SOCIAL AND HEALTH SERVICES

(Developmental Disabilities Administration)

[Filed June 12, 2023, 9:01 a.m., effective July 13, 2023]

Effective Date of Rule: Thirty-one days after filing.

Purpose: The purpose of these amendments is to allow companion home providers to access respite through overnight planned respite services (OPRS) providers; and planned respite through residential habilitation centers. Other changes include notification to a primary caregiver when a client receiving OPRS experiences an emergency.

Citation of Rules Affected by this Order: New WAC 388-829C-235; and amending WAC 388-829C-131, 388-829C-230, 388-829C-232, 388-829C-233, 388-829C-234, 388-829R-005, 388-829R-011, 388-829R-165, and 388-829R-170.

Statutory Authority for Adoption: RCW 71A.12.030.

Other Authority: RCW 71A.12.040.

Adopted under notice filed as WSR 23-07-080 on March 14, 2023.

A final cost-benefit analysis is available by contacting Chantelle Diaz, P.O. Box 45310, Olympia, WA 98504-5310, phone 360-790-4732, fax 360-407-0955, TTY 1-800-833-6388, email Chantelle.Diaz@dshs.wa.gov.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 2, Repealed 0.

Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 9, Repealed 0.

Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 9, Repealed 0.

Date Adopted: June 9, 2023.

AMENDATORY SECTION(Amending WSR 22-04-073, filed 1/31/22, effective 3/3/22)

WAC 388-829C-131How does DDA determine the daily rate?

(1) A companion home daily rate is based on the client's DDA assessment under chapter 388-828 WAC. The DDA assessment uses an algorithm to convert raw scores into support assessment scales.

(2) The following support assessment scales are used to calculate a companion home daily rate. Each support assessment scale is assigned an acuity level of "none," "low," "medium," or "high" by the DDA assessment algorithm and corresponds to the values below:

Support Assessment Scale	Acuity Levels
Support Assessment Scale	None	Low	Medium	High
Activities of daily living	0	1	2	3
Behavior	0	1	2	3
Interpersonal support	0	1	2	3
Medical	0	1	2	3
Mobility	0	1	2	3
Protective supervision	0	1	2	3

(3) DDA assigns a behavior score of four if:

(a) The client has an acuity level of "high" for behavior on the support assessment scale; and

(b) The client has a behavior support plan that meets requirements under WAC 388-829C-135.

(4) The sum of the assessment scale scores corresponds to an established daily rate. Rates are set prospectively in accordance with state legislative appropriations and will be adjusted accordingly.

(5) DSHS publishes companion home daily rates on the office of rates management's website.

(6) DDA may adjust a companion home daily rate if:

(a) The sum of the client's support assessment acuity levels changes; or

(b) DDA approves additional respite hours ((under WAC 388-829C-234(3))).

AMENDATORY SECTION(Amending WSR 18-22-106, filed 11/6/18, effective 12/7/18)

WAC 388-829C-230What is respite and where can a client access respite?

(1) Respite is ((short-term, intermittent))a scheduled break in caregiving to provide relief for the companion home provider.

(2) ((The DDA assessment determines a client's annual allocation of respite hours.

(3) Respite may be provided in:

(a) The companion home where the client lives;

(b) A community setting available to an adult, such as a camp, senior center, or adult day care center;

(d) An assisted living facility;

(e) A group home; or

(f) A group training home.

(4) To be a qualified respite provider, a person or agency must be contracted with DDA to provide respite services.))A companion home client may receive:

(a) Waiver-funded respite under chapter 388-845 WAC;

(((5) A companion home client must not receive o))(b) Overnight planned respite services under chapter 388-829R WAC((.)); and

(((6) A companion home client must not receive))(c) Planned respite at a residential habilitation center.

AMENDATORY SECTION(Amending WSR 18-22-106, filed 11/6/18, effective 12/7/18)

WAC 388-829C-232How does DDA determine the amount of waiver-funded respite a ((companion home client's annual respite allocation))client may receive?

For waiver-funded respite, DDA determines a companion home client's annual respite allocation by adding the client's companion home services support score under WAC 388-828-6010 to their adjusted companion home services support score under WAC 388-828-6011.

AMENDATORY SECTION(Amending WSR 18-22-106, filed 11/6/18, effective 12/7/18)

WAC 388-829C-233May the client or companion home provider request additional waiver-funded respite hours?

(((1))) A client may request waiver-funded respite hours in addition to their annual respite allocation, or the companion home provider may request additional respite on behalf of the client in consultation with the client or the client's legal representative if the client has one.

(((2) DDA may approve additional respite hours if a temporary and unexpected event occurs in the client or the companion home provider's life, such as an illness or injury.))

AMENDATORY SECTION(Amending WSR 18-22-106, filed 11/6/18, effective 12/7/18)

WAC 388-829C-234Will DDA reduce the companion home daily rate if additional waiver-funded respite hours are approved?

(1) ((If DDA approves additional respite hours under WAC 388-829C-233(2), the daily rate remains unchanged.

(2))) If DDA approves additional waiver-funded respite hours((for any reason not under WAC 388-829C-233(2))), DDA may reduce the companion home daily rate.

(((3)))(2)((If DDA approves additional respite hours under subsection (2) of this section))To reduce the companion home daily rate, DDA:

(a) Divides the cost of the additional respite hours by the number of days remaining in the client's plan year; and

(b) Subtracts that amount from the companion home daily rate for the remaining number of days in the plan year.

(((4)))(3) The cost of the additional respite hours is based on the identified respite provider's hourly rate.

WAC 388-829C-235Will DDA reduce the companion home daily rate if a client receives state-funded respite?

DDA may reduce a companion home daily rate if the client receives state-funded overnight planned respite services or state-funded planned respite at a residential habilitation center.

AMENDATORY SECTION(Amending WSR 20-08-033, filed 3/24/20, effective 5/1/20)

WAC 388-829R-005What definitions apply to this chapter?

The following definitions apply to this chapter:

"Administrator" means the person responsible for daily management and operation of the overnight planned respite services site. The administrator may also be the owner.

"Authorization" means DDA approval of funding for a service as identified in the person-centered service plan or evidence of payment for a service.

"Client" means a person who has a developmental disability as defined in RCW 71A.10.020(((5))) and who the DDA has determined eligible to receive services under chapter 71A.16 RCW. When used in this section, "you" is interchangeable with client.

"DDA" means the developmental disabilities administration, an administration of the department of social and health services and its employees and authorized agents.

"Direct support professional" means a person who interacts directly with a client during an overnight planned respite stay to provide services outlined in the client's overnight planned respite services individualized agreement.

"DSHS" or "the department" means the state of Washington department of social and health services and its employees and authorized agents.

"Family" means one or more of the following relatives: Spouse or registered domestic partner; natural; adoptive; or stepparent; grandparent; child; stepchild; sibling; stepsibling; uncle; aunt; first cousin; niece; or nephew.

"Legal representative" means a parent of a client if the client is under age 18, a court-appointed guardian if a decision is within the scope of the guardianship order, or any other person authorized by law to act for the client.

"Mandatory reporter" means any person working with vulnerable adults required to report suspected incidents of abandonment, abuse, neglect, financial exploitation under chapter 74.34 RCW.

"Nurse delegation" means the process by which a registered nurse transfers the performance of select nursing tasks to a nursing assistant-registered or nursing assistant-certified in select situations as set forth in chapter 18.79 RCW and WAC 246-840-910 through 246-840-970.

"Overnight planned respite services" means services that are intended to provide short-term intermittent relief for a person who lives with and acts as a DDA client's primary caregiver.

"Overnight planned respite services provider" and "provider" means an agency that is contracted to provide overnight planned respite services.

"Owner" means the person who accepts or delegates responsibility for the management and operation of the overnight planned respite services site. The owner may also be the administrator.

"Primary caregiver" means the person who provides the client's care and supervision and lives with the client.

AMENDATORY SECTION(Amending WSR 20-08-033, filed 3/24/20, effective 5/1/20)

WAC 388-829R-011Who is eligible to receive overnight planned respite services?

To be eligible to receive overnight planned respite services, a client must:

(1) Be eligible for DDA services under chapter 388-823 WAC;

(2) Be ((eighteen))18 or older;

(3) ((Be living))Live at home with a primary caregiver and not currently ((receiving))receive:

(a)Residential habilitation services, unless receiving services from a companion provider; or((under the core waiver))

(b) Community first choice residential services; and

(4) Identify a backup caregiver to respond in an emergency if the primary caregiver is unavailable.

AMENDATORY SECTION(Amending WSR 20-08-033, filed 3/24/20, effective 5/1/20)

WAC 388-829R-165What must overnight planned respite services providers do to plan for and respond to emergencies?

(1) The overnight planned respite services provider must develop an emergency response plan to address natural and other disasters.

(2) In an emergency, the overnight planned respite services provider must:

(a) Immediately call 911 if it is a life-threatening emergency;

(b) Provide emergency services;

(d) Notify the primary caregiver, client's legal representative, or backup caregiver; and

(e) Submit a written report to DDA.

AMENDATORY SECTION(Amending WSR 20-08-033, filed 3/24/20, effective 5/1/20)

WAC 388-829R-170What records must overnight planned respite services providers keep?

(1) For each client, the overnight planned respite services providers must keep the following information:

(a) The client's name and address;

(b) The name, address, and telephone number of the client's primary ((guardian))caregiver,((or))and the legal representative if the client has one;

(d) A copy of the client's overnight planned respite services individualized agreement;

(e) Nurse delegation records, if applicable;

(f) Progress notes;

(g) Incident reports, if applicable;

(h) Medication documentation, including a medication intake form and medication administration records, if applicable;

(i) A list of the client's personal property upon arrival and departure; and

(j) A record of money or gift cards managed by the respite provider on behalf of the client during the respite stay, if applicable.

(2) An overnight planned respite services provider must also keep the following:

(a) Water temperature monitoring records;

(b) Direct support professional training records;

(d) Payment records;

(e) A signed copy of DSHS form 10-403 for each direct support professional and administrator.