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PDFWAC 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.]
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