SCOPE AND DEFINITIONS |
HTMLPDF | 388-106-0005 | What is the purpose and scope of this chapter? |
HTMLPDF | 388-106-0010 | What definitions apply to this chapter? |
APPLYING FOR SERVICES |
HTMLPDF | 388-106-0015 | What long-term care services does the department provide? |
HTMLPDF | 388-106-0020 | Under the MPC, CFC, COPES, and chore programs, what services are not covered? |
HTMLPDF | 388-106-0025 | How do I apply for long-term care services? |
HTMLPDF | 388-106-0030 | Where can I receive services? |
HTMLPDF | 388-106-0033 | When may I receive services in a facility contracted to provide specialized dementia care services? |
HTMLPDF | 388-106-0035 | May I receive personal care services through any of the long-term care programs when I am out of the state of Washington? |
HTMLPDF | 388-106-0040 | Who can provide long-term care services? |
HTMLPDF | 388-106-0045 | When will the department authorize my long-term care services? |
HTMLPDF | 388-106-0047 | When can the department terminate or deny long-term care services to me? |
COMPREHENSIVE ASSESSMENT REPORTING EVALUATION (CARE) ASSESSMENT |
HTMLPDF | 388-106-0050 | What is an assessment? |
HTMLPDF | 388-106-0055 | What is the purpose of an assessment? |
HTMLPDF | 388-106-0060 | Who must perform the assessment? |
HTMLPDF | 388-106-0065 | What is the process for conducting an assessment? |
HTMLPDF | 388-106-0070 | Will I be assessed in CARE? |
HTMLPDF | 388-106-0075 | How is my need for personal care services assessed in CARE? |
CARE CLASSIFICATION |
HTMLPDF | 388-106-0080 | How is the amount of long-term care services I can receive in my own home or in a residential facility determined? |
HTMLPDF | 388-106-0085 | What criteria does the CARE tool use to place me in one of the classification groups? |
HTMLPDF | 388-106-0090 | How does the CARE tool measure cognitive performance? |
HTMLPDF | 388-106-0095 | How does the CARE tool measure clinical complexity? |
HTMLPDF | 388-106-0100 | How does the CARE tool measure mood and behaviors? |
HTMLPDF | 388-106-0105 | How does the CARE tool measure activities of daily living (ADLs)? |
HTMLPDF | 388-106-0110 | How does the CARE tool evaluate me for the exceptional care classification of the E Group? |
HTMLPDF | 388-106-0115 | How does CARE use criteria to place me in a classification group for residential facilities? |
HTMLPDF | 388-106-0120 | What is the payment rate that the department will pay the provider if I receive personal care services in a residential facility? |
HTMLPDF | 388-106-0125 | How does CARE use criteria to place me in a classification group for in-home care? |
HTMLPDF | 388-106-0130 | How does the department determine the number of hours I may receive for in-home care? |
HTMLPDF | 388-106-0135 | What is the maximum number of hours of personal care services that I can receive for in-home services? |
HTMLPDF | 388-106-0136 | What if I disagree with the result of the limitation extension decision regarding personal care? |
HTMLPDF | 388-106-0140 | What may change the maximum number of hours that I can receive for in-home personal care services? |
HTMLPDF | 388-106-0145 | What may change the maximum payment rate that will be paid for residential personal care services provided to me? |
MEDICAID PERSONAL CARE (MPC) |
HTMLPDF | 388-106-0200 | What services may I receive under medicaid personal care (MPC)? |
HTMLPDF | 388-106-0210 | Am I eligible for medicaid personal care (MPC) funded services? |
HTMLPDF | 388-106-0215 | When do MPC services start? |
HTMLPDF | 388-106-0220 | How do I remain eligible for MPC? |
HTMLPDF | 388-106-0225 | How do I pay for medicaid personal care? |
HTMLPDF | 388-106-0230 | Can I be employed and receive MPC? |
HTMLPDF | 388-106-0235 | Are there waiting lists for MPC? |
ROADS TO COMMUNITY LIVING |
HTMLPDF | 388-106-0250 | What is the roads to community living (RCL) demonstration project and who is eligible? |
HTMLPDF | 388-106-0255 | What services may I receive under RCL? |
HTMLPDF | 388-106-0256 | When do RCL services start? |
HTMLPDF | 388-106-0257 | How do I remain eligible for RCL? |
HTMLPDF | 388-106-0260 | How do I pay for RCL services? |
HTMLPDF | 388-106-0261 | How does the department determine the number of hours or the payment rate for my personal care in RCL? |
HTMLPDF | 388-106-0262 | What may change the number of hours or payment rate for my personal care in RCL? |
HTMLPDF | 388-106-0265 | Do I have the right to an administrative hearing while receiving RCL services? |
COMMUNITY FIRST CHOICE |
HTMLPDF | 388-106-0270 | What services are available under community first choice (CFC)? |
HTMLPDF | 388-106-0271 | Are there limits to the skills acquisition training I may receive? |
HTMLPDF | 388-106-0272 | Who are qualified providers for skills acquisition training? |
HTMLPDF | 388-106-0273 | May I receive additional personal emergency response services? |
HTMLPDF | 388-106-0274 | Are there limits to the assistive technology I may receive? |
HTMLPDF | 388-106-0275 | Are there limits to the community transition services I may receive? |
HTMLPDF | 388-106-0276 | Where can I receive CFC services? |
HTMLPDF | 388-106-0277 | Am I eligible for CFC services? |
HTMLPDF | 388-106-0280 | When do CFC services begin? |
HTMLPDF | 388-106-0283 | How do I remain eligible for CFC services? |
HTMLPDF | 388-106-0285 | What do I pay for if I receive CFC services? |
HTMLPDF | 388-106-0290 | What does the department pay towards the cost of care when you are receiving CFC services and live in a residential facility? |
HTMLPDF | 388-106-0295 | May I be employed and receive CFC services? |
COMMUNITY OPTIONS PROGRAM ENTRY SYSTEM (COPES) |
HTMLPDF | 388-106-0300 | What services may I receive under community options program entry system (COPES) when I live in my own home? |
HTMLPDF | 388-106-0305 | What services may I receive under COPES if I live in a residential facility? |
HTMLPDF | 388-106-0310 | Am I eligible for COPES-funded services? |
HTMLPDF | 388-106-0315 | When do COPES services start? |
HTMLPDF | 388-106-0320 | How do I remain eligible for COPES? |
HTMLPDF | 388-106-0325 | How do I pay for COPES services? |
HTMLPDF | 388-106-0330 | Can I be employed and receive COPES? |
HTMLPDF | 388-106-0335 | Are there waiting lists for COPES? |
RESIDENTIAL SUPPORT |
HTMLPDF | 388-106-0336 | What services may I receive under the residential support waiver? |
HTMLPDF | 388-106-0337 | When are you not eligible for adult day health services? |
HTMLPDF | 388-106-0338 | Am I eligible for services funded by the residential support waiver? |
HTMLPDF | 388-106-0340 | When do services from the residential support waiver start? |
HTMLPDF | 388-106-0342 | How do I remain eligible for residential support waiver services? |
HTMLPDF | 388-106-0344 | How do I pay for residential support waiver services? |
HTMLPDF | 388-106-0346 | Can I be employed and receive residential support waiver services? |
HTMLPDF | 388-106-0348 | Are there waiting lists for the residential support waiver services? |
NURSING FACILITY CARE SERVICES |
HTMLPDF | 388-106-0350 | What are nursing facility care services? |
HTMLPDF | 388-106-0355 | Am I eligible for nursing facility care services? |
HTMLPDF | 388-106-0360 | How do I pay for nursing facility care services? |
CHORE |
HTMLPDF | 388-106-0600 | What services may I receive under chore? |
HTMLPDF | 388-106-0610 | Am I eligible for chore-funded services? |
HTMLPDF | 388-106-0615 | When do chore services start? |
HTMLPDF | 388-106-0620 | How do I remain eligible for chore? |
HTMLPDF | 388-106-0625 | How do I pay for chore? |
HTMLPDF | 388-106-0630 | Can I be employed and receive chore? |
VOLUNTEER CHORE |
HTMLPDF | 388-106-0650 | What is the volunteer services program? |
HTMLPDF | 388-106-0655 | Am I eligible to receive assistance through volunteer services? |
HTMLPDF | 388-106-0660 | What types of services may be offered through volunteer services? |
HTMLPDF | 388-106-0665 | How are volunteers qualified to provide volunteer services? |
HTMLPDF | 388-106-0670 | When may volunteer services not be available or offered? |
HTMLPDF | 388-106-0675 | What if I disagree with a decision made by the contracted volunteer services provider(s) related to volunteer services? |
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) |
HTMLPDF | 388-106-0700 | What services may I receive under PACE? |
HTMLPDF | 388-106-0705 | Am I eligible for PACE services? |
HTMLPDF | 388-106-0710 | How do I pay for PACE services? |
HTMLPDF | 388-106-0715 | How do I end my enrollment in the PACE program? |
ADULT DAY SERVICES |
HTMLPDF | 388-106-0800 | What adult day care services may I receive? |
HTMLPDF | 388-106-0805 | Am I eligible for adult day care? |
HTMLPDF | 388-106-0810 | What adult day health services may I receive? |
HTMLPDF | 388-106-0815 | Am I eligible for adult day health? |
GAU-FUNDED RESIDENTIAL CARE |
HTMLPDF | 388-106-0900 | What services may I receive under medical care services? |
HTMLPDF | 388-106-0905 | Am I eligible to receive medical care services (MCS) residential care services? |
COMMUNITY TRANSITION OR SUSTAINABILITY SERVICES |
HTMLPDF | 388-106-0950 | What services may I receive under community transition or sustainability services? |
HTMLPDF | 388-106-0955 | Am I eligible for community transition or sustainability services? |
HTMLPDF | 388-106-0960 | Are there limits to the community transition or sustainability services I may receive? |
HTMLPDF | 388-106-0965 | Are there waiting lists for community transition or sustainability services? |
PRIVATE DUTY NURSING |
HTMLPDF | 388-106-1000 | What is the intent of WAC 388-106-1000 through 388-106-1055? |
HTMLPDF | 388-106-1005 | What services may I receive under private duty nursing (PDN)? |
HTMLPDF | 388-106-1010 | Am I eligible for medicaid-funded private duty nursing services? |
HTMLPDF | 388-106-1020 | How do I pay for my PDN services? |
HTMLPDF | 388-106-1025 | Who can provide my PDN services? |
HTMLPDF | 388-106-1030 | Are there limitations or other requirements for PDN? |
HTMLPDF | 388-106-1035 | What requirements must a home health agency meet in order to provide and be paid for my PDN? |
HTMLPDF | 388-106-1040 | What requirements must an RN, or LPN under the supervision of an RN, meet in order to provide and get paid for my PDN services? |
HTMLPDF | 388-106-1045 | When may I receive private duty nursing (PDN) services in a contracted PDN adult family home (AFH)? |
HTMLPDF | 388-106-1046 | When may an adult family home (AFH) be paid an all-inclusive daily rate for private duty nursing (PDN) services? |
HTMLPDF | 388-106-1047 | What is included in the all-inclusive daily rate payment to the adult family home (AFH) providing private duty nursing (PDN) services? |
HTMLPDF | 388-106-1050 | May I receive other long-term care services in addition to PDN? |
HTMLPDF | 388-106-1055 | Can I choose to self-direct my care if I receive PDN services? |
SENIOR CITIZENS' SERVICES |
HTMLPDF | 388-106-1100 | What services can I receive under the Senior Citizens' Services Act (SCSA) fund? |
HTMLPDF | 388-106-1105 | How do I apply for SCSA-funded services? |
HTMLPDF | 388-106-1110 | Am I eligible for SCSA-funded services at no cost? |
HTMLPDF | 388-106-1115 | What income and resources are exempt when determining eligibility? |
HTMLPDF | 388-106-1120 | What if I am not eligible to receive SCSA-funded services at no cost? |
RESPITE CARE SERVICES |
HTMLPDF | 388-106-1200 | What definitions apply to respite care services through the family caregiver support program? |
HTMLPDF | 388-106-1205 | What are respite care services? |
HTMLPDF | 388-106-1210 | Who is eligible to receive respite care services through the family caregiver support program? |
HTMLPDF | 388-106-1215 | Who may provide respite care services through the family caregiver support program? |
HTMLPDF | 388-106-1220 | How are respite care providers reimbursed for their services through the family caregiver support program? |
HTMLPDF | 388-106-1225 | Are participants required to pay for the cost of their respite care services through the family caregiver support program? |
HTMLPDF | 388-106-1230 | What determines emergent and nonemergent respite care services through the family caregiver support program? |
CLIENT RIGHTS |
HTMLPDF | 388-106-1300 | What rights do I have as a client of the department? |
HTMLPDF | 388-106-1303 | What responsibilities do I have as a client of the department? |
HTMLPDF | 388-106-1305 | What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department? |
HTMLPDF | 388-106-1310 | 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? |
HTMLPDF | 388-106-1315 | 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) |
HTMLPDF | 388-106-1400 | What services may I receive under New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1405 | What services are not covered under New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1410 | Am I eligible for New Freedom consumer directed services (NFCDS)-funded services? |
HTMLPDF | 388-106-1415 | When do New Freedom consumer directed services (NFCDS) start? |
HTMLPDF | 388-106-1420 | How do I remain eligible for New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1422 | What happens to my New Freedom service dollar budget if I am temporarily hospitalized, placed in a nursing facility, or intermediate care facilities for intellectual disability (ICF/ID)? |
HTMLPDF | 388-106-1425 | How do I pay for New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1430 | Can I be employed and receive New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1435 | Who can direct New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1440 | What is an individual budget? |
HTMLPDF | 388-106-1445 | How is the amount of the individual budget determined? |
HTMLPDF | 388-106-1450 | Is the individual budget intended to fully meet all of my needs? |
HTMLPDF | 388-106-1455 | What happens to individual budget funds when I don't use them? |
HTMLPDF | 388-106-1458 | How do I create and use my spending plan? |
HTMLPDF | 388-106-1460 | When can my New Freedom spending plan (NFSP) be denied? |
HTMLPDF | 388-106-1465 | Who can deny my New Freedom spending plan (NFSP)? |
HTMLPDF | 388-106-1470 | Are there waiting lists for New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1475 | How do I end enrollment in New Freedom consumer directed services (NFCDS)? |
HTMLPDF | 388-106-1480 | What are my hearing rights to appeal New Freedom consumer directed services (NFCDS) assessment and eligibility actions? |
NURSING FACILITY CERTIFICATE OF NEED |
HTMLPDF | 388-106-1600 | What definitions apply to the nursing facility certificate of need? |
HTMLPDF | 388-106-1610 | What is the purpose of determining nursing facility comparable home and community-based long-term capacity? |
HTMLPDF | 388-106-1620 | What methodology does the department use to determine statewide or county specific nursing home comparable home and community-based long-term services availability? |
SUPPORTIVE HOUSING |
HTMLPDF | 388-106-1700 | What definitions apply to supportive housing? |
HTMLPDF | 388-106-1705 | What services may I receive under supportive housing? |
HTMLPDF | 388-106-1710 | Where may I receive supportive housing services? |
HTMLPDF | 388-106-1715 | Who may provide supportive housing services? |
HTMLPDF | 388-106-1720 | Am I eligible for supportive housing funded services? |
HTMLPDF | 388-106-1725 | When do supportive housing services begin? |
HTMLPDF | 388-106-1730 | How do I remain eligible for supportive housing? |
HTMLPDF | 388-106-1735 | Do I have to pay for my supportive housing services? |
HTMLPDF | 388-106-1740 | What are my rights when I receive supportive housing services in a setting owned by a service provider? |
HTMLPDF | 388-106-1745 | May I be employed and receive supportive housing services? |
HTMLPDF | 388-106-1750 | Are there limits to the supportive housing services I receive? |
HTMLPDF | 388-106-1755 | Are there waiting lists for supportive housing? |
HTMLPDF | 388-106-1760 | Do I have the right to an administrative hearing regarding supportive housing services? |
HTMLPDF | 388-106-1765 | When may the department terminate or deny supportive housing services? |
LONG-TERM SERVICES AND SUPPORTS (LTSS) PRESUMPTIVE ELIGIBILITY (PE) |
HTMLPDF | 388-106-1800 | What definitions apply to LTSS PE? |
HTMLPDF | 388-106-1805 | Am I eligible for LTSS NFLOC PE services? |
HTMLPDF | 388-106-1810 | What services may I receive under LTSS NFLOC PE? |
HTMLPDF | 388-106-1815 | Am I eligible for LTSS MPC PE services? |
HTMLPDF | 388-106-1820 | What services may I receive under LTSS MPC PE? |
HTMLPDF | 388-106-1825 | Who can provide long-term care services when I am eligible for LTSS NFLOC or LTSS MPC PE services? |
HTMLPDF | 388-106-1830 | When will the department authorize my LTSS NFLOC or LTSS MPC PE services? |
HTMLPDF | 388-106-1835 | When do LTSS NFLOC PE or LTSS MPC PE services end? |
HTMLPDF | 388-106-1840 | Where can I receive LTSS NFLOC PE or LTSS MPC PE services? |
HTMLPDF | 388-106-1845 | What do I pay for if I receive LTSS NFLOC PE or LTSS MPC PE services? |
HTMLPDF | 388-106-1850 | Do I have a right to an administrative hearing on LTSS NFLOC PE or LTSS MPC PE determinations? |
HTMLPDF | 388-106-1855 | Can an exception to rule (ETR) be granted for eligibility or service determinations? |
MAC AND TSOA SERVICES |
HTMLPDF | 388-106-1900 | What definitions apply to MAC and TSOA services? |
HTMLPDF | 388-106-1905 | Am I eligible for MAC services? |
HTMLPDF | 388-106-1910 | Am I eligible for TSOA services? |
HTMLPDF | 388-106-1915 | What services may I receive in MAC and TSOA? |
HTMLPDF | 388-106-1920 | What is the maximum amount of step three services I may receive a month? |
HTMLPDF | 388-106-1921 | How does the TCARE assessment determine what step three services are recommended to my caregiver? |
HTMLPDF | 388-106-1925 | What are the goals in TCARE? |
HTMLPDF | 388-106-1930 | What is the purpose of the TCARE assessment? |
HTMLPDF | 388-106-1931 | What are the TCARE screening measures? |
HTMLPDF | 388-106-1932 | How is the TCARE screening scored to determine if my caregiver is eligible for a TCARE assessment and related step three services? |
HTMLPDF | 388-106-1933 | How is the GetCare screening scored to determine if I am eligible for a GetCare assessment and related step three services? |
HTMLPDF | 388-106-1935 | Where may I receive MAC and TSOA services? |
HTMLPDF | 388-106-1940 | When will my MAC or TSOA services be authorized? |
HTMLPDF | 388-106-1945 | When do my MAC or TSOA services begin? |
HTMLPDF | 388-106-1950 | How do I remain eligible for MAC and TSOA services? |
HTMLPDF | 388-106-1955 | What do I pay for if I receive MAC or TSOA services? |
HTMLPDF | 388-106-1960 | May I be employed and receive MAC or TSOA services? |
HTMLPDF | 388-106-1965 | Are there limits to the services I may receive? |
HTMLPDF | 388-106-1970 | Who may provide MAC and TSOA services? |
HTMLPDF | 388-106-1975 | Will there be a waitlist for MAC and TSOA? |
HTMLPDF | 388-106-1980 | When may the department terminate or deny MAC or TSOA services? |
HTMLPDF | 388-106-1985 | Do I have the right to an administrative hearing regarding MAC or TSOA services? |
HTMLPDF | 388-106-1990 | May I choose to receive traditional medicaid long-term services and supports instead of services under the MAC program? |
HTMLPDF | 388-106-2000 | What definitions apply to the civil transitions program? |
HTMLPDF | 388-106-2005 | Who is eligible to apply to receive services under the civil transitions program? |
HTMLPDF | 388-106-2010 | What services may I receive under the civil transitions program if I am not functionally and financially eligible for long-term services and supports? |
HTMLPDF | 388-106-2015 | What services may I receive under the civil transitions program if I am functionally and financially eligible for long-term services and supports? |
HTMLPDF | 388-106-2020 | What conditional services may I receive under the civil transitions program? |
HTMLPDF | 388-106-2025 | Who can provide long-term services and supports when I am eligible for the civil transitions program conditional services? |
HTMLPDF | 388-106-2030 | Where can I receive civil transitions program conditional services? |
HTMLPDF | 388-106-2035 | When will the department authorize my civil transitions program conditional services? |
HTMLPDF | 388-106-2040 | When will my civil transitions program conditional services end? |
HTMLPDF | 388-106-2045 | Do I have a right to an administrative hearing on civil transitions program conditional services? |
HTMLPDF | 388-106-2050 | Can an exception to rule (ETR) be granted for civil transitions program conditional services? |
HTMLPDF | 388-106-2100 | What is the home and community services guardianship and conservatorship assistance program? |
HTMLPDF | 388-106-2105 | Definitions. |
HTMLPDF | 388-106-2110 | Eligibility criteria. |
HTMLPDF | 388-106-2115 | Referral process. |
HTMLPDF | 388-106-2120 | Acceptance into the program. |
HTMLPDF | 388-106-2125 | Reconsideration of acceptance determination. |
HTMLPDF | 388-106-2130 | Notice of department decisions. |
HTMLPDF | 388-106-2135 | Appeal of acceptance determination or discontinuation of program participation. |
HTMLPDF | 388-106-2140 | Overpayment. |
HTMLPDF | 388-106-2145 | Program hold and reinstatement or forfeiture of program participation. |
HTMLPDF | 388-106-2150 | Estate recovery. |
HTMLPDF | 388-106-2155 | Exception to rule (ETR). |
HTMLPDF | 388-106-2160 | Personal needs allowance increase or participation reduction. |
HTMLPDF | 388-106-2165 | Split appointment. |