WSR 17-11-041 PROPOSED RULES DEPARTMENT OF SOCIAL AND HEALTH SERVICES (Developmental Disabilities Administration) [Filed May 11, 2017, 1:34 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 17-07-091.
Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-825-083 Is there a comprehensive list of waiver and state-only DDA services?, 388-825-084 What are the limitations of state-only funded services or programs?, 388-828-9300 What is the DDD community access acuity scale?, 388-828-9310 How does DDD determine the number of hours you may receive each month for community access services?, 388-828-9330 How does DDD determine your employment status?, 388-828-9350 Are there conditions when DDD will authorize additional hours to your monthly employment service hours?, 388-845-0600 What are community access services?, 388-845-0605 Who are qualified providers of community access services?, 388-845-0610 Are there limits to community access services I can receive?, 388-845-1030 What are individual technical assistance services?, 388-845-1040 Are there limits to the individualized technical assistance services you can receive?, 388-845-1410 Are there limits to the prevocational services you can receive?, 388-845-2100 What are supported employment services?, and 388-845-2110 Are there limits to the supported employment services I can receive?
Hearing Location(s): Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at https://www.dshs.wa.gov/sesa/rules-and-policies-assistance-unit/driving-directions-office-bldg-2), on June 27, 2017, at 10:00 a.m.
Date of Intended Adoption: Not earlier than June 28, 2017.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, email DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., June 27, 2017.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by phone (360) 664-6092, TTY (360) 664-6178, or email KildaJA@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is proposing to amend these rules in order to correct errors and clarify language.
Reasons Supporting Proposal: These proposed amendments are necessary to protect public health, safety, and welfare. They are also needed for consistency with proposed amendments to WAC 388-845-0603 filed as WSR 17-08-102 on April 5, 2017.
Statutory Authority for Adoption: RCW 71A.12.030.
Statute Being Implemented: RCW 71A.12.040.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: DSHS, governmental.
Name of Agency Personnel Responsible for Drafting: Chantelle Diaz, P.O. Box 45310, Olympia, WA 98504-5310, (360) 407-1581; Implementation and Enforcement: Branda Matson, P.O. Box 45310, Olympia, WA 98504-5310, (360) 407-1522.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed amendments are exempt from preparing a small business economic impact statement under RCW 19.85.025 and 34.05.310(4), and correct errors and clarify language as described [in] RCW 34.05.310 (4)(d).
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rules are exempt under RCW 34.05.328 (5)(b)(iv) and correct errors and clarify language.
May 10, 2017
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-825-083 Is there a comprehensive list of waiver and state-only DDA services?
The following is a list of waiver and state-only services that the developmental disabilities administration (DDA) may authorize:
(1) For medicaid state plan services authorized by DDA, see WAC 388-825-068((. The following is a list of waiver and state-only services that DDA can authorize and those services that can be either a waiver or a state-only service:));
(((1) Waiver personal care services that are not available with state-only funds include:
(a) In-home services;
(b) Adult family home; and
(c) Adult residential care.))
(2) ((Waiver services that can be funded as state-only services:)) The following waiver services may be funded as state-only services:
(a) ((Assistive technology)) Basic plus waiver services under WAC 388-845-0210;
(b) ((Behavior management and consultation)) Children's intensive in-home behavioral support waiver services under WAC 388-845-0225;
(c) Community ((engagement)) protection waiver services under WAC 388-845-0220;
(d) ((Community guide)) Core waiver services under WAC 388-845-0215; and
(e) ((Community transition)) Individual and family services under WAC 388-845-0230; and
(((f) Environmental accessibility adaptations;
(g) Medical equipment and supplies;
(h) Occupational therapy;
(i) Peer mentoring;
(j) Person-centered planning facilitation;
(k) Physical therapy;
(l) Respite care;
(m) Sexual deviancy evaluation;
(n) Skilled nursing;
(o) Specialized clothing;
(p) Specialized nutrition;
(q) Specialized medical equipment or supplies;
(r) Specialized psychiatric services;
(s) Speech, hearing and language therapy;
(t) Staff/family consultation and training;
(u) Supported parenting services;
(v) Therapeutic equipment and supplies;
(w) Transportation/mileage;
(x) Vehicle modification;
(y) Residential habilitation services (RHS), including:
(i) Alternative living;
(ii) Companion homes;
(iii) Supported living;
(iv) Group home;
(v) Child foster care;
(vi) Child group care;
(vii) Staffed residential; and
(viii) State operated living alternative (SOLA);
(z) Employment/day programs, including:
(i) Community access;
(ii) Prevocational services; and
(iii) Supported employment;
(aa)County programs, including child development services;
(bb) Behavioral health stabilization services, including:
(i) Behavior support and consultation;
(ii) Behavioral health crisis diversion bed services; and
(iii) Specialized psychiatric services.))
(3) ((State-only services that are not available as a waiver service:)) The following state-only funded services are not available as a waiver service:
(a) Adult day care;
(b) Attendant care;
(c) Child care for foster children;
(d) Child development services;
(e) Chore services;
(((e))) (f) Community services grant;
(((f))) (g) Individual and family assistance;
(((g))) (h) Information((/)) and education;
(((h))) (i) Medical and dental services;
(((i))) (j) Medical insurance copays and costs exceeding other coverage;
(k) Overnight planned respite services;
(((j))) (l) Parent and sibling education;
(((k))) (m) Parent training and counseling;
(n) Personal care mileage reimbursement;
(((l))) (o) Psychological counseling;
(((m))) (p) Recreational opportunities;
(q) Reimbursement to families for the purchase of approved items or services;
(((n))) (r) State supplementary payments;
(((o))) (s) Training of the client; and
(((p))) (t) Transportation ((- cost)) costs of escort service or travel time((;
(q) Reimbursement to families for the purchase of approved items or services; and
(r) Overnight planned respite services)).
AMENDATORY SECTION (Amending WSR 15-17-094, filed 8/18/15, effective 9/18/15)
WAC 388-825-084 What are the ((limitations)) limits of state-only funded services or programs?
In addition to any ((limitations)) limits for state-only funded services or programs that are contained in the program-specific rules, the following ((limitations apply to state-only funded services and programs.)) limits apply:
(1) All state-only funded services are limited ((by)) to available funding((.)); and
(2) ((The following programs are closed to clients not currently receiving the service:
(a) Adult day care;
(b) Attendant care; and
(c) Chore services)) Adult day care is available only to a client who is currently receiving the service.
AMENDATORY SECTION (Amending WSR 13-01-080, filed 12/18/12, effective 1/18/13)
WAC 388-828-9300 What is the ((DDD)) community access acuity scale?
The ((DDD)) developmental disabilities administration (DDA's) community access acuity scale is an algorithm ((DDD)) DDA uses to determine the number of support hours you may receive ((when)) if you are approved for community access services.
AMENDATORY SECTION (Amending WSR 13-01-080, filed 12/18/12, effective 1/18/13)
WAC 388-828-9310 How does ((DDD)) DDA determine the number of community access services hours you may receive each month ((for community access services))?
(1) The number of hours of community access services you may receive each month is based on your community access service level.
(2) ((DDD)) The developmental disabilities administration (DDA) determines your community access service level based on your ((SIS)) support intensity scale (SIS) support needs index percentile ranking (((WAC 388-828-4440))). DDA determines your SIS support needs index percentile ranking under WAC 388-828-4440 and as detailed in the following table:
AMENDATORY SECTION (Amending WSR 13-01-076, filed 12/18/12, effective 1/18/13)
WAC 388-828-9330 How does ((DDD)) DDA determine your employment status?
((DDD determines your employment status to be:))
(1) (("Working" when you meet one of the following conditions)) The developmental disabilities administration (DDA) considers your employment status "working" if:
(a) In the twelve months ((prior to)) before your assessment:
(i) You have been employed for nine consecutive months; and
(ii) You have earned at least Washington state's minimum wage((.)); or
(b) You are currently self-employed and ((meet one of the following)):
(i) The activities of your employment meet the Internal Revenue Service (IRS) rules for a business;
(ii) You have a business plan demonstrating feasibility as determined by the division of vocational rehabilitation or an impartial, agreed upon, third-party business expert; ((or)) and
(iii) You are licensed, if required, and follow all local, state, and federal regulations and rules.
(2) (("In training/job development" when you do not meet either of the conditions for "working.")) DDA considers your employment status "in training/job development" if you do not meet the conditions in subsection (1) of this section.
AMENDATORY SECTION (Amending WSR 13-01-076, filed 12/18/12, effective 1/18/13)
WAC 388-828-9350 Are there conditions when ((DDD)) DDA will authorize additional hours to your monthly employment service hours?
((DDD)) The developmental disabilities administration (DDA) may authorize ((the use of add-on)) additional hours ((in addition)) to your monthly employment service hours when your employment support plan identifies a need for additional service hours related to:
(1) Your work schedule;
(2) The number of jobs you have;
(3) The appropriateness of your job match;
(4) Natural supports available to you on the job;
(5) Health limitations that affect your job;
(6) Provider travel time and distance to your job;
(7) Behavioral or physical needs that may affect the safety of you and others while at work;
(8) Other factors ((detailed)) in your employment plan ((which)) that indicate a need for ((add-on)) additional hours ((to help you find or)) for a short-term volunteer opportunity, job development, or for you to maintain a job.
AMENDATORY SECTION (Amending WSR 12-16-095, filed 8/1/12, effective 9/1/12)
WAC 388-845-0600 What are community access services?
Community access ((is an individualized service that provides clients with opportunities to engage in community based activities that support socialization, education, recreation and personal development for the purpose of:
(1) Building and strengthening relationships with others in the local community who are not paid to be with the person.
(2) Learning, practicing and applying skills that promote greater independence and inclusion in their community)) services:
(1) Are provided in typical integrated community settings;
(2) Are individualized services that promote skill development, independent living, and community integration for individuals learning how to actively and independently engage in their community; and
(3) Provide opportunities for individuals to develop relationships and increase independence.
AMENDATORY SECTION (Amending WSR 13-24-045, filed 11/26/13, effective 1/1/14)
WAC 388-845-0605 Who are qualified providers of community access services?
Providers of community access services must be:
(1) A county contracted with the developmental disabilities administration (DDA) to provide community access services; or
(2) An individual or agency contracted with a county ((or)) that is contracted with DDA to provide community access services.
AMENDATORY SECTION (Amending WSR 13-24-045, filed 11/26/13, effective 1/1/14)
WAC 388-845-0610 Are there limits to community access services ((I can)) you may receive?
((The following limits apply to your receipt of community access services:))
(1) You ((cannot)) must not receive community access services if you are receiving prevocational or supported employment services.
(2) The maximum hours of community access services you may receive are determined by the ((DDA)) developmental disabilities administration (DDA) assessment ((per)) under WAC 388-828-9310.
AMENDATORY SECTION (Amending WSR 13-24-045, filed 11/26/13, effective 1/1/14)
WAC 388-845-1030 What are ((individual)) individualized technical assistance services?
Individualized technical ((assistance service is assessment and consultation with the employment provider and/or client)) assistance services:
(1) Provide short-term, professional expertise to identify and address ((existing)) barriers to employment((. This is)) services; and
(2) Are available in addition to supports received through supported employment services ((or prevocational services)) for ((individuals)) an individual who ((have)) has not yet achieved ((their employment)) his or her goal.
AMENDATORY SECTION (Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-845-1040 Are there limits to the individualized technical assistance services you ((can)) may receive?
(1) The developmental disabilities administration (DDA) may authorize a maximum of three months of individualized technical assistance ((service cannot)) at a time, not to exceed ((three)) six months in ((an individual's)) the plan year.
(2) ((These)) Individualized technical assistance services are available on the basic plus, core, and ((CP)) community protection waivers.
(3) ((Individual must be)) Individualized technical assistance services are available only to individuals who are receiving supported employment ((or prevocational)) services, unless approved by the regional administrator or his or her designee.
(4) Individualized technical assistance services are limited to additional hours ((per)) under WAC 388-828-9355 and 388-828-9360.
AMENDATORY SECTION (Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-845-1410 Are there limits to the prevocational services you ((can)) may receive?
The following ((limitations)) limits apply to your receipt of prevocational services:
(1) Effective September 1, 2015, no new referrals are accepted for prevocational services.
(2) Clinical and support needs for prevocational services are limited to those identified in your ((DDA)) developmental disabilities administration (DDA) assessment and documented in your person-centered service plan/individual support plan.
(((2))) (3) You must be age twenty and graduating from high school ((prior to)) before your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive prevocational services.
(((3) Effective September 1, 2015, no new referrals are accepted for prevocational services.))
(4) Prevocational services are a time limited step on the pathway toward individual employment and are dependent on your demonstrating steady progress toward gainful employment over time. Your annual employment plan will include exploration of integrated settings within your next service year. Criteria that would trigger a review of your need for these services include, but are not limited to:
(a) Compensation at more than fifty percent of the prevailing wage;
(b) Significant progress made toward your defined goals; and
(c) Recommendation by your individual support plan team.
(5) You will not be authorized to receive prevocational services in addition to community access services or supported employment services.
(6) Your service hours are determined by the assistance you need to reach your employment outcomes as described in WAC 388-828-9325.
AMENDATORY SECTION (Amending WSR 13-24-045, filed 11/26/13, effective 1/1/14)
WAC 388-845-2100 What are supported employment services?
(1) Supported employment services are for those interested in integrated gainful employment. These services provide you with intensive ongoing support if you need individualized assistance to gain ((and/or)) employment, maintain employment, or both. These services are tailored to your individual needs, interests, abilities, and promote your career development. These services are provided in individual or group settings and are available in the basic plus, core, and community protection waivers.
(((1))) (2) Individual supported employment services include activities needed to sustain Washington state's minimum wage pay or higher. These services are conducted in integrated business environments and include the following:
(a) Intake: An initial meeting to gather and share basic information and a general overview of employment supports, resources in the community, and the type of available supports that the individual may receive;
(b) Discovery: A person-centered approach to learn the individual's likes and dislikes, job preferences, and employment goals and skills;
(c) Job preparation: Includes activities of work readiness resume development, work experience, volunteer support transportation training;
(d) Marketing: A method to identify and negotiate jobs, ((building)) build relationships with employers, and customize employment development;
(e) Job coaching: The supports needed to keep the job; and
(f) Job retention: The supports needed to keep the job, maintain a relationship with employer, identify opportunities, and negotiate a raise in pay, promotion ((and/or)), or increased benefits.
(((2))) (3) Group supported employment services are a step on your pathway toward gainful employment in an integrated setting and include:
(a) Supports and paid training in an integrated business setting;
(b) Supervision by a qualified employment provider during working hours;
(c) Groupings of no more than eight workers with disabilities; and
(d) Individualized supports to obtain gainful employment.
AMENDATORY SECTION (Amending WSR 13-24-045, filed 11/26/13, effective 1/1/14)
WAC 388-845-2110 Are there limits to the supported employment services ((I can)) you may receive?
The following ((limitations)) limits apply to your receipt of supported employment services:
(1) You must be age twenty and graduating from high school ((prior to)) before your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive supported employment services((.));
(2) ((Payment will be made only for the employment support you require as a result of your disabilities.
(3))) Payment for individual supported employment services excludes the supervisory activities rendered as a normal part of the business setting((.));
(((4))) (3) You will not be authorized to receive supported employment services in addition to community access or prevocational services((.)); and
(((5))) (4) Your service hours are determined by the assistance you need to reach your employment outcomes as described in WAC 388-828-9325 and might not equal the number of hours you spend on the job or in job related activities.
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