Source: https://app.leg.wa.gov/WAC/default.aspx?cite=182-559&full=true
Timestamp: 2020-04-05 00:41:25
Document Index: 654025469

Matched Legal Cases: ['§ 182', '§ 9', '§ 213', '§ 182', '§ 182', '§ 9', '§ 213', '§ 182', '§ 9', '§ 213', '§ 182', '§ 182']

Chapter 182-559 WAC:
WACs > Title 182 > Chapter 182-559
Chapter 182-559 WAC
HTMLPDF 182-559-100 General.
HTMLPDF 182-559-150 Definitions.
HTMLPDF 182-559-200 Eligible providers.
HTMLPDF 182-559-300 Eligibility for community support services.
HTMLPDF 182-559-350 Eligibility for supported employment services.
HTMLPDF 182-559-400 Payment.
HTMLPDF 182-559-500 Foundational community supports program—Limitation of scope of benefits.
HTMLPDF 182-559-600 Grievance and appeals system.
PDF182-559-100
PDF182-559-150
PDF182-559-200
(1) Providers of community support services and supported employment services under this authority must be:
(e) Housing, employment, social service, or related agencies with demonstrated experience and ability to provide community support services, supported employment, or equivalent services.
(B) Certified in supportive housing services (WAC 388-877-0720 or 388-877-0722) by the department of social and health services/division of behavioral health and recovery (DSHS/DBHR).
(B) Certified in employment services (WAC 388-877-0718 or 388-877-0720) by DSHS/DBHR; or
(2) Providers of community support services or supported employment services must:
(c) Be qualified to bill for aging and long-term support administration services to provide community support services or supported employment services.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-15-007, § 182-559-200, filed 7/6/18, effective 8/6/18. Statutory Authority: RCW 41.05.021, 41.05.160, 2014 c 225 § 9 (1)(i) and 2016 1st sp.s c 36 § 213 (1)(f) and (g). WSR 17-11-136, § 182-559-200, filed 5/24/17, effective 7/1/17.]
PDF182-559-300
PDF182-559-350
PDF182-559-400
The medicaid agency pays for community support services and supported employment described in WAC 182-559-100 when no other public funds are already dedicated to providing comparable services to the client, unless the provider can demonstrate that the client requires services that are:
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-15-007, § 182-559-400, filed 7/6/18, effective 8/6/18. Statutory Authority: RCW 41.05.021, 41.05.160, 2014 c 225 § 9 (1)(i) and 2016 1st sp.s c 36 § 213 (1)(f) and (g). WSR 17-11-136, § 182-559-400, filed 5/24/17, effective 7/1/17.]
PDF182-559-500
Foundational community supports program—Limitation of scope of benefits.
Nothing in this chapter shall be construed as providing a legal right to any individual to any of the services referenced in this chapter. The services provided under this chapter are strictly limited to the authority granted to the state under the medicaid transformation project and available funds, as determined solely by the authority. Nothing in this section is intended to limit the right of an applicant or a beneficiary to request an administrative hearing under applicable law.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2014 c 225 § 9 (1)(i) and 2016 1st sp.s c 36 § 213 (1)(f) and (g). WSR 17-11-136, § 182-559-500, filed 5/24/17, effective 7/1/17.]
PDF182-559-600
Grievance and appeals system.
(3) Notice requirements. The TPA must follow notice and timeline requirements under chapter 182-518 WAC. The TPA sends written notice when they:
(a) Approve the client's foundational community supports eligibility and authorize the delivery of services;
(b) Deny the client's foundational community supports eligibility; and
(c) Approve the client's foundational community supports eligibility without authorization of services due to necessary funding being unavailable. Clients must be notified of placement on a waitlist until funding becomes available.
(4) The TPA grievance process.
(5) The TPA appeals process.
(e) The TPA must continue services pending the results of an appeal or subsequent agency administrative hearing.
(6) Agency administrative hearing.
(7) Effect of reversed resolutions of appeals. If the TPA or a final order as defined in chapter 182-526 WAC reverses a decision to deny or limit services, the TPA must authorize or provide the disputed services promptly and as expeditiously as the client's health condition requires.
(8) Funding unavailable. When a client receives approval for services and funding is unavailable, the client may appeal the determination that funding is unavailable.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-15-007, § 182-559-600, filed 7/6/18, effective 8/6/18.]