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 › CHORE › Section 388-106-0610 - Am I eligible for chore-funded services?

Current through Register Vol. 24-14, July 15, 2024
To be eligible for chore-funded services you must meet all
					 of the following criteria:
(1) Be
				  grandfathered on the chore program before August I, 2001 and have continued to
				  receive chore without a break in service.
(2) Not be eligible for MPC or
				  COPES.
(3) Be eighteen years of age
				  or older.
(4) Have an urmiet or
				  partially met need with at least one of the following activities of daily
				  living, as defined in WAC
				  388-106-0010.
For each Activity of Daily Living, the
							 minimum level of assistance required in
Self Performance is:
Support Provided is:
Eating
N/A
Setup
Toileting
Supervision
N/A
Bathing
Supervision
N/A
Dressing
Supervision
N/A
Transfer
Supervision
Setup
Bed Mobility
Supervision
Setup
Walk in Room OR Locomotion in Room OR Locomotion
							 Outside Immediate Living Environment
Supervision
Setup
Medication Management
Assistance Required
N/A
Personal Hygiene
Supervision
N/A
Body care which includes: Application of ointment or
							 lotions; Toenails trimmed; Dry bandage changes; or Passive range of motion
							 treatment.
Need
N/A
Your need for assistance in any of the
							 activities listed in this section did not occur because you were unable or no
							 provider was available to assist you will be counted for the purpose of
							 determining your functional eligibility.
(5) Have net household income (as described
				  in WAC 388-450-0005 and
				  388-450-0040 ) not exceeding:
(a) The sum of the cost of your chore
				  services; and
(b) One-hundred
				  percent of the federal poverty level (FPL) adjusted for family size.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › CHORE › Section 388-106-0615 - When do chore services start?

Current through Register Vol. 24-14, July 15, 2024
Your eligibility for chore services begins the date the
					 department authorizes services.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0615, 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 › CHORE › Section 388-106-0620 - How do I remain eligible for chore?

Current through Register Vol. 24-14, July 15, 2024
(1) In order to remain eligible for chore,
				  you must be in need of services in accordance with WAC
				  388-106-0610 as determined
				  through a CARE assessment. The assessment in CARE must be at least annually or
				  more often when there are significant changes in your functional or financial
				  circumstances.
(2) When eligibility
				  statutes, regulations, and/or rules for chore change, irrespective of whether
				  your functional or financial circumstances have changed, if you do not meet the
				  changed eligibility requirements, the department will terminate your chore
				  services.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0620, 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 › CHORE › Section 388-106-0625 - How do I pay for chore?

Current through Register Vol. 24-14, July 15, 2024
You may retain an amount equal to one hundred percent of
					 the federal poverty level, adjusted for family size, as the home maintenance
					 allowance and pay the difference between the FPL and your nonexempt income.
					 Exempt income includes:
(1) Income
				  listed in WAC
				  182-513-1340;
(2) Spousal income allocated and actually
				  paid as participation in the cost of the spouse's community options program
				  entry system (COPES) services;
(3)
				  Amounts paid for medical expenses not subject to third party payment;
(4) Health insurance premiums, coinsurance or
				  deductible charges; and
(5) If
				  applicable, those work expense deductions listed in WAC
				  388-106-0630(2).
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0625, 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 › CHORE › Section 388-106-0630 - Can I be employed and receive chore?

Current through Register Vol. 24-14, July 15, 2024
If you are not medicaid eligible due to your earned income
					 and resources and are receiving chore personal care services:
(1) You may be required to pay participation,
				  per WAC 388-106-0625, for any earned
				  income above one hundred percent of the federal poverty level.
(2) The department will exempt fifty percent
				  of your earned income after work expense deductions. Work expense deductions
				  are:
(a) Personal work expenses in the form
				  of self-employment taxes (FICA); and income taxes when paid;
(b) Payroll deductions required by law or as
				  a condition of employment in the amounts actually withheld;
(c) The necessary cost of transportation to
				  and from the place of employment by the most economical means, except rental
				  cars;
(d) Expenses necessary for
				  continued employment such as tools, materials, union dues, transportation to
				  service customers not furnished by the employer; and
(e) Uniforms needed on the job and not
				  suitable for wear away from the job.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › VOLUNTEER CHORE › Section 388-106-0650 - What is the volunteer services program?

Current through Register Vol. 24-14, July 15, 2024
The volunteer services program is a state-funded program
					 that provides volunteer assistance to eligible persons who need help to live
					 safely in the community. The availability of services under this program is
					 subject to available funding and volunteer resources. Further, when allocating
					 volunteer services, the needs of persons who have traditionally been served
					 through long-term care services and supports, including older adults,
					 individuals with disabilities or their unpaid caregivers, will be given
					 priority.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0650, 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 › VOLUNTEER CHORE › Section 388-106-0655 - Am I eligible to receive assistance through volunteer services?

Current through Register Vol. 24-14, July 15, 2024
You may be eligible to receive volunteer services if you
					 are:
(1)An older adult age sixty or
				  older or a person with a disability eighteen years of age or older;
				  or
(2)Living at home, unless you
				  are moving from a residential facility to home and need assistance moving;
				  or
(3)Unable to perform certain
				  independent living tasks due to a functional, mental or cognitive
				  disability;
(4)Financially unable
				  to purchase services privately; or
(5)Not receiving medicaid paid long-term care
				  services under the medicaid state plan or medicaid waiver program unless the
				  volunteer service is not available through the state plan waiver program;
				  or
(6) An unpaid caregiver who
				  provides ongoing care for an older adult or person with a disability, including
				  minors, who meets any of the criteria in WAC
				  388-106-0655(2) through
				  (5) above.
Reviser's note:
The bracketed material
						preceding the section above was supplied by the code reviser's office.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0655, 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 › VOLUNTEER CHORE › Section 388-106-0660 - What types of services may be offered through volunteer services?

Current through Register Vol. 24-14, July 15, 2024
The types of services an individual may be offered
					 include, but are not limited to:
(1)Housework and laundry;
(2)Shopping and errands;
(3)Meal preparation;
(4)Minor home repair;
(5)Yard work;
(6)Provision of wood for heating;
(7)Pet care;
(8)Auto maintenance;
(9)Moving;
(10)Limited personal care;
(11)Socialization activities to improve
				  quality of life;
(12)Electronic
				  device/computer use;
(13)Clerical
				  & budgeting tasks;
(14)Transportation
(15)Emergency preparation;
(16)Companionship or Supervision;
(17)Access to benefits;
(18)Access to employment opportunities;
				  and
(19)Health and nutrition
				  enhancement.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › VOLUNTEER CHORE › Section 388-106-0665 - How are volunteers qualified to provide volunteer services?

Current through Register Vol. 24-14, July 15, 2024
Volunteers are qualified to provide volunteer services
					 through the following mechanisms:
(1)
				  Volunteers who will have unsupervised access to vulnerable adults cannot have
				  any convictions, pending crimes or findings that are listed in WAC 388-1030001
				  or provide contracted services per RCW 43.20A.0710(1)(c) prior to working alone
				  with them.
(2) The volunteer
				  services contractor(s) will provide orientation and ongoing training as needed
				  to volunteers.
Reviser's note:
The typographical error in
						the above section occurred in the copy filed by the agency and appears in the
						Register pursuant to the requirements of
						RCW
						34.08.040.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › VOLUNTEER CHORE › Section 388-106-0670 - When may volunteer services not be available or offered?

Current through Register Vol. 24-14, July 15, 2024
Volunteer services may not be available or offered
					 when:
(1)Available funding has been
				  exhausted; or
(2)The regional area
				  does not have qualified volunteers available; or
(3)Existing volunteers do not have the skill
				  set needed to perform the task/service desired; or
(4)A volunteer stops providing services at
				  their discretion; or
(5)Providing
				  the service would cause a health or safety risk to the volunteer or
				  staff.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › VOLUNTEER CHORE › Section 388-106-0675 - What if I disagree with a decision made by the contracted volunteer services provider( s) related to volunteer services?

Current through Register Vol. 24-14, July 15, 2024
If you do not agree with a decision made by the volunteer
					 services contractor, you may make a written complaint with the volunteer
					 services program manager at the aging and long term support administration,
					 P.O. Box 45600, Olympia, WA 98504-5600. You are not entitled to a hearing under
					 Chapter 388-02 WAC.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) › Section 388-106-0700 - What services may I receive under PACE?

Current through Register Vol. 24-14, July 15, 2024
Under their contract with the department, the PACE provider
					 develops an individualized plan of care, as defined in 42 C.F.R. 460.106, that
					 integrates necessary long-term care, medical services, mental health services,
					 and alcohol and substance abuse treatment services.
(1) The care plan includes, but is not
				  limited to any of the following long-term care services:
(a) Care coordination;
(b) Home and community-based services:
(i) Personal (in-home) care;
(ii) Residential care.
(c) And, if necessary, nursing facility
				  care.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) › Section 388-106-0705 - Am I eligible for PACE services?

Current through Register Vol. 24-14, July 15, 2024
To qualify for medicaid-funded PACE services, you must
					 apply for an assessment by contacting your local home and community services
					 office. The department will assess and determine whether you:
(1) Are age:
(a) Fifty-five or older, and blind or have a
				  disability, as defined in WAC
				  182-512-0050, SSI-related
				  eligibility requirements; or
(b)
				  Sixty-five or older.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) › Section 388-106-0710 - How do I pay for PACE services?

Current through Register Vol. 24-14, July 15, 2024
Depending on your income and resources, you may be required
					 to pay for part of the PACE services. The department's financial worker will
					 determine what amount, if any, you must contribute if you decide to enroll. The
					 department pays the PACE provider the remaining amount.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0710, 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 › PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) › Section 388-106-0715 - How do I end my enrollment in the PACE program?

Current through Register Vol. 24-14, July 15, 2024
(1) You may choose to voluntarily end your
				  enrollment in the PACE program without cause at any time. To do so, you must
				  give the PACE provider written notice.
A PACE participant's voluntary disenrollment is effective
					 on the first day of the month following the date the PACE organization receives
					 the participant's notice of voluntary disen-rollment.
(2) Your enrollment may also end
				  involuntarily if you:
(a) Move out of the
				  designated service area or are out of the service area for more than thirty
				  consecutive days, unless the PACE provider agrees to a longer absence due to
				  extenuating circumstances;
(b)
				  Engage in disruptive or threatening behavior such that the behavior jeopardizes
				  your health or safety, or the safety of others;
(c) Fail to comply with your plan of care or
				  the terms of the PACE enrollment agreement;
(d) Fail to pay or make arrangements to pay
				  your part of the costs after the thirty-day grace period;
(e) Become financially ineligible for
				  medicaid services, unless you choose to pay privately;
(f) Are enrolled with a provider that loses
				  its license or contract, or both; or
(g) No longer meet the nursing facility level
				  of care requirement as defined in WAC 388-106-0205.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › ADULT DAY SERVICES › Section 388-106-0800 - What adult day care services may I receive?

Current through Register Vol. 24-14, July 15, 2024
You may receive the following services in an adult day
					 care:
(1) Core services, which include
				  assistance with:
(a) Locomotion outside of
				  room, locomotion in room, walk in room;
(b) Body care;
(c) Eating;
(d) Repositioning;
(e) Medication management that does not
				  require a licensed nurse;
(f)
				  Transfer;
(g) Toileting;
(h) Personal hygiene at a level that ensures
				  your safety and comfort while in attendance at the program; and
(i) Bathing at a level that ensures your
				  safety and comfort while in attendance at the program.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › ADULT DAY SERVICES › Section 388-106-0805 - Am I eligible for adult day care?

Current through Register Vol. 24-14, July 15, 2024
(1) If you receive COPES , you may be
				  eligible for adult day care as a waiver service if you are assessed as having
				  an unmet need for one or more of the following core services:
(a) Personal care services;
(b) Routine health monitoring with
				  consultation from a registered nurse;
(c) General therapeutic activities;
				  or
(d) Supervision and/or
				  protection if required for your safety.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › ADULT DAY SERVICES › Section 388-106-0810 - What adult day health services may I receive?

Current through Register Vol. 24-14, July 15, 2024
You may receive the following adult day health
					 services:
(1) All core services under
				  WAC 388-106-0800;
(2) Skilled nursing services other than
				  routine health monitoring with nurse consultation;
(3) At least one of the following skilled
				  therapy services: physical therapy, occupational therapy, or speech-language
				  pathology or audiology, as defined under
				  chapters
				  18.74,
				  18.59, and
				  18.35 RCW, and
(4) Psychological or counseling services,
				  including assessing for psycho-social therapy need, dementia, abuse or neglect,
				  and alcohol or drug abuse; making appropriate referrals; and providing brief,
				  intermittent supportive counseling.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0810, 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 › ADULT DAY SERVICES › Section 388-106-0815 - Am I eligible for adult day health?

Current through Register Vol. 24-14, July 15, 2024
You are eligible for adult day health if you meet the
					 conditions described in WAC
					 388-106-0300 or
					 388-106-0305.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520, and 2012 2nd sp.s. c 7.
						12-15-087, § 388-106-0815, filed 7/18/12, effective 8/18/12. Statutory
						Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0815, 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 › GAU-FUNDED RESIDENTIAL CARE › Section 388-106-0900 - What services may I receive under medical care services?

Current through Register Vol. 24-14, July 15, 2024
You may receive personal care services in an adult family
					 home or a licensed assisted living facility contracted with the department to
					 provide adult residential care services. You may also receive nurse delegation
					 services under this program.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0900, 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 › GAU-FUNDED RESIDENTIAL CARE › Section 388-106-0905 - Am I eligible to receive medical care services (MCS) residential care services?

Current through Register Vol. 24-14, July 15, 2024
You are eligible to receive MCS-funded residential care
					 services if:
(1) You meet financial
				  eligibility requirements for medical care services (MCS), described in WAC
				  182-508-0005;
(2) You are not eligible for services under
				  COPES, or MPC; and
(3) You are
				  assessed in CARE and meet the functional criteria outlined in WAC
				  388-106-0210(3)
				  or WAC
				  388-106-0355(1).
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0905, 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 › RESIDENTIAL CARE DISCHARGE ALLOWANCE › Section 388-106-0950 - What services may I receive under community transition or sustainability services?

Current through Register Vol. 24-14, July 15, 2024
Community transition or sustainability services are
					 nonrecurring setup items or services necessary to assist you to establish ,
					 resume , or stabilize your home or community-based residential setting.
					 Community transition or sustainability services may include, but are not
					 limited to:
(1) Security deposits that
				  are required to lease an apartment or home, including first month's
				  rent.
(2) Activities to assess
				  need, arrange for, and procure necessary household furnishings.
(3) Setup fees or deposits for utilities,
				  including telephone, electricity, heating, water, and garbage.
(4) Services necessary for your health and
				  safety such as pest eradication and nonrecurring extreme cleaning.
(5) Moving expenses.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-0950, 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 › RESIDENTIAL CARE DISCHARGE ALLOWANCE › Section 388-106-0955 - Am I eligible for community transition or sustainability services?

Current through Register Vol. 24-14, July 15, 2024
You may be eligible for community transition or
					 sustainability services if you:
(1)
				  Meet eligibility criteria to receive long-term services and supports from home
				  and community services;
(2) Are
				  transitioning to the community from a hospital, nursing facility, licensed
				  assisted living facility, enhanced services facility, or adult family home , or
				  are living in the community and need stabilization services to remain there;
				  and
(3) Do not have other programs,
				  services, or resources to assist you with these costs; and
(a) Have needs beyond what is covered under
				  community transition services (under community first choice); or
(b) Are not eligible for community transition
				  services (under community first choice).
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESIDENTIAL CARE DISCHARGE ALLOWANCE › Section 388-106-0960 - Are there limits to the community transition or sustainability services I may receive?

Current through Register Vol. 24-14, July 15, 2024
Community transition or sustainability services:
(1) Do not include recreational or
				  entertainment items, such as a television, cable, or a DVD player;
(2) Do not include room and board;
				  and
(3) May not exceed eight
				  hundred fifty dollars per transition or occurrence of instability that
				  threatens the loss of your home in the community.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › RESIDENTIAL CARE DISCHARGE ALLOWANCE › Section 388-106-0965 - Are there waiting lists for community transition or sustainability services?

Current through Register Vol. 24-14, July 15, 2024
There are no waiting lists for community transition or
					 sustainability services. Instead of waiting lists, the department may revise
					 rules to reduce the type of available services, the number of individuals
					 served, or maximum rate, in order to stay within the legislative
					 appropriation.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1000 - What is the intent of WAC 388-106-1000 through 388-106-1055?

Current through Register Vol. 24-14, July 15, 2024
The intent of WAC
					 388-106-1000 through
					 388-106-1055 is to:
(1) Describe the eligibility requirements
				  under which an adult age eighteen or older may receive private duty nursing
				  (PDN) services through the department's aging and disability services
				  administration (ADSA);
(2) Provide
				  assistance to clients and enable families to support clients in their own
				  homes; and
(3) Describe the
				  requirements clients and their families, home health agencies, and privately
				  contracted registered nurses (RNs) and licensed practical nurses (LPNs) must
				  meet in order for services to be authorized for PDN.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1000, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1005 - What services may I receive under private duty nursing (PDN)?

Current through Register Vol. 24-14, July 15, 2024
PDN is a program that provides skilled nursing care if you
					 have complex medical needs that cannot be met through other services. PDN is an
					 alternative to institutional care and is the program of last
					 resort.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1005, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1010 - Am I eligible for medicaid-funded private duty nursing services?

Current through Register Vol. 24-14, July 15, 2024
In order to be eligible for medicaid-funded private duty
					 nursing (PDN):
(1) You must be
				  eighteen years of age or older and financially eligible, which means you:
(a) Meet medicaid requirements under the
				  categorically needy program or the medically needy program; and
(b) Use private insurance as first payer, as
				  required by medicaid rules. Private insurance benefits, which cover
				  hos-pitalization and in-home services, must be ruled out as the first payment
				  source to PDN.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1020 - How do I pay for my PDN services?

Current through Register Vol. 24-14, July 15, 2024
You are not required to pay participation for PDN
					 services, but the cost of services is subject to estate recovery, under chapter
					 182-527 WAC. If you are also receiving other services (e.g. COPES), you may be
					 responsible for paying participation as required under WAC
					 182-515-1505. Your financial
					 worker will inform you about your participation requirements for those
					 services.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1020, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1025 - Who can provide my PDN services?

Current through Register Vol. 24-14, July 15, 2024
PDN services can be provided by:
(1) A home health agency licensed by the
				  Washington state department of health chapter 246-335 WAC that has a contract
				  with the medicaid agency to provide PDN services; or
(2) A Washington state licensed RN, or LPN
				  under the direction of an RN who has a contract with the medicaid agency to
				  provide PDN services and meets the requirements set forth in WAC
				  388-106-1040.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 11-05-079, §
						388-106-1025, filed 2/15/11, effective 3/18/11. Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1025, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1030 - Are there limitations or other requirements for PDN?

Current through Register Vol. 24-14, July 15, 2024
Limitations and other requirements to PDN services are as
					 follows:
(1) You may be authorized to
				  receive PDN services for between four to sixteen hours per day, except as noted
				  in WAC 388-106-1045(4).
(2) PDN hours will be deducted from the
				  personal care hours generated by CARE to account for services that meet your
				  need for personal care services (i.e., one hour from the available hours for
				  each hour of PDN authorized). WAC
				  388-106-0130(9)(e).
(3) Trained family members must provide for
				  any hours above your assessment determination, or you or your family must pay
				  for these additional hours.
(4) In
				  instances where your family is temporarily absent due to vacations, additional
				  PDN hours must be:
(a) Paid for by you or
				  your family; or
(b) Provided by
				  other trained family members. If this is not possible, you may require
				  placement in a long-term care facility during their absence.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1035 - What requirements must a home health agency meet in order to provide and be paid for my PDN?

Current through Register Vol. 24-14, July 15, 2024
In order for a home health agency to provide and be paid
					 for your PDN, the home health agency must:
(1) Be licensed by the Washington state
				  department of health pursuant to chapter 246-335 WAC and have a contract with
				  the medicaid agency to provide PDN services;
(2) Operate under primary care provider
				  orders;
(3) Develop and follow a
				  detailed service plan that is reviewed and signed at least every six months by
				  the client's primary care provider and submitted to CNC or NCC for
				  review;
(4) Initiate and complete
				  the PDN skilled nursing task log or an approved equivalent for seven days and
				  submit it to the CNC or NCC for review for an initial eligibility determination
				  and for ongoing eligibility every six months thereafter;
(5) Meet all documentation required by DOH
				  for in-home licensing, WAC
				  246-335-055,
				  246-335-080, and
				  246-335-110; and
(6) Submit timely and accurate invoices for
				  payments.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 11-05-079, §
						388-106-1035, filed 2/15/11, effective 3/18/11. Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1035, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1040 - What requirements must an RN, or LPN under the supervision of an RN, meet in order to provide and get paid for my PDN services?

Current through Register Vol. 24-14, July 15, 2024
In order to be paid by the department, a private RN under
					 the supervision of a primary care provider or an LPN under the supervision of
					 an RN, must:
(1) Be licensed and in
				  good standing, as provided in
				  RCW
				  18.79.030(1)(3);
(2) Have a contract with the medicaid agency
				  to provide PDN services;
(3)
				  Complete a background check which requires fingerprinting if the RN or LPN has
				  lived in Washington state less than three years;
(4) Have no conviction for a disqualifying
				  crime, as provided in
				  RCW
				  43.43.830 and
				  43.43.842 and WAC
				  388-71-0500 through
				  388-71-05640 series;
(5) Have no finding of fact and conclusion of
				  law (stipulated or otherwise), agreed order, or final order issued by a
				  disciplining authority, a court of law, or entered into a state registry with a
				  finding of abuse, neglect, abandonment or exploitation of a minor or vulnerable
				  adult;
(6) Provide services
				  according to the care plan under the supervision/direction of the primary care
				  provider;
(7) Document all PDN
				  services provided by the care plan as required by WAC
				  182-502-0020 and
				  246-840-700;
(8) Meet provider requirements under WAC
				  388-71-0510,
				  388-71-0515,
				  388-71-0540,
				  388-71-0551, and
				  388-71-0556;
(9) Complete time sheets on a monthly
				  basis;
(10) Complete the PDN
				  seven-day look back skilled nursing task log and submit it to the CNC or NCC
				  for review for initial eligibility determination, and for ongoing eligibility
				  every six months; and
(11) Submit
				  timely and accurate invoices for payment.
Reviser's note:
The typographical error in
						the above section occurred in the copy filed by the agency and appears in the
						Register pursuant to the requirements of
						RCW
						34.08.040.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 11-05-079, §
						388-106-1040, filed 2/15/11, effective 3/18/11. Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1040, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1045 - When may I receive private duty nursing (PDN) services in a contracted PDN adult family home (AFH)?

Current through Register Vol. 24-14, July 15, 2024
You may receive private duty nursing (PDN) services in an
					 adult family home (AFH) when:
(1) You
				  are assessed;
(a) Using the comprehensive
				  assessment reporting evaluation (CARE) assessment tool as provided in WAC
				  388-106-0500; and
(b) By an aging
				  and long-term support administration (ALTSA) community nurse consultant (CNC)
				  or developmental disabilities administration (DDA) nurse care consultant (NCC)
				  who, using their professional judgment, determines that you require a minimum
				  of eight hours of PDN services per day.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1046 - When may an adult family home (AFH) be paid an all-inclusive daily rate for private duty nursing (PDN) services?

Current through Register Vol. 24-14, July 15, 2024
An adult family home (AFH) may be paid for private duty
					 nursing (PDN) services when:
(1) The
				  AFH provider, as defined in WAC
				  388-76-10000, ensures
				  that personal care and nursing services are available in the home 24 hours per
				  day.
(2) The AFH provider is
				  either:
(a) A registered nurse (RN) licensed
				  in Washington state in good standing under
				  RCW
				  18.79.030(1); or
(b) Operates an in-home services agency
				  licensed through the Washington state department of health (DOH) to provide
				  home health services under chapter 246-335 WAC; and
(i) Employs a resident manager or entity
				  representative, who is a registered nurse licensed in Washington state in good
				  standing under
				  RCW
				  18.79.030(1); and
(ii) The PDN program manager has approved a
				  plan submitted by the AFH provider to replace the resident manager or entity
				  representative in the event the resident manager or entity representative is no
				  longer employed by the AFH; and
(iii) Ensures that a sufficient number of
				  capable, qualified, and trained staff are available to provide necessary care
				  and services consistent with each client's negotiated service agreement at all
				  times, including but not limited to routine conditions, emergencies, fires, and
				  disaster situations; and
(iv) May
				  use nurses employed by their own in-home services agency to provide PDN for
				  clients in the AFH.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1047 - What is included in the all-inclusive daily rate payment to the adult family home (AFH) providing private duty nursing (PDN) services?

Current through Register Vol. 24-14, July 15, 2024
Department of social and health services (DSHS) will pay
					 the adult family home (AFH) an all-inclusive daily rate for a private duty
					 nursing (PDN) client, which includes payment for PDN services, all skilled
					 nursing tasks, and all personal care services. DSHS will not authorize payment
					 for nurse delegation services or hours provided by the in-home services agency
					 nurses in addition to the PDN all-inclusive daily rate.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1050 - May I receive other long-term care services in addition to PDN?

Current through Register Vol. 24-14, July 15, 2024
(1) In addition to
				  PDN services, you may be eligible to receive care through community options
				  program entry system (COPES), or medicaid personal care (MPC), for unmet
				  personal needs not performed by informal supports.
(2) PDN hours will be deducted from the
				  personal care hours generated by CARE to account for services that meet some of
				  your need for personal care services (i.e., one hour from the available hours
				  for each hour of PDN authorized per WAC
				  388-106-1030 ).
(3) Services may not be duplicated. PDN hours
				  may not be scheduled during the same time that personal care hours are being
				  provided by an individual provider or home care agency provider.
(4) The PDN provider is responsible for
				  providing assistance with activities of daily living (ADL) and instrumental
				  activities of daily living (IADL) unless there is an informal support that is
				  providing or assisting at the same time.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 11-05-079, §
						388-106-1050, filed 2/15/11, effective 3/18/11. Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1050, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › PRIVATE DUTY NURSING › Section 388-106-1055 - Can I choose to self-direct my care if I receive PDN services?

Current through Register Vol. 24-14, July 15, 2024
You may choose to self-direct part of your health-related
					 tasks to an individual provider, as outlined in
					 RCW
					 74.39.050. You may also still receive PDN
					 services, if you meet the PDN eligibility requirements.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520 and 42 C.F.R. 440.80.
						05-24-091, § 388-106-1055, filed 12/6/05, effective
						1/6/06.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › SENIOR CITIZENS' SERVICES › Section 388-106-1100 - What services can I receive under the Senior Citizens' Services Act (SCSA) fund?

Current through Register Vol. 24-14, July 15, 2024
You may receive community-based services, described in
					 RCW
					 74.38.040.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1100, 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 › SENIOR CITIZENS' SERVICES › Section 388-106-1105 - How do I apply for SCSA-funded services?

Current through Register Vol. 24-14, July 15, 2024
To receive SCSA-funded services, you or your
					 representative must:
(1) Complete and
				  submit a department application form, providing complete and accurate
				  information; and
(2) Promptly
				  submit a written report of any changes in income or resources. For the
				  definition of income and resources, refer to chapter 182-509 WAC.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1105, 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 › SENIOR CITIZENS' SERVICES › Section 388-106-1110 - Am I eligible for SCSA-funded services at no cost?

Current through Register Vol. 24-14, July 15, 2024
To be eligible for SCSA-funded services at no cost, you
					 must:
(1) Be age:
(a) Sixty-five or older; or
(b) Sixty or older, and:
(i) Either unemployed, or
(ii) Working twenty hours a week or
				  less;
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › SENIOR CITIZENS' SERVICES › Section 388-106-1115 - What income and resources are exempt when determining eligibility?

Current through Register Vol. 24-14, July 15, 2024
The following income and resources, regardless of value,
					 are exempt when determining whether you are eligible for SCSA-funded
					 services:
(1) Your home, and the lot
				  it is upon;
(2) Garden produce,
				  livestock, and poultry used for home consumption;
(3) Program benefits which are exempt from
				  consideration in determining eligibility for needs based programs (e.g.,
				  uniform relocation assistance, Older Americans Act funds, foster grandparents'
				  stipends or similar moneys);
(4)
				  Used and useful household furnishings, personal clothing, and
				  automobiles;
(5) Personal property
				  of great sentimental value;
(6)
				  Personal property used by the individual to earn income or for
				  rehabilitation;
(7) One cemetery
				  plot for each member of the family unit;
(8) Cash surrender value of life
				  insurance;
(9) Real property held
				  in trust for an individual Indian or Indian tribe; and
(10) Any payment received from a foster care
				  agency for children in the home.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1115, 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 › SENIOR CITIZENS' SERVICES › Section 388-106-1120 - What if I am not eligible to receive SCSA-funded services at no cost?

Current through Register Vol. 24-14, July 15, 2024
(1) Even if your
				  income is above the forty percent SMI limit to receive SCSA-funded services at
				  no cost, you may receive SCSA-subsidized services. The department uses a
				  sliding fee schedule to determine what percentage the department pays for the
				  cost of your services. You pay the remaining amount, but not more than the
				  usual rate paid for services, as negotiated by the AAA or the department. The
				  formula for determining the department's share of the cost of the services is:
100% State Median Income (SMI) - Household Income
								  x 100
100% - 40% SMI
(2) Service providers must be responsible for
				  collecting fees owed by eligible persons and reporting to area agencies all
				  fees paid or owed by eligible persons.
(3) Some services are provided at no charge
				  regardless of income or need requirements. These services include, but are not
				  limited to, nutritional services, health screening, services under the
				  long-term care ombudsman program, and access services. Note: Well adult clinic
				  services may be provided in lieu of health screening services if such clinics
				  use the fee schedule established by this section.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1120, 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 388-106-1200 - What definitions apply to respite care services through the family caregiver support program?

Current through Register Vol. 24-14, July 15, 2024
The following definitions apply to respite care
					 services:
"Caregivers" means a spouse, relative, or friend who has
					 primary responsibility for the care or supervision of an adult with a
					 functional disability without receiving direct, public or private payment for
					 the caregiver services they provide.
"Continuous care or supervision" means daily assistance or
					 oversight of an adult with a functional disability.
"Family caregiver support program or FCSP" means a
					 statewide program offered by area agencies on aging to provide support for
					 unpaid caregivers who provide care to an adult with a functional
					 disability.
"Functional disability" means a physical, mental or
					 cognitive condition requiring continuous care or supervision in completing
					 activities of daily living or instrumental activities for daily living.
"Care receiver" means an adult (age eighteen and over) with
					 a functional disability who needs daily continuous care or supervision.
"Service provider" means an agency, or organization under
					 contract to the area agency on aging (AAA) or its subcontractor.
"Supervision" means providing oversight of an individual to
					 assure his/her safety and well-being.
"TCARE¦, tailored caregiver assessment and referral
					 system" means the process (screening, assessment and care planning) to
					 establish eligibility for respite care and other caregiver support services for
					 unpaid family caregivers.
Statutory Authority:
						RCW
						74.08.090 and
						74.09.520. 12-13-040, §
						388-106-1200, filed 6/13/12, effective 7/14/12; 05-11-082, § 388-106-1200,
						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 388-106-1205 - What are respite care services?

Current through Register Vol. 24-14, July 15, 2024
Respite services relieve unpaid caregivers by providing
					 temporary care or supervision to adults with a functional
					 disability.
Statutory Authority:
						RCW
						74.08.090,
						74.09.520. 05-11-082, §
						388-106-1205, filed 5/17/05, effective
						6/17/05.