PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Health and Rehabilitative Services Administration)
(Division of Developmental Disabilities)
Original Notice.
Preproposal statement of inquiry was filed as WSR 99-10-063.
Title of Rule: Division of Developmental Disabilities (DDD) individual provider qualifications rules.
WAC 388-825-020 Definitions.
WAC 388-825-260 Qualifications for individual service providers.
WAC 388-825-262 What services do individuals provide for persons with developmental disabilities?
WAC 388-825-264 If I want to provide services to persons with developmental disabilities, what do I do?
WAC 388-825-266 If I want to provide respite care in my home, what is required?
WAC 388-825-268 What is required for agencies wanting to provide care in the home of a person with developmental disabilities?
WAC 388-825-270 Are there exceptions to the licensing requirements?
WAC 388-825-272 What are the minimum requirements to become an individual provider?
WAC 388-825-276 What are required skills and abilities for this job?
WAC 388-825-278 Are there any educational requirements for individual providers?
WAC 388-825-280 What are the requirements for an individual supportive living service (also know as a companion home) contract?
WAC 388-825-282 What is "abandonment of a vulnerable adult"?
WAC 388-825-284 Are providers expected to report abuse?
Purpose: Establishes qualifications for contracting with DDD to provide services to persons with developmental disabilities.
Statutory Authority for Adoption: RCW 71A.12.030 and 71A.12.040.
Statute Being Implemented: RCW 71A.12.030 and 71A.12.040.
Summary: Division of Developmental Disabilities needs to establish basic qualifications for individual providers of services. Other parts of the department have established similar types of rules. DDD needs to establish qualifications to ensure equitable treatment of individuals applying to provide support to persons with developmental disabilities and to establish expectations for these persons in the performance of their duties after they are contracted. These WAC are numbered in the Title 388 WAC, since all DSHS WACs are being moved to that title.
Reasons Supporting Proposal: Clarifies qualifications of applicants.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Rita Dickey, Box 45310, Olympia, WA 98504, (360) 902-8451.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The rule establishes qualifications for individual providers of service. It covers the required skills and abilities necessary to provide the service. The requirements for a companion home contract are outlined and expectations around reporting of abuse and abandonment are described.
Proposal does not change existing rules.
No small business economic impact statement has been prepared under chapter 19.85 RCW. There is no appreciable cost to small business.
RCW 34.05.328 applies to this rule adoption. A memorandum delineating costs and benefits has been developed. To obtain a copy contact Rita Dickey at P.O. Box 45310, Olympia, WA 98504.
Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on August 24, 1999, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Paige Wall by August 13, 1999, phone (360) 664-6094, TTY (360) 664-6178, e-mail wallpg@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, Paige Wall, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by August 24, 1999.
Date of Intended Adoption: September 10, 1999.
July 7, 1999
Edith M. Rice
for Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
2573.3"Abandonment" means action or inaction by a person or entity with a duty to care a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.
"Adolescent" means a DDD eligible child age thirteen through seventeen years.
"Attendant care" means provision of physical and/or behavioral support to protect the safety and well being of a client.
"Best interest" includes, but is not limited to, client-centered benefits to:
(1) Prevent regression or loss of skills already acquired;
(2) Achieve or maintain economic self-support;
(3) Achieve or maintain self-sufficiency;
(4) Prevent or remedy neglect, abuse, or exploitation of individuals unable to protect their own interest;
(5) Preserve or reunite families; and
(6) Provide the least-restrictive setting that will meet the person's medical and personal needs.
"Client or person" means a person the division determines under RCW 71A.16.040 and WAC 275-27-026 eligible for division-funded services.
"Community support services" means one or more of the services listed in RCW 71A.12.040 including, but not limited to the following services: Architectural, case management, early childhood intervention, employment, counseling, family support, respite care, information and referral, health services and equipment, therapy services, and residential support.
"Department" means the department of social and health services of the state of Washington.
"Director" means the director of the division of developmental disabilities.
"Division or DDD" means the division of developmental disabilities of the department of social and health services.
"Emergency" means a sudden, unexpected occurrence demanding immediate action.
"Exemption" means the department's approval of a written request for an exception to a rule in this chapter.
"Family" means individuals, of any age, living together in the same household and related by blood, marriage, adoption or as a result of sharing legal custody of a minor child.
"Family resources coordinator" means the person who is:
(1) Recognized by the IDEA Part C lead agency; and
(2) Responsible for:
(a) Providing family resources coordination;
(b) Coordinating services across agencies; and
(c) Serving as a single contact to help families receiving assistance and services for their eligible children who are under three years of age.
"ICF/MR" means a facility certified as an intermediate care facility for the mentally retarded by Title XIX to provide services to the mentally retarded or persons with related conditions.
"ICF/MR Eligible" for admission to an ICF/MR means a person is determined by DDD as needing active treatment as defined in CFR 483.440. Active treatment requires:
(1) Twenty-four hour supervision; and
(2) Continuous training and physical assistance in order to function on a daily basis due to deficits in the following areas: Toilet training, personal hygiene, dental hygiene, self-feeding, bathing, dressing, grooming, and communication.
"Individual" means a person applying for services from the division.
"Individual alternative living" means provision of community-based individualized client training, assistance and/or ongoing support to enable a client to live as independently as possible with minimal services.
"Individual supportive living service" (also known as companion home) means provision of twenty-four hour residential support in a nonlicensed home for one adult person with developmental disabilities.
"Intelligence quotient score" means a full scale score on the Wechsler, or the intelligence quotient score on the Stanford-Binet or the Leiter International Performance Scale.
"Medicaid personal care" is the provision of medically necessary personal care tasks as defined in chapter 388-15 WAC.
"Nonresidential programs" means programs including, but not limited to, county-funded habilitation services.
"Nursing facility eligible" means a person is assessed by DDD as meeting the requirements for admission to a licensed nursing home as defined in WAC 388-97-235. The person must require twenty-four hour care provided by or under the supervision of a licensed nurse.
"Other resources" means resources that may be available to the client, including but not limited to:
(1) Private insurance;
(2) Medicaid;
(3) Indian health care;
(4) Public school services through the office of the superintendent of public instruction; and
(5) Services through the department of health.
"Part C" means early intervention for children from birth through thirty-five months of age as defined in the Individuals with Disabilities Education Act (IDEA), Part C and 34 CFR, Part 303 and Washington’s federally approved grant.
"Residential habilitation center" or "RHC" means a state-operated facility certified to provide ICF/MR and/or nursing facility level of care for persons with developmental disabilities.
"RHC capacity" means the maximum number of eligible persons that can reside in a residential habilitation center without exceeding its 1997 legislated budgeted capacity.
"Residential programs" means ((programs providing domiciliary care or other
residential services, including, but not limited to, state residential facilities, group homes, nursing
facilities, ICF/MRs, tenant support services, congregate care facilities, boarding homes,
children's foster homes,)) provision of support for persons in community living situations.
Residential programs include DDD certified community residential services and support, both
facility-based such as, licensed group homes, and non-facility based, i.e., supportive living,
intensive tenant support, and state-operated living alternatives (SOLA). Other residential
programs include intensive individual supportive living services, adult family homes, ((and
group training)) adult residential care services, nursing homes, and children’s foster homes.
"Respite care" means temporary residential services provided to a person and/or the person's family on an emergency or planned basis.
"Secretary" means the secretary of the department of social and health services or the secretary's designee.
"Vacancy" means an opening at a RHC, which when filled, would not require the RHC to exceed its 1997 biannually budgeted capacity, minus:
(1) Twenty-six beds designated for respite care use; and
(2) Any downsizing related to negotiations with the Department of Justice regarding community placements.
"Vulnerable adult" means a person who has a developmental disability as defined under RCW 71A.10.020.
[Statutory Authority: RCW 71A.12.030. 99-04-071, § 275-27-020, filed 2/1/99, effective 3/4/99. Statutory Authority: RCW 74.12A.030 and 71A.16.030. 98-20-044, § 275-27-020, filed 9/30/98, effective 10/7/98. Statutory Authority: RCW 71A.14.030 and 71A.16.020. 92-09-115 (Order 3373), § 275-27-020, filed 4/21/92, effective 5/22/92. Statutory Authority: RCW 71A.16.020. 91-17-005 (Order 3230), § 275-27-020, filed 8/9/91, effective 9/9/91. Statutory Authority: RCW 71.20.070. 89-06-049 (Order 2767), § 275-27-020, filed 2/28/89; 84-15-058 (Order 2124), § 275-27-020, filed 7/18/84. Statutory Authority: RCW 72.01.090, 72.33.040, 72.33.125 and 72.33.165. 78-04-033 (Order 1280), § 275-27-020, filed 3/16/78; Order 1143, § 275-27-020, filed 8/11/76.]
Reviser's note: The bracketed material preceding the section above was supplied by the code reviser's office.
NEW SECTION
WAC 388-825-260
Qualifications for individual service providers.
The following rules establish qualifications for:
(1) Persons whom DDD pays to provide services to individuals with developmental disabilities including children; and
(2) Agencies contracted to provide services in the home of the DDD client.
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Individual providers contract directly with DDD to provide services such as respite care, Medicaid personal care, attendant care, individual alternative living and companion home services.
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You must contact your local DDD office and ask for a contract application package.
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All out-of-home respite care funded through DDD must take place in a licensed home unless you meet criteria listed in the "exemption" section below (WAC 275-27-270). You must have a child foster care, family day care, or adult family home license.
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Agencies must be a certified home care agency or a home health agency licensed through the department of health.
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Relatives of a specified degree are exempt from the licensing requirement and may provide out-of-home respite in their home. Relatives of specified degree include parents, grandparents, brother, sister, stepparent, stepbrother, stepsister, uncle, aunt, first cousin, niece or nephew (WAC 388-76-030).
In addition, RCW 70.128.010 defines adult family home as "more than one, not more than six unrelated adults." If the person requiring out-of-home respite or attendant care is an adult, care may be provided in the nonrelative provider's home without an adult family home license when:
(1) Care is provided for no more than one unrelated person at a time; and
(2) The person or his/her legal guardian signs a statement saying they have seen the home where care will be provided and think it is an appropriate place for the care of the adult. If the person does not have a legal guardian, the parent or other relative with whom the person resides may sign a statement.
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(1) Be at least eighteen years of age;
(2) Successfully pass a criminal history background check;
(3) Not be the spouse of the client receiving services or the natural/step/adoptive parent of a child age seventeen or younger;
(4) Have no findings of fact or conclusions of law or agreed orders related to abuse, neglect, financial exploitation or abandonment of a minor or vulnerable adult, as defined in RCW 74.39A.050(8);
(5) Have not had a child foster care, daycare, adult family home or other license issued by the department of social and health services (DSHS) revoked, denied, suspended or terminated for noncompliance with state and federal regulations. Any existing contracts you hold with DDD will be terminated for cause if such an action exists;
(6) Be able to prove you can work in the United States, provide a social security card or official picture identification;
(7) Provide three satisfactory references, unless you are a relative or a Medicaid personal care provider. References are checked prior to the issuance of the initial contract; and
(8) At DDD discretion, a waiver of references may be granted under the following conditions:
(a) The service provider is recruited to provide service exclusively to a specific person;
(b) A request to waive references is submitted in writing by the person, his or her parents, or legal guardian.
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You must be able to:
(1) Adequately maintain records of services performed and payments received;
(2) Read and understand the person's service plan. Translation services may be used if needed;
(3) Be kind and caring to the DSHS client for whom services are authorized.
(4) Identify problem situations and take the necessary action;
(5) Respond to emergencies without direct supervision;
(6) Understand the way your employer wants you to do things and carry out instructions;
(7) Work independently;
(8) Be dependable and responsible;
(9) Know when and how to contact the client's representative and the client's case manager;
(10) Participate in any quality assurance reviews required by DSHS.
(11) If you are working with an adult client of DSHS as an individual alternative living, attendant care or individual supportive living provider, you must also:
(a) Be knowledgeable about the person's preferences regarding the care provided;
(b) Know the resources in the community the person prefers to use and enable the person to use them;
(c) Know who the person's friends are and enable the person to see those friends; and
(d) Enable the person to keep in touch with his/her family as preferred by the person.
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Training is mandated only for Medicaid personal care providers of adults (WAC 388-15-19650 through 388-15-19680). DSHS retains the authority to require training of any provider.
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(1) General knowledge of acceptable standards of performance, including the necessity to be dependable, report punctually, maintain flexibility and to demonstrate kindliness and caring to any DSHS client for whom services are authorized.
(2) A clean, safe and healthful environment must be available for the client, including:
(a) A telephone the client can use;
(b) A flashlight or other nonelectrical light source in working condition;
(c) Basic first aid supplies;
(d) An evacuation plan;
(e) A safe storage area for flammable and combustible materials;
(f) Unblocked exits;
(g) Accessibility by customary forms of ingress and egress for space used for residential purposes; and
(h) Smoke alarms in the residence.
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State law makes it a crime to abandon a vulnerable adult. "Abandon" means leaving a person without the means or ability to obtain any of the basic necessities of life. If you wish to "quit" or terminate your employment, you must give at least two weeks written notice to your employer, their representative (if applicable) and the DDD case manager. You will be expected to continue working until the termination date unless otherwise determined by DSHS.
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Yes. You are expected to report any abuse or suspected abuse immediately to child protective services, adult protective services or local law enforcement and make a follow-up call to the person's case manager.
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NEW SECTION
The following section of the Washington Administrative Code, as amended, is recodified
as follows:
| Old WAC Number | New WAC Number |
| 275-27-020 | 388-825-020 |