PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Disabilities and Long-Term Care Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 02-15-056.
Title of Rule: Adult day services, new WAC 388-71-0702 through 388-71-0776.
Purpose: Amending and reorganizing Aging and Adult Services Administration (AASA) rules into chapter 388-71 WAC is necessary to comply with the Governor's Executive Order 97-02 and the Secretary's Order on Regulatory Improvement. These rules will be amended to ensure that adult day services are provided within available funding as required by law. Rules are needed to clarify the purpose of adult day care/day health programs; to clarify or amend adult day care/day health services and eligibility requirements; to transfer adult day health eligibility determinations to department/AAA case managers; to clarify the status of adult day centers as contracted providers; to clarify the hearing rights of clients and providers; to adopt program cost controls; to amend administrative requirements for contracting with the department/area agencies on aging; and to adopt or clarify such other rules as are necessary or appropriate to accomplish these purposes.
This rule making was initiated by a prenotice inquiry filed as WSR 02-15-056 on July 11, 2002. This prenotice inquiry superseded the notice filed as WSR 00-08-049 on March 31, 2000. The department initiated the current rule making in response to a rule-making petition filed on June 18, 2002, by the Washington Adult Day Services Association (WADSA) and a number of adult day service providers. WADSA's proposed rules and an earlier draft of the department's proposed rules were used as a starting point for further discussions with the petitioners and other interested stakeholders.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030.
Statute Being Implemented: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030.
Summary: Repealing sections of WAC 388-15-650 through 388-15-662, adult day services. Revised sections will be reorganized and moved into chapter 388-71 WAC. This change is necessary to comply with the Governor's Executive Order 97-02 and the Secretary's Order on Regulatory Improvement. These rules will be amended to clarify eligibility requirements for adult day care and adult day health services funded by Medicaid and to make other changes as needed.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Candace Goehring, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2562, goehrcs2@dshs.wa.gov.
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: Amending and reorganizing AASA rules into chapter 388-71 WAC is necessary to comply with the Governor's Executive Order 97-02 and the Secretary's Order on Regulatory Improvement. Rules are being amended to clarify eligibility, to transfer adult day health eligibility determinations to department/area agency on aging case managers, and to make other changes as necessary.
The fiscal impact may include decreased costs for payment of adult day health service to Medicaid recipients due to clarification of eligibility criteria and the elimination of self-referral and center determination of client eligibility. Eligibility determination and authorization will be transferred to home and community services social workers or community nurse consultants, area agency on aging case managers and the Division of Developmental Disabilities (DDD) caseworkers.
Initial costs may be increased to the department/area agencies on aging to provide comprehensive assessments to an estimated four hundred fifty Medicaid recipients attending adult day centers that will be new to AASA. It is also anticipated that costs may be incurred while providing fair hearing rights and interpreter support to existing center clients that may not meet clarified eligibility criteria.
Caseload impact will include an anticipated increase in on-going case management services through area agencies on aging, as well as an estimated four hundred fifty initial comprehensive assessments provided by home and community services. The DDD will also be required to provide eligibility review and authorization to approximately one hundred eighty clients.
This administration expects the loss of revenue to the adult day care/adult day health providers affected to be minor.
Proposal Changes the Following Existing Rules: Repealing sections of WAC 388-15-650 through 388-15-662, adult day services. Revised sections will be reorganized and moved into chapter 388-71 WAC. The new rules clarify eligibility criteria, transfer adult day health eligibility determinations to the department/AAA case managers, and make other changes as necessary.
No small business economic impact statement has been prepared under chapter 19.85 RCW. No statement was prepared because upon review of all adult day services businesses operating in the state, none meet the criteria of a small business.
RCW 34.05.328 applies to this rule adoption. Cost benefit analysis is required for this rule under RCW 34.05.328 [(5)](c)(iii). The department considers its proposed rules concerning eligibility assessments (WAC 388-71-0720 and 388-71-0722) for adult day health services to be "significant legislative rules" within the meaning of RCW 34.05.328, because the proposed rules would adopt new, or make significant amendments to, a policy or regulatory program.
A copy of the cost-benefit analysis may be obtained from Candace Goehring, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-2562, goehrcs2@dshs.wa.gov.
The department's proposed rules concerning clarification of existing client medical and financial eligibility and client hearing rights as required by RCW and C.F.R., are not considered "significant legislative rules" under RCW 34.05.328 (5)(b)(vii), which exempts "rules of the Department of Social and Health Services relating only to client medical or financial eligibility and rules concerning liability for care of dependents." These amended rules provide for clarification of existing rules and ensure client rights to challenge an eligibility assessment.
Hearing Location: First Hearing at Blake Office Park East (behind Goodyear Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on February 4, 2003, at 1:00 p.m.
Second Hearing at Aging and Long-Term Care of Eastern Washington, 1222 North Post, Room B and C, Spokane, WA 99201, on February 5, 2003, at 11:00 a.m.
Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by January 31, 2003, phone (360) 664-6094, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., February 5, 2002.
Date of Intended Adoption: Not earlier than February 6, 2003.
December 4, 2002
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 03-02 issue of the Register.