Date of Adoption: February 27, 2004.

     Purpose: To implement the SSB 5579 (Chapter 231, Laws of 2003). SSB 5579 requires the department to change its current bed hold process to the process described in the bill.

     The department is filing proposed rules and a public hearing will be scheduled for April 6, 2004. The emergency rules must be continued while the department completes the regular rule adoption process.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-105-0005, 388-105-0030, and 388-105-0040.

     Statutory Authority for Adoption: Chapter 231, Laws of 2003.

     Other Authority: Chapter 18.20 RCW.

     Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

     Reasons for this Finding: The legislature made the finding in section 12 of SSB 5579 (chapter 231, Laws of 2003): "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately."

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 3, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 3, Repealed 0.
     Effective Date of Rule: March 1, 2004.

February 27, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

Four level payment system rates for AFHs, ARCs, & EARCs
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((46.06)) 45.70		$ ((44.79)) 44.43		$ ((44.79)) 44.43
Level 2	$ ((49.28)) 48.65		$ ((51.52)) 50.89		$ ((56.97)) 56.34
Level 3	$ ((57.07)) 56.32		$ ((59.51)) 58.76		$ ((65.76)) 65.01
Level 4	$ ((68.15)) 67.75		$ ((72.07)) 71.67		$ ((78.31)) 77.91

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0005, filed 10/31/02, effective 12/1/02. Statutory Authority: 2001 c 7 § 206. 01-21-077, § 388-105-0005, filed 10/18/01, effective 11/18/01. Statutory Authority: Chapter 74.39A RCW. 01-14-056, § 388-105-0005, filed 6/29/01, effective 7/30/01.]

COPES ((ALF)) AL Daily Payment Rates w/o Capital Add-on Rate
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((54.84)) 54.48		$ ((56.35)) 55.99		$ ((61.03)) 60.67
Level 2	$ ((61.14)) 60.51		$ ((62.92)) 62.29		$ ((68.52)) 67.89
Level 3	$ ((67.54)) 66.79		$ ((69.90)) 69.15		$ ((76.46)) 75.71

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0030, filed 10/31/02, effective 12/1/02.]

COPES ((ALF)) AL Add-on Rate July 1, 2002
Non- metropolitan		Metropolitan*		King Co.
$ 4.68		$ 4.39		$ 4.84

COPES ((ALF)) AL Daily Payment Rates with a Capital Add-on Rate
Care Levels	Non- metropolitan		Metropolitan*		King Co.
Level 1	$ ((59.52)) 59.16		$ ((60.74)) 60.38		$ ((65.87)) 65.51
Level 2	$ ((65.82)) 65.19		$ ((67.31)) 66.68		$ ((73.36)) 72.73
Level 3	$ ((72.22)) 71.47		$ ((74.29)) 73.54		$ ((81.30)) 80.55

*Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima counties.

[Statutory Authority: 2002 c 371. 02-22-058, § 388-105-0040, filed 10/31/02, effective 12/1/02.]

     (a) Short-term care is needed in a nursing home or hospital;

     (b) The resident is likely to return to the AFH, ARC, EARC, or AL; and

     (c) Payment is made under subsection (3) of this section.

     (2) When the department pays the provider to hold the Medicaid resident's bed or unit during the resident's short-term nursing home or hospital stay, the provider must hold the unit or bed for up to twenty days.

     (3) The department will compensate the provider for holding the bed or unit for the:

     (a) First through seventh day at seventy percent of the daily rate paid for care of the resident before the hospital or nursing home stay; and

     (b) Eighth through the twentieth day, at ten dollars and forty-three cents a day.

     (4) The AFH, ARC, EARC, and AL provider may seek third-party payment to hold a bed or unit for twenty-one days or longer. The provider may only collect from the third-party a payment not exceeding eighty-five percent of the average Medicaid daily rate paid to the facility. To compute the average Medicaid daily rate, the provider will add the highest Medicaid daily rate for each Medicaid resident residing in the facility for any part of the month in which the unit or bed hold began and divide the total by the number of Medicaid residents residing in the facility in the month in which the bed hold began.

     (5) If third-party payment is not available and the returning Medicaid resident continues to meet the admission criteria under chapter 388-71 WAC, the Medicaid resident may return to the first available and appropriate bed or unit.

     (6) The department's social worker or case manager determines whether the:

     (a) Care given in a nursing home or hospital will be short-term; and

     (b) Resident is likely to return to the AFH, ARC, EARC, or AL facility.

     (7) When the department's social worker or case manager determines that the Medicaid resident's stay in the nursing home or hospital is not short-term and the resident is unlikely to return to the AFH, ARC, EARC, or AL facility, then this section does not apply to any private contractual arrangements that the provider may make with a third party in regard to the discharged resident's unit or bed.

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