WSR 97-20-121

PREPROPOSAL STATEMENT OF INQUIRY

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Aging and Adult Services)

[Filed October 1, 1997, 9:40 a.m.]

Subject of Possible Rule Making: Adjusting functional eligibility standards or service levels for the Chore, COPES, and MPC service programs. This action may require amendments to the functional eligibility requirements contained in chapter 388-15 WAC and WAC 388-97-235.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 74.09.035, [74.09.]520, [74.09.]530; 74.39A.110, [74.39A.]120, [74.39A.]030; and chapter 149, Laws of 1997.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The 1997-99 Operating Budget (section 205 (1)(c) and section 206(3), chapter 149, Laws of 1997) authorized the department to adjust functional eligibility standards or service levels sufficiently to maintain expenditures within appropriated levels for Chore, COPES and MPC services.

The 1997-99 budget provides the Division of Developmental Disabilities (DDD) funding for MPC caseload growth or 71 clients per month for fiscal year (FY) 98 and 99. Currently, the DDD MPC caseload growth is averaging approximately 90 clients per month.

The 1997-99 budget provided the Aging and Adult Services Administration (AASA) funding for a caseload growth level of 157 clients per month for FY 98 and 237 clients per month for FY 99 for home and community programs. Home and community caseloads have grown by an average of 220 cases per month in FY 97. The department does not anticipate a sudden decrease in caseloads to the FY 98 funded level of 157 clients per month beginning July 1997.

The 1997-99 budget allows the department to offset projected overexpenditures for Chore, COPES, and MPC with underexpenditures resulting from lower than budgeted nursing home caseloads. However, the nursing home caseload growth is currently growing at higher than budgeted levels.

RCW 74.09.520 and sections 205 (1)(c) and 206(3), chapter 149, Laws of 1997, require the department to adjust functional eligibility standards or service levels for Chore, COPES, and MPC programs to stay within appropriated levels. The department will be meeting with clients, advocates and provider groups for suggested amendments to functional eligibility requirements and/or service levels for the Chore, COPES, and MPC programs. Note: The COPES functional eligibility must be the same or more restrictive than that for nursing facility level of care; consequently, it may be necessary to amend the definition of functional eligibility for nursing facility care in WAC 388-97-235.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Health Care Financing Administration. The Department of Social and Health Services will notify the Health Care Financing Administration of required amendments to the state Medicaid plan or home and community-based waiver (i.e. COPES) regarding eligibility or service levels. Aging and Adult Services will be coordinating this proposal on behalf of the department and will coordinate with the Medical Assistance Administration, Health and Rehabilitation Administration and other affected administrations.

Process for Developing New Rule: Interested parties may submit verbal or written comments, concerns, and recommendations to (AASA) at any time prior to filing the notice of proposed rule making. Public meetings will be widely publicized in advance in order to promote maximum attendance and participation in the rule development process. AASA will send notices to their mailing list of interested parties inviting them to attend informal meetings, and/or provide oral or written suggestions to the department. Anyone may be added to this list by contacting the responsible staff person at the address/phone/email indicated below. At the time the notice of proposed rule making is filed, interested parties will be notified of the scheduled rule-making hearing, and given another opportunity to submit comments.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kevin Krueger, Aging and Adult Services Administration, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 493-2578, TTY (360) 493-2637, FAX (360) 438-8633, e-mail kkrueger@dshs.wa.gov.

October 1, 1997

Merry A. Kogut, Manager