Aging & Long-Term Support Administration

Type: 
Recently Adopted Rules (CR-103P and CR-103E)

Rule Title/Subject

Contact Person

Washington State Register Citations

WAC 388-97-0300

The department is extending the amendment of the rule listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to allow nursing facilities to provide clinical records to residents and resident representatives in ten working days instead of two working days. Current state rules specify clinical records be accessible to residents and their representatives for review within 24 hours and copies must be provided within two working days. The amendment lengthens the time nursing homes have to provide the resident access to, or copies of the requested clinical record from two to ten days. The amendment does not permit the nursing facility to deny the resident access to records. The department filed a CR-101 Preproposal Statement of Inquiry on September 3, 2020 as WSR 20-19-009 to begin the permanent rulemaking process.

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-19-040
Effective Date: September 12, 2020

WAC 388-97-1260

The department is extending the amendment of the rules listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will continue to align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to allow physicians to delegate tasks to a physician assistant, nurse practitioner, or clinical nurse specialist. Current state rules specify physicians must perform some tasks. The amendment will permit delegation of those tasks as long as the task is within the scope of practice of the delegate, and the delegate works under the supervision of the physician. The department filed a CR-101 Preproposal Statement of Inquiry as WSR 20-17-133 on August 18, 2020 to begin the permanent rulemaking process.

Vicki Bouvier
(360) 725-2327
EMERGENCY ADOPTION
WSR 20-18-022
Effective Date: August 26, 2020

Chapter 388-78A WAC

The department is extending the amendment of the rules listed below to assure Assisted Living Facilities are not significantly impeded during the hiring process due to an administrator’s inability to obtain a certificate of completion of a recognized administrator training as referenced in WAC 388-78A-2521. This will help to increase the number of long-term care administrators necessary to provide essential services to some of Washington’s most vulnerable adults during the outbreak of COVID-19. The current rules require administrator training prior to assuming administrator duties or within six months of beginning duties for administrators meeting additional educational requirements. Currently, applicants for Assisted Living Facility administrator positions are unable to obtain the required training. Although the training will become available, it will not be enough to meet the backlog of administrators needing this training. The department filed a CR-101 Preproposal Statement of Inquiry as WSR 20-17-085 on August 13, 2020 to begin the permanent rulemaking process.

Vicki Bouvier
(360) 725-2327
EMERGENCY ADOPTION
WSR 20-18-001
Effective Date: August 20, 2020

Chapter 388-97 WAC

The department is extending the amendment of the rules listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will continue to align state nursing home rules with federal rules that are suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to remove the timelines for completing and transmitting resident assessments, and to delay the requirement by 30 days for a Preadmission Screening and Resident Review (PASRR) screening prior to admission to a nursing home. Federal rules also amended care-planning timelines, discharge and transfer notice requirements, and requirements that ensure residents can meet in groups. The rules identified below currently require a PASRR screen prior to admission, have timelines for completion of the comprehensive resident assessment and care plan, and have timelines for the transmission of the resident assessment. These rules also establish the right of residents to participate in resident groups and require specific notice and time requirements before a resident discharge or transfer can occur. The department filed a CR-101 Preproposal Statement of Inquiry as WSR 20-17-005 on August 5, 2020 to begin the permanent rulemaking process.

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-17-048
Effective Date: August 11, 2020

WAC 388-101-3130

The department is amending the rule listed below to assure Certified Community Residential Services and Supports (CCRSS) service providers are not significantly impeded from providing services and support to clients during the COVID-19 pandemic.  Governor Inslee’s proclamation 20-18 and subsequent extensions identified that the pandemic has resulted in disruptions to long-term care systems, including the ability to safely conduct inspections.  The governor’s proclamations included the suspension of licensing inspections for all long-term care settings with the exception of CCRSS settings.  Current rules state that the department may conduct an on-site certification evaluation for each service provider at any time, but at least once every two years. The amendment lengthens the amount of time to complete certification evaluations that are currently suspended for consistency and safety across all programs regulated by the department.  The amendment will allow the department additional time to complete certification evaluations when it is safe and practical to do so.

Antonietta Lettieri-Parkin
(509) 227-2474
EMERGENCY ADOPTION
WSR 20-17-012
Effective Date: August 6, 2020

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

The department is extending the emergency rules listed below to assure long-term care programs are not significantly impeded during the hiring process due to inability to access the tuberculosis (TB) testing required as a part of the hiring process. This will help to increase the number of long-term care workers necessary to provide essential services to some of Washington’s most vulnerable adults during the outbreak of COVID-19.  The situation continues that currently clinics providing TB testing are short of staff and have limited availability throughout the state. These clinics are unable to provide the TB testing required as a part of the hiring process in many long-term care programs. This circumstance is expected to exacerbate demand for long-term care workers when the pandemic has already significantly reduced the availability of long term care workers in the state. The department filed a CR-101 Preproposal Statement of Inquiry as WSR 20-16-069 on July 29, 2020 to begin the permanent rulemaking process.   

Vicki Bouvier
(360) 725-2327
EMERGENCY ADOPTION
WSR 20-16-102
Effective Date: July 31, 2020

Chapter 388-112A WAC

The department is amending and adding new sections to chapter 388-112A WAC, Residential Long-Term Care Services Training. The department filed a CR-102 Proposed Rulemaking as WSR 18-19-108 on September 19, 2019, a Supplemental CR-102 Proposed Rulemaking as WSR 19-11-062 on May 15, 2019, and a second Supplemental CR-102 Proposed Rulemaking as WSR 20-05-079 on February 18, 2020.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 20-14-088
Effective Date: July 31, 2020

WAC 388-97-1740, 1760, 2400

The department is amending WAC 388-97-1740, 1760, and 2400 to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic.

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-14-026
Effective Date: June 23, 2020

WAC 388-106-0715

The department is amending WAC 388-106-0715 to provide PACE clients, PACE organizations, and other stakeholders information about how clients can end their enrollment in the PACE program. This rule making will give guidance how to disenroll and the specific timelines. The amendment updates the WAC language to align with recent Centers for Medicare and Medicaid (CMS) changes to CFR 460.162 and CFR 460.164.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 20-13-027
Effective Date: July 10, 2020

WAC 388-97-0300

The department is amending the rules listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to allow nursing facilities to provide clinical records to residents and resident representatives in ten working days instead of two working days. Current state rules specify clinical records be accessible to residents and their representatives for review within 24 hours and copies must be provided within two working days. The amendment lengthens the time nursing homes have to provide the resident access to, or copies of, the requested clinical record from two to ten days. The amendment does not permit the nursing facility to deny the resident access to records.   

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-11-043
Effective Date: May 15, 2020

WAC 388-97-1260

The department is amending the rules listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to allow physicians to delegate tasks to a physician assistant, nurse practitioner, or clinical nurse specialist. Current state rules specify physicians must perform some tasks. The amendment will permit delegation of those tasks as long as the task is within the scope of practice of the delegate, and the delegate works under the supervision of the physician.

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-10-034
Effective Date: April 28, 2020

WAC 388-78A-2524, 2525, 2526

The department is temporarily amending portions of the rules listed below to assure Assisted Living Facilities are not significantly impeded during the hiring process due to an administrator’s inability to obtain a certificate of completion of a recognized administrator training as referenced in WAC 388-78A-2521. This will help to increase the number of long-term care administrators necessary to provide essential services to some of Washington’s most vulnerable adults during the outbreak of COVID-19. The current rules require administrator training prior to assuming administrator duties or within six months of beginning duties for administrators meeting additional educational requirements. Currently, applicants for Assisted Living Facility administrator positions are unable to obtain the required training because that training is no longer being provided due to the COVID-19 pandemic.  This circumstance is expected to exacerbate demand for long-term care administrators when the pandemic has already significantly reduced the availability of long-term care administrators in the state in recent weeks.

Vicki Bouvier
(360) 725-2327
EMERGENCY ADOPTION
WSR 20-10-005
Effective Date: April 23, 2020

WAC 388-78A-3181, 3183

The department is adopting rules to correct civil fine implementation dates adopted under WSR 19-18-031 and comply with RCW 18.20.190, Department response to noncompliance or violations.

Shana Privett
(360) 725-2382
PERMANENT ADOPTION
WSR 20-09-108
Effective Date: May 17, 2020

Chapter 388-97 WAC

The department is amending the rules listed below to assure nursing homes are not significantly impeded from admitting and caring for residents during the COVID-19 outbreak. These amendments will align state nursing home rules with federal rules that were suspended or amended to help facilitate care during the COVID-19 pandemic. The federal rules were amended to remove the timelines for completing and transmitting resident assessments, and to delay the requirement by 30 days for a Preadmission Screening and Resident Review (PASRR) screening prior to admission to a nursing home. Federal rules also amended care-planning timelines, discharge and transfer notice requirements, and requirements that ensure residents can meet in groups. The rules identified below currently require a PASRR screen prior to admission, have timelines for completion of the comprehensive resident assessment and care plan, and have timelines for the transmission of the resident assessment. These rules also establish the right of residents to participate in resident groups and require specific notice and time requirements before a resident discharge or transfer can occur.

Lisa Herke
(509) 225-2819
EMERGENCY ADOPTION
WSR 20-09-074
Effective Date: April 13, 2020

Chapter 388-76, 78A, 101D, and 107 WAC

The department is temporarily repealing or amending the rules listed below to assure long-term care programs are not significantly impeded during the hiring process due to inability to access the tuberculosis (TB) testing required as a part of the hiring process. This will help to increase the number of long-term care workers available to provide essential services to some of Washington’s most vulnerable adults during the outbreak of COVID-19.  Currently, clinics providing TB testing are short of staff and are only providing critical and emergent medical services. These clinics are unable to provide the TB testing required as a part of the hiring process in many long-term care programs. This circumstance is expected to exacerbate demand for long-term care workers when the pandemic has already significantly reduced the availability of long-term care workers in the state in recent weeks.

Vicki Bouvier
(360) 725-2327
EMERGENCY ADOPTION
WSR 20-09-009
Effective Date: April 2, 2020

WAC 388-96-107

To amend existing rules affecting specific programs as a result of the health crisis created by the corona virus. 

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 20-08-019
Effective Date: March 20, 2020

Chapter 388-76 WAC

These rule changes came from concerns raised by representatives of the adult family home industry regarding barriers to entry for certain provider and entity types, and are intended to address these issues and clarify other requirements for licensure that have been ambiguous. The anticipated effect is to reduce regulatory burdens for new qualified providers and to increase access to the adult family home industry and access to beds for residents. 

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 20-05-016
Effective Date: March 8, 2020

WAC 388-78A-2851

The department adopted WAC 388-78A-2851 under WSR 20-02-104. The department received a comment on the proposed text made during the open public comment period, and the department agrees with the commenter but failed to update WAC 388-78A-2851 to remove subsection (3)(c) which references 388-78A-2703. We are filing this CR 103 Correction with updated language to address that comment because leaving the reference to WAC 388-78A-2703 put unintended requirements in place for existing facilities.

Jeanette Childress
360-725-2591
PERMANENT ADOPTION
WSR 20-03-122
Effective Date: February 17, 2020

WAC 388-97-0140

The purpose of this amendment is to remove references to chapter 388-526 WAC from this rule. WAC 388-97-0140 (3) describes the appeal process for a nursing home resident or resident representative who wants to appeal a discharge or transfer decision made by the nursing home. Removing the references to chapter 388-526 WAC, which was repealed, will more clearly define the appeal process for the user. 

Lisa Herke
(509) 225-2819
PERMANENT ADOPTION
WSR 20-03-103
Effective Date: February 15, 2020

WAC 388-76-10401

The department is creating WAC 388-76-10401 to incorporate federal requirements for Home and Community Based Settings into the state licensing requirements for adult family homes. These regulations improve quality of life in adult family homes by giving residents greater opportunities to make decisions about their lives and care. The intent of these changes are to ensure that residents are able to receive care in a homelike setting and reduce dependence on isolating settings or institutions. By incorporating federal requirements into the state regulations, this will help adult family home providers to understand and meet their obligations.

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 20-03-097
Effective Date: February 14, 2020

Chapter 388-78A WAC

These rules needed updating to meet the national building code standards for licensed healthcare facilities of this type. With a moratorium on rule development, DSHS has not been able to keep the rules up to date in concert with the changes in building codes, energy efficiency standards, and the structural enhancements associated with this facility type across the nation. The regulatory amendments encompass the technological advances in building design, and the healthcare industry. This has a positive impact on the developers, architects, facility owners, and residents in new and currently licensed facilities to meet licensing requirements and building code requirements with updated safety standards.

Jeanette Childress
360-725-2591
PERMANENT ADOPTION
WSR 20-02-104
Effective Date: January 31, 2020

WAC 388-101-3120

SB 5359 (Chapter 458, Laws of 2019) was enacted during the 2019 legislative session. The bill authorizes the department to collect an annual certification fee from Certified Community Residential Services and Supports providers. The department is creating WAC 388-101-3120 to outline the collection and enforcement of the fees.

Antonietta Lettieri-Parkin
(509) 227-2474
PERMANENT ADOPTION
WSR 19-24-031
Effective Date: December 26, 2019

WAC 388-105-0005

The department is amending WAC 388-105-0005 in order to update the tables of rates in WAC 388-105-0005 to reflect rates consistent with Legislative appropriation and direction.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 19-22-003
Effective Date: October 26, 2019

WAC 388-105-0005

The department is repealing WAC 388-105-0005. Providers will still be able to find out their rates from the Aging and Long-Term Support Administration’s website, their residents’ case managers, from their union if they have one, or by contacting the department.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 19-21-175
Effective Date: November 23, 2019

WAC 388-97-4425, 4430, 4440

The department is amending WAC 388-97-4425, WAC 388-97-4430, and WAC 388-97-4440 to clarify that notices can be delivered and proof of service can be obtained electronically through the federal website, and to clarify the nursing home’s right to appeal WAC deficiency findings under the state appeal process, regardless of the delivery method of the deficiency report. 

Lisa Herke
(509) 225-2819
PERMANENT ADOPTION
WSR 19-21-006
Effective Date: November 3, 2019

WAC 388-78A-3181 and 3183

The department is creating two new sections, WAC 388-78A-3181 “Remedies—Specific—Civil Penalties” and WAC 388-78A-3183 “Remedies—Civil fine grid” to assure compliance with requirements of HB 2750 (Chapter 173, Laws of 2018) passed by the 2018 legislature. 

Teva Weissman
(360) 725-2327
PERMANENT ADOPTION
WSR 19-18-031
Effective Date: September 29, 2019

WAC 388-106-0300 and 0305

The department received approval from the Centers for Medicare and Medicaid (CMS) to add two new services to Community Options Program Entry Systems (COPES). The department is adding these services to the COPES WAC: 1) Community Choice Guiding (CCG), to assist an individual establish or stabilize a community living arrangement; and 2) Community Supports: Goods and Services which will provide necessary goods and services for individuals who choose to move from a residential living arrangement to an in-home setting. Also, the home health aide benefit was removed from the COPES waiver and is being removed from WAC.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 19-15-029
Effective Date: August 10, 2019

WAC 388-105-0005

The department is amending WAC 388-105-0005 in order to update the tables of rates in WAC 388-105-0005 to reflect rates consistent with Legislative appropriation and direction.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 19-14-070
Effective Date: July 1, 2019

WAC 388-78A-2460

The department is amending WAC 388-78A-2460 “Quality assurance committee” to assure compliance with requirements of RCW 18.20.390, which governs quality assurance committees in assisted living facilities.

 

Teva Weissman
(360) 725-2327
PERMANENT ADOPTION
WSR 19-14-031
Effective Date: July 26, 2019

WAC 388-106-1920

 The department is amending WAC 388-106-1920 “What is the maximum amount of step three services I may receive a month?” as a result of a rate change effective January 1, 2019.  This emergency is in effect until the permanent rule is effective May 5, 2019

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 19-10-048
Effective Date: May 1, 2019

WAC 388-106-1920 and 1933

The department is amending WAC 388-106-1920 to increase the step three benefit level for Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) participants. This benefit level is tied to the home care agency rate that typically increases every six months. The department recently received notice of the new rate for home care agencies effective January 1, 2019. The department is also amending WAC 388-106-1933 to describe modifications to the GetCare screening tool questions and risk level scores. A statewide Area Agencies on Aging and Home and Community Services Division workgroup made revisions to the tool and the related risk scores in order to track and trend outcomes for program recipients enrolled in this five year demonstration waiver.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 19-09-003
Effective Date: May 5, 2019

WAC 388-78A-2190

The department is amending WAC 388-78A-2190 “Activities of daily living” to assure compliance with SHB 1671 (Chapter 201, Laws of 2017), which requires the term “medication assistance” to be added to the “activities of daily living” which currently includes bathing, dressing, eating, personal hygiene, transferring, toileting, and ambulation and mobility.

Teva Weissman
(360) 725-2327
PERMANENT ADOPTION
WSR 19-07-033
Effective Date: April 13, 2019

WAC 388-71-0548

The department is adding this new overpayment section for individual providers to chapter 388-71 WAC to define the circumstances in which an individual provider is subject to an overpayment, clarify the department’s authority to collect an overpayment, clarify an individual provider’s right to an administrative hearing when they receive an overpayment notice, and provide information about how an individual provider requests an administrative hearing related to an overpayment.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 19-05-008
Effective Date: March 10, 2019

WAC 388-79A-005

The department intended to create two classes of clients with guardians: class (1) – those who had the most recent guardianship-related court order signed before June 1, 2018; and class (2) – those with the order signed on or after June 1, 2018. Language in WAC 388-79A-005 could be read to create a third class of clients with guardians, along with the intended two: those who had their guardianship established prior to June 1, 2018, but had the most recent guardianship-related order signed on or after June 1, 2018. Under this reading, inconsistent with the rest of chapters 388-79A WAC and 182-513 WAC, this third class of clients would have no enumerated limits on fees or costs under chapter 388-79A WAC, and therefore no deductions would be allowed under the WAC 388-79A-015, RCW 11.92.180, and RCW 43.20B.460. The department is clarifying that there is no third class, and that these clients fall under class (2), and therefore fee and costs deductions would be allowed under WAC 182-513-1530.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 19-04-100
Effective Date: March 8, 2019

WAC 388-106-1920

The department is amending chapter 388-106-1920 WAC “What is the maximum amount of step three services I may receive a month?” as a result of a rate change effective January 1, 2019.  

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 19-02-083
Effective Date: January 1, 2019

WACs 388-106-0045 and 0047

The department is amending WAC 388-106-0045 and 388-106-0047 in order to clarify that client services may be authorized prior to the client’s signature on the service summary and that services are not required to be terminated when the department is unable to obtain the client’s signature on the service summary. 

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-22-068
Effective Date: December 2, 2018

WAC 388-106-0905

The department is amending WAC 388-106-0905(3) to correct an eligibility error for Medical Care Services (MCS) that occurred during the implementation of the Community First Choice (CFC) program. At the time of the implementing CFC program, the department changed the eligibility for Medical Personal Care to exclude Nursing Facility Level of Care (NFLOC), which inadvertently changed eligibility for MCS.  

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-22-066
Effective Date: December 2, 2018

WAC 388-101-3170

The department is amending WAC 388-101-3170 “Group training home” in order to strike the requirement for a group training home to be licensed as an Adult Family Home. RCW 70.128.030 (3) specifically exempts facilities approved and certified under chapter 71A.22 RCW “Training Centers and Homes” from the operation of chapter 70.128 RCW “Adult Family Homes”.

Claudia Baetge
360-725-2589
PERMANENT ADOPTION
WSR 18-22-041
Effective Date: November 30, 2018

WAC 388-105-0005

The department is amending WAC 388-105-0005 in order to update the tables of rates in WAC 388-105-0005 to reflect rates consistent with Legislative appropriation and direction.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 18-22-026
Effective Date: October 27, 2018

WAC 388-106-0905

This department is amending WAC 388-106-0905(3) to correct an eligibility error for Medical Care Services (MCS) that occurred during the implementation of the Community First Choice program. At that time, the department changed the eligibility for Medicaid Personal Care to exclude Nursing Facility Level of Care (NFLOC), which inadvertently changed the eligibility for MCS. The emergency rule restores NFLOC eligibility for MCS. Without this rule change, vulnerable people with no other options for care may be harmed. This CR-103E supersedes the CR-103E filed on June 22, 2018 as WSR 18-14-009. The department filed a CR-102 on September 14, 2018 as WSR 18-19-050 and a public hearing will be held on October 23, 2018.  

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 18-21-124
Effective Date: October 21, 2018

WAC 388-105-0005

The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients who have been assessed using the CARE tool and reside at an AFH or assisted living facility contracted to provide assisted living, adult residential care, or enhanced adult residential care services” to update rates in the table for all settings to reflect new rates paid effective July 1, 2018, currently in place by emergency filed as WSR 18-14-060. 

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 18-21-001
Effective Date: November 3, 2018

Chapter 388-107 WAC

The department is amending sections in chapter 388-107 WAC to update the references to chapter 388-112 WAC contained throughout the chapter to the new chapter 388-112A WAC.  

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 18-20-040
Effective Date: October 26, 2018

Chapter 388-78A WAC

The department is amending sections in chapter 388-78A WAC to update the references to chapter 388-112 WAC contained throughout the chapter to the new chapter 388-112A WAC. Any references to chapter 388-112 WAC not addressed in this rule making that are contained in other sections of chapter 388-78A WAC currently open for rule making will be updated with the correct reference through those specific rule developments.

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 18-20-018
Effective Date: October 22, 2018

Chapter 388-76 WAC

The department is amending sections in chapter 388-76 WAC to update the references to chapter 388-112 WAC contained throughout the chapter to the new chapter 388-112A WAC. Any references to chapter 388-112 WAC not addressed in this rule making that are contained in other sections of chapter 388-76 WAC currently open for rule making will be updated with the correct reference through those specific rule developments.

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 18-20-015
Effective Date: October 22, 2018

WAC 388-106-1920

The department is amending WAC 388-106-1920 “What is the maximum amount of step three services I may receive a month?“. In WAC 388-106-1920(1)(a), the department incorrectly used three thousand three hundred and forty-five dollars instead of three thousand three hundred and forty-eight dollars (6 months x $558). The department filed a CR-105 Expedited Rule Making as WSR 18-14-003 on June 20, 2018.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-20-001
Effective Date: October 20, 2018

Chapter 388-71 WAC

The department is amending sections in chapter 388-71 WAC to define person-centered care. Updates include person-centered language, equal access to care and services, client choice in activities and staff, and maintaining dignity, respect, and privacy while attending adult day programs.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-18-006
Effective Date: September 23, 2018

WAC 388-78A-2020

The department is amending WAC 388-78A-2020 “Definitions” to remove an erroneous second occurrence of the definition of the term “Personal exploitation’ that contains a typographical error. 

Libby Wagner
(253) 234-6061
PERMANENT ADOPTION
WSR 18-18-004
Effective Date: September 23, 2018

WAC 388-106-0010

The department is amending WAC 388-106-0010 in order to clarify the definition of “informal support” to indicate that paid caregivers may not be the source of informal support unless they are household or family members of a client, to provide further detail on the determination of self-performance of Instrumental Activities of Daily Living, and to clarify how cognitive performance is determine using the Comprehensive Assessment Reporting Evaluation (CARE) tool.  

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-16-004
Effective Date: August 19, 2018

WAC 388-105-0005

The department is amending WAC 388-105-0005 in order to update the tables of rates in WAC 388-105-0005 to reflect rates consistent with Legislative appropriation and direction.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 18-14-060
Effective Date: July 1, 2018

WAC 388-106-0905

This department is amending WAC 388-106-0905(3) to correct an eligibility error for Medical Care Services (MCS) that occurred during the implementation of the Community First Choice program. At that time, the department changed the eligibility for Medicaid Personal Care to exclude Nursing Facility Level of Care (NFLOC), which inadvertently changed the eligibility for MCS. The emergency rule restores NFLOC eligibility for MCS. Without this rule change, vulnerable people with no other options for care may be harmed.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 18-14-009
Effective Date: June 22, 2018

WACs 388-106-0950, 0955

The department is creating new sections and amending existing sections in chapter 388-106 WAC in order to increase the maximum service limit to match the limit available under Community First Choice (CFC) Community Transition Services (CTS) and to expand the definition of the service to ensure continuity of services after the conclusion of the Washington Roads program when funding for the state-only funded program ends.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-12-100
Effective Date: July 6, 2018

WAC 388-97-1000

The department is amending WAC 388-97-1000 to extend the timeline for a Nursing Home to transmit required Resident Assessment Instrument (RAI) information for its residents from ten to fourteen days, in order to match federal regulations.

Teva Weissman
(360) 725-2327
PERMANENT ADOPTION
WSR 18-11-001
Effective Date: June 2, 2018

WACs 388-79A-001 and 005

The department, in coordination with the Health Care Authority, is updating and establishing rules in chapter 388-79A WAC. As part of this review, the department and agency will consider fees allowed for establishing and maintaining guardianships for individuals who must participate in the cost of their health care under chapter 182-513 WAC and chapter 182-515 WAC and will revise rules in chapter 388-79A WAC to clarify the process in place prior to the adoption of the permanent rule that will be in chapter 182-513 WAC.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-10-067
Effective Date: June 1, 2018

WACs 388-106-1045, 1046, and 1047

The department is amending WAC 388-106-1045 and creating WAC 388-106-1046 and WAC 388-106-1047 in order to clarify the definition for nurse services intervention, specifically Private Duty Nursing, to define the scope of services to be authorized and the necessity for documentation to support the required services in contracted Adult Family Homes.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-08-084
Effective Date: May 5, 2018

WAC 388-113-0020

The department is amending the list of disqualifying crimes found in WAC 388-113-0020 related to the passage of HB 1153 and HB 1163 in the 2017 legislative session. 

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-08-066
Effective Date: May 3, 2018

WAC 388-78A-2020

The department is amending WAC 388-78A-2020 “Definitions” in order to ensure compliance with requirements of SB 5600, which states the new definition of abuse to include financial exploitation of a vulnerable adult.  It also defines chemical, mechanical, and physical restraint. 

Jeanette Childress
360-725-2591
PERMANENT ADOPTION
WSR 18-08-065
Effective Date: May 3, 2018

Chapter 388-106 WAC

The department is creating new sections in chapter 388-106 WAC “Long-Term Care Services” for two new benefit packages for Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) as part of Washington’s Medicaid Transformation Demonstration.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-08-033
Effective Date: April 27, 2018

WAC 388-78A-2590, 2592, and 2594

The department is amending WAC 388-78A-2590, WAC 388-78A-2592, and WAC 388-78A-2594 in order to conform to current department practice related to management agreements.  For example, the amendments are removing language indicating that the department approves all management agreements.

Jeanette Childress
360-725-2591
PERMANENT ADOPTION
WSR 18-08-032
Effective Date: April 27, 2018

WAC 388-106-1720

The department is amending WAC 388-106-1720(3), “Am I eligible for supportive housing funded services?” to change the word “and” to “or”. This change is for housekeeping purposes only. The department filed a CR-105 on September 19, 2017 as WSR 17-19-087.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-08-002
Effective Date: April 21, 2018

WAC 388-76-10000

The department is amending WAC 388-76-10000 “Definitions” to strike the term “willful” from the definition list as a result of an order by the Division III Court of Appeals in Crosswhite v. DSHS invalidating the current definition of “willful”. The removal of the current term is necessary to comply with court’s order.

Claudia Baetge
360-725-2589
PERMANENT ADOPTION
WSR 18-07-068
Effective Date: April 16, 2018

WAC 388-101-3000

The department is amending WAC 388-101-3000 "Definitions" to strike the definition of the term "willful" from the definitions list as a result of an order by the Division Ill Court of Appeals in Crosswhite v. DSHS invalidating the current definition of "willful". The removal of the current term is necessary to comply with the court's order. The department is also amending the definition of "financial exploitation" to change an incorrect reference to RCW 74.34.020(6).

Claudia Baetge
360-725-2589
PERMANENT ADOPTION
WSR 18-07-061
Effective Date: April 15, 2018

WAC 388-105-0005

The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients who have been assessed using the CARE tool and reside at an AFH or assisted living facility contracted to provide AL, ARC, or EARC services” in order to update the comprehensive assessment reporting evaluation (CARE) table found in rule to reflect the current daily rates.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 18-03-097
Effective Date: February 17, 2018

Chapter 388-106 WAC

The department is creating new sections in chapter 388-106 WAC “Long-Term Care Services” for two new benefit packages for Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) as part of Washington’s Medicaid Transformation Demonstration.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 18-02-050
Effective Date: December 29, 2017

WAC 388-71-0105

The department is amending WAC 388-71-0105 “What definitions apply to adult protective services?” to strike the term “willful” from the definitions list as a result of an order by the Division III Court of Appeals in Crosswhite v DSHS invalidating the current definition of “willful.”  Striking the current WAC definition of “willful” is necessary because it is interpreted by the Crosswhite court as being in conflict with Washington State statute.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-02-044
Effective Date: January 26, 2018

WAC 388-106-0225

The department is amending WAC 388-106-0225 “How do I pay for Medicaid personal care?” as a result of the passage of Senate Bill 5118 to reflect an increase in the personal needs allowance effective July 1, 2017 and each fiscal year thereafter. This adjustment is subject to legislative funding.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 18-01-049
Effective Date: January 12, 2018

WAC 388-71-0105

The department is amending WAC 388-71-0105 to strike the term “willful” from the definitions list as a result of an order by the Division III Court of Appeals in Crosswhite v DSHS invalidating the current definition of “willful".”

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 17-24-086
Effective Date: December 6, 2017

WAC 388-105-0005

The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients who have been assessed using the CARE tool and reside at an AFH or assisted living facility contracted to provide AL, ARC, or EARC services”  in order to update the comprehensive assessment reporting evaluation (CARE) table found in rule to reflect the current daily rates. The department has filed proposed rules as WSR 17-21-074 and a public hearing will be held on November 21, 2017.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-23-169
Effective Date: November 22, 2017

Chapter 388-96 WAC

The department is amending chapter 388-96 WAC in order to implement the nursing facility methodology changes from SHB 1274 found in Chapter 2, Laws of 2015, 2015 2nd Special Session, and SHB 2678, Chapter 131, Laws of 2016, 2016 Regular Session. This permanent rule filing cancels and supersedes the emergency filed as WSR 17-22-012 on October 19, 2017.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 17-22-037
Effective Date: November 24, 2017

Chapter 388-112, 112A WAC

The department is repealing chapter 388-112 WAC and creating new sections in a new chapter 388-112A WAC “Residential Long-Term Care Services Training”. The new chapter 388-112A WAC provides requirements for long-term care worker training and home care aide certification, specialty training curriculum and instructor requirements, and a new category of training and certification requirements for long-term care workers in enhanced services facilities.  Chapter 388-112A WAC is organized to provide clarity in long-term care worker training, certification, curricula, and instructor requirements. New chapter organization chart available upon request to Suemary Trobaugh.

Suemary Trobaugh
(360) 725-2516
PERMANENT ADOPTION
WSR 17-22-036
Effective Date: November 24, 2017

Chapter 388-96 WAC

The department is amending these rules to implement the nursing facility methodology changes from SHB 1274, found in Chapter 2, Laws of 2015, 2015 2nd Special Session.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-22-012
Effective Date: October 20, 2017

Chapter 388-71 WAC

The department is creating WAC 388-71-0701 and WAC 388-71-0723 and amending WAC 388-71-0702, WAC 388-71-0718, and WAC 388-71-0722 to define the terms used throughout the chapter, update existing language as it pertains to the center’s responsibility in developing a negotiated care plan, and define clients rights in regards to restraints including physical restraints, chemical restraints, involuntary seclusion, and the use of medical devices.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 17-19-098
Effective Date: October 20, 2017

Chapter 388-106 WAC

The department is creating new sections in chapter 388-106 WAC “Long-Term Care Services” for two new benefit packages for Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) as part of Washington’s Medicaid Transformation Demonstration.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 17-18-044
Effective Date: August 30, 2017

WAC 388-71-0105

The department is amending WAC 388-71-0105 to strike the term “willful” from the definitions list as a result of an order by the Division III Court of Appeals in Crosswhite v DSHS invalidating the current definition of “willful".”

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 17-17-025
Effective Date: August 8, 2017

WAC 388-105-0005

The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients who have been assessed using the CARE tool and reside at an AFH or assisted living facility contracted to provide AL, ARC, or EARC services”  in order to update the comprehensive assessment reporting evaluation (CARE) table found in rule to reflect the current daily rates.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-16-065
Effective Date: July 25, 2017

Chapter 388-96 WAC

The department is amending these rules to implement the nursing facility methodology changes from SHB 1274, found in Chapter 2, Laws of 2015, 2015 2nd Special Session.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-14-016
Effective Date: June 24, 2017

Chapter 388-106 WAC

The department is creating new sections in chapter 388-106 WAC “Long-Term Care Services” in order to define the benefit package for Supportive Housing. The State has applied to Centers for Medicare and Medicaid (CMS) for an 1115 demonstration waiver that includes Supportive Housing as a service.  It is anticipated that this waiver will be implemented in 2017. In addition, the Governor issued a directive to utilize Supportive Housing services beginning in November 2016 to address the housing need for individuals leaving the state psychiatric hospitals.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 17-11-016
Effective Date: June 9, 2017

WAC 388-102-0100

The department is creating WAC 388-102-0100 “Online registration” contained in a new chapter 388-102 WAC “Online Registration of Continuing Care Retirement Communities” to establish consistent application and registration requirements for the continuing care retirement community online state registry.

Teri Smistad
(360) 725-2394
PERMANENT ADOPTION
WSR 17-10-044
Effective Date: May 29, 2017

Chapter 388-71, 106, 114 WAC

The department is adding two new sections to chapter 388-71 WAC “Home and Community Services and Programs”, amending one section in chapter 388-106 WAC “Long-Term Care Services”, and creating a new chapter as chapter 388-114 WAC “Travel Time and Work Week Limitations for Individual Providers”, as a result of the passage of E2SHB 1725.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 17-08-065
Effective Date: May 1, 2017

Chapter 388-96 WAC

The department is amending these rules to implement the nursing facility methodology changes from SHB 1274, found in Chapter 2, Laws of 2015, 2015 2nd Special Session.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-06-036
Effective Date: February 24, 2017

WAC 388-106-0270, 0274

The department is amending WAC 388-106-0270 “What services are available under community first choice (CFC)?” and WAC 388-106-0274 “Are there limits to the assistive technology I may receive?” to clarify language related to service descriptions and limits.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 17-03-127
Effective Date: February 18, 2017

Chapter 388-71, 106, 114 WAC

The department is adding two new sections to chapter 388-71 WAC “Home and Community Services and Programs”, amending one section in chapter 388-106 WAC “Long-Term Care Services”, and creating a new chapter as chapter 388-114 WAC “Travel Time and Work Week Limitations for Individual Providers”, as a result of the passage of E2SHB 1725.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 17-03-013
Effective Date: January 6, 2017

WAC 388-105-0005

The daily Medicaid payment rates are changing per collective bargaining and the FY17 state budget. The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services” to update the rate table included  in WAC 388-105-0005.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 17-02-029
Effective Date: January 28, 2017

WAC 388-105-0005

The daily Medicaid payment rates are changing per collective bargaining and the FY17 state budget. The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services” to update the rate table included  in WAC 388-105-0005.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 17-02-016
Effective Date: December 27, 2016

WAC 388-76-10135, 10660

The department is amending WAC 388-76-10135 “Qualifications – Caregiver” and WAC 388-76-10660 “Chemical restraints” as a result of comments received at the public hearing for WSR 16-14-037 on August 23, 2016. The amendment to WAC 388-76-10660 is needed to be consistent with statute.  The amendments to both sections improve clarity, are beneficial to regulated entities, and were intended to be included with the permanent rules filed as WSR 16-20-095.

Sherise Baltazar
(360) 725-3204
PERMANENT ADOPTION
WSR 17-01-002
Effective Date: January 7, 2017

WAC 388-97-0001, 1080, 1090

The department is creating WAC 388-97-1090 “Direct care hours” and amending WAC 388-97-0001 “Definitions” and WAC 388-97-1080 “Nursing services” to comply with, and be consistent with, Washington state statute and to implement the requirements of SSB 5600 (Definitions Concerning the Abuse of Vulnerable Adults), SHB 1274 (Implementing a Value-Based System for Nursing Home Rates), and SHB 2678 (Regulating Nursing Home Facilities).

Amy Abbott
(360) 725-2581
PERMANENT ADOPTION
WSR 16-23-094
Effective Date: December 17, 2016

Chapter 388-96 WAC

The department is amending these rules to implement the nursing facility methodology changes from SHB 1274, found in Chapter 2, Laws of 2015, 2015 2nd Special Session.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 16-22-040
Effective Date: October 27, 2016

Chapter 388-76 WAC

Senate Bill (SB) 5600 from the 2015 Legislative Session requires that certain definitions concerning vulnerable adults must be amended, including the definitions of abuse and sexual abuse. The department is amending sections of chapter 388-76 WAC to assure compliance with this requirement. Since the implementation of Executive Order 10-06 in 2010 suspending non-critical rule development and adoption, the department has communicated clarifying information and changes to stakeholders through Dear Provider Letters whenever the change or changes did not meet the moratorium criteria for rule change.  However, with the recent revision of the criteria for rule change, the department is incorporating the aforementioned information into rule. 
Other sections of the rule are either being amended to clarify the rule or revise the language in the rule to better align with the intent of statute. Additionally, revisions to this rule associated with the physical environment of the adult family home are being made for the health and safety of the residents residing in the home, such as ensuring adequate grab bars when showering or toileting, and stable barriers around fireplaces or woodstoves to prevent incidental contact.  Lastly, the department is repealing sections in this rule to condense the emergency evacuation sections in chapter 388-76 WAC.

Sherise Baltazar
(360) 725-3204
PERMANENT ADOPTION
WSR 16-20-095
Effective Date: November 4, 2016

WAC 388-105-0045, 388-106-0336, 0337, 0338

The department is amending WAC 388-105-0045, WAC 388-106-0336, and WAC 388-106-0338, and creating a new section WAC 388-106-0337 as a result of the 2013-2015 biennium budget to develop Enhanced Services Facilities. The DSHS Home and Community Services Division developed the 1915(c) Residential Support Waiver (RSW) to provide Medicaid funding for supports and services in certain residential settings. These rules are amended to add retainer payments to the RSW and to add two new waiver services, Adult Day Health and Expanded Community Services.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 16-19-055
Effective Date: October 17, 2016

Chapter 388-101 WAC

The department is amending existing sections, repealing sections, and creating new sections in chapter 388-101 WAC “Certified Community Residential Services and Supports” to align them with new or changed legislation. HB1307 outlines enforcement changes regarding Certified Community Residential Services and Supports (CCRSS) providers. Initiative 1163 modifies the law governing background checks, training, and home care aide certification for long-term care, requiring changes in WAC 388-101-3000 “Definitions” and creation of two new sections, WAC 388-101-3259 “Long-term-care worker requirements” and WAC 388-101-3202 “Background checks-National fingerprint background checks”. SB 5600 modified certain definitions concerning vulnerable adults including the definitions of abuse and sexual abuse, and also amended RCW 74.34.020, which is reflected in WAC 388-101-3000 “Definitions”.

Penny Rarick
(360) 725-3210
PERMANENT ADOPTION
WSR 16-18-040
Effective Date: September 30, 2016

WAC 388-105-0005

Cancel & supersede the existing CR-103E filed as WSR 16-17-013 with this new CR-103E that corrects two rates that were incorrect. The daily Medicaid payment rates are changing per collective bargaining and the FY17 state budget. The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services” to update the rate table included  in WAC 388-105-0005.

Elizabeth Pashley
(360) 725-2447
EMERGENCY ADOPTION
WSR 16-18-038
Effective Date: August 30, 2016

Chapters 388-71, 106, 114 WAC

The department is adding two new sections to chapter 388-71 WAC “Home and Community Services and Programs”, amending one section in chapter 388-106 WAC “Long-Term Care Services”, and creating a new chapter as chapter 388-114 WAC “Travel Time and Work Week Limitations for Individual Providers”, as a result of the passage of E2SHB 1725.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 16-18-091
Effective Date: September 10, 2016

WAC 388-97-0001, 1080, 1090

The department is amending WAC 388-97-0001 “Definitions” related to the passage of SB 5600 in 2015.  The department is also amending WAC 388-97-1080 “Nursing services” and creating a new section, WAC 388-97-1090 “Direct Care Hours”, related to the passage of SHB 1274 in 2015 and SHB 2678 in 2016.

Amy Abbott
(360) 725-2581
EMERGENCY ADOPTION
WSR 16-17-107
Effective Date: August 24, 2016

WAC 388-105-0005

The daily Medicaid payment rates are changing per collective bargaining and the FY17 state budget. The department is amending WAC 388-105-0005 “The daily Medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services” to update the rate table included in WAC 388-105-0005.

Elizabeth Pashley
(360) 725-2447

EMERGENCY ADOPTION
WSR 16-17-013
Effective Date: September 5, 2016

**CANCELLED/SUPERCEDED BY WSR 16-18-038**

Chapter 388-107 WAC

The department is revising this rule in order to address Center for Medicare/Medicaid Services (CMS) Home and Community Based Services (HCBS) and stakeholder concerns with implementation of the requirements stated therein.

Penny Rarick
(360) 725-3210
PERMANENT ADOPTION
WSR 16-14-078
Effective Date: August 1, 2016

Chapter 388-96 WAC

The department is adopting these rules to implement the nursing facility methodology changes from SHB 1274.

  EMERGENCY ADOPTION
WSR 16-14-050
Effective Date: July 1, 2016

Chapter 388-71, 106, 114 WAC

The department is adding two new sections to chapter 388-71 WAC “Home and Community Services and Programs”, amending one section in chapter 388-106 WAC “Long-Term Care Services”, and creating a new chapter as chapter 388-114 WAC “Travel Time and Work Week Limitations for Individual Providers”, as a result of the passage of E2SHB 1725.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 16-11-050
Effective Date: May 13, 2016

Chapter 388-97 WAC

The department is amending WAC 388-97-0001 “Definitions” related to the passage of SB 5600 in 2015.  The department is also amending WAC 388-97-1080 “Nursing services” and creating a new section, WAC 388-97-1090 “Direct Care Hours”, related to the passage of SHB 1274 in 2015 and SHB 2678 in 2016.

Amy Abbott
(360) 725-2581
EMERGENCY ADOPTION
WSR 16-10-026
Effective Date: April 28, 2016

Chapter 388-71, 106, 114 WAC

The department is adding two new sections to chapter 388-71 WAC “Home and Community Services and Programs”, amending one section in chapter 388-106 WAC “Long-Term Care Services”, and creating a new chapter as chapter 388-114 WAC “Travel Time and Work Week Limitations for Individual Providers”, as a result of the passage of E2SHB 1725.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 16-10-016
Effective Date: April 22, 2016

Chapter 388-107 WAC

The Department is amending WAC 388-107-0001, 0020, 0080, 0100, 0110, 0120, 0130, 0140, 0150, 0160, 0180, 0190, 0200, 0210, 0240, 0280, 0370, 0390, 0400, 0410, 0420, 0430, 0560, 0770, 0810, 0830, 0890, 0940, 0960, 1000, and 1190 in order to address Center for Medicare/Medicaid Services (CMS) Home and Community Based Services (HCBS) and stakeholder concerns with implementation of the requirements stated therein.

Penny Rarick
(360) 725-3210
EMERGENCY ADOPTION
WSR 16-09-072
Effective Date: April 18, 2016

Chapter 388-107 WAC

Resident Client Protection Program (RCPP) has been moved into Adult Protective Services and the rules will be administered under chapter 388-71 WAC and chapter 388-106 WAC. References to the RCPP would thus be incorrect and are being repealed from chapter 388-107 WAC. Residential Care Services is coordinating to eliminate these WAC sections at the same time Home and Community Services is incorporating them into their WACs. The CR-103s for both divisions are being filed at the same time.

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-06-027
Effective Date: April 1, 2016

Chapter 388-111 WAC

Resident Client Protection Program (RCPP) has been moved into Adult Protective Services and the rules will be administered under chapter 388-71 WAC and chapter 388-106 WAC. References to the RCPP would thus be incorrect and are being repealed from chapter 388-111 WAC. Residential Care Services is coordinating to eliminate these WAC sections at the same time Home and Community Services is incorporating them into their WACs. The CR-103s for both divisions are being filed at the same time.

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-06-035
Effective Date: April 1, 2016

WAC 388-110-222, 242

The department is creating WAC 388-110-222 “Enhanced adult residential care physical requirements” and WAC 388-110-242 “Adult residential care physical requirements” to comply with federal legislation around Home and Community Based Service Waivers (42 CFR 441.302).

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-06-006
Effective Date: April 1, 2016

Chapter 388-76 WAC

Resident Client Protection Program (RCPP) has been moved into Adult Protective Services and the rules will be administered under chapter 388-71 WAC and chapter 388-106 WAC. References to the RCPP would thus be incorrect and will be repealed from chapter 388-76 WAC. Residential Care Services is coordinating to eliminate these WAC sections at the same time Home and Community Services is incorporating them into their WACs. Repealing the rules is beneficial to or supported by the regulated entities to prevent duplication of licensing rules. Also, the department is amending rules to comply with Center for Medicare and Medicaid Services (CMS) new requirements for Home and Community Based Services regulations (42 CFR 441.302). As a part of the state’s transition plan to comply with the new rules, CMS has requested WACs be changed to ensure resident rights are being addressed.

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-06-004
Effective Date: April 1, 2016

WAC 388-110-222, 242

The change to requiring lockable doors in assisted living facilities went into effect on July 1, 2015 when WAC 388-110-222 and WAC 388-110-242 went into effect by emergency rule filing WSR 15-14-082. Current emergency rules will expire on February 19, 2016. Since permanent rules will not be in effect by that date, the emergency rules need to be extended. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety and welfare for those residents so that they can remain in the facility and not have to move.

Christi Pederson
(360) 725-2327
EMERGENCY ADOPTION
WSR 16-05-046
Effective Date: February 19, 2016

WAC 388-105-0005

The Department is amending WAC 388-105-0005 "The daily Medicaid payment rates for clients assessed using the comprehensive assessment reporting evaluation (CARE) tool and that reside in adult family homes (AFH) and assisted living facilities contracted to provide assisted living (AL), adult residential care (ARC), and enhanced adult residential care (EARC) services" to comply with the current budget.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 16-05-028
Effective Date: March 11, 2016

Chapter 388-71 WAC

The department is adding new sections to chapter 388-71 WAC "Home and community services and programs" to transfer and amend the rules for Residential Client Protection Program found in chapter 388-76 WAC "Adult family home minimum licensing requirements", chapter 388-78A WAC "Assisted living facility licensing rules", chapter 388-97 WAC "Nursing homes", chapter 388-101 WAC "Certified community residential services and supports", and chapter 388-111 WAC "Residential habilitation centers—Compliance standards", to the Adult Protective Services Program.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 16-05-022
Effective Date: April 1, 2016

Chapter 388-76 WAC

The addition of a definition for psychopharmacologic medications, the addition of a new section describing the use of psychopharmacologic medications, and the language clarifying the use of physical restraints needed to go into effect July 1, 2015. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety and welfare for those residents so that they can remain in the facility and not have to move. The current emergency rules expire on February 19, 2016.

Christi Pederson
(360) 725-2327
EMERGENCY ADOPTION
WSR 16-05-020
Effective Date: February 19, 2016

Chapter 388-78A WAC

Resident Client Protection Program (RCPP) has been moved into Adult Protective Services and the rules will be administered under chapter 388-71 WAC and chapter 388-106 WAC. References to the RCPP would thus be incorrect and are being repealed from chapter 388-78A WAC. Residential Care Services has coordinated to eliminate these WAC sections at the same time Home and Community Services is incorporating them into their WACs.

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-04-029
Effective Date: April 1, 2016

Chapter 388-106 WAC

The purpose of the proposed WAC is to add the Community First Choice (CFC) program to the array of programs and services offered by the department. New WAC sections 388-106-0270 through 388-106-0295 define CFC services, including the scope, limitations, qualified providers, and eligibility. In addition, WAC 388-106-0047 clarifies the Department’s ability to terminate services if the plan of care is not approved in writing and WAC 388-106-0050 amends and clarifies the department’s assessment and home visit requirements.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 16-04-020
Effective Date: February 22, 2016

Chapter 388-97 WAC

The Department amended WAC 388-97-0001 "Definitions" and WAC 388-97-1080 "Nursing Services" to comply with and be consistent with newly passed state laws SB 5600 (Vulnerable Adults) and SHB 1274 (Nursing Home Staffing). The Department also added a section WAC 388-97-1090 "Direct Care Hours" to chapter 388-97 WAC due to SHB 1274.

Angel Sulivan
(360) 725-2495
EMERGENCY ADOPTION
WSR 16-02-043
Effective Date: January 1, 2016

Chapter 388-76 WAC

House Bill 1132 passed and allows RCS to waive the adult family home application fee under exceptional circumstances such as the death of a provider. These changes eliminate barriers that may keep a new provider from taking over the home so residents will not have to be moved. Other changes were made to ensure resident safety and protection of their rights. Residents must now be given a 14 day notice prior to their rates increasing when they have had a significant change in their condition and at least one primary door must be equipped with hardware that allows residents to exit and re-enter the home.

Christi Pederson
(360) 725-2327
PERMANENT ADOPTION
WSR 16-01-171
Effective Date: January 22, 2016

Chapter 388-107 WAC

The Department is amending WAC 388-107-0001, 0020, 0080, 0100, 0110, 0120, 0130, 0140, 0150, 0160, 0180, 0190, 0200, 0210, 0240, 0280, 0370, 0390, 0400, 0410, 0420, 0430, 0560, 0770, 0810, 0830, 0890, 0940, 0960, 1000, and 1190 in order to address Center for Medicare/Medicaid Services (CMS) Home and Community Based Services (HCBS) and stakeholder concerns with implementation of the requirements stated therein.

Christi Pederson
(360)725-2327
EMERGENCY ADOPTION
WSR 16-01-160
Effective Date: December 22, 2015

WAC 388-111-0001

The Department is amending WAC 388-111-0001 to ensure compliance with newly passed legislation, Chapter 268 Laws of 2015, modifying definitions concerning vulnerable adults.

Christi Pederson
(360)725-2327

PERMANENT ADOPTION
WSR 16-01-096
Effective Date: January 16, 2016

WAC 388-105-0005

The department is updating the rate table contained in WAC 388-105-0005 in accordance with the 2015-2017 operating budget.

Elizabeth Pashley
(360) 725-2447

EMERGENCY ADOPTION
WSR 15-23-050
Effective Date: November 12, 2015

Chapter 388-106 WAC

The department is amending and adding new sections to chapter 388-106 WAC to implement the new Community First Choice Option (CFCO) program effective July 1, 2015. In accordance with ESHB 2746, which mandated the department to refinance Medicaid personal care services under the community first choice option, the department is establishing and implementing a new 1915 (k) State Plan Program. The purpose of this WAC is to define the scope and eligibility for the new 1915 (k) services.

Angel Sulivan
(360) 725-2495

EMERGENCY ADOPTION
WSR 15-22-028
Effective Date: October 28, 2015

Chapter 388-76 WAC

The addition of a definition for psychopharmacologic medications, the addition of a new section describing the use of psychopharmacologic medications, and the language clarifying the use of physical restraints went into effect July 1, 2015 with an emergency rule filing which will expire on 10/27/2015. Since the permanent rules will not be in effect by that date, the emergency rules need to be extended. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety, and welfare for those residents so that they can remain in the facility and not have to move.

Christi Pederson
(360) 725-2327

EMERGENCY ADOPTION
WSR 15-22-006
Effective Date: October 27, 2015

WAC 388-110-222, 242

The change to requiring lockable doors in assisted living facilities went into effect on July 1, 2015 when WAC 388-110-222 and WAC 388-110-242 went into effect by emergency rule filing WSR 15-14-082. These emergency rules will expire on October 27, 2015. Since permanent rules will not be in effect by that date, the emergency rules need to be extended. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety and welfare for those residents so that they can remain in the facility and not have to move.

Angel Sulivan
(360) 725-2495

EMERGENCY ADOPTION
WSR 15-22-005
Effective Date: October 27, 2015

WAC 388-106-0010, 0130

The Department is amending WAC 388-106-0010 to clarify the definitions of eating and set-up help in response to recent Board of Appeals decisions, add new definitions related to Modified Adjusted Gross Income (MAGI) eligibility group and clarify existing definitions related to Long-Term Care Services, clarify the definition of informal support in response to decisions from the Health Care Authority Board of Appeals, and amend existing definitions to include Enhanced Services Facilities. The Department is also amending WAC 388-106-0130 in response to decisions from the Health Care Authority Board of Appeals.

Angel Sulivan
(360) 725-2495

PERMANENT ADOPTION
WSR 15-20-054
Effective Date: October 31, 2015

Chapter 388-97 WAC

The department is amending these rules to comply with and be consistent with federal law related to the Pre-Admission Screening and Resident Review (PASRR) process in accordance with 42 CFR §483.100-138. In addition, the department is adding new WAC sections, including WAC 388-97-1910, "Definitions related with PASRR", WAC 388-97-1915, "PASRR requirements prior to the admission of new residents", and WAC 388-97-1975, "PASRR requirements after admission of a resident".

Amy Abbott
(360) 725-2581

PERMANENT ADOPTION
WSR 15-18-026
Effective Date: September 25, 2015

Chapter 388-107 WAC

The department is amending chapter 388-107 WAC in order to address concerns of the Center for Medicare/Medicaid Services (CMS) Home and Community Based Services (HCBS) and stakeholders with operationalization of the requirements stated therein.

Penny Rarick
(360) 725-3210

EMERGENCY ADOPTION
WSR 15-18-053
Effective Date: August 28, 2015

WAC 388-105-0005

The department is updating the rate table contained in WAC 388-105-0005 in accordance with the 2015-2017 operating budget.

Elizabeth Pashley
(360) 725-2447

EMERGENCY ADOPTION
WSR 15-15-124
Effective Date: July 1, 2015

Chapter 388-106 WAC

The department is amending and adding new sections to chapter 388-106 WAC to implement the new Community First Choice Option (CFCO) program effective July 1, 2015. In accordance with ESHB 2746, which mandated the department to refinance Medicaid personal care services under the community first choice option, the department is establishing and implementing a new 1915 (k) State Plan Program. The purpose of this WAC is to define the scope and eligibility for the new 1915 (k) services.

Angel Sulivan
(360) 725-2495

EMERGENCY ADOPTION
WSR 15-14-085
Effective Date: July 1, 2015

Chapter 388-76 WAC

The addition of a definition for psychopharmacologic medications and the addition of a new section describing the use of psychopharmacologic medications, and the language clarifying the use of physical restraints needs to go into effect July 1, 2015. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety and welfare for those residents so that they can remain in the facility and not have to move.

Christi Pederson
(360)725-2327

EMERGENCY ADOPTION
WSR 15-14-083
Effective Date: July 1, 2015

WAC 388-110-222, 242

The change to requiring lockable doors needs to go into effect July 1, 2015 when WAC 388-110-222 and WAC 388-110-242 go into effect. This is the only way that Medicaid clients can stay in these facilities and receive payment through Community First Choice which the legislature directed the department to implement. It is necessary for the immediate, health, safety and welfare for those residents so that they can remain in the facility and not have to move.

Jeanette Childress

(360) 725-2591

EMERGENCY ADOPTION
WSR 15-14-082
Effective Date: July 1, 2015

Chapter 388-106 WAC

The purpose of the WAC changes in WAC 388-106-0300, WAC 388-106-0305, and WAC 388-106-0310 is to remove personal care, nurse delegation, personal emergency response systems (PERS), and community transition services under the COPES program in preparation for these services being offered in the new Community First Choice state plan program. This is in accordance with ESHB 2746, which mandated the department to refinance Medicaid personal care services under the community first choice option. The proposed WAC also adds a new COPES waiver service, the Wellness Education service. The purpose of the changes to WAC 388-106-0210 (2) is to clarify that when the Community First Choice program becomes available, individuals who are eligible for this program will not be eligible for the Medicaid personal care funded services. Financial eligibility rules are also clarified and corrected.

Angel Sulivan
(360) 725-2495

PERMANENT ADOPTION
WSR 15-11-049
Effective Date: July 1, 2015

Chapter 388-107 WAC

The department is amending chapter 388-107 WAC in order to address concerns of the Center for Medicare/Medicaid Services (CMS) Home and Community Based Services (HCBS) and stakeholders with operationalization of the requirements stated therein.

Doug Mora
(360) 725-2589

EMERGENCY ADOPTION
WSR 15-10-056
Effective Date: May 1, 2015

Chapter 388-96 WAC

WAC 388-96-381 will increase the time a facility has to return resident funds from one week to thirty days and will align with a similar WAC in chapter 388-97 WAC. WAC 388-96-738 and WAC 388-96-739 will update references in the WAC to minimum data set (MDS) 3.0 to reflect the currently used terminology and clarify the department’s position on who will be counted as a Medicaid resident. WAC 388-96-718 will update the language to allow for notifications to be sent via email in addition to USPS mail. WAC 388-96-585 will address unallowable expenses on the Nursing Facility cost reports used to determine the Nursing Facility Medicaid Rates. Currently, travel expenses outside of Idaho, Oregon, Washington, and British Columbia are generally not allowed. This would remove that restriction to allow travel expenses on the cost reports. WAC 388-96-809 will allow a security held pursuant to this section to be released to the contractor if the new contractor assumes all liability. Previously, it was not clear what the proper and allowed course was in these situations.

Elizabeth Pashley
(360) 725-2447
PERMANENT ADOPTION
WSR 15-09-025
Effective Date: May 8, 2015

Chapter 388-106 WAC

The department is amending and adding new sections to chapter 388-106 WAC, the Volunteer Chore program, as it was changed to Volunteer Services per Engrossed Substitute Senate Bill 6444 (Supplemental Operating Budget). The intent in the name change was to broaden the types of assistance available to eligible clients. Current rules limit services to a traditional list of core-type services. Without revised rules, volunteers supervised by contracted agencies managing the program are unable to provide support services in keeping with the intent of ESSB 6444.

Angel Sulivan
(360) 725-2495

PERMANENT ADOPTION
WSR 15-07-074
Effective Date: April 17, 2015

Chapter 388-106 WAC

The Department is amending chapter 388-106 WAC to update references to Health Care Authority WACs that have changed. Changing references to other WACs without changing the effect of the rule is appropriate for expedited rule making under RCW 34.05.353(1)(c). Reasons supporting proposal: Updating the rule will help clients locate the appropriate WAC references related to long term care services.

Angel Sulivan
(360) 725-2495

PERMANENT ADOPTION
WSR 15-03-038
Effective Date: February 12, 2015

Chapter 388-76 WAC

The department amended these rules to comply with and be consistent with recently passed state laws: Substitute House Bill 1629 Home Care Aides—Credentialing and Continuing Education, Engrossed House Bill 1677 Adult Family Homes—Multiple Facility Operators, Substitute House Bill 1686 K-12 Schools—High School Equivalency Certificates, Substitute Senate Bill 5077 Statutes—Gender-Neutral Terms, Senate Bill 5510 Vulnerable Adults—Abuse, and Substitute Senate Bill 5630 Vulnerable Adults—Adult Family Homes. In additional the department is amending rules to comply with Substitute House Bill 2056-Assisted Living Facilities, passed (Chapter 10, Laws of 2012) in the 2012 legislative session, which change the terminology of “boarding home” to assisted living facility. In addition, a new WAC section WAC 388-76-10532 was added on the standardized disclosure of services form.

Christi Pederson
(360)725-2327

PERMANANT ADOPTION
WSR 15-03-037
Effective Date: February 12, 2015

Chapter 388-71 WAC

The department is amending chapter 388-71 WAC, specifically Adult Day Services, in order to differentiate Adult Day Care from Adult Day Health by separating the rules, and to update the rule to meet the provider practice changes.

Angel Sulivan
(360) 725-2495

PERMANENT ADOPTION
WSR 15-01-174
Effective Date: January 23, 2015

Chapter 388-106 WAC

The department is amending chapter 388-106 WAC, Long-Term Care Services to add Enhanced Services Facilities. The purpose is to add ESF as a service provider under the Residential Support Waiver. The rules identify the scope of services and client eligibility, and make minor edits regarding this facility type.

Angel Sulivan
(360) 725-2495
PERMANENT ADOPTION
WSR 15-01-085
Effective Date: January 16, 2015
Chapter 388-818 WAC

The department is amending WAC 388-818-0010, 388-818-0020, and 388-818-0040, and is adding new sections to chapter
388-818 WAC to establish the standards for sign language and intermediary interpreters to be qualified to work in
Washington Courts

Berle Ross
(360) 725-2408
PERMANENT ADOPTION
WSR 15-01-075
Effective Date: January 12, 2015
Chapter 388-107 WAC

This rule change establishes a new residential support waiver for adult family homes to provide specific behavior support services under contract with the Department, as negotiated in collective bargaining.

Angel Sulivan

(360) 725-2495

PERMANENT ADOPTION
WSR 14-19-071
Effective Date: October 13, 2014

Chapter 388-106 WAC

This rule change establishes a new residential support waiver for adult family homes to provide specific behavior support services under contract with the Department, as negotiated in collective bargaining.

Angel Sulivan

(360) 725-2495

PERMANENT ADOPTION
WSR 14-15-092
Effective Date: August 17, 2014

WAC 388-106-0745 thru 0765

The department is repealing WAC 388-106-0745 through 0765, specifically the Washington Medicaid Integration Partnership (WMIP) section, as this Snohomish County program ended on June 30, 2014.

Angel Sulivan

(360) 725-2495

PERMANENT ADOPTION
WSR 14-15-091
Effective Date: August 17, 2014

WAC 388-106-0033

This rule making corrects an error made under WSR 14-02-094 in which there is a reference to WAC 388-110-020. The correct WAC is 388-110-220.

Angel Sulivan

(360) 725-2495

PERMANENT ADOPTION
WSR 14-15-071
Effective Date: August 15, 2014