SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Preproposal statement of inquiry was filed as WSR 04-19-100.
Title of Rule and Other Identifying Information: New chapter 388-106 WAC, Long-term care services; chapter 388-71 WAC, Home and community services and programs; chapter 388-72A WAC, Comprehensive assessment reporting and evaluation (CARE) tool; and WAC 388-515-1540 through 388-515-1550, Medically needy residential waiver and medically needy in-home waiver. See below for a conversion chart of current long-term care rules and where same subject matter is located in the proposed rules.
This chart indicates the proposed WAC number which will replace those WACs currently adopted in chapters 388-71 and 388-72A WAC.
|CURRENT WAC SECTIONS IN CHAPTER 388-71 WAC||PROPOSED WAC NUMBER|
|HOME AND COMMUNITY PROGRAMS|
|388-71-0194 Home and community services -- Nursing services.||388-106-0200, 388-106-0300, 388-106-0305, 388-106-0400, 388-106-0500|
|388-71-0202 Long-term care services -- Definitions.||388-71-0215|
|388-71-0203 Long-term care services -- Assessment of task self-performance and determination of required assistance.||388-71-0230|
|388-71-0205 Long-term care services -- Service plan.||388-71-0235|
|388-71-0400 What is the intent of the department's home and community programs?||Repeal|
|388-71-0405 What are the home and community programs?||388-106-0015|
|388-71-0410 What services may I receive under HCP?||388-106-0300, 388-106-0305, 388-106-0400, 388-106-0500, and 388-106-0600|
|388-71-0415 What other services may I receive under the COPES program?||388-106-0300, 388-106-0305|
|388-71-0420 What services are not covered under HCP?||388-106-0020|
|388-71-0425 Who can provide HCP services?||388-106-0040|
|388-71-0430 Am I eligible for one of the HCP programs?||388-106-0210, 388-106-0310, 388-106-0410, 388-106-0510, and 388-106-0610|
|388-71-0435 Am I eligible for COPES-funded services?||388-106-0310|
|388-71-0440 Am I eligible for MPC-funded services?||388-106-0210|
|388-71-0442 Am I eligible for Medically Needy Residential waiver services?||388-106-0410|
|388-71-0445 Am I eligible for Chore-funded services?||388-106-0610|
|388-71-0450 How do I remain eligible for services?||388-106-0220, 388-106-0320, 388-106-0420, 388-106-0520, and 388-106-0620|
|388-71-0455 Can my services be terminated if eligibility requirements for HCP change?||388-106-0220, 388-106-0320, 388-106-0420, 388-106-0520, and 388-106-0620|
|388-71-0460 Are there limitations to HCP services I can receive?||388-106-0130|
|388-71-0465 Are there waiting lists for HCP services?||388-106-0235, 388-106-0335, 388-106-0435, and 388-106-0535|
|388-71-0470 Who pays for HCP services?||388-106-0225, 388-106-0325, 388-106-0425, 388-106-0525, and 388-106-0625|
|388-71-0480 If I am employed, can I still receive HCP services?||388-106-0230, 388-106-0330, 388-106-0430, 388-106-0530, and 388-106-0630|
|INDIVIDUAL PROVIDER AND HOME CARE AGENCY PROVIDER QUALIFICATIONS||Kept in chapter 388-71 WAC|
|RESIDENTIAL CARE SERVICES|
|388-71-0600 What are residential services?||388-106-0010|
|388-71-0605 Am I eligible for residential services?||388-106-0905|
|388-71-0610 Who pays for residential care?||388-106-0225, 388-106-0325, 388-106-0425, and 388-106-0525|
|388-71-0613 For what days will the department pay the residential care facility?||388-106-0225, 388-106-0325, 388-106-0425, and 388-106-0525|
|388-71-0615 If I leave a hospital, residential facility, or nursing facility, are there resources available to help me find a place to live?||388-106-0950|
|388-71-0620 Am I eligible for a residential discharge allowance?||388-106-0955|
|NURSING FACILITY CARE AND PAYMENT|
|388-71-0700 What are the requirements for nursing facility eligibility, assessment, and payment?||388-106-0350, 388-106-0355, and 388-106-0360|
|ADULT DAY SERVICES (IN CHAPTER 388-71 WAC EXCEPT FOR THE FOLLOWING)|
|388-71-0704 Adult day care -- Services.||388-106-0800|
|388-71-0706 Adult day health -- Services.||388-106-0805|
|388-71-0708 Adult day care -- Eligibility.||388-106-0810|
|388-71-0710 Adult day health -- Eligibility.||388-106-0815|
|PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)|
|388-71-0800 What is PACE?||388-106-0015|
|388-71-0805 What services does PACE cover?||388-106-0700|
|388-71-0810 Who provides these services?||Repeal|
|388-71-0815 Where are these services provided?||Repeal|
|388-71-0820 How do I qualify for Medicaid-funded PACE services?||388-106-0705|
|388-71-0825 What are my appeal rights?||388-106-1305|
|388-71-0830 Who pays the PACE provider?||388-106-0710|
|388-71-0835 How do I enroll into the PACE program?||388-106-0705|
|388-71-0840 How do I disenroll from the PACE program?||388-106-0715|
|388-71-0845 What are my rights as a PACE client?||388-106-1300|
|PRIVATE DUTY NURSING|
|388-71-0900 What is the intent of WAC 388-71-0900 through 388-71-0960?||388-106-1000|
|388-71-0905 What is private duty nursing (PDN) for adults?||388-106-1005|
|388-71-0910 Am I financially eligible for Medicaid-funded private duty nursing services?||388-106-1010|
|388-71-0915 Am I medically eligible to receive private duty nursing services?||388-106-1010|
|388-71-0920 How is my eligibility determined?||388-106-1015|
|388-71-0925 Am I required to pay participation toward PDN services?||388-106-1020|
|388-71-0930 Are PDN costs subject to estate recovery?||388-106-1020|
|388-71-0935 Who can provide my PDN services?||388-106-1025|
|388-71-0940 Are there limitations or other requirements for PDN?||388-106-1030|
|388-71-0945 What requirements must a home health agency meet in order to provide and get paid for my PDN?||388-106-1035|
|388-71-0950 What requirements must a private RN or LPN meet in order to provide and get paid for my PDN services?||388-106-1040|
|388-71-0955 Can I receive PDN in a licensed adult family home (AFH)?||388-106-1045|
|388-71-0960 Can I receive services in addition to PDN?||388-106-1050|
|388-71-0965 Can I choose to self-direct my care if I receive PDN?||388-106-1055|
|SENIOR CITIZEN'S SERVICES|
|388-71-1000 What is the Senior Citizens Services Act?||388-106-0015|
|388-71-1005 Who administers the Senior Citizens Services Act funds?||Repeal|
|388-71-1010 What services does the SCSA fund?||388-106-1100|
|388-71-1015 How do I apply for SCSA-funded services?||388-106-1105|
|388-71-1020 Am I eligible for SCSA-funded services at no cost?||388-106-1110|
|388-71-1025 What income and resources are exempt when determining eligibility?||388-106-1115|
|388-71-1030 What if I am not eligible to receive SCSA-funded services at no cost?||388-106-1120|
|388-71-1035 What are my rights under SCSA?||388-106-1300|
|RESPITE CARE SERVICES|
|388-71-1065 What is the purpose of the respite care program?||388-106-0015, 388-106-1205|
|388-71-1070 What definitions apply to respite care services?||388-106-1200|
|388-71-1075 Who is eligible to receive respite care services?||388-106-1210|
|388-71-1080 Who may provide respite care services?||388-106-1215|
|388-71-1085 How are respite care providers reimbursed for their services?||388-106-1220|
|388-71-1090 Are participants required to pay for the cost of their services?||388-106-1225|
|388-71-1095 Are respite care services always available?||388-106-1230|
|388-71-1100 What is volunteer chore services (VCS)?||388-106-0015, 388-106-0650|
|388-71-1105 Am I eligible to receive volunteer chore services?||388-106-0655|
|388-71-1110 How do I receive information on applying for volunteer chore services?||Repeal|
|CURRENT WAC SECTIONS IN CHAPTER 388-72A WAC||PROPOSED WAC NUMBER|
|388-72A-0005 When do the rules in chapter 388-72A WAC apply to me?||Repeal|
|388-72A-0010 Does chapter 388-71 WAC apply to me?||Repeal|
|388-72A-0015 If the department did not use the CARE tool for my last assessment, may I have my assessments done on the assessment form used for my last assessment?||Repeal|
|ASSESSMENT AND SERVICE PLANNING|
|388-72A-0020 What is an assessment?||388-106-005|
|388-72A-0025 What is the process for conducting an assessment?||388-106-0065|
|388-72A-0030 What is the purpose of an assessment?||388-106-0055|
|388-72A-0035 What are personal care services?||388-106-0015|
|388-72A-0036 How are my needs for personal care services determined?||388-106-0075|
|388-72A-0037 How are self-performance and support provided for the activities of daily living (ADLs) scored?||388-106-0075|
|388-72A-0038 How are the ADLs bathing, body care, and medication management scored?||388-106-0075|
|388-72A-0039 How are self-performance and difficulty for the instrumental activities of daily living (IADLs) scored?||388-106-0075|
|388-72A-0042 How are ADLs and IADLs scored for children?||388-106-0213|
|388-72A-0043 How are other elements in CARE scored for children age seventeen and younger and foster care clients?||388-106-0213|
|388-72A-0045 How will the department plan to meet my care needs?||Repeal|
|388-72A-0050 What if I disagree with the result of the assessment or the decisions about what services I may receive?||388-106-1305|
|388-72A-0053 Am I eligible for one of the HCP programs?||388-106-0210, 388-106-0310, 388-106-0410, 388-106-0510, and 388-106-0610|
|388-72A-0055 Am I eligible for COPES-funded services?||388-106-0310|
|388-72A-0057 Am I eligible for medically needy residential waiver (MNRW)-funded services?||388-106-0410|
|388-72A-0058 Am I eligible for medically needy in-home wavier (MNIW)-funded services?||388-106-0510|
|388-72A-0060 Am I eligible for MPC-funded services?||388-106-0210|
|388-72A-0065 Am I eligible for Chore-funded services?||388-106-0610|
|388-72A-0069 How does CARE use the information the assessor gathers?||388-106-0055|
|CLASSIFICATION FOR IN-HOME AND RESIDENTIAL CARE|
|388-72A-0070 What are the in-home hours and residential rate based on?||388-106-0080|
|388-72A-0080 What are the elements that the CARE tool evaluates for each of the criteria in WAC 388-72A-0075?||388-106-0085|
|388-72A-0081 How is cognitive performance measured in the CARE tool?||388-106-0090|
|388-72A-0082 How is clinical complexity measured within the CARE tool?||388-106-0095|
|388-72A-0083 How are mood and behaviors measured within the CARE tool?||388-106-0100|
|388-72A-0084 How are ADL scores measured within the CARE tool?||388-106-0105|
|388-72A-0085 How does the CARE tool evaluate for the two exceptional care classifications of in-home care?||388-106-0110|
|388-72A-0086 How is the information in WAC 388-72A-0081 through 388-72A-0084 used to determine the client's classification payment group for residential settings?||388-106-0115|
|388-72A-0087 How is the information in WAC 388-72A-0081 through 388-72A-0085 used to determine the classification payment group for in-home clients?||388-106-0125|
|PAYMENT METHODOLOGY FOR IN-HOME SERVICES|
|388-72A-0090 What are the maximum hours that I can receive for in-home services?||388-106-0135|
|388-72A-0092 How are my in-home hours determined?||388-106-0130|
|388-72A-0095 What additional criteria are considered to determine the number of hours I will receive for in-home services?||388-106-0130|
|388-72A-0100 Are there other in-home services I may be eligible to receive in addition to those described in WAC 388-72A-0095(3)?||388-106-0300|
|388-72A-0105 What would cause a change in the maximum hours authorized?||388-106-0140|
|HOME AND COMMUNITY PAYMENT RATES|
|388-72A-0110 How much will the department pay for my care?||388-106-0120|
|388-72A-0115 When the department adjusts an algorithm, when does the adjustment become effective?||Repeal|
|388-72A-0120 When a client requests a fair hearing to have the client's CARE tool assessment results reviewed and there is (are) a more recent CARE assessment(s), which CARE tool assessment does the administrative law judge review in the fair hearing?||388-106-1310|
Hearing Location(s): Blake Office Park East (behind Goodyear Courtesy Tire), Rose Room, 4500 10th Avenue S.E., Lacey, WA, on March 22, 2005, at 10:00 a.m.
Date of Intended Adoption: Not early than March 23, 2005.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA, e-mail email@example.com, fax (360) 664-6185, by 5:00 p.m., March 22, 2005.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by March 18, 2005, TTY (360) 664-6178 or (360) 664-6097.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: New WAC chapters and rules are required to phase out rules that no longer apply, due to the implementation of the comprehensive assessment reporting and evaluation (CARE) tool. In addition, ADSA is reorganizing, amending and streamlining rules to ensure that all rules are current and clear.
This rule making includes the following significant changes:
• Clarifies requirements for how to conduct an assessment when other who are present impede the process.
• Adds a client rights section.
• Includes the right to contest "Other decisions by the department" in the fair hearing section.
• Includes a new program, community transition services, under the COPES, MNIW, and MNRW waiver.
• Incorporates changes to the eligibility and number of hours you may receive under private duty nursing.
• Included CARE deductions (e.g., one meal is thirty minutes).
• Changes to how residential care discharge allowance can be authorized.
• Sets a minimum standards for determining eligibility under respite.
Reasons Supporting Proposal: See above.
Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.
Statute Being Implemented: RCW 74.08.090, 74.09.520.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of Social and Health Services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Brooke Buckingham, P.O. Box 45600, Olympia, WA 98504-5600, (425) 670-6458.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the rules and determined that no new costs will be imposed on businesses.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed new rules are exempt by RCW 34.05.328 (5)(b)(vii), rules relating to client medical eligibility. Amended rules are exempted by RCW 34.05.328 (5)(b)(iv), making address and name changes, and clarifying a rule without changing its effect.
January 12, 2005
Andy Fernando, 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 05-05 issue of the Register.