WSR 07-24-026

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed November 28, 2007, 10:47 a.m. , effective January 1, 2008 ]


     Effective Date of Rule: January 1, 2008.

     Purpose: The rule making amends WAC 388-106-0060, 388-106-0070, 388-106-0213 and 388-71-0540, to include information pertaining to children's medicaid personal care (MPC) services including information on the new DDD CARE assessment process, updates to foster care to ensure that a foster parent providing personal care to a child residing in their licensed foster care home does not get paid twice for providing personal care services and to assess foster children for mental health therapy needs, behaviors, and depression.

     This rule making also amends personal emergency response system (PERS) language in WAC 388-106-0300 and 388-106-0500 to clarify that two people who live together who are unable to secure help in an emergency may now be eligible for a PERS unit, and adds PERS medication management language.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-71-0540, 388-106-0060, 388-106-0070, 388-106-0213, 388-106-0300, and 388-106-0500.

     Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.

      Adopted under notice filed as WSR 07-20-064 on September 28, 2007.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 6, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 6, Repealed 0.

     Date Adopted: November 20, 2007.

Stephanie E. Schiller

Rules Coordinator

3919.3
AMENDATORY SECTION(Amending WSR 06-05-022, filed 2/6/06, effective 3/9/06)

WAC 388-71-0540   When will the department, AAA, or managed care entity deny payment for services of an individual provider or home care agency provider?   The department, AAA, or managed care entity will deny payment for the services of an individual provider or home care agency provider who:

     (1) Is the client's spouse, per 42 C.F.R. 441.360(g), except in the case of an individual provider for a chore services client. Note: For chore spousal providers, the department pays a rate not to exceed the amount of a one-person standard for a continuing general assistance grant, per WAC 388-478-0030;

     (2) Is the natural/step/adoptive parent of a minor client aged seventeen or younger receiving services under Medicaid personal care;

     (3) Is a foster parent providing personal care to a child residing in their licensed foster home.

     (4) Has been convicted of a disqualifying crime, under RCW 43.43.830 and 43.43.842 or of a crime relating to drugs as defined in RCW 43.43.830;

     (((4))) (5) Has abused, neglected, abandoned, or exploited a minor or vulnerable adult, as defined in chapter 74.34 RCW;

     (((5))) (6) Has had a license, certification, or a contract for the care of children or vulnerable adults denied, suspended, revoked, or terminated for noncompliance with state and/or federal regulations;

     (((6))) (7) Does not successfully complete the training requirements within the time limits required in WAC 388-71-05665 through 388-71-05865;

     (((7))) (8) Is already meeting the client's needs on an informal basis, and the client's assessment or reassessment does not identify any unmet need; and/or

     (((8))) (9) Is terminated by the client (in the case of an individual provider) or by the home care agency (in the case of an agency provider).

     (((9))) In addition, the department, AAA, or managed care entity may deny payment to or terminate the contract of an individual provider as provided under WAC 388-71-0546, 388-71-0551, and 388-71-0556.

[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. 06-05-022, § 388-71-0540, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-71-0540, filed 5/17/05, effective 6/17/05. Statutory Authority: Chapter 74.39A RCW and 2000 c 121. 02-10-117, § 388-71-0540, filed 4/30/02, effective 5/31/02. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830, 74.39.095. 01-11-019, § 388-71-0540, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. 00-03-043, § 388-71-0540, filed 1/13/00, effective 2/13/00.]


AMENDATORY SECTION(Amending WSR 05-11-082, filed 5/17/05, effective 6/17/05)

WAC 388-106-0060   Who must perform the assessment?   The assessment must be performed by the department. Beginning January 1, 2008, individuals requesting personal care services will be assessed as described in the following chart:


Age of person requesting an assessment for personal care services Has the person been determined to meet DDD eligibility requirements? Who will perform the assessment for personal care services? What assessment will be used?
Under eighteen years of age Yes DDD CARE/DDD Assessment per chapter 388-828 WAC
Under eighteen years of age No DDD CARE/LTC Assessment per chapter 388-106 WAC
Eighteen years of age and older Yes DDD CARE/DDD Assessment per chapter 388-828 WAC
Eighteen years of age and older No HCS CARE/LTC Assessment per chapter 388-106 WAC

[Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-106-0060, filed 5/17/05, effective 6/17/05.]


AMENDATORY SECTION(Amending WSR 07-10-024, filed 4/23/07, effective 6/1/07)

WAC 388-106-0070   Will I be assessed in CARE?   You will be assessed in CARE if you are applying for or receiving DDD services, COPES, MNIW, MNRW, MPC, chore, respite, adult day health, GAU-funded residential care, PACE, Private Duty Nursing, New Freedom or long-term care services within the MMIP or WMIP programs. ((You may not be assessed by forms previously used by the department once you have been assessed under CARE.))

     If you are under the age of eighteen and within thirty calendar days of your next birthday, CARE determines your assessment age to be that of your next birthday.

[Statutory Authority: RCW 74.08.090, 74.09.520. 07-10-024, § 388-106-0070, filed 4/23/07, effective 6/1/07; 05-11-082, § 388-106-0070, filed 5/17/05, effective 6/17/05.]


AMENDATORY SECTION(Amending WSR 07-10-024, filed 4/23/07, effective 6/1/07)

WAC 388-106-0213   How are my needs assessed if I am a child applying for MPC services?   If you are a child applying for MPC services, the department will complete a CARE assessment and:

     (1) Consider and document the role of your legally responsible natural/step/adoptive parent(s).

     (2) The CARE tool will determine your needs as met based on the guidelines outlined in the following table:


Activities of Daily Living (ADLs)
Ages
&sqbul; = Code status as Met 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Medication Management
Independent, self-directed,

administration required, or

must be administered

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Locomotion in RoomNote
Independent, supervision,

limited or extensive

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Total &sqbul; &sqbul;
Locomotion Outside

RoomNote
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul;
Walk in RoomNote
Independent, supervision,

limited or extensive

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Total &sqbul; &sqbul;
Bed Mobility
Independent, supervision,

limited or extensive

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Total &sqbul; &sqbul;
Transfers
Independent, supervision,

limited, extensive or total

& under 30 pounds

 &sqbul; &sqbul; &sqbul;
(Total & 30

pounds or more = no age limit)
Toilet Use
Support provided for

nighttime wetting only

(independent, supervision,

limited, extensive)

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Independent, supervision,

limited, extensive

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Total &sqbul; &sqbul; &sqbul; &sqbul;
Eating
Independent, supervision,

limited, extensive, or total

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Bathing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Physical help/transfer only

or physical help/part of

bathing

 &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Dressing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Personal Hygiene
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Instrumental Activities of Daily Living
Ages
&sqbul; = Code status as Met 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Telephone
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Transportation
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Shopping
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Wood Supply
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Housework
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Finances
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Meal Preparation
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;

     NOTE: If the activity did not occur, the department codes self performance as total and status as met.


Ages
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Additional guidelines based

on age
Diagnosis

Is client comatose? = No

 &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Pain Daily = No &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Any foot care needs
Status = Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Any skin care (other than

feet)
Status = Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Speech/Hearing
Score comprehension as

understood

 &sqbul; &sqbul; &sqbul;
MMSE

can be administered = no

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