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PDFWAC 388-114-0080

When may the department temporarily approve a client specific increase to an individual provider's work week limit?

(1) The department may temporarily increase an individual provider's work week limit if it determines the increase is necessary:
(a) Due to a lack of available providers who are able to adequately meet a client's care needs, as evaluated by the department in its consideration of:
(i) The overall availability of providers in the geographic region;
(ii) Whether the client has complex medical or behavioral needs;
(iii) Whether the client requires a provider with specific language skills; and
(iv) The client's good faith efforts and cooperation to manage his or her service hours and locate and select additional providers, examples of which may include:
(A) Making schedule adjustments within the work week limits of current providers who are providing services;
(B) Seeking a qualified family or friend to contract as an individual provider;
(C) Utilizing the home care referral registry; and
(D) Requesting a worker through a home care agency, unless doing so would cost more than paying the individual provider overtime;
(b) To protect a client's health and safety, as evaluated by the department in its consideration of:
(i) Whether the request is to approve service hours the individual provider spent caring for the client because of an emergent condition;
(ii) The nature and severity of the emergent condition; and
(iii) Whether the need could have been postponed until another provider could have arrived;
(c) To prevent an increased risk that the client will be unable to remain in a home or community based setting, except in cases where there are additional qualified providers available to select and the client has chosen not to select them; or
(d) To enable a client to assign to an individual provider the same number of hours in months with thirty days as are assigned in months with thirty-one days, provided that:
(i) The client is unable to assign the same number of the hours due to the individual provider's permanent work week limit;
(ii) There is no other qualified provider assigned that can work the hours within his or her permanent work week limit;
(iii) The increase does not result in a monthly total that exceeds the number of hours assigned to an individual provider in a thirty-one day month; and
(iv) The increase does not exceed two and one-half hours per week.
(2) When a client specific increase is no longer approved by the department, the individual provider's work week limit will revert back to the permanent work week limit described in WAC 388-11-0030.
(3) The department may only approve a client specific work week limit in excess of eighty service hours per week for an individual provider if the client's circumstances meet the criteria set out in WAC 388-440-0001 (1)(a) through (e) and where the department is unaware of any reason that the individual provider will be unable to appropriately meet the needs of the client.
(4) The department will not approve additional service hours to any individual provider's permanent work week limit that would result in a monthly total that exceeds the client's monthly service hours.
(5) The individual provider is not entitled to an administrative hearing under chapter 34.05 RCW regarding the department's decision on whether to approve or continue a client specific temporary increase to the work week limit.
[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.270, and 2016 1st sp.s. c 30. WSR 17-08-065, ยง 388-114-0080, filed 3/31/17, effective 5/1/17.]
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