Aging & Long-Term Support

WACs 388-71-0876, 388-71-0992, 388-112A-0081 & 388-112A-0613

The department is considering amending WAC 388-71-0876 When must a long-term care worker who was working or hired during the COVID-19 public health emergency complete training, including required specialty training?, 388-71-0992 When must continuing education be completed when public health emergency waivers are lifted, and what continuing education credit is granted to long-term care workers employed during the pandemic?, 388-112A-0081 When must long-term care workers who were working or hired during the COVID-19 public health emergency complete training, including specialty training? and 388-112A-0613 when must continuing education be completed when public health emergency waivers are lifted, and what continuing education credit is granted to long-term care workers employed during the pandemic? Availability of training and certification for long-term care workers continues to require extension to deadlines due to the COVID-19 pandemic. The extensions are critical for ensuring the ability of long-term care workers to access training, certification, and continuing education. The department intends to put current emergency rule deadlines into permanent rule to cover those long-term care workers still affected by training and certification backlogs, and to clarify a final repeal date for all COVID training rules when no longer required as directed by statute. These rules will be finalizing training, certification, and continuing education pandemic extensions and setting a date for repeal of those sections. The department is considering amending these rules and other related rules as appropriate to make them permanent.

WACs 388-71-0836 & 388-112A-0010

WAC 388-71-0836 What definitions apply to the long-term care worker training requirements? and 388-112A-0010 What definitions apply to this chapter?. The Department of Social and Health Services (department) is planning on adding a new definition to these chapters and amending other related rules as required. The rules on this subject are needed because the training of Home Care Aides is essential to the department’s goal of expanding the number of long-term care workers available to serve the quickly growing number of clients that need them. The department has identified situations where some instructors are claiming they have “mentored” students, and there has been little or no supervision of the training or feedback for instructor growth. For this reason, and to assure that students being mentored are offered the best preparation possible, the department needs to provide clarifying language to define the meaning of “being mentored”.

WAC 388-76-10315

The department is considering amending WAC 388-76-10315, Resident Record – Required. The intent is to help the regulated community comply with the rule by providing clear language about Long-Term Care Ombuds access to resident records. The department may amend other related rules as appropriate. This rulemaking was requested as a means to align the rule with federal requirements for Long-Term Care Ombuds access to resident records. The amended rule will give clarity to adult family home providers. It will also support adult family home residents who may benefit from or are currently receiving Long-Term Care Ombuds advocacy. The department will compare the draft rules with 45 CFR §1324.11(e)(2), Centers for Medicare and Medicaid Services (CMS) requirements related to Long-Term Care Ombuds access to resident records. The department will confirm consistency with the federal requirements and will consult with CMS as necessary.

Chapters 388-76, 388-78A, 388-97 & 388-107 WAC

The Department is considering amending the following rules, adding a new section, and amending other sections as needed. The intent is to provide clarity to the resident medication rules, including labeling, documentation, and storage of resident medications, specifically related to the implementation of the Death with Dignity Act: Chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements; Chapter 388-78A WAC, Assisted Living Facility Licensing Rules; Chapter 388-107 WAC, Licensing Requirements for Enhanced Services Facilities; and Chapter 388-97 WAC, Nursing Homes. This rulemaking was requested by a member of the public to reduce potential barriers to residents in Adult Family Homes accessing prescribed medications under the Death with Dignity Act. The department identified potential barriers in Assisted Living Facility, Enhanced Services Facilities, and Nursing Home rules. Death with Dignity medications can only be prescribed to individuals deemed able to “self-administer” the medication (RCW 70.245). Creating a new section in the above-referenced WAC chapters will clarify that Death with Dignity medications would not be subject to the same labeling, documentation, and storage requirements as other resident medications. This will enable residents to receive the prescribed medications timely, without potential delays that could result in the resident no longer being able to self-administer the medication.

WAC 388-106-0336

The intent of this rulemaking is to amend WAC 388-106-0336 to add a new service, Community Stability Supports, under the residential support waiver. Minor language may also be made for consistency in service language.

WACs 388-106-1900, 388-106-1910, 388-106-1915, 388-106-1933, and 388-106-1950

The department is considering amending the chapter 388-106 WAC to update definition language, add additional services that are included in the 1115 Waiver Renewal, clarify eligibility, and update language. WAC 388-106-1900 What definitions apply to Medicaid Alternative Care (MAC) and Tailored Support for Older Adults (TSOA) services?, WAC 388-106-1910 Am I eligible for TSOA services?, WAC 388-106-1915 What services may I receive in MAC and TSOA?, WAC 388-106-1933 How is the GetCare screening scored to determine if I am eligible for a GetCare assessment and related step three services?, and WAC 388-106-1950 How do I remain eligible for MAC and TSOA services?  Other related rules as may be required.
 

WAC 388-76-10750

The department is considering amending the following section in chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements: 10750-Safety and maintenance. The intent is to provide clarity about access to hand sanitizer in compliance with infection control, safety, and maintenance regulations in adult family homes. Homes must meet infection control requirements while also ensuring resident safety. The department may amend other related rules as appropriate.

Chapter 388-76 WAC

The department is considering amending Chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements, to address a process gap that occurs when residents transfer or discharge from Adult Family Homes and prescription medications for those residents continue to be filled by pharmacies. These filled prescriptions may not be returned to the pharmacy and are subject to diversion and misuse by others. The department may amend other related rules as appropriate.

WAC 388-107-0630

The department is considering amending enhanced services facilities WAC 388-107-0630-Training and home care aide certification requirements. The department may amend other related rules as appropriate.

WACs 388-106-0270 & -0274

The department is planning to amend WAC 388-106-0270, “What services are available under community first choice (CFC)?” and 388-106-0274, “Are there limits to the assistive technology I may receive?” and other related rules as may be required.

WAC chapter 388-112B

During the 2017 legislative session, House Bill 1548 was codified as RCW 74.39A.080, resulting in the department considering adding a new chapter 388-112B relating to curricula for persons in long-term care facilities with behavioral health needs. The department may amend other related rules as required.

WAC 388-76-10350, 388-78A-2100, & 388-107-0080

The department is considering amending WAC 388-76-10350, 388-78A-2100, and 388-107-0080 to extend timelines for resident assessments and other related rules as required.

WACs 388-71-0503, 388-106-0010, 388-106-0060, 388-115-0516

The department is planning to amend the Washington Administrative Code (WACs) to support the passage of Senate Bill 5866, an act relating to Medicaid long-term services and supports eligibility determinations being completed by federally recognized Indian tribes. The department is planning to amend the following WACs:

388-71-0503 – What definitions apply to WAC 388-71-0500 through WAC 388-71-05640

388-106-0010 – What definitions apply to this chapter?

388-106-0060 – Who must perform the assessment?

388-115-0516 – What are the responsibilities of the consumer directed employer when providing care to a client?

Chapter 388-96 WAC

The Department intends to amend chapter 388-96 WAC regarding its nursing facility Medicaid methodology to implement a low-wage worker wage equity funding and verification and other related rules as may be required.

WAC 388-106-0130, -0010

The department is considering amending WAC 388-106-0130, How does the department determine the number of hours I may receive for in-home care? and 388-106-0010 What definitions apply to this chapter?  The department may amend other related rules as required.

WAC 388-76-10455

The department is considering amending WAC 388-76-10455 to allow Adult Family Home providers the authority to administer epinephrine to residents in their care who have an assessed condition requiring administration of epinephrine.

Colleen Jensen

(564) 999-3182

Chapter 388-106 WAC

The department is considering amending sections in chapter 388-106 WAC, Long-Term Care Services, specifically the rules related to the TCARE assessment tool.

WAC 388-97-0120, -0140

The department is considering amending WAC 388-97-0120, Individual transfer and discharge rights and procedures; WAC 388-97-0140, Transfer and discharge appeals for residents in Medicare or Medicaid certified facilities; and other related rules as may be necessary to assure nursing homes are able to rapidly transfer and discharge residents for grouping of COVID-19 positive residents in one facility or grouping asymptomatic residents together. This helps expedite infection control processes and maximize the availability of nursing home beds.

Chapter 388-06 WAC

The department was granted rule making authority in ESHB 1120 in 2021, chapter 203 Laws of 2021, and is therefore pursuing regular rule making, as a follow-up to implementation of emergency rules, to reinstate the fingerprinting requirement for providers that was temporarily suspended by the governor’s proclamation due to the Public Health Emergency. The proposal also amends other rules in Chapter 388-06 to ensure they are consistent with one another and do not conflict with current background check rules in WAC chapter 388-113.

WAC chapter 388-71 and WAC chapter 388-113

The department is planning to repeal and amend sections of WAC chapter 388-71, Home and Community Services and Programs, and WAC chapter 388-113, Disqualifying Crimes and Negative Actions.

WAC 388-112A-0490

The department is considering adding clarifying language to WAC 388-112A-0490, What are the specialty training requirements for applicants, resident managers, administrators, and other types of entity representatives in adult family homes, assisted living facilities, and enhanced services facilities? The department may amend other related rules as required.

Chapters 388-76, 78A, 97, 107 WAC

The department is considering amending chapters 388-76, 388-78A, 388-97, 388-107 WAC to implement specific sections to SHB 1218. The department may amend other related rules as necessary to meet the legislative intent of SHB 1218. The department is considering amending the rules to add requirements related to facility communication system, resident access to communications, and facility responsiveness to outside communications. Comprehensive disaster preparedness plans, and related policies and procedures, and equipment for a range of potential hazards, emergencies, and disasters. Visitation of essential support persons. Resident’s rights to a safe and healthy environment.

Chapters 388-76, 78A, 97, 107 WAC

The department is considering amending chapters 388-76, 388-78A, 388-97, 388-107 WAC to implement specific sections to SHB 1218. The department may amend other related rules as necessary. The department is considering amending the rules to adopt requirements for providers to publicly post stop placement orders, adopt requirements for providers to create and maintain resident rosters as well as responding to requests from ombuds for roster information, incorporate new definition of resident representative, replace the phrase “his or her” with appropriate gender-neutral terms.

Chapter 388-106 WAC

The department is planning to amend New Freedom Waiver WACs 388-106-1400 through 388-106-1480.

Chapters 388-71, 112A WAC

The department is planning to reconcile the differences in the training section language between WAC 388-112A and WAC 388-71, update language related to new technologies, and update language related to inclusivity. The department may amend other related rules as required.

WACs 388-112A-0010, 0300

The department is planning to amend WAC 388-112A-0010, What definitions apply to this chapter?, and WAC 388-112A-0300, What is the seventy-hour long-term care worker basic training?, and create a new section titled What are the minimum requirements for training programs to provide remote skills training? The department may amend other related rules as required.

WAC 388-103-0001

The department is amending WAC 388-103-0001 What definitions apply to this chapter? and other related rules as appropriate.

Chapter 388-71, 112A WAC

The department is adding news sections in chapter 388-71 WAC, Home and Community Services and Programs, and chapter 388-112A WAC, Residential Long-Term Care Services Training. The department may amend other related rules as required.

Chapter 388-76 WAC

The department is considering adding a new section in chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements, and amending other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

Chapter 388-78A WAC

The department is considering adding a new section in chapter 388-78A WAC, Assisted Living Facility Licensing Rules, and amending other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

Chapter 388-107 WAC

The department is considering adding a new section in chapter 388-107 WAC, Licensing Requirements for Enhanced Services Facilities, and amending other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

WAC 388-97-1660

The department is considering amending WAC 388-97-1660, Staff and equipment, and other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

WAC 388-97-1080, 1090

The department is considering amending WAC 388-97-1080, Nursing Services, WAC 388-97-1090, Direct Care Hours, and other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

Chapter 388-97 WAC

The department is considering adding a new section in chapter 388-97 WAC, Nursing Homes, and amending other related rules as may be necessary to implement ESHB 1120 (Chapter 203, Laws of 2021).

WACs 388-97-0920, 1915, 1975

The Department of Social and Health Services, Aging and Long-Term Support Administration, is considering amending WAC 388-97-0920, Participation in resident and family groups; WAC 388-97-1915, Preadmission screening and resident review (PASRR) requirements prior to admission of new residents; WAC 388-97-1975, PASRR requirements after admission of a resident; and other related rules as may be necessary to identify the period of time portions of these rules were suspended or waived during the declared emergency of COVID-19 per Proclamation by the Governor 20-05 and extensions thereto.

WACs 388-97-1380, 1580

The department is considering amending WAC 388-97-1380, Tuberculosis – testing required; WAC 388-97-1580, Tuberculosis – Reporting – Required; and other related rules as may be necessary to assure nursing homes are not obstructed from offering the COVID-19 vaccine to residents and staff because of clinical interference from required tuberculosis (TB) testing.

WAC 388-112A-1240

The department is planning to amend WAC 388-112A-1240 and add a new section in chapter 388-112A WAC, Residential Long-Term Care Services Training. The department may amend other related rules as required.  

WAC 388-106-0275

The department is planning to amend WAC 388-106-0275, Are there limits to the community transition services I may receive? and other related rules as may be required.

WAC 388-97-0001, 1090

The department is considering amending WAC 388-97-0001, Definitions; WAC 388-97-1090, Direct Care Hours; and other related rules as may be required to implement EHB 1564 (Chapter 301, Laws of 2019).

WAC 388-106-0250

The department is planning to amend WAC 388-106-0250, What is the roads to community living (RCL) demonstration project and who is eligible?, and other related rules as may be required.

Julie Cope
(360) 725-2529

Chapter 388-106 WAC

The department is planning to add a new section in chapter 388-106 WAC for Long-Term Services and Supports (LTSS) Presumptive Eligibility, and may amend other related rules as may be required. 

WAC 388-71-0975

The department is planning to amend WAC 388-71-0975, Who is required to obtain certification as a home care aide, and when?, and other related rules as may be required.

WAC 388-101-3130

The department is considering amending WAC 388-101-3130, Certification evaluation, and other related rules as may be required to identify the period of time that portions of the rule was held in suspension during the declared emergency of COVID-19.

WAC 388-106-0050

In light of the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services waived rules requiring in-person assessments. In addition, that change clarified instances in which the in-person interviews are not required. Therefore, the department is planning to amend WAC 388-106-0050, What is an assessment? and other related rules as may be required.

WAC 388-101-3020

The department is considering amending WAC 388-101-3020, Compliance, and other related rules as may be required.

WAC 388-97-1740, 1760, 2400

The department is considering amending WAC 388-97-1740 – Disaster and emergency preparedness, WAC 388-97-1760 – Quality assessment and assurance, WAC 388-97-2400 – Resident rooms, and other related rules as may be required to identify the period of time that portions of the rules were suspended during the declared emergency of COVID-19 per Proclamation by the Governor 20-05.

WAC 388-106-0010

The department is planning to amend WAC 388-106-0010 and other related rules as may be required. 

WAC 388-78A-2360, 2371

The department is planning to amend WAC 388-78A-2360 Adult day services, WAC 388-78A-2371 Investigations, and other related rules as may be required.

WAC 388-97-0300

The department is considering amending WAC 388-97-0300, Notice of rights and services, and other related rules as may be required to identify the period of time that portions of the rule we held in suspension during the declared emergency of COVID-19 per Proclamation by the Governor 20-05.

Chapter 388-71 WAC

The department is planning to amend WAC 388-71-0100, What are the statutory references for WAC 388-71-0100 through 388-71-01281? through WAC 388-71-01281, To whom does the department report a final substantiated finding against a nursing assistant employed in a nursing facility or skilled nursing facility?, and other related rules as may be required.

WAC 388-97-1260

The department is considering amending WAC 388-97-1260, Physician services, and other related rules as may be required to identify the period of time that portions of the rule was held in suspension during the declared emergency of COVID-19 per Proclamation by the Governor 20-05.  

Chapter 388-78A WAC

The Department of Social and Health Services, Aging and Long-Term Support Administration, is considering amending WAC 388-78A-2524(1), WAC 388-78A-2525(1), and WAC 388-78A-2526(1) for certificate of training requirements required under WAC 388-78A-2521. The department may also amend other related rules as may be required to identify the period of time portions of these rules that were suspended or waived during the declared emergency of COVID-19.

Chapter 388-97 WAC

The Department of Social and Health Services, Aging and Long-Term Support Administration, is considering amending WAC 388-97-0120, Individual transfer and discharge rights and procedures; WAC 388-97-0920, Participation in resident and family groups; WAC 388-97-1000, Resident Assessment; WAC 388-97-1020, Comprehensive plan of care; WAC 388-97-1915, PASRR requirements prior to admission of new residents; WAC 388-97-1975, PASRR requirements after admission of a resident; and other related rules as may be required to identify the period of time portions of these rules were suspended or waived during the declared emergency of COVID-19 per Proclamation by the Governor 20-05 and extensions thereto.

Chapters 388-76, 78A, 101D, 107 WAC

The department is considering amending the following rules to identify the period of time Tuberculosis testing is suspended or waived during the declared emergency of COVID-19 per Proclamation by the Governor 20-05. The department may amend other related rules as may be required.

Chapter 388-112A WAC

The department is planning to add a new definition to WAC 388-112A-0010, add new sections in chapter 388-112A WAC, Residential Long-Term Care Services Training, and amend other related rules as may be required.

Chapter 388-76 WAC

The department is considering amending sections in chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements, including WAC 388-76-10695 Building codes – Structural requirements, WAC 388-76-10730 Grab bars and hand rails, and other related rules as may be required.

Chapter 388-107 WAC

The department is considering amending chapter 388-107 WAC and other related rules as may be required to implement Substitute House Bill 2448 (Chapter 278, Laws of 2020).

Chapter 388-76 WAC

The department is considering amending the following sections in chapter 388-76 WAC, Adult Family Home Minimum Licensing Requirements: WAC 388-76-10000 Definitions, WAC 388-76-10030 License capacity, WAC 388-76-10037 License requirements – Multiple adult family homes – Additional homes, WAC 388-76-10055 Application – Generally, WAC 388-76-10192 Liability insurance required – Commercial general liability insurance or business liability insurance coverage, WAC 388-76-10700 Building official – Inspection and approval, WAC 388-76-11050 Management agreements – General, WAC 388-76-11055 Management agreements – Adult family home, WAC 388-76-11060 Terms of the management agreement, WAC 388-76-11065 Management agreements – Department review, and WAC 388-76-11070 Management agreements – Resident funds. The department is also considering creating new rule sections related to applying for a capacity increase, and may amend other related rules as required.

WACs 388-97-0001 and 1090

The Department of Social and Health Services, Aging and Long-Term Support Administration, is considering amending WAC 388-97-0001, Definitions; WAC 388-97-1090, Direct Care Hours; and other related rules as may be required to implement EHB 1564 (Chapter 301, Laws of 2019).

Chapters 388-71, 106, 113, and 114 WAC

The department is planning to create a new chapter in Title 388 WAC and amend sections in chapters 388-71, 388-106, 388-113, and 388-114 WAC, and other related rules as may be required.

WAC 388-71-0115

The department is planning to amend WAC 388-71-0115 When is an investigation conducted?, and other related rules as may be required.

Will Reeves
(360) 485-3715

WAC 388-78A-2371

The department is planning to amend WAC 388-78A-2371, Investigations.

WAC 388-106-0715

The department is planning to amend WAC 388-106-0715, How do I end my enrollment in the PACE program? and other related rules as may be required.

Chapter 388-78A WAC

The department is planning to add new sections, repeal existing sections, and amend sections in chapter 388-78A WAC “Assisted Living Facility Licensing Rules” related to tuberculosis screening including WAC 388-78A-2480, WAC 388-78A-2481, WAC 388-78A-2482, WAC 388-78A-2483, WAC 388-78A-2484, WAC 388-78A-2485, WAC 388-78A-2486, WAC 388-78A-2487, WAC 388-78A-2488, WAC 388-78A-2489, and other related rules as may be required.

Chapter 388-76 WAC

The department is planning to add new sections, repeal existing sections, and amend sections in chapter 388-76 WAC “Adult Family Home Minimum Licensing Requirements” related to tuberculosis screening including WAC 388-76-10198, WAC 388-76-10265, WAC 388-76-10270, WAC 388-76-10275, WAC 388-76-10280, WAC 388-76-10285, WAC 388-76-10290, WAC 388-76-10295, WAC 388-76-10300, WAC 388-76-10305, and WAC 388-76-10310, and other related rules as may be required.

Chapter 388-107 WAC

The department is planning to add new sections, repeal existing sections, and amend sections in chapter 388-107 WAC ”Licensing Requirements for Enhanced Services Facilities” related to tuberculosis screening including  WAC 388-107-0440, WAC 388-107-0450, WAC 388-107-0460, WAC 388-107-0465, WAC 388-107-0470, WAC 388-107-0480, WAC 388-107-0490, WAC 388-107-0500, WAC 388-107-0510, WAC 388-107-0520, WAC 388-107-0530, WAC 388-107-0540, WAC 388-107-0542, and other related rules as may be required.

Chapter 388-97 WAC

The department is proposing to add new sections, repeal existing sections, and amend sections in chapter 388-97 WAC “Nursing Homes” related to tuberculosis screening including WAC 388-97-1360, WAC 388-97-1380, WAC 388-97-1400, WAC 388-97-1440, WAC 388-97-1460, WAC 388-97-1480, WAC 388-97-1500, WAC 388-97-1520, WAC 388-97-1540, WAC 388-97-1560, WAC 388-97-1580, WAC 388-97-1600, and other related rules as may be required.

Chapter 388-101 WAC

The department is planning to add a new section in chapter 388-101 WAC and amend other related rules as may be required for the collection of an annual certification fee for Certified Community Residential Services and Supports (CCRSS). 

Chapter 388-97 WAC

The department is planning to add new sections and amend existing sections in chapter 388-97 WAC “Nursing Homes”, including WAC 388-97-1090 “Direct care hours” and other related rules as may be required.

Chapter 388-106 WAC

The department is planning to amend WAC 388-106-0075 “How is my need for personal care services assessed in CARE?”, WAC 388-106-0090 “How does the CARE tool measure cognitive performance?”, WAC 388-106-0100 “How does the CARE tool measure mood and behaviors?”, WAC 388-106-0033 “When may I receive services in a facility contracted to provide specialized dementia care services?”, WAC 388-106-0130 “How does the department determine the number of hours I may receive for in-home care?”, WAC 388-106-0095 “How does the CARE tool measure clinical complexity?”, WAC 388-106-0010 “What definitions apply to this chapter?”, and other related rules as may be required to be consistent with changes, a majority of which are label changes, made to Comprehensive Assessment and Reporting Evaluation (CARE) tool as part of CARE Modernization.  

Chapter 388-78A WAC

The department is proposing to add new sections, repeal existing sections, and amend sections in chapter 388-78A WAC “Assisted Living Facility Licensing Rules” and other related rules that may be required.

WAC 388-96-808

The department is planning to amend WAC 388-96-808 “Change of ownership—Assignment of department's contract” and other related rules as may be required.  

WAC 388-106-0300

The department is planning to amend WAC 388-106-0300 “What services may I receive under community options program entry system (COPES) when I live in my own home?” and other related rules as may be required.  

WAC 388-97-1090

The department is planning to amend WAC 388-97-1090 “Direct care hours” and other related rules as may be required.   

Chapter 388-76 WAC

The department is considering adding a new section to chapter 388-76 WAC “Adult Family Home Minimum Licensing Requirements” to comply with federal Home and Community Based Services requirements. The department may also amend other related rules as may be required.

WACs 388-97-4425, 4430, and 4440

The department is planning to amend WAC 388-97-4425 “Notice—Service complete”, WAC 388-97-4430 “Notice—Proof of service”, WAC 388-97-4440 “Appeal rights”, and other related rules as may be required.

Chapter 388-76 WAC

The department is considering amending chapter 388-76 WAC “Adult Family Home Minimum Licensing Requirements” and other related rules as may be required.  The department may also develop new rule sections related to discharge and transfer notice and compliance with 42 CFR 441.302.

WACs 388-76-10000 and 10105

The department is planning to amend WAC 388-76-10000 “Definitions”, WAC 388-76-10105 “Application—Change of ownership”, and other related rules as may be required.