Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-33 - Attendant services › Section 296-33-010 - Attendant services

Current through Register Vol. 24-14, July 15, 2024
(1)
			 What are attendant services?
Attendant services are proper and necessary personal care
				services (custodial care) provided to maintain the claimant in their
				residence.
(2)
Who may
			 receive attendant services?
Claimants who are temporarily or permanently
			 totally disabled and rendered physically unable to care for themselves due to
			 the crime may receive attendant services.
(3)
Is prior authorization required for
			 attendant services?
Yes. To be covered by the crime victims compensation program,
				attendant services must be requested by the attending physician and authorized
				by the department before services begin.
(4)
Am I required to use other
			 insurance coverage before the crime victims compensation program will cover
			 attendant services?
Yes, all other insurances both private and public must be used
				first.
(5)
When will
			 the crime victims program stop paying for attendant care services?
The program will stop payment of attendant care services if the
				service is no longer medically necessary, or the maximum benefit is
				reached.
(6)
What
			 attendant services does the crime victims program cover?
The program covers proper and necessary attendant services that
				are provided consistent with the claimant's needs, abilities and safety. Only
				attendant services that are necessary due to the physical restrictions caused
				by the crime are covered.
The following are examples of attendant services that may be
				covered:
* Bathing and personal hygiene;
* Dressing;
* Administration of medications;
* Specialized skin care, including changing or caring for
				dressings or ostomies;
* Tube feeding;
* Feeding assistance (not meal preparation);
* Mobility assistance, including walking, toileting and other
				transfers;
* Turning and positioning;
* Bowel and incontinent care; and
* Assistance with basic range of motion
				exercises.
(7)
What
			 attendant services are not covered?
Services the department considers everyday environmental needs,
				unrelated to the medical needs of the claimant, are not covered. The following
				are examples of some chore services that are not covered:
*Housecleaning;
*Laundry;
*Shopping;
*Meal planning and preparation;
*Transportation of the claimant;
*Errands for the claimant;
*Recreational activities;
*Yard work;
*Child care.
(8)
Will the crime victims compensation
			 program review the attendant services being provided?
Yes. Periodic evaluations by the crime victims compensation
				program or its designee will be performed. Evaluations may include, but not be
				limited to, a medical records review and an on-site review of appropriate
				attendant services consistent with the claimant's needs, ability, and
				safety.
(9)
Who is
			 eligible to become a provider of attendant services?
Attendant services must be provided through an agency licensed,
				certified or registered to provide home care or home health
				services.
(10)
How can
			 a provider obtain a provider account number from the department?
In order to receive a provider account number from the
				department, a provider must:
*Complete a provider account application;
*Sign a provider agreement;
*Provide a copy of any practice or other license held;
*Complete, sign and return Form W-9; and
* Meet the department's provider eligibility
				requirements.
Note: A provider account number is required to receive payment
				from the department but is not a guarantee of payment for
				services.
(11)
How
			 many hours will be authorized for attendant services?
The crime victims compensation program will determine the
				maximum hours of authorized care based on an independent nursing assessment
				conducted in the claimant's residence. More than one provider may be
				authorized, based on the claimant's needs and the availability of providers.
				Attendant service providers are limited to a maximum of seventy hours per week
				per provider.
(12)
What are the provider account status definitions?
*Active - Account information is current and provider is
				eligible to receive payment.
*Inactive - Account is not eligible to receive payment based on
				action by the department or at provider request. These accounts can be
				reactivated.
*Terminated - Account is not eligible to receive payment based
				on action by the department or at provider request. These accounts cannot be
				reactivated.
(13)
When
			 may the department inactivate a provider account?
The department may inactivate a provider account when:
*There has been no billing activity on the account for eighteen
				months; or
*The provider requests inactivation; or
*Provider communications are returned due to address changes;
				or
* The department changes the provider application or
				application procedures; or
*Provider does not comply with department request to update
				information.
(14)
When
			 may the department terminate a provider account?
The department may terminate a provider account when:
*The provider is found ineligible to treat per department
				rules; or
*The provider requests termination; or
*The provider dies or is no longer in active business
				status.
(15)
How can a
			 provider reactivate a provider account?
To reactivate a provider account, the provider may call or
				write the department. The department may require the provider to update the
				provider application and/or agreement or complete other needed forms prior to
				reactivation. Account reactivation is subject to department review. If a
				provider account has been terminated, a new provider application will be
				required.
Statutory Authority:
				  Chapter
				  7.68 RCW. 12-23-085, §
				  296-33-010, filed 11/20/12, effective 1/1/13. Statutory Authority:
				  RCW
				  7.68.030. 02-06-024, § 296-33-010, filed
				  2/25/02, effective 3/28/02.