WSR 15-11-073 PROPOSED RULES DEPARTMENT OF SOCIAL AND HEALTH SERVICES (Developmental Disabilities Administration) [Filed May 19, 2015, 11:15 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 15-07-007.
Title of Rule and Other Identifying Information: WAC 388-825-145 Will my benefits continue if I request an administrative hearing?
Hearing Location(s): Office Building 2, 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 June 23, 2015, at 10:00 a.m.
Date of Intended Adoption: Not earlier than June 24, 2015.
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 5:00 p.m., June 23, 2015.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by June 9, 2015, phone (360) 664-6092 or TTY (360) 664-6178, e-mail KildaJA@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Federal regulation 42 C.F.R. §431.232(d) does not allow medicaid benefits to continue at their previous level following an evidentiary hearing decision to reduce or terminate those benefits. Therefore, this amended rule is proposed to ensure the administration has language in rule that conforms to the C.F.R. regarding continuing benefits.
Reasons Supporting Proposal: See Purpose above.
Statutory Authority for Adoption: RCW 71A.12.030.
Statute Being Implemented: 42 C.F.R. §431.232.
Rule is necessary because of federal law, [no further information supplied by agency].
Name of Proponent: Department of social and health services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Shannon Manion, Developmental Disabilities Administration, P.O. Box 45310, Olympia 98504-5310, (360) 725-3454.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule does not impact small business or nonprofits. It only impacts DSHS clients.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rule is exempt under RCW 34.05.328 (5)(b)(vii) and relate only to client medical or financial eligibility.
May 15, 2015
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 08-04-072, filed 2/4/08, effective 3/6/08)
WAC 388-825-145 Will my benefits continue if I request an administrative hearing?
(1) If you request an administrative hearing regarding the department's decision to transfer you from a residential habilitation center to the community under RCW 71A.20.080, the rules in WAC 388-825-155 apply.
(2) If you request an administrative hearing ((within the ten-day notice period, as described in chapter 388-458 WAC, unless one or more of the conditions in WAC 388-825-150 applies, the department will take no action until there is a final decision on your appeal of the department's decision to:
(a) Terminate your eligibility for services;
(b) Reduce or terminate your services;
(c) Reduce or terminate the payment of SSP set forth in chapter 388-827 WAC; or
(d) Disenroll you from a DDD home and community based services waiver under WAC 388-845-0060, including a disenrollment from a waiver and enrollment in a different waiver)) regarding the department's decision to reduce or terminate your services, and you request the hearing before the date specified on the notice of the action, and none of the conditions in WAC 388-825-150 applies, the department will not reduce or terminate those services unless and until an administrative law judge issues an initial order or a review judge issues a final order that reduces or terminates those services. This subsection also applies to the department's decision to disenroll you from a DDA home and community based services waiver under WAC 388-845-0060.
(3) The department will take no action until there is a final decision on your appeal of the department's decision to remove or transfer you to another residential service unless one or more of the conditions in WAC 388-825-150 applies.
(4) The department will take no action until there is a final decision on your appeal to terminate your provider of choice unless one or more of the circumstances described in WAC 388-825-150 applies.
(5) After the administrative hearing, you may have to pay back up to sixty days of the continued benefits you get((, as described in chapter 388-410 WAC,)) if the administrative hearing decision ((is in favor of the department)) determines your benefits should be less than the continued benefits you have received.
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. |