peer mentoring services (nonsubstantive changes in wording); update the service definition for specialized medical equipment and supplies; add a service requirement to specialized medical equipment and supplies that applies only to IFS waiver; require providers of specialized medical equipment and supplies being offered through the IFS waiver to be contracted with DDA as providers of specialized goods and services or specialized equipment and supplies; add limits to the service and exclude items under specialized medical equipment and supplies; update the service definition of staff and family consultation and training; add certified teachers to the list of providers of staff and family consultation and training; add a limit to staff and family consultation and training that states the service does not provide training necessary to meet contractual licensing or certification requirements; and remove therapeutic equipment and supplies from the IFS waiver.

Reasons Supporting Proposal: DDA is proposing to amend these rules as part of the administration's waiver renewal process. These changes were approved by the Centers for Medicare and Medicaid Services on July 30, 2019, and are effective September 1, 2019. Many of these changes were enacted by an emergency CR-103E Rule-making order filed as WSR 19-18-048, effective on September 1, 2019. These proposed changes are necessary to enact the emergency rules on a permanent basis and to provide services as approved in DDA's home and community based services waivers.

Statutory Authority for Adoption: RCW 71A.12.030.

Statute Being Implemented: RCW 71A.12.120.

Rule is necessary because of federal law, 42 C.F.R. 441 Subpart G.

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: Ann Vasilev, P.O. Box 45310, Olympia, WA 98504-5310, 360-407-1551.

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

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Chantelle Diaz, P.O. Box 45310, Olympia, WA 98504-5310, phone 360-407-1589, fax 360-407-0955, TTY 1-800-833-6388, email Chantelle.Diaz@dshs.wa.gov.

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

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 20-01 issue of the Register.