WSR 19-09-051
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed April 12, 2019, 2:48 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 19-03-104.
Title of Rule and Other Identifying Information: WAC 182-513-1620 Tailored supports for older adults—Presumptive eligibility (PE).
Hearing Location(s): On May 21, 2019, at 10:00 a.m., at the Health Care Authority (HCA), Cherry Street Plaza, Pear Conference Room #107, 626 8th Avenue, Olympia, WA 98504. Metered public parking is available street side around building. A map is available at https://www.hca.wa.gov/assets/program/Driving-parking-checkin-instructions.pdf or directions can be obtained by calling 360-725-1000.
Date of Intended Adoption: Not sooner than May 22, 2019.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, by May 21, 2019.
Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication relay services 711, email amber.lougheed@hca.wa.gov, by May 17, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending the presumptive eligibility period from twelve to twenty-four months in subsection (7) to align with Title 388 WAC. The agency is also correcting a reference to the medicaid agency in subsection (8) and replacing it with the department of social and health services.
Reasons Supporting Proposal: See purpose above.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Melinda Froud, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1408; Implementation and Enforcement: Stephen Kozak, P.O. Box 45534, Olympia, WA 98504-5534, 360-725-1343.
A school district fiscal impact statement is not required under RCW
28A.305.135.
A cost-benefit analysis is not required under RCW
34.05.328. RCW
34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The rule does not impose any costs on small businesses.
April 12, 2019
Wendy Barcus
Rules Coordinator
AMENDATORY SECTION(Amending WSR 17-12-019, filed 5/30/17, effective 7/1/17)
WAC 182-513-1620Tailored supports for older adults (TSOA)—Presumptive eligibility (PE).
(1) A person may be determined presumptively eligible for tailored supports for older adults (TSOA) services upon completion of a prescreening interview.
(2) The prescreening interview may be conducted by either:
(a) The area agency on aging (AAA); or
(b) A home and community services intake case manager or social worker.
(3) To receive services under presumptive eligibility (PE), the person must meet:
(a) Nursing facility level of care under WAC 388-106-0355;
(b) TSOA income limits under WAC 182-513-1635; and
(c) TSOA resource limits under WAC 182-513-1640.
(4) The PE period begins on the date the determination is made and:
(a) Ends on the last day of the month following the month of the PE determination if a full TSOA application is not completed and submitted by that date; or
(b) Continues through the date the final TSOA eligibility determination is made if a full TSOA application is submitted before the last day of the month following the month of the PE determination.
(5) If the person applies and is not determined financially eligible for TSOA, there is no overpayment or liability on the part of the applicant for services received during the PE period.
(6) The medicaid agency or the agency's designee sends written notice as described in WAC 182-518-0010 when PE for TSOA is approved or denied.
(7) A person may receive only one PE period within a ((twelve-consecutive-month))consecutive twenty-four-month period.
(8) If the ((agency))department of social and health services establishes a waitlist for TSOA services under WAC 388-106-1975, then PE does not apply.