reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESPITE CARE SERVICES › Section 388-106-1210 - Who is eligible to receive respite care services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
(1) To be eligible
				  to receive respite care services, the caregivers must:
(a) Have primary responsibility for the care
				  or supervision of an adult with a functional disability who is not receiving a
				  state or medicaid funded, long-term care service (e.g., COPES, personal care
				  services, DD waiver); and
(b)
				  Provide a minimum of an average of forty hours per week of care, and/or
				  supervision, or live with an adult who needs continuous care or supervision;
				  and
(c) Not receive financial
				  payment for the care; and
(d) Be
				  assessed in the TCARE¦, tailored caregiver assessment and referral
				  system and determined to meet the eligibility threshold levels determined by
				  state level policy and have TCARE¦ recommend the strategy to introduce
				  alternate sources for care to provide respite.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESPITE CARE SERVICES › Section 388-106-1215 - Who may provide respite care services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
Respite care providers include, but are not limited to the
					 following:
(1) Nursing homes (chapter
				  388-97 WAC).
(2) Adult day service
				  providers, whose services includes adult day care, dementia day services and
				  adult day health.
(3) Home care
				  and/or home health agencies licensed through the department of health for
				  in-home services.
(4)
				  Hospitals.
(5) Licensed residential
				  care facilities such as boarding homes, adult family homes, and assisted living
				  facilities.
(6) Providers such as
				  volunteer services, and senior companions.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 12-13-040, §
						388-106-1215, filed 6/13/12, effective 7/14/12; 05-11-082, § 388-106-1215,
						filed 5/17/05, effective 6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESPITE CARE SERVICES › Section 388-106-1220 - How are respite care providers reimbursed for their services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
The department reimburses:
(1) Respite care providers for the number of
				  hours or days of services authorized and provided. If the provider already has
				  a medicaid rate established for providing a similar service, that rate is to be
				  reimbursed by the local area agency on aging. If there is no established rate
				  for the service, one can be negotiated between the local area agency on aging
				  and the respite care service provider.
(2) Medicaid-certified licensed residential
				  facilities providing respite services at the medicaid rate approved for that
				  facility. Medicaid contracted providers must not charge more than the medicaid
				  rate for any services covered from the date of eligibility, unless authorized
				  by the department (see
				  RCW
				  18.51.070 ). Participants must pay for
				  services not included in the medicaid rate.
(3) Private nursing homes at their published
				  daily rate.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 12-13-040, §
						388-106-1220, filed 6/13/12, effective 7/14/12; 05-11-082, § 388-106-1220,
						filed 5/17/05, effective 6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESPITE CARE SERVICES › Section 388-106-1225 - Are participants required to pay for the cost of their respite care services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
(1) There is no charge to the care receiver
				  whose income is at or below forty percent of the state median income, based on
				  family size.
(2) If the care
				  receiver's gross income is above forty percent of the state median income, he
				  or she is required to pay for part or all of the cost of the respite care
				  services. The department will determine what amount the participant must
				  contribute based on the state median income and family size.
(3) If the care receiver's gross income is
				  one hundred percent or more of the state median income, the participant must
				  pay the full cost of the respite care services.
(4) If the care receiver is experiencing
				  extreme financial hardship (e.g., high medical expenses) and cannot pay for
				  their share of the cost of the respite care services, the area agency on aging
				  may grant an exception to policy and then must document this in the client's
				  records.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 12-13-040, §
						388-106-1225, filed 6/13/12, effective 7/14/12; 05-11-082, § 388-106-1225,
						filed 5/17/05, effective 6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESPITE CARE SERVICES › Section 388-106-1230 - What determines emergent and nonemergent respite care services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
(1) The department and the area agency on
				  aging (AAA) must first consider requests for emergency respite care. An example
				  of an emergency is when the caregiver becomes ill or injured to the extent that
				  the caregiver's ability to care for the care receiver is impaired. AAA policies
				  will determine how best to serve caregivers in crisis depending on available
				  local FCSP funding. A caregiver must be screened in TCARE¦ within thirty
				  days following the crisis if ongoing services exceeding five hundred dollars
				  are requested.
(2) In nonemergency
				  situations, respite care is allocated based upon the results of the
				  TCARE¦ assessment and available local FCSP funds. If sufficient funds
				  are not available when an eligible caregiver requests services, AAA may
				  establish wait lists to prioritize clients receiving services as funding
				  becomes available.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 12-13-040, §
						388-106-1230, filed 6/13/12, effective 7/14/12; 05-11-082, § 388-106-1230,
						filed 5/17/05, effective 6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CLIENT RIGHTS › Section 388-106-1300 - What rights do I have as a client of the department?

Current through Register Vol. 24-14, July 15, 2024
As a client of the department, you have a right to:
(1) Be treated with dignity, respect and
				  without discrimination;
(2) Not be
				  abused, neglected, financially exploited, abandoned;
(3) Have your property treated with
				  respect;
(4) Not answer questions,
				  turn down services, and not accept case management services you do not want to
				  receive. However, it may not be possible for the department to offer some
				  services if you do not give enough information;
(5) Be told about all services you can
				  receive and make choices about services you want or don't want;
(6) Have information about you kept private
				  within the limits of the laws and DSHS regulations;
(7) Be told in writing of agency decisions
				  and receive a copy of your care plan;
(8) Make a complaint without fear of
				  harm;
(9) Not be forced to answer
				  questions or do something you don't want to;
(10) Talk with your social service worker's
				  supervisor if you and your social service worker do not agree;
(11) Request a fair hearing;
(12) Have interpreter services provided to
				  you free of charge if you cannot speak or understand English well;
(13) Take part in and have your wishes
				  included in planning your care;
(14) Choose, fire, or change a qualified
				  provider you want; and
(15) Receive
				  results of the background check for any individual provider you
				  choose.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1300, filed 5/17/05, effective
						6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CLIENT RIGHTS › Section 388-106-1303 - What responsibilities do I have as a client of the department?

Current through Register Vol. 24-14, July 15, 2024
As a client of the department, you have a responsibility
					 to:
(1) Give us enough information to
				  assess your needs;
(2) Let the
				  social services worker into your home so that your needs can be
				  assessed;
(3) Follow your care
				  plan;
(4) Not act in a way that
				  puts anyone in danger;
(5) Provide
				  a safe work place;
(6) Tell your
				  social services worker if there is a change in:
(a) Your medical condition;
(b) The help you get from family or other
				  agencies;
(c) Where you live;
				  or
(d) Your financial
				  situation.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CLIENT RIGHTS › Section 388-106-1305 - What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department?

Current through Register Vol. 24-14, July 15, 2024
(1) You have a right to contest the result of
				  your CARE assessment and/or other eligibility decisions made by the department.
				  The department will notify you in writing of the right to contest a decision
				  and provide you with information on how to request a hearing.
(2) Additionally, if you believe that you
				  need more in-home personal care services than the CARE assessment has
				  authorized for you, and you believe that your situation meets the criteria in
				  WAC 388-440-0001(1) 
				  for an exception to rule (ETR), you may request additional personal care
				  services.
(a) Requests may be made to your
				  case manager or local HCS, AAA or DDA field office, either verbally or in
				  writing.
(b) Requests that are
				  approved at the field level will be forwarded to the ETR committee located in
				  Olympia for a final decision.
(c)
				  If your request is denied at the field level:
(i) You will receive a written
				  notification.
(ii) You may request
				  a headquarters review of your request by contacting your case manager or local
				  HCS, AAA or DDA field office or by contacting the headquarters committee
				  directly.
(d) You will
				  be notified in writing whether additional ETR hours are approved or if your
				  request was denied.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CLIENT RIGHTS › Section 388-106-1310 - When I request a fair hearing on my CARE assessment and another CARE assessment(s) is done between my fair hearing request and the fair hearing, which CARE assessment must the administrative law judge review?

Current through Register Vol. 24-14, July 15, 2024
When you request a fair hearing on your CARE assessment and
					 another CARE assessment(s) is done between your fair hearing request and the
					 fair hearing, the administrative law judge must review the most recent CARE
					 assessment.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1310, filed 5/17/05, effective
						6/17/05.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CLIENT RIGHTS › Section 388-106-1315 - Do I have a right to an administrative hearing if my total in-home personal care hours or New Freedom budget approved as an exception to rule are reduced or terminated or if my increased residential payment rate approved as an exception to rule is reduced or terminated?

Current through Register Vol. 24-14, July 15, 2024
Notwithstanding WAC
					 388-440-0001(3),
					 you have a right to an administrative hearing regarding the department's
					 exception to rule decision if:
(1) You
				  receive services in your own home, and:
(a)
				  The total number of in-home personal care hours you are currently receiving
				  includes in-home personal care hours approved as an exception to rule in
				  addition to the number of in-home care hours determined to be available to you
				  by CARE; and
(b) The total number
				  of in-home personal care hours or New Freedom budget you are currently
				  receiving is reduced because of a reduction or termination in the number of
				  in-home personal care hours approved as an exception to rule.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1400 - What services may I receive under New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
(1) In order for
				  services, supports, or items to be purchased under New Freedom, they must:
(a) Be for your sole benefit;
(b) Be at a reasonable cost;
(c) Meet your identified needs and outcomes
				  in the CARE assessment and address your health, safety, and welfare;
				  and
(d) Be documented on your New
				  Freedom spending plan defined in WAC
				  388-106-0010.
				  The spending plan, which is established with the Care Consultant, documents how
				  you will spend your service budget dollars.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1405 - What services are not covered under New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
(1) Goods,
				  services, and supports that are not consistent with the description in WAC
				  388-106-1400.
(2) Services, supports or items covered by
				  the state plan, medicare, or other programs or services.
(3) Any fees related to health or long-term
				  care incurred by you, including co-pays, waiver cost of care (participation),
				  or insurance.
(4) Home
				  modifications that merely add square footage to your home.
(5) Vacation or travel expenses other than
				  the direct cost of provision of personal care services while on vacation and
				  you may not use New Freedom funds to pay travel expenses for your
				  provider).
(6) Rent or room and
				  board.
(7) Tobacco or alcohol
				  products.
(8) Lottery
				  tickets.
(9) Entertainment-related
				  items such as televisions, cable, DVD players, stereos, radios, and other
				  electronics, that are nonadaptive in nature.
(10) Vehicle purchases, maintenance, or
				  upgrades that do not include maintenance to modifications related to
				  disability.
(11) Tickets and
				  related costs to attend sporting or other recreational events.
(12) Pets, therapy animals and their related
				  costs (including food and veterinary services).
(13) Postage outside of shipping costs
				  related to approved spending plan items.
(14) Experimental or investigational
				  services, procedures, treatments, devices, drugs, or application of associated
				  services, except when the individual factors of an individual client's
				  condition justify a determination of medical necessity under WAC
				  182-500-0070.
(15) Monthly service fees for
				  utilities.
(16) Warranties (for
				  equipment, furnishings, or installations).
(17) Cosmetic services and treatments (i.e.
				  manicures, pedicures, face lifts, etc).
(18) Basic groceries, clothing, and
				  footwear.
(19) Any item previously
				  purchased through medicaid funding that is within the health care authority
				  replacement period.
(20) Any goods,
				  services, or supports that are considered of general utility, meaning the
				  service/good/support is not specific to the individuals' needs based on their
				  disabilities or health conditions.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1405, filed 8/29/13 and 8/21/13, effective 10/1/13;
					 WSR 10-08-074, § 388-106-1405, filed 4/6/10, effective 5/7/10. WSR
					 13-18-003, § 388-106-1405, filed 8/21/2013, effective 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1410 - Am I eligible for New Freedom consumer directed services (NFCDS)-funded services?

Current through Register Vol. 24-14, July 15, 2024
You are eligible for NFCDS-funded services if you reside in
					 your own home and meet all of the following criteria. The department must
					 assess your needs using CARE and determine that:
(1) You are in NFCDS HCBS waiver specified
				  target groups of:
(a) Eighteen or older and
				  blind or have a physical disability; or
(b) Sixty-five or older; and (C) You reside
				  in a county where New Freedom is offered.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1415 - When do New Freedom consumer directed services (NFCDS) start?

Current through Register Vol. 24-14, July 15, 2024
Your New Freedom services begin the date personal care
					 provider(s) are authorized to begin providing services or the spending plan is
					 approved.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1415, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1415, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1415, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1420 - How do I remain eligible for New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
(1) In order to
				  remain eligible for NFCDS, you must be in need of services in accordance with
				  WAC 388-106-1410, as determined
				  through a CARE assessment, and continue to meet the financial eligibility
				  requirements in WAC
				  182-513-1315.
(a) The CARE assessment must be performed at
				  least annually or more often when there are significant changes in your
				  functional or financial circumstances.
(b) Your continued financial eligibility is
				  reviewed annually.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1422 - What happens to my New Freedom service dollar budget if I am temporarily hospitalized, placed in a nursing facility, or intermediate care facilities for Intellectual Disability (ICF/ID)?

Current through Register Vol. 24-14, July 15, 2024
If you are admitted to a hospital, nursing home, or ICF/ID,
					 you cannot access or accumulate funds to your New Freedom service budget during
					 your stay.
If you are institutionalized for 30 days or less and you
					 intend to return to New Freedom when discharged, your service budget will be
					 temporarily suspended while you are temporarily hospitalized for up to 30 days.
					 Upon discharge home, if within 30 days, your service budget will be reinstated
					 if you are still eligible for New Freedom services.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1422, filed 8/29/13 and 8/21/13, effective 10/1/13;
					 WSR 10-08-074, § 388-106-1422, filed 4/6/10, effective 5/7/10. WSR
					 13-18-003, § 388-106-1422, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1425 - How do I pay for New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
(1) Depending on
				  your income, you may be required to pay participation toward the cost of your
				  care, as described in WAC
				  182-515-1505. If you have
				  nonexempt income that exceeds the cost of NFCDS services, you may keep the
				  difference. Since you are receiving services in your own home, you are allowed
				  to keep some of your income for a maintenance allowance.
(2) You are responsible to pay for your goods
				  and services received up to your participation amount determined by the
				  department. Any approved budget expenditures for goods and services you receive
				  which exceed your participation amount will be paid by the department once your
				  participation, if any, is accounted for.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1425, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1425, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1425, filed 8/21/2013, effective 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1430 - Can I be employed and receive New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
You can be employed and receive NFCDS, if eligible, per
					 WAC 182-515-1505.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1430, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1430, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1430, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1435 - Who can direct New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
You, as an NFCDS participant, direct your services. You may
					 also designate, or a court may appoint, a representative to assist you in
					 directing your services, or to direct your services on your behalf. A New
					 Freedom designated representative cannot also be your paid
					 provider.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 10-08-074, §
						388-106-1435, filed 4/6/10, effective 5/7/10. Statutory Authority:
						RCW
						74.08.090,
						74.09.520,
						74.39A.030. 06-16-035, §
						388-106-1435, filed 7/25/06, effective
						8/25/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1440 - What is an individual budget?

Current through Register Vol. 24-14, July 15, 2024
An individual budget means the maximum amount of funding
					 authorized by the department and allocated to the participant for the purchase
					 of New Freedom consumer directed services.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520,
						74.39A.030. 06-16-035, §
						388-106-1440, filed 7/25/06, effective
						8/25/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1445 - How is the amount of the individual budget determined?

Current through Register Vol. 24-14, July 15, 2024
The department will calculate your individual budget amount
					 after you are assigned a number of monthly hours resulting from completion of
					 the comprehensive assessment reporting and evaluation tool, CARE. The
					 calculation will be based on the average wage, including a mileage allowance,
					 as determined by the collective bargaining agreement for individual provider
					 personal care multiplied by the number of units generated by the assessment,
					 multiplied by a factor of .93, plus an amount equal to the average per
					 participant expenditures for nonpersonal care supports purchased in the COPES
					 waiver.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. WSR 13-18-039 and
						13-17-125, § 388-106-1445, filed 8/29/13 and 8/21/13, effective 10/1/13;
						WSR 10-08-074, § 388-106-1445, filed 4/6/10, effective 5/7/10. Statutory
						Authority:
						RCW
						74.08.090,
						74.09.520,
						74.39A.030. WSR 06-16-035, §
						388-106-1445, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
						388-106-1445, filed 8/21/2013, effective
						9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1450 - Is the individual budget intended to fully meet all of my needs?

Current through Register Vol. 24-14, July 15, 2024
The program provides funds in an amount proportionate to
					 the amount of resources you would receive through COPES, and gives you
					 flexibility to self-direct the purchase of goods and services to address your
					 long-term care needs. The degree to which the budget meets your needs depends
					 on the supports you identify and prioritize in your spending plan. Depending on
					 your decisions, after your budget is exhausted, some of your needs may be
					 unmet, or you may find other resources to address them.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1450, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1450, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1450, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1455 - What happens to individual budget funds when I don't use them?

Current through Register Vol. 24-14, July 15, 2024
(1) The balance of
				  individual budget funds that were not allocated for purchase of personal care
				  may be used to purchase other goods and services in accordance with the
				  approved New Freedom spending plan or saved for future purchase as described in
				  (2) below.
(2) Up to $3,500 may be
				  held in savings for future purchases documented in the New Freedom spending
				  plan.
(3) Reserves in excess of
				  $3,500 may only be maintained for exceptional, planned purchases with
				  preapproval from the department.
(4) Unused funds will revert back to the
				  department under the following circumstances:
(a) You have savings funds in excess of
				  $3,500 that are not identified for exceptional, pre-approved purchases in your
				  spending plan;
(b) You disenroll
				  from New Freedom;
(c) You lose
				  eligibility for New Freedom;
(d)
				  You are hospitalized, in a nursing home, or ICF/ID for over 30 days;
				  or
(e) You have personal care funds
				  not used in the month for which you allocated them.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1458 - How do I create and use my spending plan?

Current through Register Vol. 24-14, July 15, 2024
(1) You create your spending plan in
				  collaboration with your care consultant using the CARE tool.
(2) The spending plan must be approved by
				  both you and the care consultant.
(3) You, as the participant, must identify
				  how many personal care service units you intend to purchase prior to the month
				  you plan to use them (service month).
(4) The value of those units is deducted from
				  your new freedom budget.
(5) The
				  rest of the funds can be used for other covered goods and services or
				  saved.
(6) Once a service month
				  begins, the number of personal care units may not be altered during that
				  month.
(7) The maximum number of
				  personal care units that can be purchased from the monthly budget is calculated
				  from the individual budget as described in WAC
				  388-106-1445,
				  divided by the individual provider average wage including mileage.
(8) Prior to the service month, you may elect
				  to use savings funds to buy additional personal care.
(9) You may choose to have your personal care
				  provided by an individual provider (IP) or a home care agency.
(10) Each unit will be deducted from your new
				  freedom budget at the average IP wage rate including mileage.
(11) The balance of your individual new
				  freedom budget will be available in your NFSP to save or purchase other goods
				  and services up to the limit described in WAC
				  388-106-1455(2).
(12) If you have a change of condition or
				  situation and your new freedom budget increases due to a new assessment or
				  exception to rule, you may purchase additional personal care from an IP or home
				  care agency mid-month at the average IP rate, including mileage during the
				  month your budget changed.
(13) You
				  may assign your predetermined personal care units to a different provider
				  during the month of service.
(14)
				  Under chapter 388-114 WAC, individual providers for one or more department
				  clients who work more than 40 hours in a work week, are entitled to overtime
				  and the responsibility for paying the extra cost as follows:
(a) If the individual provider is contracted
				  with the department and approved to work more than 40 hours per week as
				  described in WAC
				  388-114-0080,
				  the department will pay the extra cost for overtime up to the number of service
				  hours the individual provider is approved to work and the payment for these
				  extra costs will not be charged to your budget; and
(b) If you assign more overtime hours to your
				  individual provider than the department approved, you must pay the extra costs
				  for the unapproved overtime hours and the additional cost will impact your
				  monthly budget and may reduce the number of service hours you are able to
				  purchase from it.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1460 - When can my New Freedom spending plan (NFSP) be denied?

Current through Register Vol. 24-14, July 15, 2024
Your NFSP may be denied when the plan you develop includes
					 noncovered items from WAC
					 388-106-1405 and/or does
					 not:
(a) Include only services in the
				  New Freedom service definition found in WAC
				  388-106-1400;
(b) Address your needs as it relates to
				  performance of activities of daily living and instrumental activities of daily
				  living;
(c) Include strategies and
				  steps to address known critical risks;
(d) Identify a reasonable payment rate;
				  or
(e) Adequately describe the
				  service.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1460, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1460, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1460, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1465 - Who can deny my New Freedom spending plan (NFSP)?

Current through Register Vol. 24-14, July 15, 2024
Your plan can be denied by your New Freedom consultant,
					 who assists NFCDS participants to develop and use a New Freedom spending plan
					 to:
(a) Address identified personal
				  care, health and safety needs;
(b)
				  Develop options to meet those needs;
(c) Make informed decisions about their
				  individual budget; and
(d) Obtain
				  identified supports and services.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1465, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1465, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1465, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1470 - Are there waiting lists for New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
The department will create a waiting list for NFCDS in
					 accordance with caseload limits determined by legislative funding. Participants
					 on the waiting list will gain access in the following order:
(1) Nursing home residents who are returning
				  home and are assessed for NFCDS waiver services will be ranked first on the
				  waiting list by date of application for services;
(2) Individuals living in the community with
				  a higher level of need, as determined by the CARE assessment, will be ranked
				  higher on the wait list over participants with a lower level of need;
				  and
(3) When two or more
				  individuals on the waiting list have equal need levels, the individual with the
				  earlier application for NFCDS will have priority over later applications for
				  services.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520,
						74.39A.030. 06-16-035, §
						388-106-1470, filed 7/25/06, effective
						8/25/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1475 - How do I end enrollment in New Freedom consumer directed services (NFCDS)?

Current through Register Vol. 24-14, July 15, 2024
(1) You may
				  choose to voluntarily end your enrollment from NFCDS without cause at any time.
				  To do so, you must give notice to the department. If you give notice:
(a) Before the 15th of the month, the
				  department will end your enrollment at the end of the month; or
(b) After the 15th, the department will end
				  your enrollment the end of the following month.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1480 - What are my hearing rights to appeal New Freedom consumer directed services (NFCDS) assessment and eligibility actions?

Current through Register Vol. 24-14, July 15, 2024
You have a right to a hearing under WAC
					 388-106-1300 through
					 388-106-1315, and under chapter
					 182-526 WAC.
Statutory
					 Authority:
					 RCW
					 74.08.090 and
					 74.09.520. WSR 13-18-039 and
					 13-17-125, § 388-106-1480, filed 8/29/13 and 8/21/13, effective 10/1/13.
					 Statutory Authority:
					 RCW
					 74.08.090,
					 74.09.520,
					 74.39A.030. WSR 06-16-035, §
					 388-106-1480, filed 7/25/06, effective 8/25/06. WSR 13-18-003, §
					 388-106-1480, filed 8/21/2013, effective
					 9/21/2013
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1500 - What is the department's chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1500, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1505 - What services may I receive under the chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1505, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1510 - Who provides chronic care management services to medical assistance clients receiving long-term care services and supports? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1510, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1515 - Am I eligible to enroll in the chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1515, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1520 - How do I enroll in the chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1520, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1525 - How long can I participate in the chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1525, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1530 - Is there a cost to me for participating in the chronic care management program? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1530, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › NEW FREEDOM CONSUMER DIRECTED SERVICES (NFCDS) › Section 388-106-1535 - Do I have a right to a fair hearing while receiving chronic care management services? (Repealed)

Current through Register Vol. 24-14, July 15, 2024
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 11-22-043, §
						388-106-1535, filed 10/27/11, effective
						11/27/11.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › Nursing Facility Certificate of Need › Section 388-106-1600 - What definitions apply to the nursing facility certificate of need?

Current through Register Vol. 24-14, July 15, 2024
"Activities of daily living",
as defined in
					 WAC 388-106-0010, includes tasks such
					 as walking, eating, taking medications, maintaining personal hygiene, moving in
					 bed and toileting.
"Care assessment"
is an assessment tool used
					 to determine eligibility for services and level of service need, and identify
					 strengths, preferences and potential referrals to develop an individualized
					 care plan.
"Certificate of need program"
is a regulatory
					 process under Chapter 70.38 RCW that requires certain healthcare providers,
					 including nursing homes, to receive approval from the Department of Health
					 before building certain types of facilities or offering new or expanded
					 services.
"Community residential"
refers to licensed
					 community settings such as assisted living facilities and adult family homes
					 where long-term care services are provided to residents.
"Department
" means the Department of Social
					 and Health Services.
"Department of Health"
is the state agency
					 that operates the certificate of need review program and determines the need
					 for specific facilities and services, including nursing homes, in a manner that
					 is consistent with the statewide health resources strategy developed under
					 RCW
					 43.370.030 and 70.38.
"In-home personal care"
is care provided by an
					 agency or individual provider to clients living in their own home.
"Minimum Data Set" or "MDS"
is a tool that is
					 used to perform the comprehensive assessment of each resident's functional
					 capabilities, which is required for all residents in medicare or medicaid
					 certified nursing homes.
"RUG III Score"
is the classification of each
					 nursing facility resident into a specific group based on the individual's
					 medical condition and level of care required.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › Nursing Facility Certificate of Need › Section 388-106-1610 - What is the purpose of determining nursing facility comparable home and community-based long-term capacity?

Current through Register Vol. 24-14, July 15, 2024
The Department of Health's certificate of need program is
					 required to determine the need for nursing homes under WAC
					 246-310-210(6)(b)(ii).
					 The determination of need is based in part upon the availability of home and
					 community-based long-term services in the planning area of the proposed nursing
					 facility. When evaluating the need for additional nursing home beds, the data
					 considered by the Department of Health must include data provided by the
					 Department.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › Nursing Facility Certificate of Need › Section 388-106-1620 - What methodology does the department use to determine statewide or county specific nursing home comparable home and community-based long-term services availability?

Current through Register Vol. 24-14, July 15, 2024
The department uses the following methodology to determine
					 the statewide or county specific nursing home comparable home and
					 community-based long-term services availability.
(1) The department selects a recent, one-year
				  time period from which to use MDS assessment data.
(2) The "typical RUG-III ADL score" is
				  determined as follows. From the MDS data, two activity of daily living (ADL)
				  RUG-III score values are calculated: (1) the mean RUG-III ADL score, rounded to
				  the nearest whole number, and (2) the modal RUG-III ADL score that occurs most
				  commonly in the nursing home population in the selected time period. The
				  "typical RUG-III ADL score" is the lower of the mean and modal
				  values.
(3) Using the most recent
				  month that both payment and assessment data are considered to be complete,
				  persons receiving medicaid paid in-home personal care or community residential
				  services are identified, and the MDS-equivalent ADL score from each home and
				  community-based client's current CARE assessment is constructed.
(4) Using data from the month selected in
				  subsection (3), count the number of in-home personal care clients being served
				  by either the aging and long-term support or developmental disabilities
				  administrations who have an MDS-equivalent score at or above the typical
				  RUG-III ADL nursing home score that was calculated in subsection (2).
(5) Using data from the month selected in
				  subsection (3), calculate the proportion of medicaid-paid community residential
				  clients with an MDS-equivalent score that is at or above the typical RUG-III
				  ADL nursing home score calculated in subsection (2). (a) When determining
				  county level measures of nursing home comparable home and community based
				  capacity, the statewide average for medicaid paid community residential clients
				  is used.
(6) Calculate the overall
				  statewide licensed capacity of community residential facilities.
(7) The proportion calculated in subsection
				  (5) and the community residential capacity determined in subsection (6) are
				  multiplied to estimate the community residential capacity that is nursing home
				  comparable.
(8) Add the numbers
				  calculated in subsections (4) and (7) to determine the total countable
				  nursing-home-comparable home and community-based long-term capacity to be used
				  in reporting to the department of health the availability of other services in
				  the community as required in
				  RCW
				  70.38.115.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › SUPPORTIVE HOUSING › Section 388-106-1700 - What definitions apply to supportive housing?

Current through Register Vol. 24-14, July 15, 2024
The following definitions apply to WAC 388-106-1700
					 through 388-106-1765:
"Chronically homeless" means an individual who is homeless
					 and lives in a place not meant for human habitation, a safe haven, or in an
					 emergency shelter.
"PRISM" means predictive risk intelligence system and is a
					 web-based clinical decision support application that features predictive
					 modeling tools and data integration to support care management for high-risk
					 medicaid clients.