SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Effective Date of Rule: January 1, 2006.
Purpose: These rules are necessary to implement ESSB 6090, section 205 (1)(e), 2005-2007 conference budget (chapter 518, Laws of 2005), which establishes a flexible family support pilot program for families who are providing care and support for family members with developmental disabilities. The family support pilot program is funded through June 30, 2007. The division of developmental disabilities (DDD) determined that new sections of chapter 388-825 WAC are necessary to implement the legislature's directive in ESSB 6090.
Statutory Authority for Adoption: RCW 71A.12.030, 71A.12.040.
Other Authority: Section 205 (1)(e), chapter 518, Laws of 2005, Title 71A RCW.
Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.
Reasons for this Finding: Emergency rules are needed to implement the legislature's directive in section 205 (1)(e), chapter 518, Laws of 2005, as soon as possible in fiscal year 2006 to preserve and improve the welfare of families of persons with developmental disabilities by providing family support pilot program services. The department is adopting these emergency rules as permanent. A proposed rule (CR-102) has been filed as WSR 05-24-090 on December 6, 2005, and the hearing is scheduled for January 10, 2006. We expect the permanent rules to be adopted by March 1, 2006.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 33, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 33, Amended 0, Repealed 0.
Date Adopted: December 27, 2005.
Andy Fernando, Manager
Rules and Policies Assistance Unit3615.2
(2) The purpose of the Family Support Pilot is to provide paid services in a flexible manner to eligible DDD clients.
(1) Be a client of DDD.
(a) Your eligibility must be current.
(b) WAC 388-823-1010 may require a review of your eligibility prior to any approval of paid services.
(2) Be in DDD's current database as having requested FSP.
(3) Live with family as defined in WAC 388-825-512.
(4) Not be receiving any other DDD paid services as defined in WAC 388-825-516.
(5) Have been determined ineligible for Medicaid Personal Care (MPC).
(6) Have a gross household annual income of less than or equal to 400% of federal poverty level (FPL).
(7) Have completed a mini-assessment per chapter 388-824 WAC.
(2) The award will be paid directly to the provider.
(1) You receive other DDD funded services identified in WAC 388-823-1015, including services through the DDD HCBS waiver per WAC 388-845-0050;
(2) You are eligible for Medicaid Personal Care;
(3) You receive the State Supplementary Payment administered by DDD; or
(4) You are under age three. (All children under age three receive or are eligible to receive services through the Infant Toddler Early Intervention Program and/or child development services through DDD.)
(1) DDD cannot determine your financial eligibility for FSP without this information.
(2) If you do not provide this information, you will not be eligible for FSP services.
|Household Size||100% FPL||200% FPL||300% FPL||400% FPL|
|100% FPL||200% FPL||300% FPL||400% FPL|
(1) Ownership of income is defined in WAC 388-450-0005.
(2) Income that is not counted is defined in WAC 388-450-0015.
(3) Unearned income is defined in WAC 388-450-0025.
(4) Earned income is defined in WAC 388-450-0030.
(1) If you are under age eighteen, your household includes:
(b) Your full, half, step or adoptive siblings under age eighteen living with you; and
(c) Your natural or adoptive parent(s) or stepparent(s) living with you.
(2) If you are age eighteen or older, your household includes only you.
(2) If you are age eighteen or older, you are the only household member to declare income. You must report all unearned and earned income.
(3) Income is subject to verification upon department request.
Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
WAC 388-825-544 If I meet eligibility for FSP, will I receive paid services? You will have access to an amount of paid services called an "FSP Award" if:
(1) You are determined eligible by DDD to participate in FSP;
(2) You meet one of the priority groups in WAC 388-825-554; and
(3) There is funding available.
|Amount of Annual Income||Amount of Award|
|Equal to or less than 100% FPL||Up to $4,000 per year|
|Greater than 100% but equal to or less than 200% FPL||Up to $3,000 per year|
|Greater than 200% but equal to or less than 300% FPL||Up to $2,000 per year|
|Greater than 300% but equal to or less than 400% FPL||Up to $1,000 per year|
(1) Client or caregiver with health and safety needs that places the client at immediate risk of out-of-home placement in a nursing facility or ICF/MR.
(2) Clients living in single parent households;
(3) Clients with multiple disabilities; and
(4) Clients who are at least twenty-one years old and graduated from high school who need employment services.
(1) Respite care which is intermittent relief to your caregiver.
(a) Respite care may be provided in your home or the home of a relative or licensed provider, or community setting/activity contracted for respite care.
(b) The respite provider must be a qualified individual or agency per WAC 388-825-300 through WAC 388-825-400.
(c) Respite care may be provided by a registered or licensed nurse if you require a licensed health professional as determined by DDD.
(2) Training and consultation for you or your family, including:
(a) Counseling related to your disability or genetic counseling.
(b) Parenting classes and disability related support groups.
(c) Behavior management/counseling.
(3) Assistive technologies or specialized or adaptive equipment related to your development disability:
(a) Mobility devices such as walkers and wheelchairs are included, as well as communication devices and medical supplies such as diapers for children three years of age or older.
(b) Professional justifications may be required by the department.
(4) Employment services for those clients twenty-one years of age and older. See chapter 388-850 WAC.
(5) Extraordinary household expenses resulting from the client's developmental disability such as a portion of the power bill for a ventilator dependent client.
(a) The expense is limited to the total cost divided by the total number of persons living in the family.
(b) This will not include the purchase of any appliances, furniture, or floor coverings.
(1) FSP services are authorized only after you have accessed what is available to you under Medicaid, and any other private health insurance plan, school or child development services.
(2) All FSP service payments must be agreed to by DDD and the client in a written service plan.
(3) The department will contract directly with providers. FSP funding cannot be authorized for services or treatments determined by the department to be experimental.
(4) Your choice of qualified providers and services is limited to the most cost effective option that meets your assessed need.
(5) Respite care cannot be a replacement for child care while the parent or guardian is at work regardless of the age of the child.
(6) The department shall not authorize a birth parent, adoptive parent, step-parent or any other primary caregiver or their spouse living in the same household with the client to provide respite, nursing, therapy or counseling services.
(7) FSP will not pay for conference registrations.
(8) FSP will not pay for behavior management/counseling procedures, modifications, or equipment that are restrictive.
(9) FSP will not pay for services provided after the death of the eligible client. Payment may occur after the date of death, but not the service.
(10) FSP will not pay for employment services if you are under age twenty-one or are designated to receive DDD funded transition services.
(2) The FSP plan will last for up to twelve months, but cannot extend beyond June 30, 2007.
(3) The department has the final approval over service authorization.
(1) The one-time award can only be approved for the following services performed by a DDD contracted provider:
(a) Respite care; and/or
(b) Behavior management/counseling.
(2) A one-time award may be approved only once during the period of time covered by your FSP plan.
(3) Providers of the services in subsection (1) of this section must be contracted with and paid directly by DDD.
(2) The Family Support Pilot ends June 30, 2007.
(1) Your DDD eligibility is terminated per chapter 388-823 WAC;
(2) You no longer live with a family as defined in WAC 388-825-512;
(3) You begin living independently or with a spouse;
(4) You begin to receive other DDD funded services;
(5) Your household income exceeds 400% of the FPL;
(6) You become eligible for Medicaid Personal Care; and or
(7) FSP funding is no longer available.
(2) Changes in gross annual household income and changes in household size are effective at the time your FSP plan is reviewed.
(1) Denial of eligibility to participate in the FSP per WAC 388-825-510.
(2) A denial, reduction or termination of FSP services.
(3) A denial or termination of your choice of a qualified provider.