WSR 12-17-036



(Division of Developmental Disabilities)

[ Filed August 7, 2012, 2:02 p.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 12-11-123.

     Title of Rule and Other Identifying Information: The department is proposing the amendment of current sections and adoption of new sections in chapter 388-845 WAC.

     The proposed amendments are WAC 388-845-0005 What are home and community based services (HCBS) waivers?, 388-845-0010 What is the purpose of HCBS waivers?, 388-845-0030 Do I meet criteria for HCBS waiver-funded services?, 388-845-0045 When there is capacity to add people to a waiver, how does DDD determine who will be enrolled?, 388-845-0050 How do I request to be enrolled in a waiver?, 388-845-0060 Can my waiver enrollment be terminated?, 388-845-0070 What determines if I need ICF/MR level of care?, 388-845-0105 What criteria determine assignment to the community protection waiver?, 388-845-0110 Are there limitations to the waiver services I can receive?, 388-845-0205 Basic waiver services, 388-845-0210 Basic Plus waiver services, 388-845-0215 CORE waiver services, 388-845-0220 Community protection waiver services, 388-845-0225 Children's intensive in-home behavioral support (CIIBS) waiver services, 388-845-0310 Are there limits to the AFH services I can receive?, 388-845-0400 What are adult residential care (ARC) services?, 388-845-0405 Who is a qualified provider of ARC services?, 388-845-0410 Are there limits to the ARC services I can receive?, 388-845-0500 What is behavior management and consultation?, 388-845-0501 What is included in behavior management and consultation for the children's intensive in-home behavioral support (CIIBS) waiver?, 388-845-0505 Who is a qualified provider of behavior management and consultation?, 388-845-0510 Are there limits to the behavior management and consultation I can receive?, 388-845-0750 What are community transition services?, 388-845-0800 What is emergency assistance?, 388-845-0820 Are there limits to my use of emergency assistance?, 388-845-0900 What are environmental accessibility adaptations?, 388-845-1100 What are mental health crisis diversion bed services?, 388-845-1105 Who is a qualified provider of mental health crisis diversion bed services?, 388-845-1110 What are the limits of mental health crisis diversion bed services?, 388-845-1150 What are mental health stabilization services?, 388-845-1155 Who are qualified providers of mental health stabilization services?, 388-845-1160 Are there limitations to the mental health stabilization services that I can receive?, 388-845-1310 Are there limits to the personal care services I can receive?, 388-845-1600 What is respite care?, 388-845-1605 Who is eligible to receive respite care?, 388-845-1610 Where can respite care be provided?, 388-845-1615 Who are qualified providers of respite care?, 388-845-1620 Are there limits to the respite care I can receive?, 388-845-1710 Are there limitations to the skilled nursing services I can receive?, 388-845-1800 What are specialized medical equipment and supplies?, 388-845-1900 What are specialized psychiatric services?, 388-845-1910 Are there limitations to the specialized psychiatric services I can receive?, 388-845-2000 What is staff/family consultation and training?, 388-845-2200 What are transportation services?, 388-845-3000 What is the process for determining the services I need?, 388-845-3055 What is a waiver individual support plan (ISP)?, 388-845-3056 What if I need assistance to understand my individual support plan?, 388-845-3060 When is my plan of care or individual support plan effective?, 388-845-3061 Can a change in my plan of care or individual support plan be effective before I sign it?, 388-845-3062 Who is required to sign or give verbal consent to the plan of care or individual support plan?, 388-845-3065 How long is my plan effective?, 388-845-3070 What happens if I do not sign or verbally consent to my individual support plan (ISP)?, 388-845-3075 What if my needs change?, 388-845-3080 What if my needs exceed the maximum yearly funding limit or the scope of services under the Basic or Basic Plus waiver?, 388-845-3085 What if my needs exceed what can be provided under the CIIBS, CORE or community protection waiver?, 388-845-4000 What are my appeal rights under the waiver?, and 388-845-4005 Can I appeal a denial of my request to be enrolled in a waiver?

     The proposed new sections are WAC 388-845-1607 Can someone who lives with me be my respite provider? and 388-845-3063 Can my individual support plan be effective before the end of the month?

     Hearing Location(s): Office Building 2, Lookout Room, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at, on October 9, 2012, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than October 9, 2012.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail, fax (360) 664-6185, by 5 p.m. on October 9, 2012.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by September 19, 2012, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Chapter 388-845 WAC is being amended to comply with federal and state law. Proposed updates include:

Rename ICF/MR to ICF/ID;
Rename behavior management and consultation and mental health stabilization;
Remove duplication of plan of care language;
Remove obsolete link and rule citations;
Eliminate skilled nursing services under mental health stabilization services;
Clarify residential setting to community transition services;
Clarify when ISP is effective, and
Clarify intent of respite services.

     The changes that are reflected above are required to maintain compliance with the HCBS waiver programs for the division of developmental disabilities that was approved by the Centers for Medicare and Medicaid Services. This request for rule modification is to address obsolete language that is in conflict in all of the approved HCBS waivers, clarify language to ensure that services are implemented consistent with services contained in the approved HCBS waiver program, or to update language that is no longer in compliance with federal and state law. These changes ensure the division is in compliance with the HCBS waiver program and to ensure the division can continue to collect federal financial match for the receipt of services.

     Reasons Supporting Proposal: See above.

     Statutory Authority for Adoption: RCW 71A.12.030, 74.08.090.

     Statute Being Implemented: RCW 71A.12.030, 74.08.090.

     Rule is necessary because of federal law, [no further information supplied by agency].

     Name of Proponent: Department of social and health services.

     Name of Agency Personnel Responsible for Drafting and Implementation: Kris Pederson, P.O. Box 45310, Olympia, WA 98504-5310, (360) 725-3445; and Enforcement: Mark Eliason, P.O. Box 45310, Olympia, WA 98504-5310, (360) 725-3452.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The preparation of a small business impact statement is not required as no new costs will be imposed on small businesses or nonprofits as a result of this rule amendment.

     A cost-benefit analysis is not required under RCW 34.05.328. Rules are exempt per RCW 34.05.328 (5)(b)(v), rules the content of which is explicitly and specifically dictated by statute.

July 30, 2012

Katherine J. Vasquez

Rules Coordinator

     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 12-18 issue of the Register.