WSR 02-08-089



(Medical Assistance Administration)

[ Filed April 3, 2002, 11:31 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 01-03-096.

Title of Rule: Amending WAC 388-551-2000 Home health services -- General, 388-551-2010 Home health services -- Definitions, 388-551-2020 Home health services -- Eligible clients, 388-551-2100 Covered home health services -- Nursing, 388-551-2110 Home health services -- Specialized therapy, 388-551-2120 Home health aid services, 388-551-2130 Noncovered home health services, 388-551-2200 Home health services -- Eligible providers, 388-551-2210 Home health services -- Provider requirements, 388-551-2220 Home health services -- Provider payments; and new section WAC 388-551-2030 Home health skilled services -- Requirements.

Purpose: To meet the requirements of the Centers for Medicare and Medicaid Services (CMS), formerly Health Care Financing Administration (HCFA), the department is amending home health services sections in chapter 388-551 WAC that refer to "homebound" criteria. At the same time, the department is changing references to "plan of treatment (POT)" to "plan of care (POC)" to be consistent with Department of Health (DOH). Also, to update rule content, including the addition of a new section, and to reflect current department policy and business practices.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, 74.09.530, and 74.09.500.

Statute Being Implemented: RCW 74.08.090, 74.09.520, 74.09.530, and 74.09.500.

Summary: The rules amend language in the home health services sections that refers to "homebound" criteria. The rules also clarify and update rule content to reflect current department policy, including POC requirements.

Reasons Supporting Proposal: To meet the requirements of CMS to amend sections in the home health services sections that refer to "homebound" criteria. To update rule content to reflect current department policy.

Name of Agency Personnel Responsible for Drafting: Kathy Sayre, P.O. Box 45533, Olympia, WA 98504, (360) 725-1342; Implementation and Enforcement: Pam Colyar, P.O. Box 45506, Olympia, WA 98504, (360) 725-1582.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The proposed amendments incorporate into rule a mandate by CMS that requires the department to remove references to the "homebound" criteria from the home health services program and rule. In addition, the new rules update, clarify, and add new language to the home health services program.

The purpose of these rules is to meet the mandate to remove the "homebound" requirement from the program's rule and provide clearly written language that is easier to understand.

The anticipated effects are (1) to increase effectiveness of MAA's staff who administer and enforce home health services rules; (2) to improve the quality of home health service care provided to clients; (3) to reduce confusion and, consequently, provide savings to service providers in time and money due to the clarification of the format and content of the POC and what to add to it during a review; (4) to increase the quality of care that a client receives by assuring follow through with needed care from the DSHS case manager after the client discharges from home health services; and (5) to provide savings to home health agency providers by allowing the providers to utilize a client's DSHS case manager instead of their agency's social worker for services that are not MAA-covered services.

Proposal Changes the Following Existing Rules: All references to "homebound" criteria are removed. The verbiage "plan of treatment (POT)" is changed to "plan of care (POC)." The proposal adds a new section WAC 388-551-2030 that incorporates existing MAA policy requirements for home health agency to provide home health skilled services.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the new rules and concluded that no new costs will be imposed on businesses affected by them. The analysis is contained in the cost benefit analysis described below.

RCW 34.05.328 applies to this rule adoption. Although the adoption of WAC 388-551-2030 (new section) meets the definition of a "significant legislative rule," this section and amendments to the other listed sections impose no additional costs to businesses. A cost benefit analysis was completed and is available upon request from Kathy Sayre, Medical Assistance Administration, P.O. Box 45533, Olympia, WA 98504-5533, phone (360) 725-1342, fax (360) 586-9727, e-mail

Hearing Location: Office Building - 2 (DSHS Headquarters) (parking off 12th and Jefferson), 1115 Washington, Olympia, WA 98504, on May 21, 2002, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by May 17, 2002, phone (360) 664-6094, TTY (360) 664-6178, e-mail

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail, by 5:00 p.m., May 21, 2002.

Date of Intended Adoption: No sooner than May 22, 2002.

March 29, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

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 02-09 issue of the Register.

Washington State Code Reviser's Office