WSR 02-01-043



(Aging and Adult Services Administration)

[ Filed December 11, 2001, 3:33 p.m. ]

Subject of Possible Rule Making: Amendments to WAC 388-79-030, 388-79-040, and related sections in chapter 388-79 WAC, Guardianship fees for clients of the department.

Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 11.92.180, 43.20B.460.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: (1) To modify existing rules on guardianship fees charged to Medicaid recipients receiving long-term care services who are required to participate in the cost of their care. (2) To preclude allowance of retroactive guardianship fees and administrative costs prior to the Medicaid recipient's eligibility for long-term care services or after the recipient's death. The rule was established when the federal Health Care Financing Authority (HCFA), now referred to as the Center for Medicare and Medicaid Services (CMS), placed the state on the Title XIX noncompliance report for allowing unreasonable guardian fees paid from clients' Medicaid participation amounts. Being on the compliance list placed the state at risk of losing federal funds for the Medicaid program. (3) To change the Home and Community Services RA notice from ten to thirty days. This will allow more time for the local manager and the AAG to respond and negotiate with the guardian. Changing this time frame also will decrease the need for continuances and resetting matters. (4) To eliminate the fee adjustment from the 1-3 year accounting review process. This will reduce the amount of additional fees paid during the review process. It is also intended to regulate the fee process, allowing for a balanced budget, and for the closing of the accounting period in this area. This also should save time if bargaining for additional fees is eliminated.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: Center for Medicare and Medicaid (CMS), formerly the Health Care Financing Authority (HCFA). Include CMS in the review process.

Process for Developing New Rule: Through regular meetings and review drafts. DSHS welcomes the public to take part in developing its rules. Anyone interested in participating should contact the staff person indicated below. After the rule is drafted, DSHS will file a copy with the Office of the Code Reviser with a notice of proposed rule making, and send a copy to everyone currently on the mailing list and anyone else who requests a copy.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Kristi Olson, DSHS/Home and Community Services Division, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2537, fax (360) 438-8633, e-mail

December 10, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

Washington State Code Reviser's Office