PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 98-15-112.
Title of Rule: Repealing WAC 388-86-024 Enhanced benefits for pregnant women and new section WAC 388-533-0300 Enhanced benefits for pregnant women.
Purpose: The department originally intended to rewrite this rule to meet the mandates of the Governor's Executive Order 97-02 on regulatory reform. However, since the department is establishing new WAC chapters to consolidate its rules in one area, it was decided to move this rule to new chapter 388-533 WAC (proposed as a new chapter under WSR 99-06-043, filed February 26, 1999), which will contain the rules regarding maternity-related services. Therefore, WAC 388-86-024 is being repealed and moved into WAC 388-533-0300. The rule reflects long-standing program policy; it has been written to be more readable and has been reviewed in consultation with the Department of Health and the regulated community.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.770, 74.09.800.
Statute Being Implemented: RCW 74.08.090, 74.09.770, 74.09.800.
Summary: The department is moving the rule to a new chapter of WAC that consolidates all maternity-related services, chapter 388-533 WAC. The new rule does not change existing program policy.
Reasons Supporting Proposal: To ensure that department rules reflect current and accurate department policy, to eliminate confusion by consolidating related rules and to comply with the Governor's Executive Order 97-02 on regulatory reform.
Name of Agency Personnel Responsible for Drafting: L. Mike Freeman, RIP, 925 Plum Street, Olympia, WA 98501, (360) 725-1350; Implementation and Enforcement: Diane Tiffany, 805 Plum Street, Olympia, WA 98501, (360) 725-1655.
Name of Proponent: Department of Social and Health Services, Medical Assistance Administration, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The rule implements portions of the maternity access program that was enacted by the legislature and codified at RCW 74.09.760 through 74.09.800. The program provides assistance for clients who might otherwise have problems accessing appropriate maternity care. Benefits and client rights are described in this rule.
Proposal Changes the Following Existing Rules: The rule listed above will be repealed in order to move the policy to a new WAC chapter. The proposed new rule clarifies and provides greater detail about long-standing program policy. The proposed rule does not place additional eligibility restrictions or increase the costs to clients, contractors or the department.
No small business economic impact statement has been prepared under chapter 19.85 RCW. MAA reviewed these proposed rules and concluded that the impact of these rewritten rules will not place "a more than minor impact on businesses" affected by this rule.
RCW 34.05.328 does not apply to this rule adoption. The proposed rule does not meet the definition of "a significant legislative rule."
Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on May 23, 2000, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Paige Wall by May 12, 2000, phone (360) 664-6094, TDD (360) 664-6178, e-mail wallpg@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, Paige Wall, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by May 23, 2000.
Date of Intended Adoption: Not sooner than May 24, 2000.
April 10, 2000
Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
2664.4The medical assistance administration (MAA) provides enhanced services to eligible women during and after their pregnancy.
(1) Refer to WAC 388-462-0015 for client eligibility requirements.
(2) MAA requires providers to have specific MAA approval to provide maternity support services (MSS) to eligible clients. MSS services must be provided by professionals from all of the following fields:
(a) Community health nursing;
(b) Nutrition; and
(c) Social work.
(3) MAA allows paraprofessional community health workers to provide MSS services to eligible clients when both of the following are met:
(a) The services are provided under the supervision of one of the qualified professionals described in subsection (2) of this section; and
(b) The services provided are limited to basic health education.
(4) A client may choose to receive MSS services from any MAA-approved MSS provider.
(5) MAA covers the following enhanced benefits for eligible women during and after their pregnancy:
(a) One childbirth education course per pregnancy (see subsection (8) in this section);
(b) Chemical dependency assessment and treatment when appropriate. A client may choose to be referred for either inpatient or outpatient drug and alcohol treatment services; and
(c) MSS services, which include all of the following:
(i) Assessment, counseling, education, and interventions by those qualified professionals described in subsections (2) and (3) of this section;
(ii) Child care for the client's children (see subsection (6) of this section).
(6) MAA requires the MSS provider to document all of the following for child care:
(a) That the MSS provider arranged and authorized the child care arrangements;
(b) That the child care arrangement is safe and appropriate; and
(c) That child care is necessary in order to assist the eligible client in obtaining necessary services. The MSS provider may authorize child care for any of the following reasons:
(i) Health care appointments for the client;
(ii) The maternity services medical provider ordered bed rest for the client; or
(iii) Other circumstances that the MSS provider considers necessary and are specifically approved by MAA.
(7) MAA covers up to ten MSS visits. If it is determined that a client is at high-risk for a poor birth outcome, MAA may cover up to twenty MSS visits. The MSS provider must maintain documentation of the high-risk circumstances in the client's file.
(8) MAA allows a provider to bill only once per client per pregnancy for childbirth education. The provider must document that the client attended at least one childbirth education session in order for MAA to cover the service.
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2631.1 The following section of the Washington Administrative Code is repealed:
| WAC 388-86-024 | Enhanced benefits for pregnant women. |