Chapter 388-106 Long-term care services.

Under the assistive technology benefit, you may be eligible to receive:(1) A fall detection system, if:(a) You are eligible for a standard PERS unit; and(b) You have a recent documented history of falls.(2) A global positioning system (GPS) tracking device with locator capabiliti…

(1) There are limits to the assistive technology you may receive. Assistive technology excludes:(a) Any purchase solely for recreational purposes;(b) Items of general utility, meaning they are used by people in the absence of illness, injury, or disability, such as a wood splitte…

Community transition services:(1) Do not include recreational or diverting items, such as a television, cable or VCR;(2) Do not include room and board;(3) Do not include residential unit furnishings, as outlined in WAC 388-78A-3011 for assisted living facilities and WAC 388-76-10…

You may receive CFC services;(1) In your own home; or(2) In a residential facility, which include licensed and contracted:(a) Adult family homes, as defined in RCW 70.128.010; or(b) Assisted living facilities as defined in RCW 18.20.020.(3) As applicable, while you are out of the…

You are eligible for CFC services if you meet the following criteria:(1) Your CARE assessment shows you need the level of care provided in a hospital, nursing facility, intermediate care facility for the intellectually disabled (ICF/ID), institution providing psychiatric services…

Your services begin on the date the department authorizes services.[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0280, filed 1/22/16, effective 2/22/16.]

(1) In order to remain eligible for CFC, you must remain financially eligible and be in need of services in accordance with WAC 388-106-0310 as determined through a CARE assessment. The assessment in CARE must be completed at least annually or more often when there are significan…

(1) If you are receiving services through CFC only, you may be required to pay toward the cost of your care as outlined in WAC 182-513-1215. If you are receiving services in:(a) Your own home, you will not have to pay toward the cost of your care.(b) A residential facility, you m…

When you receive CFC services and live in a residential facility, the department pays the facility the difference between what you are required to pay the facility and the department-set rate for the facility. The department pays the residential facility from the first day of ser…

You may be employed and continue to receive CFC services as long as you remain medicaid eligible under the categorically needy (CN) or alternative benefit plan (ABP) program.[Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 3…

When you live in your own home, you may be eligible to receive the following services under COPES:(1) Adult day care if you meet the eligibility requirements under WAC 388-106-0805;(2) Environmental modifications, if the minor physical adaptations to your home:(a) Are necessary t…

If you live in one of the following residential facilities: A licensed assisted living facility contracted with the department to provide assisted living, enhanced adult residential care, enhanced adult residential care-specialized dementia care, or an adult family home, you may …

You are eligible for COPES-funded services if you meet all of the following criteria. The department must assess your needs in CARE and determine that:(1) You are age:(a) Eighteen or older and blind or have a disability, as defined in WAC 182-512-0050; or(b) Sixty-five or older.(…

Your eligibility for COPES begins the date the department authorizes services.[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0315, filed 5/17/05, effective 6/17/05.]

(1) In order to remain eligible for COPES, you must be in need of services in accordance with WAC 388-106-0310 as determined through a CARE assessment. The assessment in CARE must be at least annually or more often when there are significant changes in your functional or financia…

Depending on your income and resources, you may be required to pay participation toward the cost of your care, as outlined in WAC 182-515-1505. If you have nonexempt income that exceeds the cost of COPES services, you may retain the difference. If you are receiving services in:(1…

You can be employed and receive COPES, per WAC 182-515-1505.[Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0330, filed 1/12/15, effective 2/12/15; WSR 05-11-082, § 388-106-0330, filed 5/17/05, effective 6/17/05.]

The department will create a waiting list in accordance with caseload limits determined by legislative funding. Wait listed clients will gain access in the following manner:(1) Nursing home residents wanting COPES waiver services will be ranked first on the waitlist by date of ap…

You may receive the following services under the residential support waiver:(1) Adult family homes and assisted living facilities with an expanded community services contract that will provide:(a) Personal care;(b) 24-hour on-site support and response staff;(c) The development an…

You are not eligible for adult day health if you:(1) Can independently perform or obtain the services provided in an adult day health center; or(2) Have referred care needs that:(a) Exceed the scope of authorized services that the adult day health center is able to provide;(b) Do…

(1) You are eligible for services funded by the residential support waiver if the department, based on its assessment of your needs in CARE, determines you meet all of the following criteria:(a) You are at least 18 years old and blind or have a disability as defined in WAC 182-51…

Your eligibility for Residential Support begins the date the department authorizes services.[Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0340, filed 7/18/14, effective 8/18/14.]

(1) In order to remain eligible for residential support waiver services, you must be in need of services as determined through a CARE assessment and as determined by the department. Your CARE assessment must show your need for the level of care provided in a nursing facility, as …

Depending on your income and resources, you may be required to pay participation toward the cost of your care, as outlined in WAC 182-515-1505. If you have nonexempt income that exceeds the cost of residential support services, you may retain the difference. If you are receiving …

You can be employed and receive residential support services, per WAC 182-515-1505.[Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0346, filed 7/18/14, effective 8/18/14.]

The department will create a waiting list in accordance with caseload limits determined by legislative funding. Wait listed clients will gain access in the following manner:(1) Length of time since the participant requested placement;(2) Continued functional and financial eligibi…

You may receive care in a nursing facility, as outlined in chapter 388-97 WAC.[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0350, filed 5/17/05, effective 6/17/05.]

You are eligible for nursing facility care if the department:(1) Assesses you in CARE and determines that you meet the functional criteria for nursing facility level of care which means one of the following applies:(a) You require care provided by or under the supervision of a re…

(1) If you are medicaid eligible and the nursing facility admits you without a request for assessment from the department, the nursing facility will not:(a) Be reimbursed by the department; or(b) Be allowed to collect payment, including a deposit or minimum stay fee, from you or …

You may receive personal care services in your own home and, as applicable, assistance with personal care tasks while you are out of the home accessing community resources or working.[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0600, filed 5/17/05, eff…

To be eligible for chore-funded services you must meet all of the following criteria:(1) Be grandfathered on the chore program before August 1, 2001 and have continued to receive chore without a break in service.(2) Not be eligible for MPC or COPES.(3) Be eighteen years of age or…

Your eligibility for chore services begins the date the department authorizes services.[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0615, filed 5/17/05, effective 6/17/05.]

(1) In order to remain eligible for chore, you must be in need of services in accordance with WAC 388-106-0610 as determined through a CARE assessment. The assessment in CARE must be at least annually or more often when there are significant changes in your functional or financia…

You may retain an amount equal to one hundred percent of the federal poverty level, adjusted for family size, as the home maintenance allowance and pay the difference between the FPL and your nonexempt income. Exempt income includes:(1) Income listed in WAC 182-513-1340;(2) Spous…

If you are not medicaid eligible due to your earned income and resources and are receiving chore personal care services:(1) You may be required to pay participation, per WAC 388-106-0625, for any earned income above one hundred percent of the federal poverty level.(2) The departm…

The volunteer services program is a state-funded program that provides volunteer assistance to eligible persons who need help to live safely in the community. The availability of services under this program is subject to available funding and volunteer resources. Further, when al…

You may be eligible to receive volunteer services if you are:(1) An older adult age sixty or older or a person with a disability eighteen years of age or older; or(2) Living at home, unless you are moving from a residential facility to home and need assistance moving; or(3) Unabl…

The types of services an individual may be offered include, but are not limited to:(1) Housework and laundry;(2) Shopping and errands;(3) Meal preparation;(4) Minor home repair;(5) Yard work;(6) Provision of wood for heating;(7) Pet care;(8) Auto maintenance;(9) Moving;(10) Limit…

Volunteers are qualified to provide volunteer services through the following mechanisms:(1) Volunteers who will have unsupervised access to vulnerable adults cannot have any convictions, pending crimes or findings that are listed in WAC 388-103-0001 or provide contracted services…

Volunteer services may not be available or offered when:(1) Available funding has been exhausted; or(2) The regional area does not have qualified volunteers available; or(3) Existing volunteers do not have the skill set needed to perform the task/service desired; or(4) A voluntee…

If you do not agree with a decision made by the volunteer services contractor, you may make a written complaint with the volunteer services program manager at the aging and long term support administration, P.O. Box 45600, Olympia, WA 98504-5600. You are not entitled to a hearing…

Under their contract with the department, the PACE provider develops an individualized plan of care, as defined in 42 C.F.R. 460.106, that integrates necessary long-term care, medical services, mental health services, and alcohol and substance abuse treatment services.(1) The car…

To qualify for medicaid-funded PACE services, you must apply for an assessment by contacting your local home and community services office. The department will assess and determine whether you:(1) Are age:(a) Fifty-five or older, and blind or have a disability, as defined in WAC …

Depending on your income and resources, you may be required to pay for part of the PACE services. The department's financial worker will determine what amount, if any, you must contribute if you decide to enroll. The department pays the PACE provider the remaining amount.[Statuto…

(1) You may choose to voluntarily end your enrollment in the PACE program without cause at any time. To do so, you must give the PACE provider written notice. A PACE participant's voluntary disenrollment is effective on the first day of the month following the date the PACE organ…

You may receive the following services in an adult day care:(1) Core services, which include assistance with:(a) Locomotion outside of room, locomotion in room, walk in room;(b) Body care;(c) Eating;(d) Repositioning;(e) Medication management that does not require a licensed nurs…

(1) If you receive COPES, you may be eligible for adult day care as a waiver service if you are assessed as having an unmet need for one or more of the following core services:(a) Personal care services;(b) Routine health monitoring with consultation from a registered nurse;(c) G…

You may receive the following adult day health services:(1) All core services under WAC 388-106-0800;(2) Skilled nursing services other than routine health monitoring with nurse consultation;(3) At least one of the following skilled therapy services: physical therapy, occupationa…

You are eligible for adult day health if you meet the conditions described in WAC 388-106-0300 or 388-106-0305.[Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 2nd sp.s. c 7. WSR 12-15-087, § 388-106-0815, filed 7/18/12, effective 8/18/12. Statutory Authority: RCW 74.08.0…

You may receive personal care services in an adult family home or a licensed assisted living facility contracted with the department to provide adult residential care services. You may also receive nurse delegation services under this program.[Statutory Authority: RCW 74.08.090 a…