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Chapter 246-710 WAC

Last Update: 12/17/98

COORDINATED CHILDREN'S SERVICES

WAC Sections

HTMLPDF246-710-001Declaration of purpose.
HTMLPDF246-710-010Definitions.
HTMLPDF246-710-030Program limitations.
HTMLPDF246-710-050Authorization of services.
HTMLPDF246-710-060Qualifications of hospitals and providers.
HTMLPDF246-710-070Fees and payments.
HTMLPDF246-710-080Third-party resources.
HTMLPDF246-710-090Repayment.
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
246-710-020Program eligibility. [Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-020, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-030, filed 12/2/82.] Repealed by WSR 99-01-100, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.140.
246-710-040Funding ceilings on neuromuscular program and individual neuromuscular centers. [Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-040, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-050, filed 12/2/82.] Repealed by WSR 97-20-100, filed 9/29/97, effective 10/30/97. Statutory Authority: RCW 43.20.050.


PDF246-710-001

Declaration of purpose.

The following rules implement RCW 43.20.140 and chapter 43.70 RCW. The state board of health may develop rules that are necessary to implement RCW 43.20A.635 authorizing the secretary of the department of health to administer a program of services for children with special health care needs. The purpose of the CSHCN program is to develop, extend, and improve services and service systems for locating, diagnosing, and treating children with special health care needs within available resources.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-001, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-001, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-010, filed 12/2/82.]



PDF246-710-010

Definitions.

(1) "Client" means an individual with special health care needs, seventeen years of age or younger, who is being served by a local CSHCN agency.
(2) "Children with special health care needs" means children with disabilities or handicapping conditions; chronic illnesses or conditions; health related educational or behavioral problems; or children at risk of developing such disabilities, conditions, illnesses or problems.
(3) "CSHCN" means the children with special health care needs program.
(4) "Department" means department of health.
(5) "Local CSHCN agency" means the local health jurisdiction or other agency locally administering the CSHCN program for the county where the client resides in the state of Washington.
(6) "Service systems" means community-based systems of services such as primary and specialty medical services, early intervention, special education, and social and family support services for children with special health care needs and their families.
(7) "Services" means health-related interventions, including early identification, care coordination, medical, surgical and rehabilitation care, and equipment provided in hospitals, clinics, offices, and homes by local CSHCN agencies, physicians and other health care providers.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-010, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-020, filed 12/2/82.]



PDF246-710-030

Program limitations.

(1) The department may reduce the scope of CSHCN services and impose or revise funding limitations on certain services when required for budgetary reasons to accommodate available funding.
(2) Financial eligibility for a client must be determined annually when health-related services and equipment are paid for with CSHCN funds. Financial eligibility will be determined according to national standards of living for low-income families such as federal poverty levels or state median income adjusted for family size. Financial eligibility is not entitlement to CSHCN services.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-030, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-040, filed 12/2/82.]



PDF246-710-050

Authorization of services.

Authorization for services paid for with CSHCN funds will be accomplished in accordance with the following:
(1) Financial eligibility for a client has been determined.
(2) A request for services to be paid for with CSHCN funds has been reviewed for consistency with program directions. Services must be recognized as an acceptable form of treatment by a significant portion of the professional community.
(3) No services will be authorized for out-of-state providers if an equivalent service is available within the state of Washington. However, use of resources in bordering states will be authorized when appropriate.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-050, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-060, filed 12/2/82.]



PDF246-710-060

Qualifications of hospitals and providers.

Providers of services paid for with CSHCN funds must meet the following minimum qualifications.
(1) Hospitals will be:
(a) Accredited by the joint commission on the accreditation of health care organizations; and
(b) Licensed in the state where the hospital is located.
(2) Physicians will be:
(a) Licensed to practice medicine in Washington, or other state where they practice; and
(b) Board-certified or board-eligible by the appropriate specialty board.
(3) Providers other than physicians will be:
(a) Licensed or certified in Washington or in the state where they practice; or
(b) Accredited by the appropriate national professional organization when there is no state licensure or certification process.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-060, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-060, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-070, filed 12/2/82.]



PDF246-710-070

Fees and payments.

(1) Payments to providers of services using CSHCN funds will be made using the current CSHCN standards and payment schedules, including the Washington state department of social and health services medical assistance administration fee schedule and the CSHCN supplemental fee schedule.
(2) A provider will accept the fees paid under this section as full payment for services rendered.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-070, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-070, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-080, filed 12/2/82.]



PDF246-710-080

Third-party resources.

CSHCN is a secondary payer to all private and other public funded health programs. The department may pay for services with CSHCN funds only after payment by all entitlement programs and by all other private and public funding resources, except where prohibited by federal law.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-080, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-090, filed 12/2/82.]



PDF246-710-090

Repayment.

Repayment to the department from the provider, family or other source is required should insurance benefits, trusts, court-awarded damages or like funds become available, and where payments have been made to the family or provider for services paid for by CSHCN.
[Statutory Authority: RCW 43.20.140. WSR 99-01-100, § 246-710-090, filed 12/17/98, effective 1/17/99. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-710-090, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.20.140 and 43.20.050. WSR 83-01-002 (Order 247), § 248-105-100, filed 12/2/82.]