WSR 08-11-072

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed May 19, 2008, 10:35 a.m. , effective June 19, 2008 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: These amendments and new sections define and reorganize the rules governing the delivery of services to individuals with developmental disabilities.

Washington Administrative Code Effect of Rule Impact Small Business?
388-825-020 Definitions

"Abandonment" - repealed

"Adolescent" - repealed

"Attendant care" - repealed

"Best interest" - repealed

"Client or person" - amended

"Community support services" - repealed

"Companion home" - repealed

"Division or DDD" - amended

"Emergency" - repealed

"Exemption" - repealed

"Family" - amended

"Family resource coordinator" - repealed

"ICF/MR" - amended

"Individual support plan (ISP)" - new

"Individual" - repealed

"Individual alternative living" - repealed

"Intelligence quotient score" - repealed

"Intensive individual supported living support" - repealed

"Medicaid personal care" - amended

"Non-residential programs" - repealed

"Nursing facility eligible" - repealed

"Other resources" - repealed

"Part C" - repealed

"RHC capacity" - repealed

"Residential programs - amended

"Respite care" - amended

"Vacancy" - repealed

"Vulnerable adult" - repealed

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is now contained in WAC 388-825-074.

Definition is no longer used in this chapter.

Revises definition to correspond with other chapters.

Definition is no longer used in this chapter.

Definition is now contained in chapter 388-829C WAC.

Adds the aging and disability services administration to the definition.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Revises definition of "family" to correspond with other chapters.

Definition is no longer used in this chapter.

Clarifies the definition of ICF/MR.

Adds the definition of ISP.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Corrects the cross reference to chapter 388-106 WAC.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

Corrects the types of programs considered to be residential and adds cross references.

Amends definition for consistency with other programs.

Definition is no longer used in this chapter.

Definition is no longer used in this chapter.

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388-825-025 - repealed Exemptions are no longer valid. No
388-825-045 - repealed Section is broken down into more manageable sections later in this chapter. No
388-825-050 - repealed Individual service plans are no longer in use. No
388-825-055 - repealed Section is broken down into more manageable sections later in this chapter. No
388-825-056 - new Describes how DDD services benefit persons with developmental disabilities. No
388-825-057 - new Describes how eligibility for paid services is determined. No
388-825-0571 - new Describes the services available to persons under eighteen who are in a dependency guardianship or foster care with children's administration. No
388-825-058 - new Lists services that DDD may authorize. No
388-825-059 - new Clarifies that the individual support plan identifies the services and the amount to be received. No
388-825-061 - new Describes services for persons under the age of three. No
388-825-062 - new Defines the infant toddler early intervention program (ITEIP). No
388-825-063 - new Defines services available under ITEIP. No
388-825-065 - repealed Section is no longer applicable. No
388-825-066 - new Describes where program eligibility rules and service definitions for ITEIP can be found. No
388-825-067 - new Defines medicaid state plan services. No
388-825-068 - new Describes what medicaid state plan service that DDD can authorize. No
388-825-069 - new Describes service available under the DDD home and community-based services (HCBS) waiver. No
388-825-071 - new Describes eligibility criteria for services for persons enrolled in a DDD HCBS waiver. No
388-825-072 - new Describes where information on DDD's HCBS waivers can be found. No
388-825-073 - new Defines "state-only funded" services. No
388-825-074 - new Describes eligibility for state-only funded services. No
388-825-079 - new Defines which HCBS waiver services that DDD can authorize with state-only funding for persons not on an HCBS waiver. No
388-825-080 - repealed Section is moved to WAC 388-825-098 and reworded. No
388-825-081 - new Defines which state-only funded services not available in a HCBS waiver that DDD can authorize. No
388-825-082 - new Lists and defines other state-only funded services that are not contained in other DDD rules. No
388-825-083 - new Lists all of the services available through DDD. No
388-825-084 - new Lists limitations of state-only services and programs. No
388-825-0871 - new Lists out-of-home residential services that address the special needs of persons with developmental disabilities. No
388-825-088 - new Lists where additional information can be found about DDD contracted residential services. No
388-825-089 - new Defines residential habilitation centers (RHCs) and lists the RHCs' locations in the state. No
388-825-091 - new Defines the eligibility for RHC services. No
388-825-093 - new Defines when a person can receive a short-term stay at an RHC. No
388-825-094 - new Describes when a person can request to live in an RHC and how the request is processed. No
388-825-096 - new Describes what a person must pay toward the cost of DDD services. No
388-825-097 - new Describes what expenses can be deducted from income in determining participation. No
388-825-098 - new Moved from WAC 388-825-080 and reworded for clarity. No

Citation of Existing Rules Affected by this Order: Repealing WAC 388-825-025, 388-825-045, 388-825-050, 388-825-055, 388-825-065 and 388-825-080; and amending WAC 388-825-020.

Statutory Authority for Adoption: RCW 71A.10.015, 71A.12.020, and 71A.12.030.

Other Authority: Title 71A RCW.

Adopted under notice filed as WSR 08-07-103 on March 19, 2008.

Changes Other than Editing from Proposed to Adopted Version: The WAC cross reference in WAC 388-825-057(1) is corrected from WAC 388-825-061 through 388-825-066 to 388-823-0800 through 388-823-0850.

The changes were made because the WAC cross reference in the proposed rule was incorrect.

A final cost-benefit analysis is available by contacting Steve Brink, P.O. Box 45310, Olympia, WA 98507-5310, phone (360) 725-3416, fax (360) 404-0955, e-mail brinksc@dshs.wa.gov.

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 0, 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 30, Amended 1, Repealed 6.

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 30, Amended 1, Repealed 6.

Date Adopted: May 16, 2008.

Robin Arnold-Williams

Secretary

3896.9
AMENDATORY SECTION(Amending WSR 04-02-014, filed 12/29/03, effective 1/29/04)

WAC 388-825-020   Definitions.   (("Abandonment" means action or inaction by a person or entity with a duty to care for a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.

"Adolescent" means a DDD eligible child age thirteen through seventeen years.

"Attendant care" means provision of physical and/or behavioral support to protect the safety and well being of a client.

"Best interest" includes, but is not limited to, client-centered benefits to:

(1) Prevent regression or loss of skills already acquired;

(2) Achieve or maintain economic self-support;

(3) Achieve or maintain self-sufficiency;

(4) Prevent or remedy neglect, abuse, or exploitation of individuals unable to protect their own interest;

(5) Preserve or reunite families; and

(6) Provide the least-restrictive setting that will meet the person's medical and personal needs.))

"Client or person" means a person ((the division determines under RCW 71A.16.040 and WAC 388-825-030 eligible for division-funded services)) who has a developmental disability as defined in RCW 71A.10.020(3) who also has been determined eligible to receive services by the division under chapter 71A.16 RCW.

(("Community support services" means one or more of the services listed in RCW 71A.12.040 including, but not limited to the following services: Architectural, case management, early childhood intervention, employment, counseling, family support, respite care, information and referral, health services and equipment, therapy services, and residential support.

"Companion home" means the same as "intensive individual supported living support."))

"Department" means the department of social and health services of the state of Washington.

"Director" means the director of the division of developmental disabilities.

"Division or DDD" means the division of developmental disabilities within the aging and disability services administration of the department of social and health services.

(("Emergency" means a sudden, unexpected occurrence demanding immediate action.

"Exemption" means the department's approval of a written request for an exception to a rule in this chapter.))

"Family" means ((individuals, of any age, living together in the same household and related by blood, marriage, adoption or as a result of sharing legal custody of a minor child)) relatives who live in the same home with the eligible client. Relatives include spouse; natural, adoptive or step parents; grandparents; brother; sister; stepbrother; stepsister; uncle; aunt; first cousin; niece; or nephew.

(("Family resources coordinator" means the person who is:

(1) Recognized by the IDEA Part C lead agency; and

(2) Responsible for:

(a) Providing family resources coordination;

(b) Coordinating services across agencies; and

(c) Serving as a single contact to help families receiving assistance and services for their eligible children who are under three years of age.))

"ICF/MR" means a facility certified as an intermediate care facility for the mentally retarded by Title XIX to provide diagnosis, treatment and rehabilitation services to the mentally retarded or persons with related conditions.

"ICF/MR eligible" for admission to an ICF/MR means a person is determined by DDD as needing active treatment as defined in CFR 483.440. Active treatment requires:

(1) Twenty-four hour supervision; and

(2) Continuous training and physical assistance in order to function on a daily basis due to deficits in the following areas: Toilet training, personal hygiene, dental hygiene, self-feeding, bathing, dressing, grooming, and communication.

"Individual Support Plan (ISP)" is a document that authorizes and identifies the DDD paid services to meet a client's assessed needs.

(("Individual" means a person applying for services from the division.

"Individual alternative living" means provision of community-based individualized client training, assistance and/or ongoing support to enable a client to live as independently as possible with minimal services.

"Intelligence quotient score" means a full scale score on the Wechsler, or the intelligence quotient score on the Stanford-Binet or the Leiter International Performance Scale.

"Intensive individual supported living support" (also known as companion home) means provision of twenty-four hour residential support in a nonlicensed home for no more than one adult person with developmental disabilities in a regular family residence approved and contracted by the department ensuring client health, safety and well-being.))

"Medicaid personal care" is the provision of medically necessary personal care tasks as defined in chapter ((388-15)) 388-106 WAC.

(("Nonresidential programs" means programs including, but not limited to, county-funded habilitation services.

"Nursing facility eligible" means a person is assessed by DDD as meeting the requirements for admission to a licensed nursing home as defined in WAC 388-71-0700 (3) through (5). The person must require twenty-four hour care provided by or under the supervision of a licensed nurse.

"Other resources" means resources that may be available to the client, including but not limited to:

(1) Private insurance;

(2) Medicaid;

(3) Indian health care;

(4) Public school services through the office of the superintendent of public instruction; and

(5) Services through the department of health.

"Part C" means early intervention for children from birth through thirty-five months of age as defined in the Individuals with Disabilities Education Act (IDEA), Part C and 34 CFR, Part 303 and Washington's federally approved grant.))

"Residential habilitation center" or "RHC" means a state-operated facility certified to provide ICF/MR and/or nursing facility level of care for persons with developmental disabilities.

(("RHC capacity" means the maximum number of eligible persons that can reside in a residential habilitation center without exceeding its 1997 legislated budgeted capacity.))

"Residential programs" means provision of support for persons in community living situations. Residential programs include DDD certified community residential services and support, both facility-based such as((,)) licensed group homes, and nonfacility based, ((i.e., supportive)) such as supported living((, intensive tenant support,)) and state-operated living alternatives (SOLA). Other residential programs include ((individual)) alternative living (as described in chapter 388-829A WAC, companion homes (as described in chapter 388-829C WAC), ((intensive individual supportive living services,)) adult family homes, adult residential care services, ((nursing homes, and)) children's foster homes, group care and staffed residential homes.

"Respite care" means ((temporary residential services provided to a person and/or the person's family on an emergency or planned basis)) short-term intermittent relief for persons normally providing care for the individuals.

"Secretary" means the secretary of the department of social and health services or the secretary's designee.

"State supplementary payment (SSP)" is the state paid cash assistance program for certain DDD eligible SSI clients.

(("Vacancy" means an opening at a RHC, which when filled, would not require the RHC to exceed its 1997 biannually budgeted capacity, minus:

(1) Twenty-six beds designated for respite care use; and

(2) Any downsizing related to negotiations with the Department of Justice regarding community placements.

"Vulnerable adult" means a person who has a developmental disability as defined under RCW 71A.10.020.))

[Statutory Authority: RCW 71A.12.030, 71A.10.020 and 2002 c 371. 04-02-014, 388-825-020, filed 12/29/03, effective 1/29/04. Statutory Authority: RCW 71A.16.010, 71A.16.030, 71A.12.030, chapter 71A.20 RCW, RCW 72.01.090, and 72.33.125. 02-16-014, 388-825-020, filed 7/25/02, effective 8/25/02. Statutory Authority: RCW 71A.12.030 and 71A.12.040. 99-23-021, amended and recodified as 388-825-020, filed 11/9/99, effective 12/10/99. Statutory Authority: RCW 71A.12.030. 99-04-071, 275-27-020, filed 2/1/99, effective 3/4/99. Statutory Authority: RCW 74.12A.030 and 71A.16.030. 98-20-044, 275-27-020, filed 9/30/98, effective 10/7/98. Statutory Authority: RCW 71A.14.030 and 71A.16.020. 92-09-115 (Order 3373), 275-27-020, filed 4/21/92, effective 5/22/92. Statutory Authority: RCW 71A.16.020. 91-17-005 (Order 3230), 275-27-020, filed 8/9/91, effective 9/9/91. Statutory Authority: RCW 71.20.070. 89-06-049 (Order 2767), 275-27-020, filed 2/28/89; 84-15-058 (Order 2124), 275-27-020, filed 7/18/84. Statutory Authority: RCW 72.01.090, 72.33.040, 72.33.125 and 72.33.165. 78-04-033 (Order 1280), 275-27-020, filed 3/16/78; Order 1143, 275-27-020, filed 8/11/76.]


NEW SECTION
WAC 388-825-056   What benefits do DDD paid services provide to me?   DDD paid services provide one or more of the following benefits:

(1) An opportunity to learn, improve or retain social and adaptive skills necessary for living in the community;

(2) Health and safety;

(3) Personal power and choice;

(4) Competence and self reliance;

(5) Positive recognition by self and others;

(6) Positive relationships; and

(7) Integration into the physical and social life of the community.

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NEW SECTION
WAC 388-825-057   Am I eligible to receive paid services from DDD?   You may be eligible to receive paid services from DDD if you are currently an eligible client of DDD per chapter 388-823 WAC and:

(1) You are under the age of three and meet the eligibility requirements contained in WAC 388-823-0800 through 388-823-0850; or

(2) You are a recipient of Washington State medicaid under the categorically needy program (CNP) and meet the eligibility requirements contained in chapters 388-474, 388-475 and 388-513 WAC; or

(3) You are enrolled in a DDD home and community based services waiver and meet the eligibility requirements contained in chapter 388-845 WAC; or

(4) You have been enrolled in the individual and family services program and meet the eligibility requirements contained in chapter 388-832 WAC; or

(5) You have been approved to receive a state-only funded service.

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NEW SECTION
WAC 388-825-0571   What services am I eligible to receive from DDD if I am under the age of eighteen, have been determined to meet DDD eligibility requirements, and I am in a dependency guardianship or foster care with children's administration?   Your services from DDD are limited to Medicaid personal care services and related case management if you meet the programmatic eligibility for Medicaid personal care in chapter 388-106 and 388-71 WAC governing Medicaid personal care (MPC) using the current department approved assessment form, comprehensive assessment reporting evaluation (CARE), and:

(1) You are under the age of eighteen;

(2) You have been determined to meet DDD eligibility requirements; and

(3) You are in a dependency guardianship or foster care with children's administration.

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NEW SECTION
WAC 388-825-058   What services does DDD authorize?   DDD authorizes:

(1) Medicaid state plan services;

(2) Infant toddler early intervention program (ITEIP) services;

(3) Home and community based services (HCBS) waiver services; and

(4) State-only funded services.

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NEW SECTION
WAC 388-825-059   How will I know which paid services I will receive?   Your individual support plan (ISP) identifies the services and the amount of service you can receive.

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NEW SECTION
WAC 388-825-061   What service am I eligible for if I am under the age of three?   (1) Children under age three are eligible for the infant toddler early intervention program (ITEIP) under the individuals with disabilities education act, (IDEA), Part C, and Washington's federally approved plan.

(2) Infants and toddlers eligible for DDD may receive DDD state-only funded child development services if funding is available.

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NEW SECTION
WAC 388-825-062   What is infant toddler early intervention program (ITEIP)?   Infant toddler early intervention program (ITEIP) is a statewide, multi-agency program, administered by and located with DDD, to coordinate a system of early intervention services for children, birth to three, and their families under the individuals with disabilities education act (IDEA), Part C/ITEIP state rules and regulations.

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NEW SECTION
WAC 388-825-063   What services can infant toddler early intervention program (ITEIP) provide?   Infant toddler early intervention program (ITEIP) provides family resources coordination (FRC) services. The FRC assists the family and child through the team evaluation/assessment process, eligibility determination. If eligible, the FRC coordinates the development of the individualized family service plan (IFSP) that documents outcomes, early intervention services, funding sources, supports and other information required for service delivery.

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NEW SECTION
WAC 388-825-066   Where do I find the program eligibility rules and service definitions for infant toddler early intervention program (ITEIP)?   Eligibility for infant toddler early intervention program (ITEIP) is defined by the individuals with disabilities education act (IDEA), Part C, and Washington's federally approved plan. Additional ITEIP program and service information is on the ITEIP website: http://www1.dshs.wa.gov/iteip. You can locate the name of the family resources coordinator (FRC) online at http:/www1.dshs.wa.gov/iteip/CountyOrgLinks.html or call the family health hotline at 1-800-322-2588. Parents may self-refer and do not need a doctor's referral for entry into early intervention.

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NEW SECTION
WAC 388-825-067   What are medicaid state plan services?   (1) Medicaid state plan services are those services available to all persons eligible for medicaid under the categorically needy program. See WAC 388-475-0100 for the categorically needy program requirements.

(2) To receive the service, you must be assessed by DSHS to have an unmet need for the service and meet the eligibility criteria for the program. See WAC 388-825-068 for services authorized by DDD.

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NEW SECTION
WAC 388-825-068   What medicaid state plan services can DDD authorize?   DDD can authorize the following medicaid state plan services:

(1) Medicaid personal care, per chapter 388-106 WAC;

(2) Private duty nursing for adults age eighteen and older; per chapter 388-106 WAC;

(3) Private duty nursing for children under the age of eighteen, per WAC 388-551-3000;

(4) Adult day health for adults, per WAC 388-106-0810 and 388-106-0815; and

(5) ICF/MR services, per chapters 388-835 and 388-837 WAC.


Medicaid State Plan Services
Adult day health


ICF/MR services


Medically intensive home care program for children


Private duty nursing for adults

Medicaid personal care

In-home

Adult family home

Adult residential care

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NEW SECTION
WAC 388-825-069   What services are provided under a home and community based services (HCBS) waiver?   (1) Home and community based services (HCBS) waivers provide specific services approved by the federal centers for medicare and medicaid services (CMS) under section 1915 (c) of the social security act as an alternative to placement in an intermediate care facility for the mentally retarded (ICF/MR).

(2) Certain federal regulations governing ICF/MRs are "waived" enabling the provision of services in the home and community to persons who would otherwise require the services provided in an ICF/MR as defined in chapters 388-835 and 388-837 WAC.

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NEW SECTION
WAC 388-825-071   What services am I eligible for if I am enrolled in a DDD home and community based services (HCBS) waiver?   If you are enrolled in a DDD home and community based services waiver, you are eligible for the services identified in your assessment and authorized in your Individual Support Plan.

(1) Your waiver services are limited to the services available in your specific waiver based on an assessment of your health and welfare needs.

(2) The services available through each of DDD's HCBS waivers are described in chapter 388-845 WAC.

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NEW SECTION
WAC 388-825-072   Where do I find information on DDD's home and community based services (HCBS) waiver services, eligibility rules and definitions?   Home and community based services (HCBS) waiver eligibility, the scope of services provided by each waiver, the definitions of the services, the limitations of the service, and qualified providers for the service are contained in chapter 388-845 WAC.

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NEW SECTION
WAC 388-825-073   What is a "state-only funded" service?   State-only funded services are those services paid entirely with state funds. These services are limited by available funding.

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NEW SECTION
WAC 388-825-074   Am I eligible for state-only funded services?   You are eligible to receive available state-only funded services if you have been approved for funding for that service, and all of the following conditions apply:

(1) You have a current DDD assessment that identifies the need for the service;

(2) You meet the programmatic and financial eligibility requirements for the specific service or program;

(3) Your need cannot be met through medicaid state plan services;

(4) You are not enrolled in a DDD home and community based services (HCBS) waiver;

(5) You do not receive SSP as a replacement for the requested service;

(6) The program or service is funded by the legislature.

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NEW SECTION
WAC 388-825-079   If I am not on a DDD HCBS waiver, can I receive services that are available through the DDD HCBS waivers with state-only funding?   (1) With the exception of personal care, you may be authorized to receive any of the services that are available through the DDD HCBS waivers with state-only funding.

(2) Services that are available through the DDD HCBS waivers and authorized with state-only funding:

(a) Are subject to the definitions, limitations and provider qualifications contained in chapter 388-845 WAC; and

(b) Require prior approval by the director of DDD or designee.

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NEW SECTION
WAC 388-825-081   Can I receive state-only funded services that are not available in a DDD HCBS waiver?   You may be authorized to receive state-only funded services that are available in other DSHS rules as defined below:

(1) Adult day care (WAC 388-106-0800);

(2) Attendant care (WAC 388-825-082);

(3) Childcare for foster children (chapter 388-826 WAC);

(4) Chore services (chapter 388-106 WAC);

(5) Supported living allowance (chapter 388-101 WAC);

(6) Individual and family assistance by the county (WAC 388-825-082);

(7) Information and education by the county (WAC 388-825-082);

(8) Medical and dental services (WAC 388-825-082);

(9) Psychological counseling (WAC 388-825-082);

(10) Reimbursement through a family support program to families for the purchase of approved items or service (WAC 388-825-242);

(11) State supplementary payments (chapter 388-827 WAC); and

(12) Transportation reimbursement for an escort (WAC 388-825-082).

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NEW SECTION
WAC 388-825-082   What state-only funded services are authorized in DDD rules?   The following state-only funded services defined below are authorized only by DDD and are not contained in other rules governing DDD.

(1) "Adult day care" not covered by Medicaid is a DDD county service providing a structured social program for adults and is limited to persons receiving the service prior to June 2005.

(2) "Attendant care" provides respite care or personal care and is limited to persons who:

(a) Are not eligible for other DDD services to meet their need; and

(b) Were receiving attendant care in March 2004.

(3) "Individual and family assistance" is a time limited county service available to individuals and families.

(a) Supports are provided to additional families and persons with developmental disabilities in need of services within existing resources;

(b) Individuals and families receiving services have more control and flexibility with the use of the resources; and

(c) The individual and family are assisted in connecting to and using natural and informal community supports.

(4) "Information and education" is a county service that provides a variety of activities and strategies to assure that individuals with developmental disabilities and families have full access to current information about services and support that will assist them in becoming full participants in their communities.

(5) "Medical and dental services" means those services which are necessary for the health of the client and are not covered by medicaid or private insurance.

(6) "Psychological counseling" may provide specialized cognitive counseling, strategies for effectively relating to people or coping with situations and problems.

(7) "Transportation reimbursement for an escort" is the payment for someone other than the driver to provide one-on-one attention to the client being transported.

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NEW SECTION
WAC 388-825-083   Is there a comprehensive list of waiver and state-only DDD services?   For Medicaid state plan services authorized by DDD, see WAC 388-825-068. The following is a list of waiver and state-only services that DDD can authorize and those services that can be either a waiver or a state-only service:

(1) Waiver personal care services that are not available with state-only funds include:

(a) In-home services;

(b) Adult family home; and

(c) Adult residential care.

(2) Waiver services that can be funded as state-only services:

(a) Behavior management and consultation;

(b) Community transition;

(c) Environmental accessibility adaptations;

(d) Medical equipment and supplies;

(e) Occupational therapy;

(f) Physical therapy;

(g) Respite care;

(h) Sexual deviancy evaluation;

(i) Skilled nursing;

(j) Specialized medical equipment or supplies;

(k) Specialized psychiatric services;

(l) Speech, hearing and language therapy;

(m) Staff/family consultation and training;

(n) Transportation/mileage;

(o) Residential habilitation services (RHS), including:

(i) Alternative living;

(ii) Companion homes;

(iii) Supported living;

(iv) Group home;

(v) Child foster care;

(vi) Child group care;

(vii) Staffed residential; and

(viii) State operated SL;

(p) Employment/day programs, including:

(i) Community access;

(ii) Community guide;

(iii) Person-to-person;

(iv) Prevocational services; and

(v) Supported employment;

(q) ITEIP/County programs, including child development services;

(r) Mental health stabilization services, including:

(i) Behavior management and consultation;

(ii) Mental health crisis; and

(iii) Skilled nursing; and

(s) Specialized psychiatric services.

(3) State-only services that are not available as a waiver service:

(a) Adult day care;

(b) Architectural and vehicle modification;

(c) Attendant care;

(d) Child care for foster children;

(e) Chore services;

(f) Community services grant;

(g) Individual and family assistance;

(h) Information/education;

(i) Medical and dental services;

(j) Medical insurance co-pays and costs exceeding other coverage;

(k) Parent and sibling education;

(l) Parent training and counseling;

(m) Psychological counseling;

(n) Recreational opportunities;

(o) State supplementary payments;

(p) Specialized clothing;

(q) Specialized nutrition;

(r) Supported living;

(s) Training of the client;

(t) Transportation - cost of escort service or travel time; and

(u) Reimbursement to families for the purchase of approved items or services.

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NEW SECTION
WAC 388-825-084   What are the limitations of state-only funded services or programs?   In addition to any limitations for state-only funded services or programs that are contained in the program specific rules, the following limitations apply to state-only funded services and programs.

(1) All state-only funded services are limited by available funding.

(2) The following programs are closed to new admissions:

(a) Adult day care; and

(b) Attendant care.

(3) Chore services are limited to persons who were receiving the service in 1998 and who have continued to receive this service monthly.

(4) Traditional family support (TFS) is limited to persons enrolled in the program as of May 31, 1996. This program ends on June 30, 2008.

(5) Family support opportunity (FSO) is limited to persons enrolled in the program from June 1, 1996 through March 27, 2006. This program ends on June 30, 2008.

(6) Family support pilot (FSP) is limited to persons enrolled in the program March 28, 2006 or later. This program ends on June 30, 2008.

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NEW SECTION
WAC 388-825-0871   Does DDD provide out-of-home residential services that address the special needs of persons with developmental disabilities?   DDD provides the following out-of-home residential services that address the special needs of adults and children with developmental disabilities:

(1) Contracted and DDD-certified community based residential services for adults;

(2) Contracted community based services for children; and

(3) Residential habilitation centers (RHC) for a person of any age who requires ICF/MR or nursing facility care.

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NEW SECTION
WAC 388-825-088   Where can I find more information about DDD contracted residential services?   The information about DDD contracted residential services is in the following rules:

(1) Certified community residential services and supports are contained in chapter 388-101 WAC and include information regarding:

(a) Group homes (GH);

(b) Group training home;

(c) Supported living (SL); and

(d) State operated living alternative (SOLA).

(2) Alternative living services are contained in chapter 388-829A WAC;

(3) Companion home services are contained in chapter 388-829C WAC;

(4) Voluntary placement program services for children are contained in chapter 388-826 WAC and include information regarding:

(a) Foster homes;

(b) Group homes;

(c) Group training homes;

(d) Child placing agencies; and

(e) Staffed residential homes.

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NEW SECTION
WAC 388-825-089   What is a residential habilitation center (RHC)?   A residential habilitation center or RHC is a state-only facility certified to provide ICF/MR services (see chapter 388-837 WAC) and/or nursing facility services (chapter 388-97 WAC) for persons who are eligible clients of DDD. RHCs include:

(1) Rainier School in Buckley, Washington;

(2) Francis Hadden Morgan Center in Bremerton, Washington;

(3) Fircrest School in Shoreline, Washington;

(4) Yakima Valley School in Selah, Washington; and

(5) Lakeland Village in Medical Lake, Washington.

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NEW SECTION
WAC 388-825-091   Am I eligible for residential habilitation center (RHC) services?   You are eligible to receive residential habilitation center (RHC) services if:

(1) You are currently DDD eligible;

(2) You choose to receive services in the RHC;

(3) You need the level of care provided at the RHC; and

(4) DDD has determined that you can be supported safely in an RHC environment and will not pose a danger to other residents of the RHC.

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NEW SECTION
WAC 388-825-093   Can I receive a short term stay at a residential habilitation center (RHC)?   If there is capacity at a residential habilitation center (RHC), the vacancies may be available for short term stays.

(1) Short term stays are limited by available vacancies;

(2) Short term stays must be included in your individual support plan; and

(3) Short term stays in excess of thirty days in a calendar year require approval by the director of the division of developmental disabilities.

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NEW SECTION
WAC 388-825-094   Can I request to live in an RHC?   You may request admission to an RHC at any time.

(1) Your case/resource manager will update your DDD assessment and gather other information.

(2) Admission to an RHC requires approval by the director of the division of developmental disabilities or designee.

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NEW SECTION
WAC 388-825-096   Will I have to pay for the services DDD authorizes for me?   (1) If you live in your own home, you do not pay toward the cost of your services except chore services. You must pay toward the cost of chore services as described in WAC 388-106-0625.

(2) If DDD authorizes you to live in a licensed community residential facility you must pay your room and board costs from your earned and unearned income. You may also be responsible for a portion of the cost of your care.

(a) If you are eligible for and receiving SSI or have SSI related eligibility per WAC 388-475-0100 (2)(a) or (b), you are not required to pay toward the cost of your care if you are living at home or in a community setting.

(b) If you are enrolled in a DDD HCBS waiver you must pay toward the cost of your services as described in WAC 388-515-1510.

(c) If you are not enrolled in a DDD HCBS waiver you must pay toward the cost of your services as described in WAC 388-106-0225.

(3) If you live in a medical institution you must pay toward the cost of your care as described in WAC 388-513-1380. See WAC 388-500-0005 for the definition of a medical institution.

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NEW SECTION
WAC 388-825-097   Are any of my expenses deducted from the income available to pay for my care in a licensed facility?   After you pay for your room and board costs, some expenses may be deducted from the income available to pay for the cost of your care.

(1) If you have SSI related eligibility the cost of your payee or guardianship service may be deducted as described in chapter 388-79 WAC and WAC 388-475-0800(5).

(2) If you are enrolled in a DDD HCBS waiver refer to WAC 388-515-1510 for rules used to determine allowable deductions.

(3) If you are not enrolled in a DDD HCBS waiver refer to WAC 388-106-0225 for rules used to determine allowable deductions.

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NEW SECTION
WAC 388-825-098   Does DDD provide guardianship services?   If it appears that you require a guardian to make legal, medical, and/or services decisions and to exercise your appeal rights to department decisions, the division's field services may request that an assistant attorney general initiate and/or assist in guardianship proceedings. The state does not pay the cost of guardianship fees.

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REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-825-025 Exemptions.
WAC 388-825-045 Determination for necessary services.
WAC 388-825-050 Individual service plan.
WAC 388-825-055 Authorization of services.
WAC 388-825-065 Financial services.
WAC 388-825-080 Guardianship services.

Washington State Code Reviser's Office