(1) After September 1, 2003, where a client is subject to a guardianship the department shall be entitled to notice of proceedings as described in RCW 11.92.150
(2) The notice must be served to the department's regional administrator of the program that is providing services to the client. A list of the regional administrators will be furnished upon request.
(3) If the fees and costs requested and established by the order are equal to or less than the maximum amounts allowed under WAC 388-79-030
, then the department will adjust the client's current participation to reflect the amounts allowed upon receipt by the department of the court order setting the monthly amounts.
(4) Should fees and costs in excess of the amounts allowed in WAC 388-79-030
(a) At least ten days before filing the request with the court, the guardian must present the request in writing to the appropriate regional administrator to allow the department an opportunity to consider whether the request should be granted on an exceptional basis.
(b) In considering a request for extraordinary fees or costs, the department must consider the following factors:
(i) The department's obligation under federal and state law to ensure that federal medicaid funding is not jeopardized by noncompliance with federal regulations limiting deductions from the client's participation amount;
(ii) The usual and customary guardianship services for which the maximum fees and costs under WAC 388-79-030
must be deemed adequate for a medicaid client, including but not limited to:
(A) Acting as a representative payee;
(B) Managing the client's financial affairs;
(C) Preserving and/or disposing of property;
(D) Making health care decisions;
(E) Visiting and/or maintaining contact with the client;
(F) Accessing public assistance programs on behalf of the client;
(G) Communicating with the client's service providers; and
(H) Preparing any reports or accountings required by the court.
(iii) Extraordinary services provided by the guardian, such as:
(A) Unusually complicated property transactions;
(B) Substantial interactions with adult protective services or criminal justice agencies;
(C) Extensive medical services setup needs and/or emergency hospitalizations; and
(D) Litigation other than litigating an award of guardianship fees or costs.
(c) Should the court determine after consideration of the facts and law that fees and costs in excess of the amounts allowed in WAC 388-79-030
are just and reasonable and should be allowed, then the department will adjust the client's current participation to reflect the amounts allowed upon receipt by the department of the court order setting the monthly amounts.
(5) In no event may a client's participation be prospectively or retrospectively reduced to pay fees and costs incurred before the effective date of the client's medicaid eligibility; or during any subsequent time period when the client was not eligible for, or did not receive long-term care services; or after the client has died. There is no client participation towards DDD certified and contracted supported living services under chapter 388-820
WAC, so the department has no responsibility to reimburse the client for guardianship fees when those fees result in the client having insufficient income to pay their living expenses.
(6) If the court at a prior accounting has allowed the guardian to receive fees and costs from the client's monthly income in advance of services rendered by the guardian, and the client dies before the next accounting, the fees and costs allowed by the court at the final accounting may be less than, but may not exceed, the amounts advanced and paid to the guardian from the client's income.
(7) Guardians must furnish the regional administrator with complete packets to include all documents filed with the court and with formal notice clearly identifying the amount requested.
[Statutory Authority: RCW 11.92.180, 43.20B.460. 03-16-022, § 388-79-050, filed 7/28/03, effective 8/28/03.]