WSR 17-14-063
HEALTH CARE AUTHORITY
[Filed June 29, 2017, 1:10 p.m.]
NOTICE
Title or Subject: Medicaid State Plan Amendment (SPA) 17-0029 Long-Term Care Provider Rates.
Effective Date: July 1, 2017.
Description: The health care authority (the agency) in conjunction with the aging and long-term support administration (ALTSA) of the department of social and health services (DSHS) intends to submit medicaid SPA 17-0029 in order to update certain long-term care medicaid rates in accordance with anticipated budget appropriations and direction from the state legislature.
SPA 17-0029 is expected to increase the annual aggregate expenditures for adult family homes, individual providers, essential service facilities, and home care agency providers. Increases are listed by provider type below.
SPA 17-0029 is in the development process; therefore a copy is not yet available for review. The agency and DSHS would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available, you may contact the agency in your county listed in the table or the person named below. To submit comments, please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).
Interested parties may submit comments and concerns about the rates or the effects the changes may have on beneficiary access to care or continued service access. Please submit comments and concerns to Elizabeth.Pashley@dshs.wa.gov by August 15, 2017. Please note that all comments are subject to public review and disclosure, as are the names of those who comment.
NOTE: Effective March 20, 2017, official public notice of proposed medicaid SPAs is published on the agency's web site at the Public Notices link. As a convenience, the agency will continue to publish copies of SPA notices in the Washington State Register.
Contact Elizabeth Pashley, Long-Term Care Medicaid Rates Unit, P.O. Box 45600, Olympia, WA 98504, phone (360) 725-2447, TDD/TTY 1-877-905-0454, fax (360) 725-2641, email Elizabeth.Pashley@dshs.wa.gov, web site https://www.dshs.wa.gov/altsa/management-services-division/office-rates-management.
The proposed rates, methodologies, and justifications are as follows:
1. Adult family homes
The following are the proposed changes to the adult family home rates:
a. Adult family home daily rates will increase as follows:
Service Area
King County
**Metropolitan Counties
***Non metropolitan Counties
Classification
AFH w/CI Daily Rate
AFH w/CI Daily Rate
AFH w/CI Daily Rate
A Low (1)
$73.78
$72.55
$70.78
A Med (2)
$76.56
$75.26
$73.38
A High (3)
$83.05
$81.57
$79.44
B Low (4)
$75.22
$73.95
$72.13
B Med (5)
$81.60
$80.16
$78.09
B Med H (6)
$88.38
$86.75
$84.42
B High (7)
$90.87
$89.18
$86.75
C Low (8)
$82.85
$81.38
$79.26
C Med (9)
$95.15
$93.34
$90.75
C Med H (10)
$100.23
$95.40
$92.72
C High (11)
$101.58
$98.80
$94.79
D Low (12)
$88.28
$86.66
$84.33
D Med (13)
$97.07
$95.21
$92.54
D Med H (14)
$114.41
$110.96
$106.07
D High (15)
$129.83
$125.65
$118.91
E Med (16)
$156.21
$150.78
$142.65
E High (17)
$182.62
$175.90
$166.41
** Metropolitan counties (urban): Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane, Thurston, Whatcom, and Yakima.
*** Nonmetropolitan counties: Adams, Asotin, Chelan, Clallam, Columbia, Cowlitz, Douglas, Ferry, Kittitas, Garfield, Grant, Grays Harbor, Jefferson, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oreille, San Juan, Skagit, Skamania, Stevens, Wahkiakum, Walla Walla, and Whitman.
b. The cap on the sum of the adult family home daily rate plus the expanded community service add-on rate will increase from $117.72 to $122.43.
c. Specialty private duty nursing daily rate will increase from $591.82 to $627.33.
d. HIV/AIDS rate will increase from $95.50 to $99.32. The adult family home will continue to receive either the specialized HIV/AIDS daily rate or the base daily rate, whichever is greater.
e. Respite services rates will increase from $10.03 to $14.76 per hour. Stays of nine hours or more are paid at a maximum of $132.84 per day.
f. Community integration is a new rate being offered at $1.82 for providers in King County, $1.77 for providers in metropolitan statistical areas (MSA), and $1.71 for providers in nonmetropolitan statistical areas (NMSA). MSA and NMSA are defined in (a) above.
g. Adult family home providers who transport residents to medical providers as authorized in the client's care or service plans are compensated per mile driven at the standard set by the IRS up to fifty miles per month.
h. Adult family home providers who have a contract with the state to provide meaningful home-based activities (MHBA) for an eligible client will receive the MHBA pilot project rate – the rate for providers located in King County will increase from $14.25 to $15.11; the rate for providers in MSA will increase from $13.70 to $14.52; and the rate for providers in NMSA will increase from $13.20 to $13.99. MSA and NMSA are defined in (a) above.
These changes to the adult family home rates have an estimated federal impact of $1,762,160 for FFY 2017 and $7,490,396 for FFY 2018. These proposed changes are being made in accordance with a collective bargaining agreement between the state and the adult family home council.
2. Individual providers
Individual provider base rate range will increase from $13.75 - $16.00 as follows:
Cumulative Career Hours
Home Care Aide (Without Certification)
Certified Home Care Aide or Certified Nurse Assistant License
Certified Home Care Aide With Completed Advanced Training
0-700
$13.75
$14.00
$14.25
701-2000
$14.00
$14.25
$14.50
2001-4000
$14.20
$14.45
$14.70
4001-6000
$14.40
$14.65
$14.90
6001-8000
$14.60
$14.85
$15.10
8001-10000
$14.80
$15.05
$15.30
10001-12000
$15.00
$15.25
$15.50
12001-14000
$15.20
$15.45
$15.70
14001-16000
$15.75
$16.00
$16.25
16001 and above
$16.00
$16.25
$16.50
Note: Wages shall be adjusted by one dollar ($1.00) an hour for individual providers who perform duties as mentors, preceptors, or trainers as assigned by the training partnership. Time worked as a mentor will not count toward cumulative care hours.
These changes to the individual provider rates have an estimated federal impact of $4,130,585 in FFY 2017 and $24,268,167 in FFY 2018. These changes are in accordance with the collective bargaining agreement reached with individual providers.
3. Enhanced service facility
The daily rate for enhanced service facility providers is increasing from $350 to $425. This change is expected to increase federal spending by $69,000 in FFY 2017 and $273,750 in FFY 2018. The rates were raised due to provider feedback that the previous rates were insufficient and a lack of interest from providers in offering these services for the old rate.
4. Home care agency providers
The vendor rate for contracted home care agency providers will increase from $25.96 to $27.12 per hour. This change to the home care agency providers has an estimated impact of $2,368,897 for FFY 2017 and $27,552,917 for FFY 2018. These changes are due to home care agency providers have [having] negotiated parity with individual providers.
County Contacts
Adams County
Adams County Health Department
108 West Main
Ritzville, WA 99169
Phone (509) 659-3315
Asotin County
Clarkston Home and Community Services Office
525 Fifth Street
Clarkston, WA 99403
Web site http://www.altcwashington.com
Phone (509) 751-4672
Alt. Phone 1-800-310-4881
Fax (509) 758-4593
Benton County
Tri-Cities Home and Community Services Office
500 North Morain Street
Suite 2210
Kennewick, WA 99336
Phone (509) 374-2100
Alt. Phone 1-800-310-4833
Fax (509) 374-7559
Chelan County
Chelan Community Services Office
805 South Mission Street
Wenatchee, WA 98801
Phone (509) 667-6000
Clallam County
Port Angeles Home and Community Services Office
235 West 1st Street
Port Angeles, WA 98362
Phone (360) 565-2160
Alt. Phone 1-800-280-9891
TTY (360) 417-5651
Fax (360) 417-1416
Clark County
Vancouver Home and Community Services Office
800 N.E. 136th Avenue
Suite 220
Vancouver, WA 98684
Phone (360) 397-9500
Alt. Phone 1-800-280-0586
TTY (360) 750-4079
Fax (360) 992-7949
Columbia County
Aging and Disability Resource Center
410 East Main
Dayton, WA 99328
Web site http://www.altcwashington.com/
Phone (509) 382-4787
Cowlitz County
Kelso Home and Community Services Office
711 Vine Street
Kelso, WA 98626
Phone (360) 501-2500
Alt. Phone 1-800-605-7322
TTY (360) 577-7591
Fax (360) 578-4106
Douglas County
Wenatchee Home and Community Services Office
50 Simon Street S.E.
Suite B
East Wenatchee, WA 98802
Phone (509) 886-6140
Alt. Phone 1-800-670-8874
Fax (509) 886-6221
Ferry County
Republic Home and Community Services Office
89 East Delaware
Republic, WA 99166
Phone (509) 775-2227
Alt. Phone 1-888-437-0516
TTY (509) 775-2661
Fax (509) 775-2401
Franklin County
Franklin County Commissioners Office 
1016 North 4th Avenue
Pasco, WA 99301
Phone (509) 545-3535
Garfield County
Garfield County District Court
789 West Main Street
P.O. Box 817 or 819
Pomeroy, WA 99347
Phone (509) 843-1002
Grant County
Moses Lake Home and Community Services Office
1651 South Pilgrim Street
Moses Lake, WA 98837
Phone (509) 764-5657
Alt. Phone 1-800-671-8902
TTY 1-800-833-6388
Fax (509) 764-5656
Grays Harbor County
Aberdeen Home and Community Services Office
415 West Wishkah Street
Suite A2
Aberdeen, WA 98520
Phone (360) 533-9222
Alt. Phone 1-800-487-0119
TTY (360) 533-9730
Fax (360) 533-9782
Island County
Oak Harbor Home and Community Services Office
900 East College Way
Suite 210
Mt. Vernon, WA 98273
Phone (360) 429-2961
Alt. Phone 1-866-608-0836
Fax (360) 429-2958
Jefferson County
Port Townsend Home and Community Services Office
915 Sheridan Street
Suite 201
Port Townsend, WA 98368
Phone (360) 379-4326
Alt. Phone 1-800-280-9991
Fax (360) 344-4600
King County
King County Home and Community Services Office
1737 Airport Way South
Suite 130
P.O. Box 24847
Seattle, WA 98134
Phone (206) 341-7750
Alt. Phone 1-800-346-9257
TTY 1-800-833-6384
Kitsap County
Bremerton Home and Community Services Office
4710 Auto Center Boulevard
Bremerton, WA 98312
Phone (360) 473-2299
Alt. Phone 1-800-422-7114
TTY (360) 478-4928
Fax (360) 478-6467
Kittitas County
Ellensburg Home and Community Services Office
100 East Jackson Avenue
Suite 100
Ellensburg, WA 98926
Phone (509) 925-0433
Alt. Phone 1-800-310-4999
Fax (509) 962-7755
Klickitat County
White Salmon Home and Community Services Office
221 North Main Street
White Salmon, WA 98672
Phone (509) 493-6157
Alt. Phone 1-800-504-1180
Lewis County
Chehalis Home and Community Services Office
3451 Galvin Road
Centralia, WA 98531
Phone (360) 807-7150
Alt. Phone 1-800-487-0360
Fax (360) 330-7552
Lincoln County
Lincoln County Health Department
90 Nicholls Street
Davenport, WA 99122
Phone (509) 725-1001
Mason County
Shelton Home and Community Services Office
2505 Olympic Highway North
Suite 440
Shelton, WA 98584
Phone (360) 664-9050
Alt. Phone 1-800-462-4957
Fax (360) 432-2045
Okanogan County
Omak Home and Community Services Office
130 South Main
Omak, WA 98841
Phone (509) 846-2103
Alt. Phone 1-888-437-0529
TTY (509) 826-7389
Fax (509) 826-7439
Pacific County
South Bend Home and Community Services Office
307 East Robert Bush Drive
P.O. Box 87
South Bend, WA 98586
Phone (360) 875-4222
Alt. Phone 1-800-458-3747
Fax (360) 875-0590
Pend Oreille County
Newport Home and Community Services Office
1600 West First Avenue
Newport, WA 99156
Phone (509) 447-6223
Alt. Phone 1-888-437-0516
Fax (509) 447-5256
Pierce County
Tacoma Home and Community Services Office
1949 South State Street
Tacoma, WA 98405
Phone (253) 476-7200
Alt. Phone 1-800-442-5129
TTY (253) 593-5471
Fax (253) 597-4161
San Juan County
San Juan County Health Services
145 Rhone Street
Friday Harbor, WA 98250
Phone (360) 378-4474
Fax (360) 378-7036
Skagit County
Mount Vernon Home and Community Services Office
900 East College Way
Suite 210
Mt. Vernon, WA 98273
Phone (360) 429-2961
Alt. Phone 1-866-608-0836
Fax (360) 416-7401
Skamania County
Stevenson Home and Community Services Office
266 S.W. Second Street
P.O. Box 817
Stevenson, WA 98648
Phone (509) 427-5611
Alt. Phone 1-800-505-4203
Fax (509) 427-4604
Snohomish County
Smokey Point Home and Community Services Office
3906 172nd Street N.E.
Suite 101
Arlington, WA 98223
Phone (360) 651-6800
Alt. Phone 1-800-827-2984
Fax (360) 651-6832
Spokane County
Spokane Home and Community Services Office
1330 North Washington Street
Suite 3000
Spokane, WA 99201
Phone (509) 568-3700
Alt. Phone 1-800-459-0421
TTY (509) 568-3697
Fax (509) 568-3771
Stevens County
Colville Home and Community Services Office
1100 South Main
Colville, WA 99114
Phone (509) 685-5644
Alt. Phone 1-800-437-0516
Fax (509) 684-7430
Thurston County
Tumwater Home and Community Services Office
6639 Capitol Boulevard S.W.
Tumwater, WA 98512
Phone (360) 664-9050
Alt. Phone 1-800-462-4957
TTY (360) 407-1678
Fax (360) 664-9107
Wahkiakum County
Health and Human Services
42 Elochoman Valley Road
Cathlamet, WA 98612
Phone (360) 795-8630
Alt. Phone 1-800-635-5989
Walla Walla County
Walla Walla Home and Community Services Office
206 West Poplar
Walla Walla, WA 99362
Phone (509) 524-4960
Alt. Phone 1-800-310-5678
Fax (509) 527-4142
Whatcom County
Bellingham Home and Community Services Office
600 Lakeway Drive
Bellingham, WA 98225
Phone (360) 756-5750
Alt. Phone 1-800-239-8292
Fax (360) 676-2239
Whitman County
Colfax Home and Community Services Office
418 South Main Street
Suite 3
Colfax, WA 99111
Phone (509) 397-5091
Alt. Phone 1-800-459-0421
Fax (509) 397-4323
Yakima County
Yakima Home and Community Services Office
1002 North 16th Avenue
Yakima, WA 98902
Phone (509) 225-4400
Alt. Phone 1-800-822-2097
Fax (509) 575-2286