WSR 12-21-093

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed October 22, 2012, 3:51 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 12-10-090.

Title of Rule and Other Identifying Information: WAC 388-105-0005 The daily medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and boarding homes contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services.

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 http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), on November 27, 2012, at 10:00 a.m.

Date of Intended Adoption: Not earlier than November 28, 2012.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on November 27, 2012.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by November 6, 2012, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at jennisha.johnson@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: WAC 388-105-0005 contains the rate table used to calculate the daily medicaid rate for AFH and AL facilities (formerly called boarding homes) contracted to provide AL, ARC, and EARC. To comply with the budgetary directives put forth by the legislature in ESHB 2127 (2012 supplementary budget), changes need to be made to WAC 388-105-0005 including: AFH will have their rates adjusted to include adjusted funding for training costs and a vendor rate increase corresponding to a higher license fee. AL facilities (formerly called boarding homes) contracted to provide AL, ARC, and EARC will have their rates adjusted to include adjusted funding for training costs and a two percent reduction in rates.

AFH and AL facilities (formerly called boarding homes) contracted to provide AL, ARC, and EARC will be affected by this rule change. The proposed rule change will update the dollar amounts in the table. Additionally, it will update the language from "boarding homes" to "assisted living facilities" per SHB 2056.

Reasons Supporting Proposal: See above.

Statutory Authority for Adoption: RCW 74.39A.030 (3)(a).

Statute Being Implemented: ESHB 2127 and SHB 2056.

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: Elizabeth Pashley, 4450 10th Avenue S.E., Lacey, WA 98503, (360) 725-2447; Implementation and Enforcement: Ken Callaghan, 4450 10th Avenue S.E., Lacey, WA 98503, (360) 725-2499.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The rule change is adjusting rates pursuant to legislative standards. Exemption: RCW 34.05.310 (4)(f).

A cost-benefit analysis is not required under RCW 34.05.328. The rule change is adjusting rates pursuant to legislative standards. RCW 34.05.328 (5)(b)(vi).

October 18, 2012

Katherine I. Vasquez

Rules Coordinator

4360.3
AMENDATORY SECTION(Amending WSR 12-02-050, filed 12/30/11, effective 1/30/12)

WAC 388-105-0005   The daily medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and ((boarding homes)) assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services.   For contracted AFH and ((boarding homes)) assisted living facilities contracted to provide AL, ARC, and EARC services, the department pays the following daily rates for care of a medicaid resident:


COMMUNITY RESIDENTIAL DAILY RATES FOR CLIENTS ASSESSED USING CARE
KING COUNTY
CARE CLASSIFICATION AL Without Capital Add-on AL With Capital Add-on ARC EARC AFH
A Low $((66.52))

65.58

$((71.94))

71.00

$((47.06))

46.51

$((47.06))

46.51

$((46.61))

47.45

A Med $((72.02))

70.97

$((77.44))

76.39

$((53.39))

52.71

$((53.39))

52.71

$((52.86))

53.70

A High $((80.81))

79.58

$((86.23))

85.00

$((58.63))

57.85

$((58.63))

57.85

$((59.12))

59.96

B Low $((66.52))

65.58

$((71.94))

71.00

$((47.06))

46.51

$((47.06))

46.51

$((46.84))

47.68

B Med $((74.22))

73.13

$((79.64))

78.55

$((59.72))

58.92

$((59.72))

58.92

$((59.41))

60.25

B Med-High $((84.05))

82.76

$((89.47))

88.18

$((63.50))

62.62

$((63.50))

62.62

$((63.64))

64.48

B High $((88.48))

87.10

$((93.90))

92.52

$((72.58))

71.52

$((72.58))

71.52

$((72.73))

73.57

C Low $((72.02))

70.97

$((77.44))

76.39

$((53.39))

52.71

$((53.39))

52.71

$((52.86))

53.70

C Med $((80.81))

79.58

$((86.23))

85.00

$((67.00))

66.05

$((67.00))

66.05

$((67.44))

68.28

C Med-High $((100.58))

98.96

$((106.00))

104.38

$((89.29))

87.89

$((89.29))

87.89

$((88.28))

89.12

C High $((101.58))

99.94

$((107.00))

105.36

$((90.14))

88.73

$((90.14))

88.73

$((89.51))

90.35

D Low $((74.22))

73.13

$((79.64))

78.55

$((72.14))

71.09

$((72.14))

71.09

$((68.74))

69.58

D Med $((82.46))

81.20

$((87.88))

86.62

$((83.57))

82.29

$((83.57))

82.29

$((84.09))

84.93

D Med-High $((106.61))

104.87

$((112.03))

110.29

$((106.26))

104.52

$((106.26))

104.52

$((101.14))

101.98

D High $((114.88))

112.97

$((120.30))

118.39

$((114.88))

112.97

$((114.88))

112.97

$((115.12))

115.96

E Med $((138.82))

136.43

$((144.24))

141.85

$((138.82))

136.43

$((138.82))

136.43

$((139.06))

139.90

E High $((162.76))

159.89

$((168.18))

165.31

$((162.76))

159.89

$((162.76))

159.89

$((163.01))

163.85


COMMUNITY RESIDENTIAL DAILY RATES FOR CLIENTS ASSESSED USING CARE
METROPOLITAN COUNTIES*
CARE CLASSIFICATION AL Without Capital Add-on AL With Capital Add-on ARC EARC AFH
A Low $((61.02))

60.19

$((65.94))

65.11

$((47.06))

46.51

$((47.06))

46.51

$((46.61))

47.45

A Med $((64.33))

63.43

$((69.25))

68.35

$((51.28))

50.64

$((51.28))

50.64

$((50.77))

51.61

A High $((78.61))

77.43

$((83.53))

82.35

$((55.91))

55.18

$((55.91))

55.18

$((55.98))

56.82

B Low $((61.02))

60.19

$((65.94))

65.11

$((47.06))

46.51

$((47.06))

46.51

$((46.84))

47.68

B Med $((69.81))

68.80

$((74.73))

73.72

$((56.56))

55.82

$((56.56))

55.82

$((56.26))

57.10

B Med-High $((79.07))

77.88

$((83.99))

82.80

$((60.14))

59.33

$((60.14))

59.33

$((60.32))

61.16

B High $((86.29))

84.95

$((91.21))

89.87

$((70.53))

69.51

$((70.53))

69.51

$((70.68))

71.52

C Low $((64.33))

63.43

$((69.25))

68.35

$((51.49))

50.85

$((51.49))

50.85

$((51.15))

51.99

C Med $((78.61))

77.43

$((83.53))

82.35

$((66.14))

65.21

$((66.14))

65.21

$((65.80))

66.64

C Med-High $((97.27))

95.71

$((102.19))

100.63

$((82.96))

81.69

$((82.96))

81.69

$((82.04))

82.88

C High $((98.24))

96.67

$((103.16))

101.59

$((88.24))

86.87

$((88.24))

86.87

$((87.03))

87.87

D Low $((69.81))

68.80

$((74.73))

73.72

$((71.15))

70.12

$((71.15))

70.12

$((67.23))

68.07

D Med $((80.21))

79.00

$((85.13))

83.92

$((81.90))

80.65

$((81.90))

80.65

$((81.83))

82.67

D Med-High $((103.11))

101.44

$((108.03))

106.36

$((103.63))

101.95

$((103.63))

101.95

$((98.06))

98.90

D High $((111.72))

109.88

$((116.64))

114.80

$((111.72))

109.88

$((111.72))

109.88

$((111.38))

112.22

E Med $((134.51))

132.21

$((139.43))

137.13

$((134.51))

132.21

$((134.51))

132.21

$((134.17))

135.01

E High $((157.30))

154.54

$((162.22))

159.46

$((157.30))

154.54

$((157.30))

154.54

$((156.96))

157.80

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.


COMMUNITY RESIDENTIAL DAILY RATES FOR CLIENTS ASSESSED USING CARE
NONMETROPOLITAN COUNTIES**
CARE CLASSIFICATION AL Without Capital Add-on AL With Capital Add-on ARC EARC AFH
A Low $((59.94))

59.13

$((65.18))

64.37

$((47.06))

46.51

$((47.06))

46.51

$((46.61))

47.45

A Med $((64.33))

63.43

$((69.57))

68.67

$((50.23))

49.62

$((50.23))

49.62

$((49.74))

50.58

A High $((78.61))

77.43

$((83.85))

82.67

$((55.01))

54.30

$((55.01))

54.30

$((54.95))

55.79

B Low $((59.94))

59.13

$((65.18))

64.37

$((47.06))

46.51

$((47.06))

46.51

$((46.84))

47.68

B Med $((69.81))

68.80

$((75.05))

74.04

$((55.51))

54.79

$((55.51))

54.79

$((55.22))

56.06

B Med-High $((79.07))

77.88

$((84.31))

83.12

$((59.01))

58.22

$((59.01))

58.22

$((59.14))

59.98

B High $((86.29))

84.95

$((91.53))

90.19

$((66.71))

65.77

$((66.71))

65.77

$((66.86))

67.70

C Low $((64.33))

63.43

$((69.57))

68.67

$((50.23))

49.62

$((50.23))

49.62

$((49.74))

50.58

C Med $((78.61))

77.43

$((83.85))

82.67

$((62.52))

61.66

$((62.52))

61.66

$((63.29))

64.13

C Med-High $((97.27))

95.71

$((102.51))

100.95

$((79.79))

78.58

$((79.79))

78.58

$((78.92))

79.76

C High $((98.24))

96.67

$((103.48))

101.91

$((83.41))

82.13

$((83.41))

82.13

$((82.32))

83.16

D Low $((69.81))

68.80

$((75.05))

74.04

$((67.26))

66.30

$((67.26))

66.30

$((63.59))

64.43

D Med $((80.21))

79.00

$((85.45))

84.24

$((77.42))

76.26

$((77.42))

76.26

$((77.39))

78.23

D Med-High $((103.11))

101.44

$((108.35))

106.68

$((97.95))

96.38

$((97.95))

96.38

$((92.74))

93.58

D High $((105.60))

103.88

$((110.84))

109.12

$((105.60))

103.88

$((105.60))

103.88

$((105.32))

106.16

E Med $((127.14))

124.99

$((132.38))

130.23

$((127.14))

124.99

$((127.14))

124.99

$((126.86))

127.70

E High $((148.68))

146.10

$((153.92))

151.34

$((148.68))

146.10

$((148.68))

146.10

$((148.41))

149.25


** Nonmetropolitan counties: Adams, Asotin, Chelan, Clallam, Columbia, Cowlitz, Douglas, Ferry, Garfield, Grant, Grays Harbor, Jefferson, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Orielle, San Juan, Skagit, Skamania, Stevens, Wahkiakum, Walla Walla and Whitman.

[Statutory Authority: RCW 74.34 RCW based on 2011 1st sp.s. c 7. 12-02-050, 388-105-0005, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 74.39A.030(3) and 2010 c 37 206 (19)(a). 10-21-035, 388-105-0005, filed 10/12/10, effective 10/29/10. Statutory Authority: RCW 74.39A.030(3), 18.20.290, and 2009 c 564 206(4). 09-20-011, 388-105-0005, filed 9/25/09, effective 10/26/09. Statutory Authority: RCW 74.39A.030 (3)(a). 09-11-053, 388-105-0005, filed 5/13/09, effective 6/13/09. Statutory Authority: Chapter 74.39A RCW, RCW 18.20.290, 2006 c 372, 260, and 64. 06-19-017, 388-105-0005, filed 9/8/06, effective 10/9/06. Statutory Authority: Chapter 74.39A RCW. 06-07-013, 388-105-0005, filed 3/3/06, effective 4/3/06. Statutory Authority: RCW 74.39A.030, 2003 c 231. 04-09-092, 388-105-0005, filed 4/20/04, effective 5/21/04. Statutory Authority: 2002 c 371. 02-22-058, 388-105-0005, filed 10/31/02, effective 12/1/02. Statutory Authority: 2001 c 7 206. 01-21-077, 388-105-0005, filed 10/18/01, effective 11/18/01. Statutory Authority: Chapter 74.39A RCW. 01-14-056, 388-105-0005, filed 6/29/01, effective 7/30/01.]