June 7, 2012_AFH "Dear Provider" Letters

June 7, 2012

ADSA:  AFH #2012-009

Dear Adult Family Home Provider:

In the past several months there have been at least four incidents in residential long-term care related to toxic substances that were unsecured and available to vulnerable residents.  See the following for examples:

  • A resident drank laundry detergent and died.  The detergent was in a milk carton in a place where the resident had full access.
  • In three cases the toxic substances, such as bleach, were unsecured and readily accessible to residents.

As you are aware, you are required to protect the vulnerable residents you serve.  WAC 388-76-10330 requires the adult family home to obtain a written assessment that contains accurate information about the resident's needs and preferences.  The assessment, including significant known behaviors or symptoms that may cause concern, must identify each resident with cognitive and/or behavioral impairments that may place them at risk of ingesting toxic substances and steps should be taken to ensure they are kept free from harm.  In order to make sure that staff are aware of the potential problems and to know what to do, the issues identified and specific plans to address the issues must be included on the negotiated care plan, WAC 388-76-10355.

Washington Administrative Code (WAC) 388-76-10750 requires that you ensure a safe environment that is free from hazards.  The department found in the four toxic substance cases that the provider had not ensured a safe and hazard free environment for residents who had been identified at risk.    

In order to ensure a safe and hazard-free environment for residents the provider and caregivers must be constantly vigilant about identifying potential hazards to residents.

Thank you for your commitment to the health & safety of the vulnerable residents you serve.


Joyce Pashley Stockwell, Director
Residential Care Services

ADSA:  AFH #2012-010
Managed Medical Care Program

Dear Adult Family Home Provider:

The purpose of this letter is to inform you that Washington Health Care Authority (HCA) will be requiring most Medicaid-only blind/disabled Supplemental Security Income (SSI) residents to enroll in a managed medical care program.  Examples of Medicaid only blind/disabled SSI residents not required to enroll are those who are over 65 years old, or those who have Medicare coverage. Washington HCA is making the change to improve care, reduce costs, expand service delivery options and implement payment reform and quality control features authorized by the Legislature. 

Eligible Medicaid residents living in your home should receive a letter from HCA notifying them of this change.  These residents will be assigned a health plan beginning July 1, 2012.  The enrollment date depends on where residents live. 

  • For those living in Eastern Washington, enrollment begins July 1, 2012. 
  • For those living in Western Washington (except King and Pierce counties), enrollment begins August 1, 2012 and for King and Pierce Counties, enrollment begins September 1, 2012.

Prior to enrolling, residents who wish to continue care with their current doctor, specialist, or hospital will need to verify that these care providers accept their health plan. Please assist your residents with this issue as needed.
For more information, visit the HCA website https://www.hca.wa.gov/billers-providers-partners/programs-and-services/managed-care and for questions, please contact Medicaid at 1-800-562-3022.  


Joyce Pashley Stockwell, Director
Residential Care Services