(1) The department, or an area agency on aging (or other department designee) as authorized by the department, must determine that the adult day care or day health center meets the applicable adult day care or day health requirements and any additional requirements for contracting with the area agency on aging, according to each AAA's procurement procedure, through a state contract.
(2) All ADH centers must also have a core provider agreement with the health care authority in order to bill for providing care and services to the COPES, RSW, and RCL participants.
(3) If a center is contracting for both day care and day health, requirements of both adult day services must be met.
(4) A prospective provider desiring to provide adult day services shall be provided an application form from the department or the area agency on aging. A prospective provider convicted of abuse or neglect of a vulnerable adult is not eligible to provide adult day services in any capacity within the organization per chapter
74.34 RCW.
(5) The prospective provider will provide the area agency on aging with evidence of compliance with, or administrative procedures to comply with, the adult day service rules under this chapter.
(6) The area agency on aging will conduct a site inspection of the adult day center and review of the requirements for contracting.
(7) Within thirty days of completing the site visit, the area agency on aging will advise the prospective provider in writing of any deficiencies in meeting contracting requirements.
(8) The area agency on aging will verify correction of any deficiencies within thirty days of receiving notice from the prospective provider that deficiencies have been corrected, before contracting can take place.
(9) The area agency on aging will provide the department with a written recommendation as to whether or not the center meets contracting requirements.
(10) Minimum application information required to apply for contract(s) with the department, or an area agency on aging includes:
(a) Mission statement, business structure, bylaws, articles of organization or articles of incorporation if applicable and current business license;
(b) Names and addresses of the center's owners, officers, and directors as applicable;
(c) Organizational chart;
(d) Fiscal policies and procedures;
(e) A business plan to address the future financial needs of the center. This plan must include projected program growth, capital purchases, projected revenue, projected expenses, and plans for fund raising, if applicable. Also include an annual program operating budget including all anticipated revenue sources and expenditures and any fees generated;
(f) The most current financial statement prepared in accordance with generally accepted account principles (GAAP) or the latest audit report of the organization by a certified public accountant;
(g) Program policies and operating procedure manual;
(h) Personnel policies and job descriptions and qualifications of each paid staff position and volunteer position functioning as staff;
(i) Policies and procedures meeting the requirements of mandatory reporting procedures as described in chapter
74.34 RCW to adult protective services for vulnerable adults and local law enforcement for other participants;
(j) Floor plan of the facility;
(k) Local building inspection, fire department, and health department reports with food handler permits if applicable;
(l) Updated TB test results for each staff member according to WAC
388-71-0750;
(m) Sample client case file including all forms that will be used;
(n) Activities calendar with alternative choice activities, for the month prior to application, or a sample calendar if the day service provider is new;
(o) Role and function of the board of directors and advisory committee, if applicable;
(p) Monthly menu or sample if center is new, which accommodates each resident's:
(i) Preferences;
(ii) Food allergies and sensitivities;
(iii) Caloric needs;
(iv) Cultural and ethnic background; and
(v) Physical condition that may make food intake difficult such as being hard for the resident to chew or swallow; and
(11) The area agency on aging or other department designee monitors the adult day center at least annually to determine continued compliance with adult day care and/or adult day health requirements and the requirements for contracting with the department or the area agency on aging.
(a) The area agency on aging will send a written notice to the provider indicating either compliance with contracting requirements or any deficiencies based on the annual monitoring visit and request a corrective action plan. The area agency on aging will determine the date by which the corrective action must be completed.
(b) The area agency on aging will notify the department of the adult day center's compliance with contracting requirements or corrected deficiencies and approval of the corrective action plan for continued contracting.
(12) Adult day care services are reimbursed on an hourly basis up to four hours per day. Service provided four or more hours per day will be reimbursed at the daily rate.
(13) Adult day center reimbursements are adopted by rule with adjustments determined by the state legislature. Providers seeking current reimbursement rates can refer to the billing instructions.
(14) A one-time only initial intake evaluation provided by an adult day health center, including development of a negotiated care plan, is reimbursed at an established rate as may be adopted in rule. Rate adjustments are determined by the state legislature. Separate reimbursement is not available for subsequent evaluations.
(15) Transportation to and from the program site is not reimbursed under the adult day care rate. Transportation arrangements are made with locally available transportation companies or informal resources.
(16) Transportation to and from the program site is reimbursed under the adult day health daily rate. Adult day health is required to assist clients in arranging or providing transportation to and from the program sites.
