Chapter 388-845 WAC

Last Update: 5/15/19

DDA HOME AND COMMUNITY BASED SERVICES WAIVERS

WAC Sections

388-845-0001Definitions.
388-845-0005What are home and community based services (HCBS) waivers?
388-845-0010What is the purpose of HCBS waivers?
388-845-0015What HCBS waivers are provided by the developmental disabilities administration (DDA)?
388-845-0020When were the HCBS waivers effective?
388-845-0030Do I meet criteria for HCBS waiver-funded services?
388-845-0031Can I be enrolled in more than one HCBS waiver?
388-845-0035Am I guaranteed placement on a waiver if I meet waiver criteria?
388-845-0040Is there a limit to the number of people who can be enrolled in each HCBS waiver?
388-845-0041What is DDA's responsibility to provide your services under the DDA HCBS waivers administered by DDA?
388-845-0045When there is capacity to add people to a waiver, how does DDA determine who will be enrolled?
388-845-0050How do I request to be enrolled in a waiver?
388-845-0051How will I be notified of the decision by DDA to enroll me in a waiver?
388-845-0052What is the process if I am already on a DDA HCBS waiver and request enrollment onto a different DDA HCBS waiver?
388-845-0055How do I remain eligible for the waiver?
388-845-0060Can your waiver enrollment be terminated?
388-845-0065What happens if I am terminated or choose to disenroll from a waiver?
388-845-0070What determines if I need ICF/ID level of care?
388-845-0100What determines which waiver I am assigned to?
388-845-0105What criteria determine assignment to the community protection waiver?
388-845-0110What are the limits to the waiver services you may receive?
388-845-0111Are there limitations regarding who can provide services?
388-845-0115Does your waiver eligibility limit your access to DDA nonwaiver services?
388-845-0120Will I continue to receive state supplementary payments (SSP) if I am on the waiver?
388-845-0200What waiver services are available to you?
388-845-0210What services are available under the basic plus waiver?
388-845-0215What services are available under the core waiver?
388-845-0220What services are available under the community protection waiver?
388-845-0225What services are available under the children's intensive in-home behavioral support (CIIBS) waiver?
388-845-0230What services are available under the individual and family services (IFS) waiver?
WAIVER SERVICES DEFINITIONS
388-845-0300What are adult family home (AFH) services?
388-845-0305Who is a qualified provider of AFH services?
388-845-0310Are there limits to the AFH services I can receive?
388-845-0400What are adult residential care (ARC) services?
388-845-0405Who is a qualified provider of ARC services?
388-845-0410Are there limits to the ARC services I can receive?
388-845-0415What is assistive technology?
388-845-0420Who may be a qualified provider of assistive technology?
388-845-0425Are there limits to the assistive technology you may receive?
388-845-0500What is positive behavior support and consultation?
388-845-0501What is included in positive behavior support and consultation for the children's intensive in-home behavioral support (CIIBS) waiver?
388-845-0505Who is a qualified provider of positive behavior support and consultation?
388-845-0506Who is a qualified provider of positive behavior support and consultation for the children's intensive in-home behavioral support (CIIBS) waiver?
388-845-0510Are there limits to the positive behavior support and consultation you may receive?
388-845-0515What is chemical extermination of bedbugs?
388-845-0520Who are qualified providers of chemical extermination of bedbugs?
388-845-0525Are there limits to the chemical extermination of bedbugs services I may receive?
388-845-0600What are community access services?
388-845-0603Who is eligible to receive community inclusion services?
388-845-0605Who are qualified providers of community access services?
388-845-0610Are there limits to community access services you may receive?
388-845-0650What are community engagement services?
388-845-0655Who are qualified providers of community engagement services?
388-845-0660Are there limits to the community engagement services you may receive?
388-845-0700What are community guide services?
388-845-0705Who may be a qualified provider of community guide services?
388-845-0710Are there limits to the community guide services I may receive?
388-845-0750What are community transition services?
388-845-0755Who are qualified providers of community transition services?
388-845-0760Are there limits to community transition services I can receive?
388-845-0800What is emergency assistance?
388-845-0805Who is a qualified provider of emergency assistance?
388-845-0810How do I qualify for emergency assistance?
388-845-0820Are there limits to your use of emergency assistance?
388-845-0900What are environmental adaptations?
388-845-0905Who is a qualified provider for environmental adaptations?
388-845-0910What limits apply to environmental adaptations?
388-845-1030What are individualized technical assistance services?
388-845-1035Who are qualified providers of individualized technical assistance services?
388-845-1040Are there limits to the individualized technical assistance services you may receive?
388-845-1100What are behavioral health crisis diversion bed services?
388-845-1105Who is a qualified provider of behavioral health crisis diversion bed services?
388-845-1110What are the limits of behavioral health crisis diversion bed services?
388-845-1150What are behavioral health stabilization services?
388-845-1155Who are qualified providers of behavioral health stabilization services?
388-845-1160Are there limitations to the behavioral health stabilization services that you can receive?
388-845-1170What is nurse delegation?
388-845-1175Who is a qualified provider of nurse delegation?
388-845-1180Are there limitations to the nurse delegation services that you receive?
388-845-1181What is occupational therapy?
388-845-1182Who may be a qualified provider of occupational therapy?
388-845-1183Are there limits to occupational therapy?
388-845-1190What is peer mentoring?
388-845-1191Who are qualified providers of peer mentoring?
388-845-1192What limitations are there for peer mentoring?
388-845-1195What is person-centered plan facilitation?
388-845-1196Who are qualified providers of person-centered plan facilitation?
388-845-1197What limitations are there for person-centered plan facilitation?
388-845-1300What are personal care services?
388-845-1305Who are the qualified providers of personal care services?
388-845-1310Are there limits to the personal care services you can receive?
388-845-1315What is physical therapy?
388-845-1316Who may be a qualified provider of physical therapy?
388-845-1317Are there limits to physical therapy?
388-845-1400What are prevocational services?
388-845-1405Who are the qualified providers of prevocational services?
388-845-1410Are there limits to the prevocational services you may receive?
388-845-1500What are residential habilitation services?
388-845-1505Who are qualified providers of residential habilitation services for the core waiver?
388-845-1510Who are qualified providers of residential habilitation services for the community protection waiver?
388-845-1515Are there limits to the residential habilitation services I may receive?
388-845-1600What is respite care?
388-845-1605Who is eligible to receive respite care?
388-845-1607Can someone who lives with you be your respite provider?
388-845-1610Where may respite care be provided?
388-845-1615Who may be qualified providers of respite care?
388-845-1620Are there limits to the respite care you may receive?
388-845-1650What is a risk assessment?
388-845-1655Who is a qualified provider of a risk assessment?
388-845-1660Are there limits to the risk assessment you may receive?
388-845-1700What is waiver skilled nursing?
388-845-1705Who is a qualified provider of skilled nursing services?
388-845-1710Are there limits to the skilled nursing services you may receive?
388-845-1800What are specialized medical equipment and supplies?
388-845-1805Who are the qualified providers of specialized medical equipment and supplies?
388-845-1810Are there limits to the specialized medical equipment and supplies you may receive?
388-845-1855What is specialized clothing?
388-845-1860Who are qualified providers of specialized clothing?
388-845-1865Are there limits to your receipt of specialized clothing?
388-845-1900What are specialized psychiatric services?
388-845-1905Who are qualified providers of specialized psychiatric services?
388-845-1910Are there limitations to the specialized psychiatric services you can receive?
388-845-1915What are speech, hearing, and language services?
388-845-1916Who may be a qualified provider of speech, hearing, and language services?
388-845-1917Are there limits to the speech, hearing, and language services you may receive?
388-845-2000What is staff and family consultation and training?
388-845-2005Who is a qualified provider of staff/family consultation and training?
388-845-2010Are there limits to the staff and family consultation and training you may receive?
388-845-2100What are supported employment services?
388-845-2105Who are qualified providers of supported employment services?
388-845-2110Are there limits to the supported employment services you may receive?
388-845-2130What are supported parenting services?
388-845-2135Who are qualified providers of supported parenting services?
388-845-2140Are there any limitations on your receipt of supported parenting services?
388-845-2160What is therapeutic equipment and supplies?
388-845-2165Who are qualified providers of therapeutic equipment and supplies?
388-845-2170Are there limits to your receipt of therapeutic equipment and supplies?
388-845-2200What are transportation services?
388-845-2205Who is qualified to provide transportation services?
388-845-2210Are there limitations to the transportation services you can receive?
388-845-2260What are vehicle modifications?
388-845-2265Who are providers of vehicle modifications?
388-845-2270Are there limitations to your receipt of vehicle modification services?
WELLNESS EDUCATION
388-845-2280What is wellness education?
388-845-2283How are my wellness educational materials selected?
388-845-2285Are there limits to wellness education?
388-845-2290Who are qualified providers of wellness education?
ASSESSMENT AND INDIVIDUAL SUPPORT PLAN
388-845-3000What is the process for determining the services you need?
388-845-3015How is the waiver respite assessment administered?
388-845-3020Who can be the respondent for the waiver respite assessment?
388-845-3055What is a waiver person-centered service plan/individual support plan (ISP)?
388-845-3056What if you need assistance to understand your person-centered service plan/individual support plan?
388-845-3060When is your person-centered service plan/individual support plan effective?
388-845-3061Can a change in your person-centered service plan/individual support plan be effective before you sign it?
388-845-3062Who is required to sign the person-centered service plan/individual support plan?
388-845-3063Can your person-centered service plan/individual support plan be effective before the end of the month?
388-845-3065How long is your plan effective?
388-845-3070What happens if you do not sign your person-centered service plan?
388-845-3075What if your needs change?
388-845-3080What if my needs exceed the maximum yearly funding limit or the scope of services under the basic plus waiver?
388-845-3085What if your needs exceed what can be provided under the IFS, CIIBS, core, or community protection waiver?
388-845-3090What if my identified health and welfare needs are less than what is provided in my current waiver?
388-845-3095Will I have to pay toward the cost of waiver services?
388-845-4000What are my appeal rights under the waiver?
388-845-4005Can I appeal a denial of my request to be enrolled in a waiver?
388-845-4010How do I appeal a department action?
388-845-4015Will my services continue during an appeal?
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
388-845-0025Does this change in waivers affect the waiver services I am currently receiving? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0025, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0075How is a child age twelve or younger assessed for ICF/MR level of care? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0075, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0080What score indicates ICF/MR level of care if I am age twelve or younger? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0080, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0085If I am age twelve or younger, what if my score on the current needs assessment does not indicate ICF/MR level of care? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0085, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0090How is a person age thirteen or older assessed for ICF/MR level of care? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0090, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0095What score indicates ICF/MR level of care if I am age thirteen or older? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0095, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0096If I am age thirteen or older, what if my score on the current needs assessment does not indicate the need for ICF/MR level of care? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0096, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-0205Basic waiver services. [Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0205, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-0205, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120. WSR 07-05-014, § 388-845-0205, filed 2/9/07, effective 3/12/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0205, filed 12/13/05, effective 1/13/06.] Repealed by WSR 13-24-045, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030 and 2012 c 49.
388-845-1000What are extended state plan services? [Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1000, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1000, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1000, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1010Who is a qualified provider of extended state plan services? [Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1010, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1010, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1015Are there limits to the extended state plan services you can receive? [Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1015, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1015, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1015, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1015, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1200What are "person-to-person" services? [Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1200, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1200, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1200, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1205Who are qualified providers of person-to-person services? [Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1205, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1205, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1210Are there limits to the person-to-person service I can receive? [Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-1210, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1210, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1210, filed 12/13/05, effective 1/13/06.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1606Can DDD approve an exception to the requirements in WAC 388-845-1605? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1606, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-1840What is specialized nutrition? [Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1840, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1840, filed 11/1/10, effective 12/2/10.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1845Who are qualified providers of specialized nutrition? [Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1845, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1845, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1845, filed 11/1/10, effective 12/2/10.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-1850Are there limitations to your receipt of specialized nutrition? [Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1850, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1850, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-1850, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1850, filed 11/1/10, effective 12/2/10.] Repealed by WSR 18-14-001, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G.
388-845-3005What is the waiver respite assessment? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3005, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3010Who must have a waiver respite assessment? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3010, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3025How often is this waiver respite assessment completed? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3025, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3030What items are assessed to determine my respite allocation? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3030, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3035How is the waiver respite assessment scored? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3035, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3040When will the new respite assessment go into effect? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3040, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3045How will I know the results of my respite assessment? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3045, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.
388-845-3050What is the effective date of my respite allocation? [Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3050, filed 12/13/05, effective 1/13/06.] Repealed by WSR 07-20-050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW.


388-845-0001
Definitions.

"Aggregate services" means a combination of services subject to the dollar limits in the basic plus waiver.
"Allocation" means the amount of individual and family services (IFS) waiver funding available to a client for a maximum of twelve months.
"CARE" means comprehensive assessment and reporting evaluation.
"Client" means a person who has a developmental disability under RCW 71A.10.020(5) and has been determined eligible to receive services from the administration under chapter 71A.16 RCW.
"Community crisis stabilization services" or "CCSS" means a state-operated program that provides short-term supports to clients who are in crisis, or who are at risk of hospitalization or institutional placement.
"DDA" means the developmental disabilities administration, of the department of social and health services.
"DDA assessment" refers to the standardized assessment tool under chapter 388-828 WAC, used by DDA to measure the support needs of people with developmental disabilities.
"Department" means the department of social and health services (DSHS).
"Evidence-based treatment" means the use of physical, mental, and behavioral health interventions for which systematic, empirical research has provided evidence of statistically significant effectiveness as treatments for specific conditions. Alternate terms with the same meaning are evidence-based practice (EBP) and empirically supported treatment (EST).
"Family" means one or more of the following relatives: Spouse or registered domestic partner; natural, adoptive or step parent; grandparent; child; stepchild; sibling; stepsibling; uncle; aunt; first cousin; niece; or nephew.
"Family home" means the residence where you and your family live.
"Gainful employment" means employment that reflects achievement of or progress towards a living wage.
"Home" means present or intended place of residence.
"ICF/IID" means an intermediate care facility for individuals with intellectual disabilities.
"Integrated business settings" means a setting that enables participants to either work alongside or interact with individuals who do not have disabilities, or both.
"Integrated settings" mean typical community settings not designed specifically for individuals with disabilities in which the majority of persons employed and participating are individuals without disabilities.
"Legal representative" means a parent of a person who is under eighteen years of age, a person's legal guardian, a person's limited guardian when the subject matter is within the scope of limited guardianship, a person's attorney at law, a person's attorney in fact, or any other person who is authorized by law to act for another person.
"Living wage" means the amount of earned wages needed to enable an individual to meet or exceed his or her living expenses.
"Necessary supplemental accommodation representative" means an individual who receives copies of DDA planned action notices (PANs) and other department correspondence in order to help a client understand the documents and exercise the client's rights. A necessary supplemental accommodation representative is identified by a client of DDA when the client does not have a legal guardian and the client is requesting or receiving DDA services.
"Participant" means a client who is enrolled in a home and community based services waiver program.
"Person-centered service plan" is a document that identifies your goals and assessed health and welfare needs. Your person-centered service plan also indicates the paid services and natural supports that will assist you to achieve your goals and address your assessed needs.
"Primary caregiver" means the person who provides the majority of your care and supervision.
"Provider" means an individual or agency who meets the provider qualifications and is contracted with DSHS to provide services to you.
"Respite assessment" means an algorithm within the DDA assessment that determines the number of hours of respite care you may receive per year if you are enrolled in the basic plus, children's intensive in-home behavioral support, or core waiver.
"SSI" means supplemental security income, an assistance program administered by the federal Social Security Administration for blind, disabled and aged individuals.
"SSP" means state supplementary payment program, a state-paid cash assistance program for certain clients of the developmental disabilities administration.
"State-funded services" means services that are funded entirely with state dollars.
"You" means the client or participant.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0001, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0001, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0001, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0001, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0001, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0001, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-0001, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0001, filed 12/13/05, effective 1/13/06.]



388-845-0005
What are home and community based services (HCBS) waivers?

(1) Home and community based services (HCBS) waivers are services approved by the Centers for Medicare and Medicaid Services (CMS) under section 1915(c) of the Social Security Act as an alternative to intermediate care facility for the individuals with intellectual disabilities (ICF/ID).
(2) Certain federal regulations are "waived" enabling the provision of services in the home and community to individuals who would otherwise require the services provided in an ICF/ID as defined in chapters 388-835 and 388-837 WAC.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0005, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0005, filed 12/13/05, effective 1/13/06.]



388-845-0010
What is the purpose of HCBS waivers?

The purpose of HCBS waivers is to provide services in the community to individuals with ICF/ID level of need to prevent their placement in an ICF/ID.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0010, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0010, filed 12/13/05, effective 1/13/06.]



388-845-0015
What HCBS waivers are provided by the developmental disabilities administration (DDA)?

DDA provides services through five HCBS waivers:
(1) Basic plus waiver;
(2) Core waiver;
(3) Community protection (CP) waiver;
(4) Children's intensive in-home behavioral support waiver (CIIBS); and
(5) Individual and family services (IFS) waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0015, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0015, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0015, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0015, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0015, filed 12/13/05, effective 1/13/06.]



388-845-0020
When were the HCBS waivers effective?

Basic plus, children's intensive in-home behavioral support, core and community protection waivers were effective September 1, 2012. Individual and family services waiver was effective June 1, 2015.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0020, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0020, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0020, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0020, filed 12/13/05, effective 1/13/06.]



388-845-0030
Do I meet criteria for HCBS waiver-funded services?

(1) You meet criteria for DDA HCBS waiver-funded services if you meet all of the following:
(a) You have been determined eligible for DDA services per RCW 71A.10.020.
(b) You have been determined to meet ICF/IID level of care per WAC 388-845-0070, 388-828-3060 and 388-828-3080.
(c) You meet disability criteria established in the Social Security Act.
(d) You meet financial eligibility requirements as defined in WAC 182-515-1510.
(e) You choose to receive services in the community rather than in an ICF/IID facility.
(f) You have a need for monthly waiver services or monthly monitoring as identified in your person-centered service plan/individual support plan.
(g) You are not residing in hospital, jail, prison, nursing facility, ICF/IID, or other institution.
(h) Additionally, for the children's intensive in-home behavioral support (CIIBS) waiver-funded services:
(i) You are age eight or older and under the age of eighteen for initial enrollment and under age twenty-one for continued enrollment;
(ii) You have been determined to meet CIIBS program eligibility per chapter 388-828 WAC prior to initial enrollment only;
(iii) You live with your family; and
(iv) Your parent/guardian(s) and primary caregiver(s), if other than parent/guardian(s), have signed the participation agreement.
(2) For individual and family services waiver funded services, you must meet the criteria in subsection (1) of this section and also:
(a) Live in your family home; and
(b) Are age three or older.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0030, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0030, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0030, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0030, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0030, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0030, filed 12/13/05, effective 1/13/06.]



388-845-0031
Can I be enrolled in more than one HCBS waiver?

You cannot be enrolled in more than one HCBS waiver at the same time.
[Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0031, filed 9/26/07, effective 10/27/07.]



388-845-0035
Am I guaranteed placement on a waiver if I meet waiver criteria?

(1) If you are not currently enrolled in a waiver, meeting criteria for the waiver does not guarantee access to or receipt of waiver services.
(2) If you are currently on a waiver and you have been determined to have health and welfare needs that can be met only by services available on a different waiver, you are not guaranteed enrollment in that different waiver.
(3) WAC 388-845-0041, 388-845-3080 and 388-845-3085 describe DDA's responsibilities to provide services.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0035, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0035, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0035, filed 12/13/05, effective 1/13/06.]



388-845-0040
Is there a limit to the number of people who can be enrolled in each HCBS waiver?

Each waiver has a capacity limit on the number of people who can be served in a waiver year. In addition, DDA has the authority to limit capacity based on availability of funding for new waiver participants.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0040, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0040, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0040, filed 12/13/05, effective 1/13/06.]



388-845-0041
What is DDA's responsibility to provide your services under the DDA HCBS waivers administered by DDA?

If you are enrolled in an HCBS waiver administered by DDA.
(1) DDA will provide an annual comprehensive assessment to evaluate your health and welfare needs. Your person-centered service plan/individual support plan, as specified in WAC 388-845-3055, will document:
(a) Your identified health and welfare needs; and
(b) Your HCBS waiver services and nonwaiver services authorized to meet your assessed need.
(2) You have access to DDA paid services that are provided within the scope of your waiver, subject to the limitations in WAC 388-845-0110 and 388-845-0115.
(3) DDA will provide waiver services you need and qualify for within your waiver.
(4) DDA will not deny or limit, based on lack of funding, the number of waiver services for which you are eligible.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0041, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0041, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0041, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0041, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0041, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0041, filed 12/13/05, effective 1/13/06.]



388-845-0045
When there is capacity to add people to a waiver, how does DDA determine who will be enrolled?

When there is capacity on a waiver and available funding for new waiver participants, DDA may enroll people from the statewide database in a waiver based on the following priority considerations:
(1) First priority will be given to current waiver participants assessed to require a different waiver because their identified health and welfare needs have increased and these needs cannot be met within the scope of their current waiver.
(2) DDA may also consider any of the following populations in any order:
(a) Priority populations as identified and funded by the legislature.
(b) Persons DDA has determined to be in immediate risk of ICF/IID admission due to unmet health and welfare needs.
(c) Persons identified as a risk to the safety of the community.
(d) Persons currently receiving services through state-only funds.
(e) Persons on an HCBS waiver that provides services in excess of what is needed to meet their identified health and welfare needs.
(f) Persons who were previously on an HCBS waiver since April 2004 and lost waiver eligibility per WAC 388-845-0060 (1)(i).
(3) DDA may consider persons who need the waiver services available in the basic plus or IFS waivers to maintain them in their family's home or in their own home.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0045, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0045, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0045, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0045, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0045, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-0045, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0045, filed 12/13/05, effective 1/13/06.]



388-845-0050
How do I request to be enrolled in a waiver?

(1) You can contact DDA and request to be enrolled in a waiver or to enroll in a different waiver at any time.
(2) If you are assessed as meeting ICF/ID level of care as defined in WAC 388-845-0070 and chapter 388-828 WAC, your request for waiver enrollment will be documented by DDA in a statewide database.
(3) For the children's intensive in-home behavioral support (CIIBS) waiver only, if you are assessed as meeting both ICF/ID level of care and CIIBS eligibility as defined in WAC 388-845-0030 and chapter 388-828 WAC, your request for waiver enrollment will be documented by DDA in a statewide database.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0050, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0050, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0050, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0050, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0050, filed 12/13/05, effective 1/13/06.]



388-845-0051
How will I be notified of the decision by DDA to enroll me in a waiver?

DDA will notify you in writing of its decision to enroll you in a waiver or its decision to deny your request to be enrolled in a waiver.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0051, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0051, filed 12/13/05, effective 1/13/06.]



388-845-0052
What is the process if I am already on a DDA HCBS waiver and request enrollment onto a different DDA HCBS waiver?

(1) If you are already enrolled in a DDA HCBS waiver and you request to be enrolled in a different waiver DDA will do the following:
(a) Assess your needs to determine whether your health and welfare needs can be met with services available on your current waiver or whether those needs can only be met through services offered on a different waiver.
(b) If DDA determines your health and welfare needs can be met by services available on your current waiver your enrollment request will be denied.
(c) If DDA determines your health and welfare needs can only be met by services available on a different waiver your service need will be reflected in your person-centered service plan/individual support plan.
(d) If DDA determines there is capacity on the waiver that is determined to meet your needs, DDA will place you on that waiver.
(2) You will be notified in writing of DDA's decision under subsection (1)(a) of this section and if your health and welfare needs cannot be met on your current waiver, DDA will notify you in writing whether there is capacity on the waiver that will meet your health and welfare needs and whether you will be enrolled on that waiver. If current capacity on that waiver does not exist, your eligibility for enrollment onto that different waiver will be tracked on a statewide database.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0052, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0052, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0052, filed 9/26/07, effective 10/27/07.]



388-845-0055
How do I remain eligible for the waiver?

(1) Once you are enrolled in a DDA HCBS waiver, you can remain eligible if you continue to meet eligibility criteria in WAC 388-845-0030, and:
(a) You complete a reassessment with DDA at least once every twelve months to determine if you continue to meet all of these eligibility requirements;
(b) You must either receive a waiver service at least once in every thirty consecutive days, as specified in WAC 182-513-1320(3), or your health and welfare needs require monthly monitoring, which will be documented in your client record;
(c) You complete an in-person DDA assessment/reassessment interview per WAC 388-828-1520.
(2) For the children's intensive in-home behavioral supports waiver, you must meet the criteria in subsection (1) of this section and:
(a) Be under age twenty-one;
(b) Live with your family; and
(c) Have an annual participation agreement signed by your parent/guardian(s) and primary caregiver(s), if other than parent/guardian(s).
(3) For the individual and family services waiver, you must meet the criteria in subsection (1) of this section and:
(a) Live in the family home; and
(b) Be age three or over.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0055, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0055, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0055, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0055, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0055, filed 12/13/05, effective 1/13/06.]



388-845-0060
Can your waiver enrollment be terminated?

DDA may terminate your waiver enrollment if DDA determines that:
(1) Your health and welfare needs cannot be met in your current waiver or for one of the following reasons:
(a) You no longer meet one or more of the requirements listed in WAC 388-845-0030;
(b) You do not have an identified need for a waiver service at the time of your annual person-centered service plan/individual support plan;
(c) You do not use a waiver service at least once in every thirty consecutive days and your health and welfare do not require monthly monitoring;
(d) You are on the community protection waiver and:
(i) You choose not to be served by a certified residential community protection provider-intensive supported living services (CP-ISLS);
(ii) You engage in any behaviors identified in WAC 388-831-0240 (1) through (4); and
(iii) DDA determines that your health and safety needs or the health and safety needs of the community cannot be met in the community protection program;
(e) You choose to unenroll from the waiver;
(f) You reside out-of-state;
(g) You cannot be located or do not make yourself available for the annual waiver reassessment of eligibility;
(h) You refuse to participate with DDA in:
(i) Service planning;
(ii) Required quality assurance and program monitoring activities; or
(iii) Accepting services agreed to in your person-centered service plan/individual support plan as necessary to meet your health and welfare needs;
(i) You are residing in a hospital, jail, prison, nursing facility, ICF/IID, or other institution and remain in residence at least one full calendar month, and are still in residence:
(i) At the end of that full calendar month, there is no immediate plan for you to return to the community;
(ii) At the end of the twelfth month following the effective date of your current person-centered service plan/individual support plan, as described in WAC 388-845-3060; or
(iii) The end of the waiver fiscal year, whichever date occurs first;
(j) Your needs exceed the maximum funding level or scope of services under the basic plus waiver as specified in WAC 388-845-3080; or
(k) Your needs exceed what can be provided under WAC 388-845-3085.
(2) Services offered on a different waiver can meet your health and welfare needs and DDA enrolls you on a different waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0060, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0060, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0060, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, and Title 71A RCW. WSR 09-10-021, § 388-845-0060, filed 4/28/09, effective 5/29/09; WSR 07-20-050, § 388-845-0060, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0060, filed 12/13/05, effective 1/13/06.]



388-845-0065
What happens if I am terminated or choose to disenroll from a waiver?

If you are terminated from a waiver or choose to disenroll from a waiver, DDA will notify you.
(1) DDA cannot guarantee continuation of your current services, including medicaid eligibility.
(2) Your eligibility for nonwaiver state-only funded DDA services is based upon availability of funding and program eligibility for a particular service.
(3) If you are terminated from the CIIBS waiver due to turning age twenty-one, DDA will assist with transition planning at least twelve months prior to your twenty-first birthday.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0065, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0065, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0065, filed 12/13/05, effective 1/13/06.]



388-845-0070
What determines if I need ICF/ID level of care?

DDA determines if you need ICF/ID level of care based on your need for waiver services. To reach this decision, DDA uses the DDA assessment as specified in chapter 388-828 WAC.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0070, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0070, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0070, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0070, filed 12/13/05, effective 1/13/06.]



388-845-0100
What determines which waiver I am assigned to?

DDA will assign you to the waiver with the minimum service package necessary to meet your health and welfare needs, based on its evaluation of your DDA assessment as described in chapter 388-828 WAC and the following criteria:
(1) For the individual and family services waiver, you:
(a) Are age three or older;
(b) Live in your family home; and
(c) Are assessed to need a waiver service to remain in the family home.
(2) For the basic plus waiver your health and welfare needs require a waiver service to remain in the community.
(3) For the core waiver:
(a) You are at immediate risk of out-of-home placement; and/or
(b) You have an identified health and welfare need for residential services that cannot be met by the basic plus waiver.
(4) For the community protection waiver, refer to WAC 388-845-0105 and chapter 388-831 WAC.
(5) For the children's intensive in-home behavioral support waiver, you:
(a) Are age eight or older and under age eighteen;
(b) Live with your family;
(c) Are assessed at high or severe risk of out of home placement due to challenging behavior per chapter 388-828 WAC; and
(d) You have a signed participation agreement from your parent/guardian(s) and primary caregiver(s), if other than parent/guardian(s).
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0100, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0100, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0100, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0100, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0100, filed 12/13/05, effective 1/13/06.]



388-845-0105
What criteria determine assignment to the community protection waiver?

DDA may assign you to the community protection waiver only if you are at least eighteen years of age, not currently residing in a hospital, jail or other institution, and meet the following criteria:
(1) You have been identified by DDA as a person who meets one or more of the following:
(a) You have been convicted of or charged with a crime of sexual violence as defined in chapter 71.09 RCW;
(b) You have been convicted of or charged with acts directed towards strangers or individuals with whom a relationship has been established or promoted for the primary purpose of victimization, or persons of casual acquaintance with whom no substantial personal relationship exists;
(c) You have been convicted of or charged with a sexually violent offense and/or predatory act, and may constitute a future danger as determined by a qualified professional;
(d) You have not been convicted and/or charged, but you have a history of stalking, violent, sexually violent, predatory and/or opportunistic behavior which demonstrates a likelihood to commit a sexually violent and/or predatory act based on current behaviors that may escalate to violence, as determined by a qualified professional; or
(e) You have committed one or more violent offense, as defined in RCW 9.94A.030;
(2) You receive or agree to receive residential services from certified residential community protection provider-intensive supported living services (CP-ISLS); and
(3) You comply with the specialized supports and restrictions in one or more of the following:
(a) Your person-centered service plan/individual support plan;
(b) Your individual instruction and support plan (IISP); or
(c) Your treatment plan provided by DDA approved certified individuals and agencies.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0105, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0105, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0105, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0105, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0105, filed 12/13/05, effective 1/13/06.]



388-845-0110
What are the limits to the waiver services you may receive?

The following limits apply to the waiver services you may receive:
(1) A service must be available in your waiver and address an unmet need identified in your person-centered service plan.
(2) Behavioral health stabilization services may be added to your person-centered service plan after the services have been provided.
(3) Waiver services are limited to services required to prevent placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID).
(4) The daily cost of your waiver services must not exceed the average daily cost of care in an ICF/IID.
(5) Waiver services must not replace or duplicate other available paid or unpaid supports or services. Before DDA will cover a service through waiver services, you must first request and be denied all applicable services through private insurance, medicare, the medicaid state plan, and other resources.
(6) Waiver funding must not be authorized for treatments determined by DSHS to be experimental or investigational under WAC 182-531-0050.
(7) For the individual and family services (IFS) and basic plus waivers, services must not exceed the yearly limits specified in these programs for specific services or combinations of services.
(8) Your choice of qualified providers and services is limited to the most cost-effective option that meets your unmet need identified in your person-centered service plan.
(9) Services provided out-of-state, other than in recognized bordering cities, are limited to respite care and personal care during vacations of not more than thirty consecutive days.
(10) You may receive services in a recognized out-of-state bordering city under WAC 182-501-0175.
(11) Other out-of-state waiver services require an approved exception to rule before DDA will authorize payment.
(12) Waiver services do not cover:
(a) Copays;
(b) Deductibles;
(c) Dues;
(d) Membership fees; or
(e) Subscriptions.
(13) Waiver services do not cover a product unless the product is:
(a) Necessary to meet a basic health and safety need; and
(b) The least restrictive means for meeting that need.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0110, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0110, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0110, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0110, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0110, filed 12/13/05, effective 1/13/06.]



388-845-0111
Are there limitations regarding who can provide services?

The following limitations apply to providers for waiver services:
(1) Your spouse must not be your paid provider for any waiver service.
(2) If you are under age eighteen, your natural, step, or adoptive parent must not be your paid provider for any waiver service.
(3) If you are age eighteen or older, your natural, step, or adoptive parent must not be your paid provider for any waiver service with the exception of:
(a) Personal care;
(b) Transportation to and from a waiver service;
(c) Residential habilitation services per WAC 388-845-1510 if your parent is certified as a residential agency per chapter 388-101 WAC; or
(d) Respite care if you and the parent who provides the respite care live in separate homes.
(4) If you receive CIIBS waiver services, your legal representative or family member per WAC 388-845-0001 must not be your paid provider for any waiver service with the exception of:
(a) Transportation to and from a waiver service; and
(b) Respite per WAC 388-845-1605 through 388-845-1620.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0111, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0111, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0111, filed 9/26/07, effective 10/27/07.]



388-845-0115
Does your waiver eligibility limit your access to DDA nonwaiver services?

If you are enrolled in a DDA HCBS waiver:
(1) You are not eligible for state-only funding for DDA services; and
(2) You may be eligible for medicaid personal care or community first choice services.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0115, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0115, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0115, filed 12/13/05, effective 1/13/06.]



388-845-0120
Will I continue to receive state supplementary payments (SSP) if I am on the waiver?

Your participation in one of the DDA HCBS waivers may affect your continued receipt of state supplemental payment from DDA. To continue to receive SSP, you must meet DDA/SSP programmatic eligibility requirements as identified in WAC 388-827-0115.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0120, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0120, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0120, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0120, filed 12/13/05, effective 1/13/06.]



388-845-0200
What waiver services are available to you?

Each of the DDA HCBS waivers has a different scope of service and your person-centered service plan/individual support plan defines the waiver services available to you.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0200, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0200, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0200, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0200, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0200, filed 12/13/05, effective 1/13/06.]



388-845-0210
What services are available under the basic plus waiver?

The following services are available under the basic plus waiver:
service
yearly limit
aggregate services:
Total costs must not exceed six thousand one hundred ninety-two dollars per year per participant
Chemical extermination of cimex lectularius (bedbugs)
Community guide
Environmental adaptations
Occupational therapy
 
Physical therapy
 
Positive behavior support and consultation
 
Skilled nursing
 
Specialized medical equipment and supplies
 
Specialized psychiatric services
 
Speech, hearing, and language services
 
Staff and family consultation and training
 
Transportation
 
Wellness education
 
employment services:
 
Individual technical assistance
Limits determined by DDA assessment and employment status; no new enrollment in prevocational services after September 1, 2015
Prevocational services
Supported employment
Community inclusion
Limits determined by DDA assessment
behavioral health stabilization services:
Limits determined by a behavioral health professional or DDA
Behavioral health crisis diversion bed services
Positive behavior support and consultation
Specialized psychiatric services
 
Personal care
Limits determined by the CARE tool used as part of the DDA assessment
Respite care
Limits determined by DDA assessment
Risk assessment
Limits determined by DDA
Emergency assistance is only for basic plus waiver aggregate services
Six thousand dollars per year; preauthorization required
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0210, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0210, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0210, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0210, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-0210, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.120. WSR 07-05-014, § 388-845-0210, filed 2/9/07, effective 3/12/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0210, filed 12/13/05, effective 1/13/06.]



388-845-0215
What services are available under the core waiver?

(1) The following services are available under the core waiver:
SERVICE
YEARLY LIMIT
Chemical extermination of cimex lectularius (bedbugs)
Community guide
Community transition
Environmental adaptions
Occupational therapy
Physical therapy
Positive behavior support and consultation
Residential habilitation
Risk assessment
Skilled nursing
Specialized medical equipment and supplies
Specialized psychiatric services
Speech, hearing, and language services
Staff and family consultation and training
Transportation
Wellness education
Determined by the person-centered service plan
EMPLOYMENT SERVICES:
Individualized technical assistance
Prevocational services
Supported employment
Limits determined by DDA assessment and employment status; no new enrollment in prevocational services after September 1, 2015
Community inclusion
Limits determined by DDA assessment
BEHAVIORAL HEALTH STABILIZATION SERVICES:
Behavioral health crisis diversion bed services
Positive behavior support and consultation
Specialized psychiatric services
Limits determined by a behavioral health professional or DDA
Respite care
Limits determined by DDA assessment
(2) A participant's core waiver services are subject to additional limits under this chapter.
(3) The total cost of a participant's core waiver services must not exceed the average cost of care at an intermediate care facility for individuals with intellectual disabilities (ICF/IID).
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0215, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0215, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0215, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0215, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0215, filed 12/13/05, effective 1/13/06.]



388-845-0220
What services are available under the community protection waiver?

(1) The following services are available under the community protection waiver:
service
yearly limit
Chemical extermination of cimex lectularius (bedbugs)
Determined by the person-centered service plan
Community transition
Environmental adaptations
Occupational therapy
Physical therapy
Positive behavior support and consultation
 
Residential habilitation
 
Risk assessment
 
Skilled nursing
 
Specialized medical equipment and supplies
 
Specialized psychiatric services
 
Speech, hearing, and language services
 
Staff and family consultation and training
 
Transportation
 
EMPLOYMENT SERVICES:
Individual technical assistance
Prevocational services
Supported employment
Limits determined by DDA assessment and employment status; no new enrollment in prevocational services after September 1, 2015
behavioral health stabilization services:
Behavioral health crisis diversion bed services
Positive behavior support and consultation
Specialized psychiatric services
Limits determined by a behavioral health professional or DDA
(2) A participant's community protection waiver services are subject to additional limits under this chapter.
(3) The total cost of a participant's community protection waiver services must not exceed the average cost of care at an intermediate care facility for individuals with intellectual disabilities (ICF/IID).
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0220, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0220, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0220, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0220, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0220, filed 12/13/05, effective 1/13/06.]



388-845-0225
What services are available under the children's intensive in-home behavioral support (CIIBS) waiver?

(1) The following services are available under the children's intensive in-home behavioral support (CIIBS) waiver:
SERVICE
YEARLY LIMIT
Assistive technology
Environmental adaptations
Nurse delegation
Positive behavior support and consultation
Specialized clothing
Specialized medical equipment and supplies
Staff and family consultation and training
Therapeutic equipment and supplies
Transportation
Vehicle modifications
Determined by the person-centered service plan. Total cost of waiver services must not exceed the average cost of four thousand dollars per month per participant.
Respite care
Limits determined by the DDA assessment. Costs are included in the total average cost of four thousand dollars per month per participant for all waiver services.
BEHAVIORAL HEALTH STABILIZATION SERVICES:
Behavioral health crisis diversion bed services
Positive behavior support and consultation
Limits determined by behavioral health professional or DDA
Risk assessment
Limits determined by DDA
(2) A participant's CIIBS waiver services are subject to additional limits under this chapter.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0225, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0225, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0225, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0225, filed 11/1/10, effective 12/2/10.]



388-845-0230
What services are available under the individual and family services (IFS) waiver?

(1) The following services are available under the individual and family services (IFS) waiver:
SERVICE
YEARLY LIMIT
Assistive technology
Community engagement
Environmental adaptions
Occupational therapy
Peer mentoring
Person-centered plan facilitation
Physical therapy
Positive behavior support and consultation
Respite care
Skilled nursing
Specialized clothing
Specialized medical equipment and supplies
Total cost of waiver services must not exceed annual allocation determined by the person-centered service plan
Specialized psychiatric services
Speech, hearing, and language services
Staff and family consultation and training
Supported parenting services
Therapeutic equipment and supplies
Transportation
Vehicle modifications
Wellness education
 
Risk assessment
Limits determined by DDA. Costs are excluded from the annual allocation.
BEHAVIORAL HEALTH STABILIZATION SERVICES:
Positive behavior support and consultation
Specialized psychiatric services
Limits determined by behavioral health professional or DDA. Costs are excluded from the annual allocation
(2) Your IFS waiver services annual allocation is based upon the DDA assessment under chapter 388-828 WAC. The DDA assessment determines your service level and annual allocation based on your assessed need. Annual allocations are as follows:
(a) Level 1 = one thousand two hundred dollars;
(b) Level 2 = one thousand eight hundred dollars;
(c) Level 3 = two thousand four hundred dollars; or
(d) Level 4 = three thousand six hundred dollars.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0230, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0230, filed 8/4/16, effective 9/4/16.]



388-845-0300
What are adult family home (AFH) services?

Per RCW 70.128.010 an adult family home (AFH) is a regular family abode in which a person or persons provide personal care, special care, room, and board to more than one but not more than six adults who are not related by blood or marriage to the person or persons providing the service. Adult family homes (AFH) may provide residential care to adults in the basic plus waiver.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0300, filed 12/13/05, effective 1/13/06.]



388-845-0305
Who is a qualified provider of AFH services?

The provider of AFH services must be licensed and contracted with DSHS as an AFH who has successfully completed the DDA specialty training provided by the department.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0305, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0305, filed 12/13/05, effective 1/13/06.]



388-845-0310
Are there limits to the AFH services I can receive?

Adult family homes services are limited by the following:
(1) AFH services are defined and limited per chapter 388-106 WAC governing medicaid personal care and the comprehensive assessment and reporting evaluation (CARE).
(2) Rates are determined by and limited to department published rates for the level of care generated by CARE.
(3) AFH reimbursement cannot be supplemented by other department funding.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0310, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0310, filed 12/13/05, effective 1/13/06.]



388-845-0400
What are adult residential care (ARC) services?

Adult residential care (ARC) facilities may provide residential care to adults. This service is available in the basic plus waiver.
(1) An ARC is a licensed assisted living facility for seven or more unrelated adults.
(2) Services include, but are not limited to, individual and group activities; assistance with arranging transportation; assistance with obtaining and maintaining functional aids and equipment; housework; laundry; self-administration of medications and treatments; therapeutic diets; cuing and providing physical assistance with bathing, eating, dressing, locomotion and toileting; stand-by one person assistance for transferring.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0400, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0400, filed 12/13/05, effective 1/13/06.]



388-845-0405
Who is a qualified provider of ARC services?

The provider of ARC services must:
(1) Be a licensed assisted living facility;
(2) Be contracted with DSHS to provide ARC services; and
(3) Have completed the required and approved DDA specialty training.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0405, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0405, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0405, filed 12/13/05, effective 1/13/06.]



388-845-0410
Are there limits to the ARC services I can receive?

ARC services are limited by the following:
(1) ARC services are defined and limited by assisted living facility licensure and rules in chapter 388-78A WAC, and chapter 388-106 WAC governing medicaid personal care and the comprehensive assessment and reporting evaluation (CARE).
(2) Rates are determined and limited to department published rates for the level of care generated by CARE.
(3) ARC reimbursement cannot be supplemented by other department funding.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0410, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0410, filed 12/13/05, effective 1/13/06.]



388-845-0415
What is assistive technology?

Assistive technology consists of items, equipment, or product systems used to increase, maintain, or improve functional capabilities of waiver participants, as well as services to directly assist the participant and caregivers to select, acquire, and use the technology. Assistive technology is available in the CIIBS and IFS waivers, and includes the following:
(1) The evaluation of the needs of the waiver participant, including a functional evaluation of the participant in the participant's customary environment;
(2) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices;
(3) Selecting, designing, fitting, customizing, adapting, applying, retaining, repairing, or replacing assistive technology devices;
(4) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
(5) Training or technical assistance for the participant and/or if appropriate, the participant's family; and
(6) Training or technical assistance for professionals, including individuals providing education and rehabilitation services, employers, or other individuals who provide services to, employ, or are otherwise involved in the assistive technology related life functions of individuals with disabilities.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0415, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0415, filed 11/1/10, effective 12/2/10.]



388-845-0420
Who may be a qualified provider of assistive technology?

The provider of assistive technology must be an entity contracted with DDA to provide assistive technology, or one of the following professionals contracted with DDA and licensed, registered, or certified as:
(1) An audiologist;
(2) A behavior health professional;
(3) A certified music therapist;
(4) An occupational therapist;
(5) A physical therapist;
(6) A rehabilitation counselor;
(7) A speech and language pathologist; or
(8) A speech therapist.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0420, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0420, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0420, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0420, filed 11/1/10, effective 12/2/10.]



388-845-0425
Are there limits to the assistive technology you may receive?

The assistive technology you may receive has the following limits:
(1) Clinical and support needs for assistive technology are identified in your DDA assessment and documented in the person-centered service plan.
(2) DDA requires your treating professional's written recommendation regarding your need for the technology. This recommendation must take into account that:
(a) The treating professional has personal knowledge of and experience with the requested assistive technology; and
(b) The treating professional has recently examined you, reviewed your medical records, and conducted a functional evaluation of your use of the equipment and determined its effectiveness in meeting your identified need.
(3) Assistive technology requires prior approval by the DDA regional administrator or designee.
(4) DDA may require a written second opinion from a DDA-selected professional.
(5) The dollar amounts for your individual and family services (IFS) waiver annual allocation limit the amount of assistive technology you are authorized to receive.
(6) Assistive technology excludes any item that is for recreational or diversion purposes such as a television, cable, or DVD player.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0425, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0425, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0425, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0425, filed 11/1/10, effective 12/2/10.]



388-845-0500
What is positive behavior support and consultation?

(1) Positive behavior support and consultation may be provided to persons on any of the DDA HCBS waivers and includes the development and implementation of programs designed to support waiver participants using:
(a) Individualized strategies for effectively relating to caregivers and other people in the waiver participant's life; and
(b) Direct interventions with the person to decrease aggressive, destructive, and sexually inappropriate or other behaviors that compromise their ability to remain in the community (i.e., training, specialized cognitive counseling, conducting a functional assessment, and development and implementation of a positive behavior support plan).
(2) Positive behavior support and consultation may also be provided as a behavioral health stabilization service in accordance with WAC 388-845-1150 through 388-845-1160.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0500, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0500, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0500, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0500, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0500, filed 12/13/05, effective 1/13/06.]



388-845-0501
What is included in positive behavior support and consultation for the children's intensive in-home behavioral support (CIIBS) waiver?

(1) In addition to the definition in WAC 388-845-0500, positive behavior support and consultation in the children's intensive in-home behavioral support (CIIBS) waiver must include:
(a) Treatments that are evidence based, driven by individual outcome data, and consistent with DDA's positive behavior support guidelines as outlined in contract;
(b) Objective and measurable treatment goals that decrease challenging behaviors and increase skills that promote quality of life for the child and family;
(c) Behavioral support strategies individualized and coordinated across all environments, such as home, school, and community, in order to promote a consistent approach among all involved persons; and
(d) The following components developed with the child, family, and a behavior specialist under WAC 388-845-0506:
(i) A functional behavioral assessment; and
(ii) A positive behavior support plan based on the functional behavioral assessment.
(2) Positive behavior support and consultation in the CIIBS waiver may include:
(a) Positive behavior support plans implemented by a behavioral technician under WAC 388-845-0506, which may include 1:1 behavior interventions and skill development activity;
(b) Recommendations from a music therapist under WAC 388-845-2005; and
(c) Recommendations from a recreation therapist under WAC 388-845-2005.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0501, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0501, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0501, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0501, filed 11/1/10, effective 12/2/10.]



388-845-0505
Who is a qualified provider of positive behavior support and consultation?

Under the basic plus, core, community protection (CP), and individual and family services (IFS) waivers, the provider of positive behavior support and consultation must be one of the following professionals contracted with DDA and duly licensed, registered, or certified as a:
(1) Marriage and family therapist;
(2) Mental health counselor;
(3) Psychologist;
(4) Sex offender treatment provider;
(5) Social worker;
(6) Registered nurse (RN) or licensed practical nurse (LPN);
(7) Psychiatrist;
(8) Psychiatric advanced registered nurse practitioner (ARNP);
(9) Physician assistant working under the supervision of a psychiatrist;
(10) Counselor registered or certified under chapter 18.19 RCW;
(11) Polygrapher; or
(12) State-operated positive behavior support agency qualified to provide behavioral health stabilization services.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0505, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0505, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0505, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0505, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0505, filed 12/13/05, effective 1/13/06.]



388-845-0506
Who is a qualified provider of positive behavior support and consultation for the children's intensive in-home behavioral support (CIIBS) waiver?

Under the children's intensive in-home behavioral support (CIIBS) waiver, providers of positive behavior support and consultation must be contracted with DDA to provide CIIBS intensive services as a:
(1) Master's or PhD-level behavior specialist who is licensed, certified, or registered to provide behavioral assessments, interventions, and training; or
(2) Behavior technician, licensed, certified, or registered to provide behavioral intervention and training under the supervision of the behavior specialist.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0506, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0506, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0506, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0506, filed 11/1/10, effective 12/2/10.]



388-845-0510
Are there limits to the positive behavior support and consultation you may receive?

(1) Clinical and support needs for positive behavior support and consultation must be identified in your DDA assessment and documented in the person-centered service plan.
(2) DDA determines the amount of positive behavior support and consultation you may receive based on your needs and information from your treating professional.
(3) The dollar amounts for aggregate services in your basic plus waiver or the dollar amounts in the annual allocation for the individual and family services (IFS) waiver limit the amount of service unless provided as a behavioral health stabilization service.
(4) DDA may require a second opinion from a DDA-selected provider.
(5) Positive behavior support and consultation not provided as a behavioral health stabilization service requires prior approval by the DDA regional administrator or designee for the following waivers:
(a) Basic plus;
(b) Core;
(c) Children's intensive in-home behavior support (CIIBS); and
(d) IFS.
(6) Positive behavior support and consultation services are limited to services:
(a) Consistent with waiver objectives of avoiding institutionalization; and
(b) Not otherwise covered under the medicaid state plan.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0510, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0510, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0510, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0510, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0510, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0510, filed 12/13/05, effective 1/13/06.]



388-845-0515
What is chemical extermination of bedbugs?

(1) Chemical extermination of cimex lectularius (bedbugs) is professional chemical extermination of bedbugs.
(2) DDA covers professional chemical extermination of bedbugs in your primary residence if you:
(a) Receive residential habilitation services; or
(b) Live in a private house or apartment for which you are financially responsible.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0515, filed 6/20/18, effective 7/21/18.]



388-845-0520
Who are qualified providers of chemical extermination of bedbugs?

A qualified chemical extermination provider must be:
(1) Licensed as a chemical pesticide applicator by the Washington state department of agriculture; and
(2) Contracted with DDA to provide chemical extermination of bedbugs.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0520, filed 6/20/18, effective 7/21/18.]



388-845-0525
Are there limits to the chemical extermination of bedbugs services I may receive?

(1) Chemical extermination services covers only:
(a) The assessment or inspection by the qualified provider;
(b) Application of chemical-based pesticide; and
(c) One follow-up visit.
(2) Chemical extermination of bedbugs is limited to two treatments per plan year.
(3) Chemical extermination of bedbugs excludes:
(a) Lodging during the chemical extermination process; and
(b) Preparatory housework associated with the extermination process.
(4) DDA does not cover chemical extermination of bedbugs for a participant who lives with their family.
(5) DDA requires prior approval by the regional administrator or designee for chemical extermination of bedbugs.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0525, filed 6/20/18, effective 7/21/18.]



388-845-0600
What are community access services?

Community access services:
(1) Are provided in typical, integrated community settings;
(2) Are individualized services that promote skill development, independent living, and community integration for individuals learning how to actively and independently engage in their community; and
(3) Provide opportunities for individuals to develop relationships and increase independence.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-0600, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0600, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0600, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0600, filed 12/13/05, effective 1/13/06.]



388-845-0603
Who is eligible to receive community inclusion services?

You are eligible for community inclusion services if you are enrolled in the basic plus or core waivers and:
(1) You are sixty-two or older; or
(2) You meet age requirements under WAC 388-845-2110(1) and:
(a) You have participated in developmental disabilities administration (DDA) supported employment services for nine consecutive months; or
(b) DDA has determined that you are exempt from the nine-month DDA supported employment service requirement because:
(i) Your medical or behavioral health records document a condition that prevents you from completing nine consecutive months of DDA supported employment services; or
(ii) You were referred to and were available for DDA supported employment services, but the service was not delivered within ninety days of the referral.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0603, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030. WSR 17-12-002, § 388-845-0603, filed 5/24/17, effective 6/24/17. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0603, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0603, filed 8/1/12, effective 9/1/12.]



388-845-0605
Who are qualified providers of community access services?

Providers of community access services must be:
(1) A county contracted with the developmental disabilities administration (DDA) to provide community access services; or
(2) An individual or agency contracted with a county that is contracted with DDA to provide community access services.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-0605, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0605, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0605, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0605, filed 12/13/05, effective 1/13/06.]



388-845-0610
Are there limits to community access services you may receive?

(1) You must not receive community access services if you are receiving prevocational or supported employment services.
(2) The maximum hours of community access services you may receive are determined by the developmental disabilities administration (DDA) assessment under WAC 388-828-9310.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-0610, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0610, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-0610, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0610, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0610, filed 12/13/05, effective 1/13/06.]



388-845-0650
What are community engagement services?

(1) Community engagement services are services designed to increase a waiver participant's connection to and engagement in formal and informal community supports.
(2) Services are designed to develop creative, flexible, and supportive community resources and relationships for individuals with developmental disabilities.
(3) Waiver participants are introduced to the community resources and supports that are available in their area.
(4) Participants are supported to develop skills that will facilitate integration into their community.
(5) Outcomes for this service include skill development, opportunities for socialization, valued community roles, and involvement in community activities, organizations, groups, projects, and other resources.
(6) This service is available in the IFS waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0650, filed 8/4/16, effective 9/4/16.]



388-845-0655
Who are qualified providers of community engagement services?

Qualified providers of community engagement services must be contracted with DSHS to provide this service and must be an individual or organization that has specialized training to provide services to people with developmental disabilities. Qualified provider types include:
(1) Registered recreational therapists in the state of Washington; or
(2) Organizations that provide services that promote skill development, improved functioning, increased independence, as well as reducing or eliminating the effects of illness or disability, including, but not limited to:
(a) Community centers;
(b) Municipal parks and recreation programs;
(c) Therapeutic recreation camps and programs; and
(d) Organizations that provide supports for individuals with developmental disabilities.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0655, filed 8/4/16, effective 9/4/16.]



388-845-0660
Are there limits to the community engagement services you may receive?

(1) Community engagement services are limited to the support needs identified in your DDA assessment and documented in your person-centered service plan.
(2) The dollar amounts in the annual allocation for the individual and family services (IFS) waiver limit the amount of community engagement services you may receive.
(3) Community engagement services are limited to the community where you live.
(4) Community engagement services do not cover:
(a) Membership fees or dues;
(b) Equipment related to activities; or
(c) The cost of any activities.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0660, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0660, filed 8/4/16, effective 9/4/16.]



388-845-0700
What are community guide services?

Community guide services increase access to informal community supports. Community guide services are short-term services designed to develop creative, flexible, and supportive community resources for individuals with developmental disabilities to meet a goal identified in the waiver participant's person-centered service plan. These services are available in basic plus and core waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0700, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0700, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0700, filed 12/13/05, effective 1/13/06.]



388-845-0705
Who may be a qualified provider of community guide services?

Any individual or agency contracted with DDA as a community guide may be qualified to provide community guide services.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0705, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0705, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0705, filed 12/13/05, effective 1/13/06.]



388-845-0710
Are there limits to the community guide services I may receive?

(1) You must not receive community guide services if you are receiving residential habilitation services under WAC 388-845-1500.
(2) You may receive community guide services up to the aggregate services dollar amount available to you in your basic plus waiver.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0710, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0710, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0710, filed 12/13/05, effective 1/13/06.]



388-845-0750
What are community transition services?

(1) Community transition services are reasonable costs (necessary expenses in the judgment of the state for you to establish your basic living arrangement) associated with moving from:
(a) An institutional setting to a community setting in which you are living in your own home or apartment, responsible for your own living expenses and receiving services from a DDA certified residential habilitation services provider as defined in WAC 388-845-1505 and 388-845-1510; or
(b) A provider operated setting, such as a group home, staffed residential, adult family home or companion home in the community to a community setting in which you are living in your own home or apartment, responsible for your own living expenses, and receiving services from a DDA certified residential habilitation services provider as defined in WAC 388-845-1505 and 388-845-1510.
(2) Community transition services include:
(a) Security deposits (not to exceed the equivalent of two month's rent) that are required to obtain a lease on an apartment or home;
(b) Essential furnishings such as a bed, a table, chairs, window blinds, eating utensils and food preparation items;
(c) Moving expenses required to occupy your own home or apartment;
(d) Set-up fees or deposits for utility or service access (e.g., telephone, electricity, heating); and
(e) Health and safety assurances, such as pest eradication, allergen control or one-time cleaning prior to occupancy.
(3) Community transition services are available in the CORE and community protection waivers.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0750, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0750, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0750, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0750, filed 12/13/05, effective 1/13/06.]



388-845-0755
Who are qualified providers of community transition services?

(1) Providers of community transition services for individuals in the core waiver must meet the requirements as a provider of residential habilitation services contained in WAC 388-845-1505.
(2) Providers of community transition services for individuals in the community protection waiver must meet the requirements as a provider of residential habilitation services contained in WAC 388-845-1510.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0755, filed 12/13/05, effective 1/13/06.]



388-845-0760
Are there limits to community transition services I can receive?

Community transition services does not include:
(a)[(1)] Diversional or recreational items such as televisions, cable TV access, VCRs, MP3, CD, or DVD players;
(2) Computers, if primarily used as a diversion or for recreation; or
(3) Rent assistance.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0760, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-0760, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0760, filed 12/13/05, effective 1/13/06.]



388-845-0800
What is emergency assistance?

Emergency assistance is a temporary increase to the yearly basic plus waiver aggregate dollar limit when additional waiver aggregate services are required to prevent placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID).
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0800, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0800, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0800, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0800, filed 12/13/05, effective 1/13/06.]



388-845-0805
Who is a qualified provider of emergency assistance?

The provider of the service you need to meet your emergency must meet the provider qualifications for that service.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0805, filed 12/13/05, effective 1/13/06.]



388-845-0810
How do I qualify for emergency assistance?

You qualify for emergency assistance only if you have used all of your waiver aggregate funding and your current situation meets one of the following criteria:
(1) You involuntarily lose your present residence for any reason either temporary or permanent;
(2) You lose your present caregiver for any reason, including death;
(3) There are changes in your caregiver's mental or physical status resulting in the caregiver's inability to perform effectively for the individual; or
(4) There are significant changes in your emotional or physical condition that requires a temporary increase in the amount of a waiver service.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0810, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0810, filed 12/13/05, effective 1/13/06.]



388-845-0820
Are there limits to your use of emergency assistance?

All of the following limits apply to the emergency assistance you may receive:
(1) Prior approval by the DDA regional administrator or designee is required based on a reassessment of your person-centered service plan to determine the need for emergency services;
(2) Payment authorizations are reviewed every thirty days and must not exceed six thousand dollars per twelve months based on the effective date of your current person-centered service plan;
(3) Emergency assistance services are limited to the following basic plus waiver aggregate services:
(a) Community guide;
(b) Environmental adaptations;
(c) Occupational therapy;
(d) Physical therapy;
(e) Positive behavior support and consultation;
(f) Skilled nursing;
(g) Specialized medical equipment and supplies;
(h) Specialized psychiatric services;
(i) Speech, hearing, and language services;
(j) Staff and family consultation and training, which excludes individual and family counseling;
(k) Transportation; and
(4) Emergency assistance may be used for interim services until:
(a) The emergency situation has been resolved;
(b) You are transferred to alternative supports that meet your assessed needs; or
(c) You are transferred to an alternate waiver that provides the service you need.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0820, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0820, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0820, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0820, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0820, filed 12/13/05, effective 1/13/06.]



388-845-0900
What are environmental adaptations?

(1) Environmental adaptations provide physical adaptations within the physical structure of the home, or outside the home to provide access to the home. The need must be identified by the DDA assessment and the participant's person-centered service plan.
(2) Environmental adaptions are available in all of the DDA HCBS waivers.
(3) An environmental adaption must be necessary to:
(a) Maintain the health, welfare, and safety of the participant, the participant's caregiver, or both; or
(b) Increase the participant's independence in the home.
(4) Only the children's intensive in-home behavioral support (CIIBS) and individual and family services (IFS) waivers may include adaptations to the home necessary to prevent property destruction caused by the participant's behavior, as addressed in the participant's positive behavior support plan.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0900, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0900, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0900, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-0900, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0900, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0900, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0900, filed 12/13/05, effective 1/13/06.]



388-845-0905
Who is a qualified provider for environmental adaptations?

(1) For adaptations that do not require installation, qualified providers are retail vendors with a valid business license contracted with DDA to provide this service.
(2) For adaptations requiring installation, qualified providers must be a registered contractor per chapter 18.27 RCW and contracted with DDA. The contractor or subcontractor must be licensed and bonded to perform the specific type of work they are providing.
(3) For debris removal, qualified providers must be contracted with DDA.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0905, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0905, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0905, filed 12/13/05, effective 1/13/06.]



388-845-0910
What limits apply to environmental adaptations?

The following service limits apply to environmental adaptations:
(1) Clinical and support needs for environmental adaptations must be identified in the waiver participant's DDA assessment and documented in the person-centered service plan.
(2) Environmental adaptations require prior approval by the DDA regional administrator or designee and must be supported by itemized and written bids from licensed contractors. For an adaptation that costs:
(a) One thousand five hundred dollars or less, one bid is required;
(b) More than one thousand five hundred dollars and equal to or less than five thousand dollars, two bids are required; or
(c) More than five thousand dollars, three bids are required.
(3) All bids must include:
(a) The cost of all required permits and sales tax; and
(b) An itemized and clearly outlined scope of work.
(4) DDA may require an occupational therapist, physical therapist, or construction consultant to review and recommend an appropriate environmental adaptation statement of work prior to the waiver participant soliciting bids or purchasing adaptive equipment.
(5) Environmental adaptations to the home are excluded if they are of general utility without direct medical or remedial benefit to the individual, such as carpeting, roof repair, or central air conditioning.
(6) Environmental adaptations must meet all local and state building codes. Evidence of any required completed inspections must be submitted to DDA prior to authorizing payment for work.
(7) The condition of the dwelling or other projects in progress in the dwelling may prevent or limit some or all environmental adaptations at the discretion of DDA.
(8) Location of the dwelling in a flood plain, landslide zone, or other hazardous area may limit or prevent any environmental adaptations at the discretion of DDA.
(9) Written consent from the dwelling landlord is required prior to starting any environmental adaptations for a rental property. The landlord must not require removal of the environmental adaptations at the end of the waiver participant's tenancy as a condition of the landlord approving the environmental adaptation to the waiver participant's dwelling.
(10) Environmental adaptations must not add to the total square footage of the home.
(11) The dollar amounts for aggregate services in your basic plus waiver or the dollar amount of your annual IFS allocation limit the amount of service you may receive.
(12) For core, community protection, and CIIBS waivers, annual environmental adaptation costs must not exceed twelve thousand one hundred ninety-two dollars.
(13) Damage repairs under the CIIBS and IFS waivers are subject to the following restrictions:
(a) Limited to the cost of restoration to the original function;
(b) Limited to the dollar amounts of the IFS waiver participant's annual allocation;
(c) Behaviors of waiver participants that resulted in damage to the dwelling must be addressed in a positive behavior support plan prior to the repair of damages;
(d) Repairs to personal property such as furniture and appliances are excluded; and
(e) Repairs due to normal wear and tear are excluded.
(14) The following adaptations are not covered as an environmental adaption:
(a) Building fences and fence repairs;
(b) Carpet or carpet replacement;
(c) Air conditioning, heat pumps, generators, or ceiling fans; and
(d) Roof repair or siding.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-0910, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-0910, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-0910, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-0910, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-0910, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-0910, filed 12/13/05, effective 1/13/06.]



388-845-1030
What are individualized technical assistance services?

Individualized technical assistance services:
(1) Provide short-term, professional expertise to identify and address barriers to employment services; and
(2) Are available in addition to supports received through supported employment services for an individual who has not yet achieved his or her goal.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-1030, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1030, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-1030, filed 8/1/12, effective 9/1/12.]



388-845-1035
Who are qualified providers of individualized technical assistance services?

Providers of individualized technical assistance service must be a county or an individual or agency contracted with a county or DDA.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1035, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-1035, filed 8/1/12, effective 9/1/12.]



388-845-1040
Are there limits to the individualized technical assistance services you may receive?

(1) The developmental disabilities administration (DDA) may authorize a maximum of three months of individualized technical assistance at a time, not to exceed six months in the plan year.
(2) Individualized technical assistance services are available on the basic plus, core, and community protection waivers.
(3) Individualized technical assistance services are available only to individuals who are receiving supported employment services, unless approved by the regional administrator or his or her designee.
(4) Individualized technical assistance services are limited to additional hours under WAC 388-828-9355 and 388-828-9360.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-1040, filed 1/23/18, effective 2/23/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1040, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1040, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-1040, filed 8/1/12, effective 9/1/12.]



388-845-1100
What are behavioral health crisis diversion bed services?

Behavioral health crisis diversion bed services are temporary residential and behavioral services that may be provided in a client's home, licensed or certified setting or state operated setting. These services are available to eligible clients who are at risk of serious decline of mental functioning and who have been determined to be at risk of psychiatric hospitalization. These services are available in all four HCBS waivers administered by DDA as behavioral health stabilization services in accordance with WAC 388-845-1150 through 388-845-1160.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1100, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1100, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1100, filed 12/13/05, effective 1/13/06.]



388-845-1105
Who is a qualified provider of behavioral health crisis diversion bed services?

Providers of behavioral health crisis diversion bed services must be:
(1) DDA certified residential agencies per chapter 388-101 WAC;
(2) Other department licensed or certified agencies; or
(3) State operated agency.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1105, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1105, filed 12/13/05, effective 1/13/06.]



388-845-1110
What are the limits of behavioral health crisis diversion bed services?

(1) Clinical and support needs for behavioral health crisis diversion bed services are limited to those identified in the waiver participant's DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Behavioral health crisis diversion bed services are intermittent and temporary. The duration and amount of services you need to stabilize your crisis is determined by a behavioral health professional and/or DDA.
(3) These services are available in the CIIBS, basic plus, core, and community protection waivers administered by DDA as behavioral health stabilization services in accordance with WAC 388-845-1150 through 388-845-1160.
(4) The costs of behavioral health crisis diversion bed services do not count toward the dollar amounts for aggregate services in the basic plus waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1110, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1110, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1110, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1110, filed 12/13/05, effective 1/13/06.]



388-845-1150
What are behavioral health stabilization services?

(1) Behavioral health stabilization services assist persons who are experiencing a behavioral health crisis.
(2) Behavioral health stabilization services are available in the basic plus, core, children's intensive in-home behavior support (CIIBS), individual and family services (IFS), and community protection waivers.
(3) A participant may be eligible for behavioral health stabilization services if:
(a) A behavioral health professional or DDA has determined the participant is at risk of institutionalization or hospitalization;
(b) The participant needs:
(i) Positive behavior support and consultation;
(ii) Specialized psychiatric services for people age twenty-one and older; or
(iii) Behavioral health crisis diversion bed services available to participants on the basic plus, core, CIIBS, and community protection waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1150, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1150, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1150, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1150, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1150, filed 12/13/05, effective 1/13/06.]



388-845-1155
Who are qualified providers of behavioral health stabilization services?

Providers of these behavioral health stabilization services are listed in the rules in this chapter governing the specific services listed in WAC 388-845-1150.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1155, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1155, filed 12/13/05, effective 1/13/06.]



388-845-1160
Are there limitations to the behavioral health stabilization services that you can receive?

(1) Clinical and support needs for behavioral health stabilization services are limited to those identified in your DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Behavioral health stabilization services are intermittent and temporary. The duration and amount of services you need to stabilize your crisis is determined by a behavioral health professional and/or DDA.
(3) The costs of behavioral health stabilization services do not count toward the dollar amounts for aggregate services in the basic plus waiver or the annual allocation in the IFS waiver.
(4) Behavioral health stabilization services require prior approval by DDA or its designee.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1160, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1160, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1160, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1160, filed 12/13/05, effective 1/13/06.]



388-845-1170
What is nurse delegation?

(1) Nurse delegation services are services in compliance with WAC 246-840-910 through 246-840-970 by a registered nurse to provide training and nursing management for nursing assistants who perform delegated nursing tasks.
(2) Delegated nursing tasks include, but are not limited to, administration of noninjectable medications except for insulin, blood glucose testing, and tube feedings.
(3) Services include the initial visit, care planning, competency testing of the nursing assistant, consent of the client, additional instruction and supervisory visits.
(4) Clients who receive nurse delegation services must be considered "stable and predictable" by the delegated nurse.
(5) Nurse delegation services are available on all DDA HCBS waivers.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1170, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1170, filed 11/1/10, effective 12/2/10.]



388-845-1175
Who is a qualified provider of nurse delegation?

Providers of nurse delegation are registered nurses contracted with DDA to provide this service or employed by a nursing agency contracted with DDA to provide this service.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1175, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1175, filed 11/1/10, effective 12/2/10.]



388-845-1180
Are there limitations to the nurse delegation services that you receive?

The following limitations apply to receipt of nurse delegation services:
(1) Clinical and support needs for nurse delegation are limited to those identified in your DDA assessment and documented in the person-centered service plan/individual support plan.
(2) The department requires the delegating nurse's written recommendation regarding your need for the service. This recommendation must take into account that the nurse has recently examined you, reviewed your medical records, and conducted a nursing assessment.
(3) The department may require a written second opinion from a department selected nurse delegator that meets the same criteria in subsection (2) of this section.
(4) The following tasks must not be delegated:
(a) Injections, other than insulin;
(b) Central lines;
(c) Sterile procedures; and
(d) Tasks that require nursing judgment.
(5) The dollar amounts for aggregate services in your basic plus waiver or the dollar amounts for your annual allocation in your IFS waiver limit the amount of nurse delegation service you are authorized to receive.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1180, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1180, filed 11/1/10, effective 12/2/10.]



388-845-1181
What is occupational therapy?

(1) Occupational therapy is a service provided to improve, maintain, or maximize the waiver participant's abilities for independent functioning and health maintenance.
(2) Occupational therapy is available under the basic plus, community protection, core, and individual and family services waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1181, filed 6/20/18, effective 7/21/18.]



388-845-1182
Who may be a qualified provider of occupational therapy?

A qualified provider of occupational therapy must:
(1) Be licensed, registered, and certified as required by law;
(2) Be contracted with the developmental disabilities administration to provide occupational therapy; and
(3) Have a core provider agreement with the health care authority.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1182, filed 6/20/18, effective 7/21/18.]



388-845-1183
Are there limits to occupational therapy?

(1) Occupational therapy is limited to:
(a) Waiver participants age twenty-one or older;
(b) Services identified in your developmental disabilities administration (DDA) assessment and documented in your person-centered service plan;
(c) The dollar amounts for aggregate services in your basic plus waiver or the dollar amounts in the annual allocation for the individual and family services waiver; and
(d) An amount determined by DDA based on your needs and information from your treating professional.
(2) DDA may require a second opinion from a DDA-selected provider.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1183, filed 6/20/18, effective 7/21/18.]



388-845-1190
What is peer mentoring?

(1) Peer mentoring is a form of mentorship that takes place between a person who is living through the experience of having a developmental disability or family member of a person who has a developmental disability (peer mentor) and a person who is new to that experience (the peer mentee).
(2) Peer mentors utilize their personal experiences to provide support and guidance to a waiver participant and family members of a waiver participant.
(3) Peer mentors may orient a waiver participant to local community services, programs, and resources and provide answers to participants' questions or suggest other sources of support.
(4) Peer mentoring is available in the IFS waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1190, filed 8/4/16, effective 9/4/16.]



388-845-1191
Who are qualified providers of peer mentoring?

Qualified providers include organizations who are contracted with DDA to provide peer mentoring support and training to individuals with developmental disabilities or to families with a member with a developmental disability.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1191, filed 8/4/16, effective 9/4/16.]



388-845-1192
What limitations are there for peer mentoring?

(1) Support needs for peer mentoring are limited to those identified in the waiver participant's DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Peer mentors cannot mentor their own family members.
(3) The dollar amounts for the waiver participant's annual allocation in the IFS waiver limit the amount of peer mentoring service that the participant is authorized to receive.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1192, filed 8/4/16, effective 9/4/16.]



388-845-1195
What is person-centered plan facilitation?

(1) Person-centered plan facilitation is an approach to forming life plans that is centered on the individual. It is used as a life planning process to enable individuals with disabilities to increase personal self-determination. Person-centered plan facilitation is available in the IFS waiver.
(2) Person-centered plan facilitation typically includes:
(a) Identifying and developing a potential circle of people who know and care about the individual;
(b) Exploring what matters to the waiver participant by listening to and learning from the person;
(c) Developing a vision for a meaningful life, as defined by the waiver participant, which may include goals for education, employment, housing, relationships, and recreation;
(d) Discovering capacities and assets of the waiver participant, and his or her family, neighborhood, and support network;
(e) Generating an action plan; and
(f) Facilitating follow-up meetings to track progress toward goals.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1195, filed 8/4/16, effective 9/4/16.]



388-845-1196
Who are qualified providers of person-centered plan facilitation?

Qualified providers include organizations and individuals who are contracted with DDA to provide person-centered plan facilitation to individuals with developmental disabilities.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1196, filed 8/4/16, effective 9/4/16.]



388-845-1197
What limitations are there for person-centered plan facilitation?

(1) Support needs for person-centered planning facilitation are limited to those identified in the waiver participant's DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Person-centered plan facilitation may include follow up contacts with the waiver participant and his or her family to consult on plan implementation.
(3) The dollar amounts for the waiver participants' annual allocation in the IFS waiver limit the amount of person-centered plan facilitation service the individual is authorized to receive.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1197, filed 8/4/16, effective 9/4/16.]



388-845-1300
What are personal care services?

Personal care services as defined in WAC 388-106-0010 are the provision of assistance with personal care tasks. These services are available in the basic plus waiver if:
(1) You do not meet the programmatic eligibility requirements for community first choice services in chapter 388-106 WAC; and
(2) You meet the programmatic eligibility requirements for medicaid personal care in chapter 388-106 WAC.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1300, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1300, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1300, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1300, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1300, filed 12/13/05, effective 1/13/06.]



388-845-1305
Who are the qualified providers of personal care services?

(1) Qualified providers of personal care services may be individuals or licensed homecare agencies contracted with DSHS.
(2) All individual providers and homecare agency providers must meet provider qualifications for in-home caregivers in WAC 388-71-0500 through 388-71-0556.
(3) Providers of personal care services for adults must comply with the training requirements in these rules governing medicaid personal care providers in WAC 388-71-0841 through 388-71-1006. Additionally, providers must meet the certification requirements in WAC 388-71-0975 through 388-71-0980 and WAC 246-980-010 through 246-980-990.
(4) Natural, step, or adoptive parents can be the personal care provider of their adult child age eighteen or older.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1305, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1305, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1305, filed 12/13/05, effective 1/13/06.]



388-845-1310
Are there limits to the personal care services you can receive?

(1) Clinical and support needs for personal care services are limited to those identified in your DDA assessment and documented in your person-centered service plan/individual support plan.
(2) You must meet the programmatic eligibility for medicaid personal care in chapter 388-106 WAC governing medicaid personal care (MPC) using the current department approved assessment form: Comprehensive assessment reporting evaluation (CARE).
(3) The maximum hours of personal care you may receive are determined by the CARE tool used as part of the DDA assessment.
(a) Provider rates are limited to the department established hourly rates for in-home medicaid personal care.
(b) Homecare agencies must be licensed through the department of health and contracted with DSHS.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1310, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1310, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1310, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1310, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-1310, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1310, filed 12/13/05, effective 1/13/06.]



388-845-1315
What is physical therapy?

(1) Physical therapy is the evaluation and treatment of functional limitations in movement to facilitate self-care and reintegration into the home, community, or work.
(2) Physical therapy is available under the basic plus, community protection, core, and individual and family services waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1315, filed 6/20/18, effective 7/21/18.]



388-845-1316
Who may be a qualified provider of physical therapy?

A qualified provider of physical therapy must:
(1) Be licensed, registered, and certified as required by law;
(2) Be contracted with the developmental disabilities administration to provide physical therapy; and
(3) Have a core provider agreement with the health care authority.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1316, filed 6/20/18, effective 7/21/18.]



388-845-1317
Are there limits to physical therapy?

(1) Physical therapy is limited to:
(a) Waiver participants age twenty-one and older;
(b) Services identified in your developmental disabilities administration (DDA) assessment and documented in your person-centered service plan;
(c) The dollar amounts for aggregate services in your basic plus waiver or the dollar amounts in the annual allocation for the individual and family services waiver; and
(d) An amount determined by DDA based on your needs and information from your treating professional.
(2) DDA may require a second opinion from a DDA-selected provider.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1317, filed 6/20/18, effective 7/21/18.]



388-845-1400
What are prevocational services?

(1) Prevocational services typically occur in a specialized or segregated setting and include individualized monthly employment related activities in the community. Prevocational services are designed to prepare those interested in gainful employment in an integrated setting through training and skill development.
(2) Prevocational services are available in the basic plus, core and community protection waivers.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1400, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1400, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1400, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1400, filed 12/13/05, effective 1/13/06.]



388-845-1405
Who are the qualified providers of prevocational services?

Providers of prevocational services must be a county or an individual or agency contracted with a county or DDA to provide prevocational services.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1405, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1405, filed 12/13/05, effective 1/13/06.]



388-845-1410
Are there limits to the prevocational services you may receive?

The following limits apply to your receipt of prevocational services:
(1) Effective September 1, 2015, no new referrals are accepted for prevocational services.
(2) Effective March 1, 2019, prevocational services are no longer available.
(3) Clinical and support needs for prevocational services are limited to those identified in your developmental disabilities administration (DDA) assessment and documented in your person-centered service plan.
(4) You must be age twenty and graduating from high school before your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive prevocational services.
(5) Prevocational services are a time limited step on the pathway toward individual employment and are dependent on your demonstrating steady progress toward gainful employment over time. Your annual employment plan will include exploration of integrated settings within your next service year. Criteria that would trigger a review of your need for these services include, but are not limited to:
(a) Compensation at more than fifty percent of the prevailing wage;
(b) Significant progress made toward your defined goals; and
(c) Recommendation by your individual support plan team.
(6) You will not be authorized to receive prevocational services in addition to community inclusion services or supported employment services.
(7) Your service hours are determined by the assistance you need to reach your employment outcomes as described in WAC 388-828-9325.
[Statutory Authority: RCW 71A.12.030, 71A.12.120 and 42 C.F.R. 441.301 (c)(4). WSR 19-11-061, § 388-845-1410, filed 5/15/19, effective 6/15/19. Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-1410, filed 1/23/18, effective 2/23/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1410, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1410, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1410, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1410, filed 12/13/05, effective 1/13/06.]



388-845-1500
What are residential habilitation services?

Residential habilitation services (RHS) are available in the core and community protection waivers.
(1) Residential habilitation services include assistance:
(a) With personal care and supervision; and
(b) To learn, improve or retain social and adaptive skills necessary for living in the community.
(2) Residential habilitation services may provide instruction and support addressing one or more of the following outcomes:
(a) Health and safety;
(b) Personal power and choice;
(c) Competence and self-reliance;
(d) Positive recognition by self and others;
(e) Positive relationships; and
(f) Integration into the physical and social life of the community.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1500, filed 12/13/05, effective 1/13/06.]



388-845-1505
Who are qualified providers of residential habilitation services for the core waiver?

Providers of residential habilitation services for participants in the core waiver must be one of the following:
(1) Individuals contracted with DDA to provide residential support as a "companion home" provider;
(2) Individuals contracted with DDA to provide training as an "alternative living provider";
(3) Agencies contracted with DDA and certified per chapter 388-101 WAC;
(4) State-operated living alternatives (SOLA);
(5) Licensed and contracted group care homes, foster homes, child placing agencies or staffed residential homes per chapter 388-148 WAC.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1505, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1505, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1505, filed 12/13/05, effective 1/13/06.]



388-845-1510
Who are qualified providers of residential habilitation services for the community protection waiver?

Providers of residential habilitation services for participants of the community protection waiver are limited to state operated living alternatives (SOLA) and supported living providers who are contracted with DDA and certified under chapter 388-101 WAC as a residential community protection provider intensive supported living services (CP-ISLS).
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1510, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1510, filed 12/13/05, effective 1/13/06.]



388-845-1515
Are there limits to the residential habilitation services I may receive?

(1) You may only receive one type of residential habilitation service at a time.
(2) None of the following may be paid for under the core or community protection waiver:
(a) Room and board;
(b) The cost of building maintenance, upkeep, improvement, modifications or adaptations required to assure the health and safety of residents, or to meet the requirements of the applicable life safety code;
(c) Activities or supervision already being paid for by another source;
(d) Services provided in your parent's home unless you are receiving alternative living services for a maximum of six months to transition you from your parent's home into your own home.
(3) Alternative living services in the core waiver cannot:
(a) Exceed forty hours per month;
(b) Provide personal care or protective supervision.
(4) The following persons cannot be paid providers for your service:
(a) Your spouse;
(b) Your natural, step, or adoptive parents if you are a child age seventeen or younger;
(c) Your natural, step, or adoptive parent unless your parent is certified as a residential agency per chapter 388-101 WAC or is employed by a certified or licensed agency qualified to provide residential habilitation services.
(5) The initial authorization of residential habilitation services requires prior approval by the DDA regional administrator or designee.
(6) If you are under age eighteen, the residential habilitation services you receive are subject to requirements under chapter 388-826 WAC.
[Statutory Authority: RCW 71A.12.030 and 74.13.350. WSR 18-23-004, § 388-845-1515, filed 11/7/18, effective 12/8/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1515, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1515, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1515, filed 12/13/05, effective 1/13/06.]



388-845-1600
What is respite care?

(1) Respite care is short-term intermittent care to provide relief for a person who lives with you, is your primary care provider, and is:
(a) Your family member and your paid or unpaid care provider;
(b) A nonfamily member who is not paid to provide care for you;
(c) A contracted companion home provider paid by DDA to provide support to you; or
(d) A licensed children's foster home provider paid by DDA to provide support to you.
(2) Respite care is available in the:
(a) Basic plus waiver;
(b) Children's intensive in-home behavioral support (CIIBS);
(c) Core waiver; and
(d) Individual and family services (IFS) waiver.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1600, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1600, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1600, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1600, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1600, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1600, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1600, filed 12/13/05, effective 1/13/06.]



388-845-1605
Who is eligible to receive respite care?

You are eligible to receive respite care if you are in the basic plus, CIIBS, core, or IFS waiver and meet the criteria in WAC 388-845-1600.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1605, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1605, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1605, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1605, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.30 [71A.12.030], 71A.12.120, and Title 71A RCW. WSR 08-03-109, § 388-845-1605, filed 1/22/08, effective 2/22/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1605, filed 12/13/05, effective 1/13/06.]



388-845-1607
Can someone who lives with you be your respite provider?

Someone who lives with you may be your respite provider as long as he or she is not your primary care provider and is not contracted to provide any other DSHS paid service to you. The limitations listed in WAC 388-845-0111 also apply.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1607, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1607, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1607, filed 1/24/13, effective 2/24/13.]



388-845-1610
Where may respite care be provided?

(1) Respite care may be provided in any of the following licensed or certified settings that have a respite contract with the developmental disabilities administration (DDA):
(a) Adult family home;
(b) Assisted living facility;
(c) Child care center;
(d) Children's foster home;
(e) Children's group home;
(f) Group home;
(g) Group training home;
(h) Staffed residential home.
(2) Respite care may also be provided in:
(a) The individual's home or place of residence;
(b) The individual's relative's home; and
(c) Other DDA-contracted community settings such as a camp, senior center, and adult day care center.
(3) Your respite care provider may take you into the community while providing respite services.
[Statutory Authority: RCW 71A.12.030. WSR 17-12-011, § 388-845-1610, filed 5/26/17, effective 6/26/17. Statutory Authority: RCW 71A.12.030, 71A.12.120, and 2015 3rd sp.s. c 4. WSR 16-17-003, § 388-845-1610, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1610, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1610, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1610, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1610, filed 12/13/05, effective 1/13/06.]



388-845-1615
Who may be qualified providers of respite care?

Providers of respite care may be any of the following individuals or agencies contracted with the developmental disabilities administration (DDA) for respite care:
(1) Individuals who meet the provider qualifications under chapter 388-825 WAC;
(2) Home health agencies licensed under chapter 246-335 WAC, Part 1;
(3) Homecare agencies licensed under chapter 246-335 WAC, Part 1 and contracted with the area agencies on aging (AAA);
(4) Licensed and contracted group homes, foster homes, child placing agencies, staffed residential homes, and foster group care homes;
(5) Licensed and contracted adult family homes;
(6) Licensed and contracted adult residential care facilities;
(7) Licensed and contracted adult residential treatment facilities under chapter 246-337 WAC;
(8) Licensed child care centers under chapter 110-300A WAC;
(9) Licensed child day care centers under chapter 110-300A WAC;
(10) Adult day care providers under chapter 388-71 WAC contracted with DDA;
(11) Certified providers under chapter 388-101 WAC when respite is provided within the DDA contract for certified residential services;
(12) A licensed practical nurse (LPN) or registered nurse (RN) acting within the scope of the standards of nursing conduct or practice under chapter 246-700 WAC and contracted with DDA to provide this service; or
(13) Other DDA contracted providers such as a community center, senior center, parks and recreation, and summer programs.
[Statutory Authority: RCW 71A.12.030, 71A.12.120 and 42 C.F.R. 302 (a)(2). WSR 19-04-090, § 388-845-1615, filed 2/5/19, effective 3/8/19. Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1615, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030. WSR 17-12-011, § 388-845-1615, filed 5/26/17, effective 6/26/17. Statutory Authority: RCW 71A.12.030, 71A.12.120, and 2015 3rd sp.s. c 4. WSR 16-17-003, § 388-845-1615, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1615, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1615, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1615, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1615, filed 12/13/05, effective 1/13/06.]



388-845-1620
Are there limits to the respite care you may receive?

The following limits apply to the respite care you may receive:
(1) For basic plus, core, and the children's intensive in-home behavioral support (CIIBS) waivers, the developmental disabilities administration (DDA) assessment will determine how much respite you may receive under chapter 388-828 WAC.
(2) For the individual and family services (IFS) waiver, the dollar amount for your annual allocation in your IFS waiver limits the amount of respite care you may receive.
(3) Respite must not replace:
(a) Day care while your parent or guardian is at work; or
(b) Personal care hours available to you.
(4) If you receive respite in a private home, the home must be licensed to provide respite care unless the home is:
(a) Your private home; or
(b) The home of a relative under WAC 388-825-345.
(5) If you receive respite from a provider who requires licensure, the respite services are limited to activities and age-specific criteria contained in the provider's license.
(6) Your individual respite provider must not provide:
(a) Other DDA services for you during your respite care hours; or
(b) DDA paid services to other persons during your respite care hours.
(7) Your primary caregivers must not provide other DDA services for you during your respite care hours.
(8) If your personal care provider is your parent and you live in your parent's adult family home you must not receive respite.
(9) DDA must not pay for fees - Such as a membership or insurance fee - Associated with your respite care.
(10) If you require respite care from a licensed practical nurse (LPN) or a registered nurse (RN), respite services may be authorized using an LPN or RN. Respite services are limited to the assessed respite care hours identified in your person-centered service plan. Respite provided by an LPN or RN requires a prior approval by the regional administrator or designee.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1620, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1620, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1620, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1620, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1620, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1620, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-1620, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1620, filed 12/13/05, effective 1/13/06.]



388-845-1650
What is a risk assessment?

(1) A risk assessment is a professional evaluation that:
(a) Assesses a person's needs and the person's level of risk of sexual predatory behavior or aggression;
(b) Determines the need for psychological, medical, or therapeutic services; and
(c) Provides treatment recommendations to mitigate any assessed risk.
(2) A risk assessment is available in all DDA HCBS waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1650, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1650, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1650, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1650, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1650, filed 12/13/05, effective 1/13/06.]



388-845-1655
Who is a qualified provider of a risk assessment?

The provider of a risk assessment must be a:
(1) Licensed psychologist under chapter 246-924 WAC; or
(2) Certified sexual offender treatment provider (SOTP) and meet requirements under WAC 246-930-030 and WAC 246-930-040 if the provider is performing a risk assessment for sexually aggressive behavior.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1655, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1655, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1655, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1655, filed 12/13/05, effective 1/13/06.]



388-845-1660
Are there limits to the risk assessment you may receive?

(1) Clinical and support needs for a risk assessment are limited to those identified in your DDA assessment and documented in your person-centered service plan.
(2) A risk assessment must meet requirements under WAC 246-930-320.
(3) A risk assessment requires prior approval by the DDA regional administrator or designee.
(4) The cost of a risk assessment does not count toward the:
(a) Dollar limit for aggregate services in the basic plus waiver;
(b) Annual allocation in the individual and family services waiver; or
(c) Monthly average cost limit in the children's intensive in-home behavior support waiver.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1660, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1660, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1660, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-1660, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-1660, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1660, filed 12/13/05, effective 1/13/06.]



388-845-1700
What is waiver skilled nursing?

(1) Waiver skilled nursing means long-term, intermittent, and hourly skilled nursing services consistent with waiver objectives of avoiding institutionalization.
(2) Waiver skilled nursing services are available in the basic plus, community protection (CP), core, and individual and family services (IFS) waivers.
(3) Waiver skilled nursing services include nurse delegation services provided by a registered nurse under WAC 388-845-1170.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1700, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1700, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1700, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1700, filed 12/13/05, effective 1/13/06.]



388-845-1705
Who is a qualified provider of skilled nursing services?

The provider of skilled nursing services must be a licensed practical nurse (LPN) or registered nurse (RN) acting within the scope of the standards of nursing conduct or practice chapter 246-700 WAC and contracted with DDA to provide this service.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1705, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1705, filed 12/13/05, effective 1/13/06.]



388-845-1710
Are there limits to the skilled nursing services you may receive?

The following limits apply to skilled nursing services you may receive:
(1) Clinical and support needs for skilled nursing services are limited to those identified in your DDA assessment and documented in your person-centered service plan.
(2) Skilled nursing services, except for nurse delegation and nursing evaluations, require prior approval by the DDA regional administrator or designee.
(3) Skilled nursing hours must not exceed the number of hours determined by the nursing care consultant's skilled nursing assessment.
(4) DDA may require a second opinion by a DDA-selected provider.
(5) The dollar amount for aggregate services in your basic plus waiver or the dollar amount of your annual allocation in your IFS waiver limits the amount of skilled nursing services you may receive.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1710, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1710, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1710, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1710, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1710, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1710, filed 12/13/05, effective 1/13/06.]



388-845-1800
What are specialized medical equipment and supplies?

(1) Specialized medical equipment and supplies are durable and nondurable medical equipment not available through medicaid or the state plan or are in excess of what is available through the medicaid state plan benefit which enables individuals to:
(a) Increase their abilities to perform their activities of daily living; or
(b) Perceive, control, or communicate with the environment in which they live.
(2) Durable medical equipment and medical supplies are defined in WAC 182-543-1000 and 182-543-5500 respectively.
(3) Also included are items necessary for life support and ancillary supplies and equipment necessary to the proper functioning of the equipment and supplies described in subsection (1) of this section.
(4) Specialized medical equipment and supplies include the maintenance and repair of specialized medical equipment not covered through the medicaid state plan.
(5) Specialized medical equipment and supplies are available in all DDA HCBS waivers.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1800, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1800, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1800, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1800, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1800, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1800, filed 12/13/05, effective 1/13/06.]



388-845-1805
Who are the qualified providers of specialized medical equipment and supplies?

The provider of specialized medical equipment and supplies must be a medical equipment supplier contracted with DDA or have a state contract as a Title XIX vendor.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1805, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1805, filed 12/13/05, effective 1/13/06.]



388-845-1810
Are there limits to the specialized medical equipment and supplies you may receive?

The following limits apply to the specialized medical equipment and supplies you may receive:
(1) Clinical and support needs for specialized medical equipment and supplies are limited to those identified in your DDA assessment and documented in your person-centered service plan.
(2) Specialized medical equipment and supplies require prior approval by the DDA regional administrator or designee for each authorization.
(3) DDA may require a second opinion by a DDA-selected provider.
(4) Items must be of direct medical or remedial benefit to you and necessary as a result of your disability.
(5) Medications and vitamins are excluded.
(6) The dollar amounts for aggregate services in your basic plus waiver limit the amount of service you may receive.
(7) The dollar amounts for your annual allocation in your individual and family services (IFS) waiver limit the amount of service you may receive.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1810, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1810, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1810, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1810, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1810, filed 12/13/05, effective 1/13/06.]



388-845-1855
What is specialized clothing?

Specialized clothing is available to you in the CIIBS and IFS waivers and is defined as nonrestrictive clothing adapted to your individual needs and related to your disability, such as weighted clothing, clothing designed for tactile defensiveness, specialized footwear, or reinforced clothing.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1855, filed 8/4/16, effective 9/4/16.]



388-845-1860
Who are qualified providers of specialized clothing?

Qualified providers of specialized clothing are specialized clothing vendors contracted with DDA to provide this service.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1860, filed 8/4/16, effective 9/4/16.]



388-845-1865
Are there limits to your receipt of specialized clothing?

(1) The following limits apply to specialized clothing you may receive:
(a) Clinical and support needs for specialized clothing are limited to those identified in your DDA assessment and documented in your person-centered service plan.
(b) DDA requires written documentation from an appropriate health professional regarding your need for the service. This recommendation must take into account that the health professional has recently examined you, reviewed your medical records, and conducted an assessment.
(c) DDA may require a second opinion from a DDA-selected provider.
(2) For the IFS waiver, the dollar amount for your annual allocation limits the amount of service you may receive.
(3) You must receive prior approval from the DDA regional administrator or designee to receive specialized clothing.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1865, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1865, filed 8/4/16, effective 9/4/16.]



388-845-1900
What are specialized psychiatric services?

(1) Specialized psychiatric services are specific to the individual needs of persons with developmental disabilities who are experiencing behavioral health symptoms. These services are available to people age twenty-one and older.
(2) Specialized psychiatric services includes:
(a) Psychiatric evaluation;
(b) Medication evaluation and monitoring; and
(c) Psychiatric consultation.
(3) Specialized psychiatric services are also available as a behavioral health stabilization service under WAC 388-845-1150 through 388-845-1160.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1900, filed 6/20/18, effective 7/21/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1900, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1900, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-1900, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1900, filed 12/13/05, effective 1/13/06.]



388-845-1905
Who are qualified providers of specialized psychiatric services?

Providers of specialized psychiatric services must be one of the following licensed or registered, and contracted health care professionals:
(1) Psychiatrist;
(2) Psychiatric advanced registered nurse practitioner (ARNP); or
(3) Physician assistant working under the supervision of a psychiatrist.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1905, filed 12/13/05, effective 1/13/06.]



388-845-1910
Are there limitations to the specialized psychiatric services you can receive?

(1) Clinical and support needs for specialized psychiatric services are limited to those identified in your DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Specialized psychiatric services are excluded if they are available through other medicaid programs.
(3) DDA and the treating professional will determine the need and amount of service you will receive in the IFS, basic plus, core, CIIBS, and CP waivers, subject to the limitations in subsection (4) of this section.
(4) The dollar amounts for aggregate service in your basic plus waiver or the dollar amount of your annual allocation in your IFS waiver limit the amount of specialized psychiatric services you are authorized to receive, unless provided as a behavioral health stabilization service.
(5) Specialized psychiatric services require prior approval by the DDA regional administrator or designee.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-1910, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-1910, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-1910, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-1910, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-1910, filed 12/13/05, effective 1/13/06.]



388-845-1915
What are speech, hearing, and language services?

(1) Speech, hearing, and language services are services provided to a person with speech, hearing, and language disorders by or under the supervision of a speech pathologist or audiologist.
(2) Speech, hearing, and language services are available under the basic plus, community protection, core, and individual and family services waivers.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1915, filed 6/20/18, effective 7/21/18.]



388-845-1916
Who may be a qualified provider of speech, hearing, and language services?

To be a qualified provider of speech, hearing, and language services, a person must:
(1) Be licensed, registered, and certified as an audiologist or speech pathologist as required by law or work under the supervision of a qualified speech pathologist or audiologist;
(2) Be contracted with the developmental disabilities administration to provide speech, hearing, and language services; and
(3) Have a core provider agreement with the health care authority.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1916, filed 6/20/18, effective 7/21/18.]



388-845-1917
Are there limits to the speech, hearing, and language services you may receive?

(1) Speech, hearing, and language services are limited to:
(a) Waiver participants age twenty-one and older;
(b) Services identified in your developmental disabilities administration (DDA) assessment and documented in your person-centered service plan;
(c) The dollar amounts for aggregate services in your basic plus waiver or the dollar amounts in the annual allocation for the individual and family services waiver; and
(d) An amount determined by DDA based on your needs and information from your treating professional.
(2) DDA may require a second opinion from a DDA-selected provider.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-1917, filed 6/20/18, effective 7/21/18.]



388-845-2000
What is staff and family consultation and training?

(1) Staff and family consultation and training is professional assistance to families or direct service providers to help them better meet the needs of a participant.
(2) Staff and family consultation and training is available in all DDA HCBS waivers.
(3) Staff and family consultation and training is provided to families, direct staff, or personal care providers to meet the specific needs of a participant as outlined in the participant's person-centered service plan.
(4) Staff and family consultation and training includes:
(a) Health and medication monitoring;
(b) Positioning and transfer;
(c) Basic and advanced instructional techniques;
(d) Positive behavior support;
(e) Augmentative communication systems;
(f) Diet and nutritional guidance;
(g) Disability information and education;
(h) Strategies for effectively and therapeutically interacting with the participant;
(i) Environmental consultation; and
(j) For the basic plus, IFS, and CIIBS waivers only, individual and family counseling.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-2000, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2000, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2000, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-2000, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2000, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-2000, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2000, filed 12/13/05, effective 1/13/06.]



388-845-2005
Who is a qualified provider of staff/family consultation and training?

To provide staff/family consultation and training, a provider must be contracted with DDA and one of the following licensed, registered, or certified professionals:
(1) Audiologist;
(2) Licensed practical nurse;
(3) Marriage and family therapist;
(4) Mental health counselor;
(5) Occupational therapist;
(6) Physical therapist;
(7) Registered nurse;
(8) Sex offender treatment provider;
(9) Speech/language pathologist;
(10) Social worker;
(11) Psychologist;
(12) Certified American sign language instructor;
(13) Nutritionist;
(14) Counselors registered or certified in accordance with chapter 18.19 RCW;
(15) Certified dietician;
(16) Recreation therapist registered in Washington and certified by the national council for therapeutic recreation;
(17) Providers listed in WAC 388-845-0506 and contracted with DDA to provide CIIBS intensive services;
(18) Certified music therapist (for CIIBS only);
(19) Psychiatrist; or
(20) Professional advocacy organization.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2005, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2005, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-2005, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2005, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-2005, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2005, filed 12/13/05, effective 1/13/06.]



388-845-2010
Are there limits to the staff and family consultation and training you may receive?

(1) Staff and family consultation and training are limited to supports identified in your DDA assessment and documented in the person-centered service plan.
(2) Expenses to the family or provider for room and board or attendance, including registration, at conferences are excluded as a service under staff and family consultation and training.
(3) The dollar amounts for aggregate service in your basic plus waiver or the dollar amount of the annual allocation in your individual and family services (IFS) waiver limit the amount of staff and family consultation and training you may receive.
(4) Under the basic plus waiver, individual and family counseling is limited to family members who:
(a) Live with the participant; and
(b) Have been assaulted by the participant and the assaultive behavior was:
(i) Documented in the participant's person-centered service plan; and
(ii) Addressed in the participant's positive behavior support plan or therapeutic plan.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-2010, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2010, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2010, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-2010, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2010, filed 12/13/05, effective 1/13/06.]



388-845-2100
What are supported employment services?

(1) Supported employment services are for those interested in integrated gainful employment and should facilitate paid employment that is covered by the Washington State Minimum Wage Act under chapter 49.46 RCW and the Fair Labor Standards Act under 29 U.S.C. Section 201. These services provide you with intensive ongoing support if you need individualized assistance to gain employment, maintain employment, or both. These services are tailored to your individual needs, interests, abilities, and promote your career development. These services are provided in individual or group settings and are available in the basic plus, core, and community protection waivers.
(2) Individual supported employment services include activities needed to sustain Washington state's minimum wage pay or higher. These services are conducted in integrated business environments and include the following:
(a) Intake: An initial meeting to gather and share basic information and a general overview of employment supports, resources in the community, and the type of available supports that the individual may receive;
(b) Discovery: A person-centered approach to learn the individual's likes and dislikes, job preferences, and employment goals and skills;
(c) Job preparation: Includes activities of work readiness resume development, work experience, volunteer support transportation training;
(d) Marketing: A method to identify and negotiate jobs, build relationships with employers, and customize employment development;
(e) Job coaching: The supports needed to keep the job; and
(f) Job retention: The supports needed to keep the job, maintain a relationship with employer, identify opportunities, and negotiate a raise in pay, promotion, or increased benefits.
(3) Group supported employment services are a step on your pathway toward gainful employment in an integrated setting and include:
(a) Supports and paid training in an integrated business setting;
(b) Supervision by a qualified employment provider during working hours;
(c) Groupings of no more than eight workers with disabilities; and
(d) Individualized supports to obtain gainful employment.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 71A.12.120, and 34.05.330. WSR 19-06-053, § 388-845-2100, filed 3/4/19, effective 4/4/19. Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-2100, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2100, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2100, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-2100, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2100, filed 12/13/05, effective 1/13/06.]



388-845-2105
Who are qualified providers of supported employment services?

Providers of supported employment services must be a county, or agency or an individual contracted with a county or DDA.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2105, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-2105, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2105, filed 12/13/05, effective 1/13/06.]



388-845-2110
Are there limits to the supported employment services you may receive?

The following limits apply to your receipt of supported employment services:
(1) You must be age twenty and graduating from high school before your July or August twenty-first birthday, age twenty-one and graduated from high school, or age twenty-two or older to receive supported employment services;
(2) Payment for individual supported employment services excludes the supervisory activities rendered as a normal part of the business setting;
(3) You will not be authorized to receive supported employment services in addition to community access or prevocational services; and
(4) Your service hours are determined by the assistance you need to reach your employment outcomes as described in WAC 388-828-9325 and might not equal the number of hours you spend on the job or in job related activities.
[Statutory Authority: RCW 71A.12.030, 71A.12.040, 2015 3rd sp.s. c 4, and 42 C.F.R. § 441.301 (c)(4)-(5). WSR 18-03-174, § 388-845-2110, filed 1/23/18, effective 2/23/18. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2110, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-2110, filed 9/22/08, effective 10/23/08. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2110, filed 12/13/05, effective 1/13/06.]



388-845-2130
What are supported parenting services?

(1) Supported parenting services are professional services offered to participants who are parents or expectant parents.
(2) Services may include teaching, parent coaching, and other supportive strategies in areas critical to parenting, including child development, nutrition and health, safety, child care, money management, time and household management, and housing.
(3) Supported parenting services are designed to build parental skills around the child's developmental domains of cognition, language, motor, social-emotional, and self-help.
(4) Supported parenting services are offered in the IFS waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2130, filed 8/4/16, effective 9/4/16.]



388-845-2135
Who are qualified providers of supported parenting services?

Qualified providers of supported parenting services must:
(1) Have an understanding of individual learning styles related to child development and family dynamics;
(2) Have skills in child development and family dynamics;
(3) Have a supported parenting contract with DDA; and
(4) Be one or more of the following licensed, registered or certified professionals:
(a) Audiologist;
(b) Licensed practical nurse;
(c) Marriage and family therapist;
(d) Mental health counselor;
(e) Occupational therapist;
(f) Physical therapist;
(g) Registered nurse or licensed practical nurse;
(h) Speech/language pathologist;
(i) Social worker;
(j) Psychologist;
(k) Certified American sign language instructor;
(l) Nutritionist;
(m) Counselors registered or certified in accordance with chapter 18.19 RCW;
(n) Certified dietician;
(o) Recreation therapist registered in Washington and certified by the national council for therapeutic recreation;
(p) Psychiatrist;
(q) Professional advocacy organization.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2135, filed 8/4/16, effective 9/4/16.]



388-845-2140
Are there any limitations on your receipt of supported parenting services?

The following limitations apply to your receipt of supported parenting services:
(1) Clinical and support needs for supported parenting services are limited to those identified in your DDA assessment and documented in your person-centered service plan/individual support plan; and
(2) The dollar amount of your annual allocation in your IFS waiver limit the amount of supported parenting service you are authorized to receive.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2140, filed 8/4/16, effective 9/4/16.]



388-845-2160
What is therapeutic equipment and supplies?

(1) Therapeutic equipment and supplies are only available in the CIIBS and IFS waivers.
(2) Therapeutic equipment and supplies are equipment and supplies that are necessary to implement a behavioral support plan or other therapeutic plan, designed by an appropriate professional, such as a sensory integration or communication therapy plan, and necessary in order to fully implement the therapy or intervention.
(3) Included are items such as a weighted blanket, supplies that assist to calm or redirect the individual to a constructive activity, or a vestibular swing.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2160, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2160, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2160, filed 11/1/10, effective 12/2/10.]



388-845-2165
Who are qualified providers of therapeutic equipment and supplies?

Providers of therapeutic equipment and supplies are therapeutic equipment and supply vendors contracted with DDA to provide this service.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2165, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2165, filed 11/1/10, effective 12/2/10.]



388-845-2170
Are there limits to your receipt of therapeutic equipment and supplies?

The following limits apply to your receipt of therapeutic equipment and supplies under the children's intensive in-home behavior support (CIIBS) and individual and family services (IFS) waivers:
(1) DDA requires your treating professional's written recommendation regarding your need for the service. This recommendation must take into account that the treating professional has recently examined you, reviewed your medical records, and conducted a functional evaluation.
(2) DDA may require a second opinion from a DDA-selected professional.
(3) The dollar amount of your annual allocation in your IFS waiver limits the amount of therapeutic equipment and supplies you are authorized to receive.
(4) Therapeutic equipment and supplies requires a prior approval by the DDA regional administrator or designee.
(5) Therapeutic equipment and supplies excludes nonspecialized recreational items such as trampolines, swing sets, and hot tubs.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-2170, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2170, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 c 49. WSR 12-16-095, § 388-845-2170, filed 8/1/12, effective 9/1/12. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2170, filed 11/1/10, effective 12/2/10.]



388-845-2200
What are transportation services?

Transportation services provide reimbursement to a provider when the transportation is required and specified in the waiver individual support plan. This service is available in all DDA HCBS waivers if the cost and responsibility for transportation is not already included in your provider's contract and payment.
(1) Transportation provides you access to waiver services, specified by your individual support plan.
(2) Whenever possible, you must use family, neighbors, friends, or community agencies that can provide this service without charge.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2200, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-2200, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2200, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-2200, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2200, filed 12/13/05, effective 1/13/06.]



388-845-2205
Who is qualified to provide transportation services?

(1) The provider of transportation services can be an individual or agency contracted with DDA whose contract includes transportation in the statement of work.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2205, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2205, filed 12/13/05, effective 1/13/06.]



388-845-2210
Are there limitations to the transportation services you can receive?

The following limitations apply to transportation services:
(1) Support needs for transportation services are limited to those identified in your DDA assessment and documented in your person-centered service plan/individual support plan.
(2) Transportation is limited to travel to and from a waiver service. When the waiver service is supported employment, transportation is limited to days when you receive employment support services.
(3) Transportation does not include the purchase of a bus pass.
(4) Reimbursement for provider mileage requires prior authorization by DDA and is paid according to contract.
(5) This service does not cover the purchase or lease of vehicles.
(6) Reimbursement for provider travel time is not included in this service.
(7) Reimbursement to the provider is limited to transportation that occurs when you are with the provider.
(8) You are not eligible for transportation services if the cost and responsibility for transportation is already included in your provider's contract and payment.
(9) The dollar limitations for aggregate services in your basic plus waiver or the dollar amount of your annual allocation in the IFS waiver limit the amount of service you may receive.
(10) If your individual waiver personal care provider uses his or her own vehicle to provide transportation to you for essential shopping and medical appointments as a part of your personal care service, your provider may receive up to one hundred miles per month in mileage reimbursement. If you work with more than one individual personal care provider, your limit is still a total of one hundred miles per month. This cost is not counted toward the dollar limitation for aggregate services in the basic plus waiver.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2210, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2210, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 08-20-033, § 388-845-2210, filed 9/22/08, effective 10/23/08; WSR 07-20-050, § 388-845-2210, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-2210, filed 12/13/05, effective 1/13/06.]



388-845-2260
What are vehicle modifications?

(1) Vehicle modifications are adaptations or alterations to a vehicle required in order to accommodate the unique needs of the participant, enable full integration into the community, and ensure the health, welfare, and safety of the participant or the safety of a caregiver.
(2) Vehicle modifications require prior approval from the DDA regional administrator or designee.
(3) Examples of vehicle modifications include:
(a) Manual hitch-mounted carrier and hitch for all wheelchair types;
(b) Wheelchair cover;
(c) Wheelchair strap-downs;
(d) Portable wheelchair ramp;
(e) Accessible running boards and steps;
(f) Assist poles and grab handles.
(g) Power activated carrier for all wheelchair types;
(h) Permanently installed wheelchair ramps;
(i) Repairs and maintenance to vehicular modifications as needed for client safety; and
(j) Other access modifications.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2260, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2260, filed 11/1/10, effective 12/2/10.]



388-845-2265
Who are providers of vehicle modifications?

Providers of vehicle modifications are:
(1) Vehicle service providers contracted with DDA to provide this service; or
(2) Vehicle adaptive equipment vendors contracted with DDA to provide this service.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2265, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2265, filed 11/1/10, effective 12/2/10.]



388-845-2270
Are there limitations to your receipt of vehicle modification services?

Vehicle modification services are only available on the CIIBS or IFS waiver. The following limitations apply:
(1) Clinical and support needs for vehicle modification services are limited to those identified in your DDA assessment and documented in the person-centered service plan/individual support plan.
(2) Vehicle modifications are excluded if they are of general utility without direct medical or remedial benefit to you.
(3) If you are eligible for or enrolled with division of vocational rehabilitation (DVR) you must pursue this benefit through DVR first.
(4) Vehicle modifications must be the most cost effective modification based upon a comparison of contractor bids as determined by DDA.
(5) Modifications will only be approved for a vehicle that serves as your primary means of transportation and is owned by you, your family, or both.
(6) DDA requires your treating professional's written recommendation regarding your need for the service. This recommendation must take into account that the treating professional has recently examined you, reviewed your medical records, and conducted a functional evaluation.
(7) The department may require a second opinion from a department selected provider that meets the same criteria as subsection (6) of this section.
(8) The dollar amount for your annual allocation in your IFS waiver limits the amount of vehicle modification service you are authorized to receive.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-2270, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-2270, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-2270, filed 11/1/10, effective 12/2/10.]



388-845-2280
What is wellness education?

Wellness education provides you with monthly individualized printed educational materials designed to assist you in managing health related issues and achieving wellness goals identified in your person-centered service plan that address your health and safety issues. Individualized educational materials are developed by the state, other content providers, and the contracted wellness education provider. This service is available on the basic plus, individual and family services, and core waivers.
[Statutory Authority: RCW 71A.12.030 and CMS. WSR 16-19-031, § 388-845-2280, filed 9/13/16, effective 10/14/16. Statutory Authority: RCW 71A.12.030. WSR 16-05-053, § 388-845-2280, filed 2/11/16, effective 3/13/16.]



388-845-2283
How are my wellness educational materials selected?

Individualized educational materials are selected for you by the wellness education provider's algorithm and are based on your DDA assessment. Goals, diagnoses, treatments, conditions and other factors identified in your DDA assessment provide the basis for the algorithm to select educational materials for you. These goals, diagnoses, treatments, conditions and other factors may include, but are not limited to the following:
(1) Diabetes - IDDM;
(2) Diabetes - NIDDM;
(3) COPD;
(4) Cardiovascular disease;
(5) Rheumatoid arthritis;
(6) Traumatic brain injury;
(7) Cerebral palsy;
(8) Alzheimer's disease;
(9) Anxiety disorder;
(10) Asthma;
(11) Autism;
(12) Stroke;
(13) Congestive heart failure;
(14) Decubitus ulcer;
(15) Depression;
(16) Emphysema;
(17) GERD;
(18) Hypertension;
(19) Hypotension;
(20) Down's syndrome;
(21) Fragile X syndrome;
(22) Prader-Willi;
(23) ADD;
(24) ADHD;
(25) Post-traumatic stress disorder;
(26) Asperger's syndrome;
(27) Hepatitis;
(28) Paraplegia;
(29) Quadriplegia;
(30) Fetal alcohol syndrome/fetal alcohol effect;
(31) Epilepsy;
(32) Seizure disorder;
(33) Sleep apnea;
(34) Urinary tract infection;
(35) Multiple sclerosis;
(36) Falls;
(37) Smoking;
(38) Alcohol abuse;
(39) Substance abuse;
(40) Bowel incontinence;
(41) Bladder incontinence;
(42) Diabetic foot care;
(43) Pain daily;
(44) Sleep issues;
(45) BMI = or greater than 25;
(46) BMI less than 18.5;
(47) Skin care (pressure ulcers, abrasions, burns, rashes);
(48) Seasonal allergies;
(49) Edema;
(50) Poor balance;
(51) Recent loss/grieving;
(52) Conflict management;
(53) Importance of regular dental visits;
(54) ADA diet;
(55) Cardiac diet;
(56) Celiac diet;
(57) Low sodium diet;
(58) Goals; and
(59) Parkinson's disease.
[Statutory Authority: RCW 71A.12.030. WSR 16-05-053, § 388-845-2283, filed 2/11/16, effective 3/13/16.]



388-845-2285
Are there limits to wellness education?

Wellness education is a once a month service. In the basic plus waiver, you are limited to the aggregate service expenditure limits defined in WAC 388-845-0210. The dollar amount for your individual and family services (IFS) waiver annual allocation defined in WAC 388-845-0230 limits the amount of service you may receive.
[Statutory Authority: RCW 71A.12.030 and CMS. WSR 16-19-031, § 388-845-2285, filed 9/13/16, effective 10/14/16. Statutory Authority: RCW 71A.12.030. WSR 16-05-053, § 388-845-2285, filed 2/11/16, effective 3/13/16.]



388-845-2290
Who are qualified providers of wellness education?

The wellness education provider must have the ability and resources to:
(1) Receive and manage client data in compliance with all applicable federal HIPPA regulations, state law and rules and ensure client confidentiality and privacy;
(2) Translate materials into the preferred language of the participant;
(3) Ensure that materials are targeted to the participant's assessment and person-centered service plan;
(4) Manage content sent to participants to prevent duplication of materials;
(5) Deliver newsletters and identify any undeliverable client/representative addresses prior to each monthly mailing and manage any returned mail in a manner that ensures participants receive the monthly information; and
(6) Contract with ALTSA or DDA to provide this service.
[Statutory Authority: RCW 71A.12.030. WSR 16-05-053, § 388-845-2290, filed 2/11/16, effective 3/13/16.]



388-845-3000
What is the process for determining the services you need?

Your service needs are determined through the DDA assessment and the service planning process as defined in chapter 388-828 WAC. Only identified health and welfare needs will be authorized for payment in the person-centered service plan/individual support plan.
(1) You receive an initial and annual assessment of your needs using a department-approved form.
(a) You meet the eligibility requirements for ICF/IID level of care.
(b) The comprehensive assessment reporting evaluation (CARE) tool will determine your eligibility and amount of personal care services.
(c) If you are in the basic plus, CIIBS, or core waiver, the DDA assessment will determine the amount of respite care available to you.
(2) From the assessment, DDA develops your waiver person-centered service plan/individual support plan (ISP) with either you, or you and your legal representative, and others who are involved in your life such as your parent or guardian, advocate, and service providers.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3000, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3000, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3000, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-3000, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3000, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3000, filed 12/13/05, effective 1/13/06.]



388-845-3015
How is the waiver respite assessment administered?

The waiver respite assessment is administered by department staff during an in-person interview with you if you choose to be present, and at least one other person with knowledge of you, such as your primary caregiver.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3015, filed 12/13/05, effective 1/13/06.]



388-845-3020
Who can be the respondent for the waiver respite assessment?

The respondent for your waiver respite assessment must be an adult who is well acquainted with you and can provide the information needed to complete the assessment, such as your primary caregiver.
(1) You cannot be the respondent for your own respite assessment.
(2) The department may select and interview additional respondents as needed to get complete and accurate information.
[Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3020, filed 12/13/05, effective 1/13/06.]



388-845-3055
What is a waiver person-centered service plan/individual support plan (ISP)?

(1) The person-centered service plan/individual support plan (ISP) is the primary tool DDA uses to determine and document your needs and to identify the services to meet those needs.
(2) Your person-centered service plan/ISP must include:
(a) Your identified health and welfare needs;
(b) Both paid and unpaid services and supports approved to meet your identified health and welfare needs as identified in WAC 388-828-8040 and 388-828-8060; and
(c) How often you will receive each waiver service, how long you will need it, and who will provide it.
(3) For any person-centered service plan/ISP, you or your legal representative must sign the plan indicating your agreement to the receipt of services.
(4) You may choose any qualified provider for the service, who meets all of the following:
(a) Is able to meet your needs within the scope of their contract, licensure, and certification;
(b) Is reasonably available;
(c) Meets provider qualifications in chapters 388-845 and 388-825 WAC for contracting; and
(d) Agrees to provide the service at department rates.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3055, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3055, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3055, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3055, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3055, filed 12/13/05, effective 1/13/06.]



388-845-3056
What if you need assistance to understand your person-centered service plan/individual support plan?

If you are unable to understand your person-centered service plan/individual support plan and the individual who has agreed to provide assistance to you as your necessary supplemental accommodation representative is unable to assist you with understanding your individual support plan, DDA will take the following steps:
(1) Consult with the office of the attorney general to determine if you require a legal representative or guardian to assist you with your individual support plan;
(2) Continue your current waiver services; and
(3) If the office of the attorney general or a court determines that you do not need a legal representative, DDA will continue to try to provide necessary supplemental accommodations in order to help you understand your person-centered service plan/individual support plan.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3056, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3056, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3056, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3056, filed 9/26/07, effective 10/27/07.]



388-845-3060
When is your person-centered service plan/individual support plan effective?

Your person-centered service plan/individual support plan is effective the last day of the month in which DDA signs and dates it.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3060, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3060, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3060, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3060, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3060, filed 12/13/05, effective 1/13/06.]



388-845-3061
Can a change in your person-centered service plan/individual support plan be effective before you sign it?

If you verbally request a change in service to occur immediately, DDA can sign the person-centered service plan/individual support plan and approve it prior to receiving your signature.
(1) Your person-centered service plan/individual support plan will be mailed to you for signature.
(2) You retain the same appeal rights as if you had signed the person-centered service plan/individual support plan.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3061, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3061, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3061, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3061, filed 9/26/07, effective 10/27/07.]



388-845-3062
Who is required to sign the person-centered service plan/individual support plan?

(1) If you do not have a legal representative, you must sign the person-centered service plan/individual support plan.
(2) If you have a legal representative, your legal representative must sign the person-centered service plan/individual support plan.
(3) If you need assistance to understand your person-centered service plan/individual support plan, DDA will follow the steps outlined in WAC 388-845-3056 (1) and (3).
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3062, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3062, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3062, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3062, filed 9/26/07, effective 10/27/07.]



388-845-3063
Can your person-centered service plan/individual support plan be effective before the end of the month?

You may request to DDA to have your person-centered service plan/individual support plan effective prior to the end of the month. The effective date will be the date DDA signs and dates it.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3063, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3063, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3063, filed 1/24/13, effective 2/24/13.]



388-845-3065
How long is your plan effective?

Your person-centered service plan/individual support plan is effective through the last day of the twelfth month following the effective date or until another ISP is completed, whichever occurs sooner.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3065, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3065, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3065, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3065, filed 12/13/05, effective 1/13/06.]



388-845-3070
What happens if you do not sign your person-centered service plan?

(1) If you do not sign your initial person-centered service plan (PCSP), DDA must not provide waiver services to you until you sign the PCSP.
(2) If you do not sign your PCSP and it is a reassessment or review, DDA will:
(a) Continue providing services identified in your current PCSP until the end of the notice period under WAC 388-825-105; and
(b) Return your PCSP to you for your signature.
(3) If you do not return your signed PCSP within two months of your reassessment or review, DDA must terminate your services.
(4) Your appeal rights are under:
(a) WAC 388-845-4000; and
(b) WAC 388-825-120 through 388-825-165.
[Statutory Authority: RCW 71A.12.030, 71A.12.120, 42 C.F.R. 441 Subpart G. WSR 18-14-001, § 388-845-3070, filed 6/20/18, effective 7/21/18. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3070, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3070, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3070, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3070, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3070, filed 12/13/05, effective 1/13/06.]



388-845-3075
What if your needs change?

You may request a review of your person-centered service plan/individual support plan at any time by calling your case manager. If there is a significant change in your condition or circumstances, DDA must reassess your person-centered service plan/individual support plan with you and amend the plan to reflect any significant changes. This reassessment does not affect the end date of your annual person-centered service plan/individual support plan.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3075, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3075, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3075, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3075, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3075, filed 12/13/05, effective 1/13/06.]



388-845-3080
What if my needs exceed the maximum yearly funding limit or the scope of services under the basic plus waiver?

(1) If you are on the basic plus waiver and your assessed need for services exceeds the maximum permitted, DDA will make the following efforts to meet your health and welfare needs:
(a) Identify more available natural supports;
(b) Initiate an exception to rule to access available nonwaiver services not included in the basic plus waiver other than natural supports;
(c) Authorize emergency assistance up to six thousand dollars per year if your needs meet the definition of emergency assistance in WAC 388-845-0800.
(2) If emergency assistance and other efforts are not sufficient to meet your needs, you will be offered:
(a) An opportunity to apply for an alternate waiver that has the services you need;
(b) Priority for placement on the alternative waiver when there is capacity to add people to that waiver;
(c) Placement in an ICF/ID.
(3) If none of the options in subsections (1) and (2) above is successful in meeting your health and welfare needs, DDA may terminate your waiver eligibility.
(4) If you are terminated from a waiver, you will remain eligible for nonwaiver DDA services but access to state-only funded DDA services is limited by availability of funding.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3080, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3080, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3080, filed 12/13/05, effective 1/13/06.]



388-845-3085
What if your needs exceed what can be provided under the IFS, CIIBS, core, or community protection waiver?

(1) If you are on the IFS, CIIBS, core, or community protection waiver and your assessed need for services exceeds the scope of services provided under your waiver, DDA will make one or more of the following efforts to meet your health and welfare needs:
(a) Identify more available natural supports;
(b) Initiate an exception to rule to access available nonwaiver services not included in the IFS, CIIBS, core, or community protection waiver other than natural supports;
(c) Offer you the opportunity to apply for an alternate waiver that has the services you need, subject to WAC 388-845-0045; or
(d) Offer you placement in an ICF/IID.
(2) If none of the above options is successful in meeting your health and welfare needs, DDA may terminate your waiver eligibility.
(3) If you are terminated from a waiver, you will remain eligible for nonwaiver DDA services but access to state-only funded DDA services is limited by availability of funding.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-845-3085, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3085, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-3085, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-3085, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3085, filed 12/13/05, effective 1/13/06.]



388-845-3090
What if my identified health and welfare needs are less than what is provided in my current waiver?

If your identified health and welfare needs are less than what is provided in your current waiver, DDA may terminate you from your current waiver and enroll you in a waiver that meets but does not exceed your assessed need for waiver services.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3090, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3090, filed 12/13/05, effective 1/13/06.]



388-845-3095
Will I have to pay toward the cost of waiver services?

(1) You are required to pay toward board and room costs if you live in a licensed facility or in a companion home as room and board is not considered to be a waiver service.
(2) You will not be required to pay towards the cost of your waiver services if you receive SSI.
(3) You may be required to pay towards the cost of your waiver services if you do not receive SSI. DDA determines what amount, if any, you pay in accordance with WAC 182-515-1510.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-3095, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-3095, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-3095, filed 12/13/05, effective 1/13/06.]



388-845-4000
What are my appeal rights under the waiver?

In addition to your appeal rights under WAC 388-825-120, you have the right to appeal the following decisions:
(1) Disenrollment from a waiver under WAC 388-845-0060, including a disenrollment from a waiver and enrollment in a different waiver.
(2) A denial of your request to receive ICF/ID services instead of waiver services; or
(3) A denial of your request to be enrolled in a waiver, subject to the limitations described in WAC 388-845-4005.
[Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-4000, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-4000, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-4000, filed 12/13/05, effective 1/13/06.]



388-845-4005
Can I appeal a denial of my request to be enrolled in a waiver?

(1) If you are not enrolled in a waiver and your request to be enrolled in a waiver is denied, your appeal rights are limited to the decision that you are not eligible to have your request documented in a statewide database due to the following:
(a) You do not need ICF/ID level of care per WAC 388-845-0070, 388-828-8040 and 388-828-8060; or
(b) You requested enrollment in the CIIBS waiver and do not meet CIIBS eligibility per WAC 388-828-8500 through 388-828-8520.
(2) If you are enrolled in a waiver and your request to be enrolled in a different waiver is denied, your appeal rights are limited to the following:
(a) DDA's decision that the services contained in a different waiver are not necessary to meet your health and welfare needs and that the services available on your current waiver can meet your health and welfare needs; or
(b) DDA's decision that you are not eligible to have your request documented in a statewide database because you requested enrollment in the CIIBS waiver and do not meet CIIBS eligibility per WAC 388-828-8500 through 388-828-8520.
(3) If DDA determines that the services offered in a different waiver are necessary to meet your health and welfare needs, but there is not capacity on the different waiver, you do not have the right to appeal any denial of enrollment on a different waiver when DDA determines there is not capacity to enroll you on a different waiver.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-4005, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 74.08.090 and 2012 c 49. WSR 13-04-005, § 388-845-4005, filed 1/24/13, effective 2/24/13. Statutory Authority: RCW 71A.12.030, 71A.12.120, 2009 c 194, and 2008 c 329 § 205 (1)(i), and Title 71A RCW. WSR 10-22-088, § 388-845-4005, filed 11/1/10, effective 12/2/10. Statutory Authority: RCW 71A.12.030, 71A.12.120 and Title 71A RCW. WSR 07-20-050, § 388-845-4005, filed 9/26/07, effective 10/27/07. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-4005, filed 12/13/05, effective 1/13/06.]



388-845-4010
How do I appeal a department action?

(1) Your rights to appeal a department decision are in RCW 71A.10.050 and WAC 388-825-120 and are limited to an applicant, recipient, or former recipient of services from the DDA.
(2) If you want to appeal a department action, you must request an appeal within ninety days from receipt of the department notice of the action you are disputing.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-4010, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-4010, filed 12/13/05, effective 1/13/06.]



388-845-4015
Will my services continue during an appeal?

Services may continue according to the provisions contained in WAC 388-825-145.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-24-045, § 388-845-4015, filed 11/26/13, effective 1/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.12 [71A.12.120] and chapter 71A.12 RCW. WSR 06-01-024, § 388-845-4015, filed 12/13/05, effective 1/13/06.]