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Chapter 388-106 WAC

Last Update: 7/25/12

LONG-TERM CARE SERVICES

WAC Sections

SCOPE AND DEFINITIONS
388-106-0005 What is the purpose and scope of this chapter?
388-106-0010 What definitions apply to this chapter?
APPLYING FOR SERVICES
388-106-0015 What long-term care services does the department provide?
388-106-0020 Under the MPC, COPES, and chore programs, what services are not covered?
388-106-0025 How do I apply for long-term care services?
388-106-0030 Where can I receive services?
388-106-0035 May I receive personal care services through any of the long-term care programs when I am out of the state of Washington?
388-106-0040 Who can provide long-term care services?
388-106-0045 When will the department authorize my long-term care services?
388-106-0047 When can the department terminate or deny long-term care services to me?
COMPREHENSIVE ASSESSMENT REPORTING EVALUATION (CARE) ASSESSMENT
388-106-0050 What is an assessment?
388-106-0055 What is the purpose of an assessment?
388-106-0060 Who must perform the assessment?
388-106-0065 What is the process for conducting an assessment?
388-106-0070 Will I be assessed in CARE?
388-106-0075 How is my need for personal care services assessed in CARE?
CARE CLASSIFICATION
388-106-0080 How is the amount of long-term care services I can receive in my own home or in a residential facility determined?
388-106-0085 What criteria does the CARE tool use to place me in one of the classification groups?
388-106-0090 How does the CARE tool measure cognitive performance?
388-106-0095 How does the CARE tool measure clinical complexity?
388-106-0100 How does the CARE tool measure mood and behaviors?
388-106-0105 How does the CARE tool measure activities of daily living (ADLs)?
388-106-0110 How does the CARE tool evaluate me for the exceptional care classification of the E Group?
388-106-0115 How does CARE use criteria to place me in a classification group for residential facilities?
388-106-0120 What is the payment rate that the department will pay the provider if I receive personal care services in a residential facility?
388-106-0125 How does CARE use criteria to place me in a classification group for in-home care?
388-106-0130 How does the department determine the number of hours I may receive for in-home care?
388-106-0135 What are the maximum hours that I can receive for in-home services?
388-106-0140 What may change the maximum number of hours that I can receive for in-home personal care services?
388-106-0145 What may change the maximum payment rate that will be paid for residential personal care services provided to me?
MEDICAID PERSONAL CARE (MPC)
388-106-0200 What services may I receive under medicaid personal care (MPC)?
388-106-0210 Am I eligible for MPC-funded services?
388-106-0215 When do MPC services start?
388-106-0220 How do I remain eligible for MPC?
388-106-0225 How do I pay for MPC?
388-106-0230 Can I be employed and receive MPC?
388-106-0235 Are there waiting lists for MPC?
ROADS TO COMMUNITY LIVING
388-106-0250 What is the roads to community living (RCL) demonstration project and who is eligible?
388-106-0255 How long are RCL services available to me?
388-106-0260 How do I pay for RCL services?
388-106-0265 Do I have the right to a fair hearing while receiving RCL services?
COMMUNITY OPTIONS PROGRAM ENTRY SYSTEM (COPES)
388-106-0300 What services may I receive under community options program entry system (COPES) when I live in my own home?
388-106-0305 What services may I receive under COPES if I live in a residential facility?
388-106-0310 Am I eligible for COPES-funded services?
388-106-0315 When do COPES services start?
388-106-0320 How do I remain eligible for COPES?
388-106-0325 How do I pay for COPES services?
388-106-0330 Can I be employed and receive COPES?
388-106-0335 Are there waiting lists for COPES?
NURSING FACILITY CARE SERVICES
388-106-0350 What are nursing facility care services?
388-106-0355 Am I eligible for nursing facility care services?
388-106-0360 How do I pay for nursing facility care services?
CHORE
388-106-0600 What services may I receive under chore?
388-106-0610 Am I eligible for chore-funded services?
388-106-0615 When do chore services start?
388-106-0620 How do I remain eligible for chore?
388-106-0625 How do I pay for chore?
388-106-0630 Can I be employed and receive chore?
VOLUNTEER CHORE
388-106-0650 What services may I receive under volunteer chore?
388-106-0655 Am I eligible to receive volunteer chore services?
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
388-106-0700 What services may I receive under PACE?
388-106-0705 Am I eligible for PACE services?
388-106-0710 How do I pay for PACE services?
388-106-0715 How do I end my enrollment in the PACE program?
WASHINGTON MEDICAID INTEGRATION PARTNERSHIP (WMIP)
388-106-0745 What services may I receive under WMIP?
388-106-0750 Am I eligible to enroll in WMIP?
388-106-0755 How do I pay for WMIP services?
388-106-0760 How do I disenroll from WMIP?
388-106-0765 What is the fair hearing process for enrollee appeals of managed care organization actions?
ADULT DAY SERVICES
388-106-0800 What adult day care services may I receive?
388-106-0805 Am I eligible for adult day care?
388-106-0810 What adult day health services may I receive?
388-106-0815 Am I eligible for adult day health?
GAU-FUNDED RESIDENTIAL CARE
388-106-0900 What services may I receive under GAU-funded residential care?
388-106-0905 Am I eligible to receive GAU-funded residential care services?
RESIDENTIAL CARE DISCHARGE ALLOWANCE
388-106-0950 What services may I receive under the residential care discharge allowance?
388-106-0955 Am I eligible for residential care discharge allowance?
PRIVATE DUTY NURSING
388-106-1000 What is the intent of WAC 388-106-1000 through 388-106-1055?
388-106-1005 What services may I receive under private duty nursing (PDN)?
388-106-1010 Am I eligible for medicaid-funded private duty nursing services?
388-106-1020 How do I pay for my PDN services?
388-106-1025 Who can provide my PDN services?
388-106-1030 Are there limitations or other requirements for PDN?
388-106-1035 What requirements must a home health agency meet in order to provide and be paid for my PDN?
388-106-1040 What requirements must a RN, or LPN under the supervision of an RN, meet in order to provide and get paid for my PDN services?
388-106-1045 Can I receive PDN services in a licensed adult family home (AFH)?
388-106-1050 May I receive other long-term care services in addition to PDN?
388-106-1055 Can I choose to self-direct my care if I receive PDN services?
SENIOR CITIZENS' SERVICES
388-106-1100 What services can I receive under the Senior Citizens' Services Act (SCSA) fund?
388-106-1105 How do I apply for SCSA-funded services?
388-106-1110 Am I eligible for SCSA-funded services at no cost?
388-106-1115 What income and resources are exempt when determining eligibility?
388-106-1120 What if I am not eligible to receive SCSA-funded services at no cost?
RESPITE CARE SERVICES
388-106-1200 What definitions apply to respite care services through the family caregiver support program?
388-106-1205 What are respite care services?
388-106-1210 Who is eligible to receive respite care services through the family caregiver support program?
388-106-1215 Who may provide respite care services through the family caregiver support program?
388-106-1220 How are respite care providers reimbursed for their services through the family caregiver support program?
388-106-1225 Are participants required to pay for the cost of their respite care services through the family caregiver support program?
388-106-1230 What determines emergent and nonemergent respite care services through the family caregiver support program?
CLIENT RIGHTS
388-106-1300 What rights do I have as a client of the department?
388-106-1303 What responsibilities do I have as a client of the department?
388-106-1305 What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department?
388-106-1310 When I request a fair hearing on my CARE assessment and another CARE assessment(s) is done between my fair hearing request and the fair hearing, which CARE assessment must the administrative law judge review?
388-106-1315 Do I have a right to an administrative hearing if my total in-home personal care hours approved as an exception to rule are reduced or terminated or if my increased residential payment rate approved as an exception to rule is reduced or terminated?
NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS)
388-106-1400 What services may I receive under New Freedom consumer directed services (NFCDS)?
388-106-1405 What services are not covered under New Freedom consumer directed services (NFCDS)?
388-106-1410 Am I eligible for New Freedom consumer directed services (NFCDS)-funded services?
388-106-1415 When do New Freedom consumer directed services (NFCDS) start?
388-106-1420 How do I remain eligible for New Freedom consumer directed services (NFCDS)?
388-106-1422 What happens to my New Freedom service dollar budget if I am temporarily hospitalized, placed in a nursing facility or intermediate care facilities for the mentally retarded (ICF/MR)?
388-106-1425 How do I pay for New Freedom consumer directed services (NFCDS)?
388-106-1430 Can I be employed and receive New Freedom consumer directed services (NFCDS)?
388-106-1435 Who can direct New Freedom consumer directed services (NFCDS)?
388-106-1440 What is an individual budget?
388-106-1445 How is the amount of the individual budget determined?
388-106-1450 Is the individual budget intended to fully meet all of my needs?
388-106-1455 What happens to unused funds from my individual budget?
388-106-1460 When can my New Freedom spending plan (NFSP) be denied?
388-106-1465 Who can deny my New Freedom spending plan (NFSP)?
388-106-1470 Are there waiting lists for New Freedom consumer directed services (NFCDS)?
388-106-1475 How do I end enrollment in New Freedom consumer directed services (NFCDS)?
388-106-1480 What are my hearing rights to appeal New Freedom consumer directed services (NFCDS) actions?
388-106-1500 What is the department's chronic care management program?
388-106-1505 What services may I receive under the chronic care management program?
388-106-1510 Who provides chronic care management services to medical assistance clients receiving long-term care services and supports?
388-106-1515 Am I eligible to enroll in the chronic care management program?
388-106-1520 How do I enroll in the chronic care management program?
388-106-1525 How long can I participate in the chronic care management program?
388-106-1530 Is there a cost to me for participating in the chronic care management program?
388-106-1535 Do I have a right to a fair hearing while receiving chronic care management services?