Search

Chapter 388-106 WAC

Last Update: 7/18/14

LONG-TERM CARE SERVICES

WAC Sections

SCOPE AND DEFINITIONS
What is the purpose and scope of this chapter?
What definitions apply to this chapter?
APPLYING FOR SERVICES
What long-term care services does the department provide?
Under the MPC, COPES, and chore programs, what services are not covered?
How do I apply for long-term care services?
Where can I receive services?
When may I receive services in a facility contracted to provide specialized dementia care services?
May I receive personal care services through any of the long-term care programs when I am out of the state of Washington?
Who can provide long-term care services?
When will the department authorize my long-term care services?
When can the department terminate or deny long-term care services to me?
COMPREHENSIVE ASSESSMENT REPORTING EVALUATION (CARE) ASSESSMENT
What is an assessment?
What is the purpose of an assessment?
Who must perform the assessment?
What is the process for conducting an assessment?
Will I be assessed in CARE?
How is my need for personal care services assessed in CARE?
CARE CLASSIFICATION
How is the amount of long-term care services I can receive in my own home or in a residential facility determined?
What criteria does the CARE tool use to place me in one of the classification groups?
How does the CARE tool measure cognitive performance?
How does the CARE tool measure clinical complexity?
How does the CARE tool measure mood and behaviors?
How does the CARE tool measure activities of daily living (ADLs)?
How does the CARE tool evaluate me for the exceptional care classification of the E Group?
How does CARE use criteria to place me in a classification group for residential facilities?
What is the payment rate that the department will pay the provider if I receive personal care services in a residential facility?
How does CARE use criteria to place me in a classification group for in-home care?
How does the department determine the number of hours I may receive for in-home care?
What is the maximum number of hours of personal care services that I can receive for in-home services?
What if I disagree with the result of the limitation extension decision regarding personal care?
What may change the maximum number of hours that I can receive for in-home personal care services?
What may change the maximum payment rate that will be paid for residential personal care services provided to me?
MEDICAID PERSONAL CARE (MPC)
What services may I receive under medicaid personal care (MPC)?
Am I eligible for MPC-funded services?
When do MPC services start?
How do I remain eligible for MPC?
How do I pay for MPC?
Can I be employed and receive MPC?
Are there waiting lists for MPC?
ROADS TO COMMUNITY LIVING
What is the roads to community living (RCL) demonstration project and who is eligible?
What services may I receive under RCL?
When do RCL services start?
How do I remain eligible for RCL?
How do I pay for RCL services?
How does the department determine the number of hours or the payment rate for my personal care in RCL?
What may change the number of hours or payment rate for my personal care in RCL?
Do I have the right to an administrative hearing while receiving RCL services?
COMMUNITY OPTIONS PROGRAM ENTRY SYSTEM (COPES)
What services may I receive under community options program entry system (COPES) when I live in my own home?
What services may I receive under COPES if I live in a residential facility?
Am I eligible for COPES-funded services?
When do COPES services start?
How do I remain eligible for COPES?
How do I pay for COPES services?
Can I be employed and receive COPES?
Are there waiting lists for COPES?
NURSING FACILITY CARE SERVICES
What are nursing facility care services?
Am I eligible for nursing facility care services?
How do I pay for nursing facility care services?
CHORE
What services may I receive under chore?
Am I eligible for chore-funded services?
When do chore services start?
How do I remain eligible for chore?
How do I pay for chore?
Can I be employed and receive chore?
VOLUNTEER CHORE
What services may I receive under volunteer chore?
Am I eligible to receive volunteer chore services?
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
What services may I receive under PACE?
Am I eligible for PACE services?
How do I pay for PACE services?
How do I end my enrollment in the PACE program?
ADULT DAY SERVICES
What adult day care services may I receive?
Am I eligible for adult day care?
What adult day health services may I receive?
Am I eligible for adult day health?
GAU-FUNDED RESIDENTIAL CARE
What services may I receive under GAU-funded residential care?
Am I eligible to receive GAU-funded residential care services?
RESIDENTIAL CARE DISCHARGE ALLOWANCE
What services may I receive under the residential care discharge allowance?
Am I eligible for residential care discharge allowance?
PRIVATE DUTY NURSING
What is the intent of WAC 388-106-1000 through 388-106-1055?
What services may I receive under private duty nursing (PDN)?
Am I eligible for medicaid-funded private duty nursing services?
How do I pay for my PDN services?
Who can provide my PDN services?
Are there limitations or other requirements for PDN?
What requirements must a home health agency meet in order to provide and be paid for my PDN?
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?
Can I receive PDN services in a licensed adult family home (AFH)?
May I receive other long-term care services in addition to PDN?
Can I choose to self-direct my care if I receive PDN services?
SENIOR CITIZENS' SERVICES
What services can I receive under the Senior Citizens' Services Act (SCSA) fund?
How do I apply for SCSA-funded services?
Am I eligible for SCSA-funded services at no cost?
What income and resources are exempt when determining eligibility?
What if I am not eligible to receive SCSA-funded services at no cost?
RESPITE CARE SERVICES
What definitions apply to respite care services through the family caregiver support program?
What are respite care services?
Who is eligible to receive respite care services through the family caregiver support program?
Who may provide respite care services through the family caregiver support program?
How are respite care providers reimbursed for their services through the family caregiver support program?
Are participants required to pay for the cost of their respite care services through the family caregiver support program?
What determines emergent and nonemergent respite care services through the family caregiver support program?
CLIENT RIGHTS
What rights do I have as a client of the department?
What responsibilities do I have as a client of the department?
What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department?
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?
Do I have a right to an administrative hearing if my total in-home personal care hours or New Freedom budget 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)
What services may I receive under New Freedom consumer directed services (NFCDS)?
What services are not covered under New Freedom consumer directed services (NFCDS)?
Am I eligible for New Freedom consumer directed services (NFCDS)-funded services?
When do New Freedom consumer directed services (NFCDS) start?
How do I remain eligible for New Freedom consumer directed services (NFCDS)?
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)?
How do I pay for New Freedom consumer directed services (NFCDS)?
Can I be employed and receive New Freedom consumer directed services (NFCDS)?
Who can direct New Freedom consumer directed services (NFCDS)?
What is an individual budget?
How is the amount of the individual budget determined?
Is the individual budget intended to fully meet all of my needs?
What happens to individual budget funds when I don't use them?
How do I create and use my spending plan?
When can my New Freedom spending plan (NFSP) be denied?
Who can deny my New Freedom spending plan (NFSP)?
Are there waiting lists for New Freedom consumer directed services (NFCDS)?
How do I end enrollment in New Freedom consumer directed services (NFCDS)?
What are my hearing rights to appeal New Freedom consumer directed services (NFCDS) assessment and eligibility actions?
Nursing Facility Certificate of Need
What definitions apply to the nursing facility certificate of need?
What is the purpose of determining nursing facility comparable home and community-based long-term capacity?
What methodology does the department use to determine statewide or county specific nursing home comparable home and community-based long-term services availability?